Euthanasia: Difference between revisions

In active euthanasia, a physician or another person commits the act of killing a patient who is suffering from an illness with no hope of recovery. According to contemporary jurists, active euthanasia is forbidden (*haram*), and its performance establishes the right of retribution (*qisas*) or blood money (*diyah*) for the deceased's heirs. Passive euthanasia, meaning withholding treatment from an incurable patient, is also forbidden; however, there is a difference of opinion among jurists regarding the necessity of retribution or payment of blood money.

The jurisprudential discussion of euthanasia is separate from the topic of [[brain-dead]] patients. Thus, a jurist might permit disconnecting life support from a brain-dead patient or a patient in a coma with no hope of recovery, but the same jurist would consider passive euthanasia—withholding treatment out of compassion—to be forbidden (*haram*).<ref>For example, see Makarem Shirazi, Naser, *Istifta'at-i Jadid*, vol. 1, pp. 479-480; Khoei & Tabrizi, *Ahkam-i Jami'-i Masa'il-i Pizishki*, p. 280; Khoei, *Fiqh al-A'dhar al-Shar'iyya wa al-Masa'il al-Tibbiyya*, p. 198.</ref>

Although related topics have been addressed in past jurisprudential works in the chapters on retribution (*qisas*) and blood money (*diyah*), and within issues such as "the prohibition of killing a soul"<ref>Muhaqqiq al-Hilli, *Shara'i' al-Islam*, vol. 4, p. 180.</ref> and "the impermissibility of killing someone who consents to it,"<ref>Muhaqqiq al-Hilli, *Shara'i' al-Islam*, vol. 4, p. 185.</ref> and the issue of *ijhaz*{{Note|Delivering a coup de grâce to a wounded infidel enemy who has been captured by Muslims before the end of the war. (A group of authors, *Farhang-e Fiqh-e Farsi*, vol. 1, p. 284.)}} which is discussed in the chapter on jihad,<ref>A group of authors, *Farhang-e Fiqh-e Farsi*, vol. 1, p. 284.</ref> there has been no discussion on the rulings of euthanasia. This issue is an emergent one in the field of medical jurisprudence, which has now attracted the attention of contemporary jurists, who have addressed it in response to various inquiries.<ref>Al-'Ammari and Ben Hami, *Al-Qatl al-Rahim: Dirasa Muqarana bayn al-Shari'a al-Islamiyya wa al-Qanun al-Wad'i*, p. 9.</ref>

*'''Ruling on Passive Euthanasia:''' Many jurists have considered passive euthanasia (withholding or ceasing treatment for an incurable patient who is suffering from their illness) to be forbidden (*haram*).<ref>Safi Golpayegani, *Istifta'at-i Pizishki*, p. 100; Makarem Shirazi, *Istifta'at-i Jadid*, vol. 1, p. 479; Montazeri, *Ahkam-i Pizishki*, p. 122.</ref> [[Mirza Jawad Tabrizi]] has not considered continuing treatment in this condition to be obligatory.<ref>Khoei and Tabrizi, *Ahkam-i Jami'-i Masa'il-i Pizishki*, p. 281.</ref> Some jurists have permitted withholding treatment under specific conditions; among them, [[Naser Makarem Shirazi]], in response to an inquiry about a person who has been in a coma for 12 years or a patient who has not regained consciousness for a long time after surgery, has said: If the patient's return to a normal state is customarily impossible, it is permissible to cease treatment.<ref>["Ending the life of patients who have been unconscious for years,"](https://makarem.ir/main.aspx?lid=0&typeinfo=21&catid=46873) Information website of the office of Grand Ayatollah Makarem Shirazi.</ref> [[Sayyid Ali Khamenei]] and [[Sayyid Abulqasim Khoei]] have not considered it obligatory to preserve a dying patient for whom there is no hope of recovery, and therefore, in their view, withholding treatment from this patient is not forbidden.<ref>["Rulings on Euthanasia (Mercy Killing),"](https://www.leader.ir/fa/book/64/احکام-پزشکی) Information website of the office of the Supreme Leader; Khoei, *Fiqh al-A'dhar al-Shar'iyya wa al-Masa'il al-Tibbiyya*, p. 198.</ref> It can be said that the permissibility of withholding treatment by physicians in the answers given to these inquiries may be because in all these cases the patient had an unstable life, and if the patient has a stable life, withholding treatment is not permissible.

* In the book *Wasa'il al-Shi'a*, there is a chapter titled "The Prohibition of Killing Unjustly," under which 20 narrations are mentioned.<ref>Hurr al-'Amili, *Wasa'il al-Shi'a*, vol. 29, p. 9.</ref> Jurists have argued from these narrations for the prohibition of killing a soul,<ref>Najafi, *Jawahir al-Kalam*, vol. 42, pp. 9-10.</ref> and since euthanasia is considered unjust killing, it has been declared forbidden.<ref>Makarem Shirazi, *Istifta'at-i Jadid*, vol. 1, p. 479.</ref>

*The evidence that indicates the prohibition of suicide also, by implication, indicates the obligation to preserve life.<ref>Soltani and Karachiyan Thani, "Jurisprudential and Legal Proof of the Rule of the Necessity of Preserving Life," p. 96.</ref> Furthermore, according to some jurists, the obligation to preserve life is one of the [[rational independents (*mustaqillat 'aqliyya*)]] that reason alone can rule as necessary, and consequently, it leads to the discovery of the command of God Almighty.<ref>[https://www.irna.ir/news/83715766/فاضل-لنکرانی-حفظ-جان-از-اهم-واجبات-است Fazel Lankarani, "Preserving life is one of the most important obligations," Islamic Republic News Agency.]</ref>

*'''Passive Euthanasia:''' Passive euthanasia or withholding treatment and ceasing medical care due to hopelessness of recovery is either on the part of the patient or the physician, and there is a difference of opinion among jurists on both cases.<ref>Abd al-Hamid Isma'il, "Al-Qatl al-Rahim wa Mawqif Shari'at al-Islamiyya Minhu: Dirasa Fiqhiyya Muqarana," p. 540.</ref> Some Hanafi, Shafi'i, Hanbali, and Zahiri jurists consider treatment and medication to be obligatory.<ref>Abd al-Hamid Isma'il, "Al-Qatl al-Rahim wa Mawqif Shari'at al-Islamiyya Minhu: Dirasa Fiqhiyya Muqarana," p. 541.</ref> Some Maliki jurists have called medication absolutely permissible (*mubah*).<ref>Ibn 'Abd al-Barr, *Al-Kafi fi Fiqh Ahl al-Madina*, vol. 2, p. 1142.</ref> And some Hanafi, Maliki, and Shafi'i jurists have considered medication and treatment to be recommended (*mustahabb*).<ref>Abd al-Hamid Isma'il, "Al-Qatl al-Rahim wa Mawqif Shari'at al-Islamiyya Minhu: Dirasa Fiqhiyya Muqarana," p. 541.</ref> According to some Hanbali jurists, treatment is not obligatory, and refraining from it out of reliance on God is preferable.<ref>Al-Hajjawi, *Al-Iqna' fi Fiqh al-Imam Ahmad ibn Hanbal*, vol. 1, p. 210; Buhuti, *Kashf al-Qina' 'an Matn al-Iqna'*, vol. 2, p. 76.</ref>

The declarative ruling in euthanasia is the liability for retribution (*qisas*) or blood money (*diyah*) that may be incumbent upon the perpetrator. Jurists have differing opinions on this matter:

# '''Forfeiture of the Right to Retribution and Blood Money:''' According to jurists such as Muhaqqiq al-Hilli, Shahid al-Thani, the author of *Jawahir*, Sayyid Abd al-A'la Sabzevari, and [[Sayyid Ruhollah Mousavi Khomeini|Sayyid Ruhollah Khomeini]], since the victim consented to his own murder, he has forfeited the right to retribution and blood money.<ref>Muhaqqiq al-Hilli, *Shara'i' al-Islam*, vol. 4, p. 185; Najafi, *Jawahir al-Kalam*, vol. 42, p. 54; Shahid al-Thani, *Masalik al-Afham*, vol. 15, p. 89; Sabzevari, *Muhadhdhab al-Ahkam*, vol. 28, p. 199; Khomeini, *Tahrir al-Wasilah*, vol. 2, p. 489.</ref>

Examining the declarative ruling of passive euthanasia or withholding treatment from a patient suffering from their illness depends on which of the titles "prohibition of killing a soul" or "obligation to save a respected soul" applies to it.<ref>Ansari Qomi, "Mercy Killing," p. 138.</ref> According to [[Mohammad Reza Ansari Qomi]], from a customary perspective, the issue falls under the title "obligation to save a respected soul"; because the act of killing has not been committed by him, but rather he has simply not saved the patient from death.<ref>Ansari Qomi, "Mercy Killing," p. 138.</ref> And according to Allamah al-Hilli and the author of *Jawahir*, whoever sees a person in a state of peril and does not save them—while being able to save them—although the person has committed a sin, they are not liable (for retribution or blood money).<ref>Allamah al-Hilli, *Tahrir al-Ahkam*, vol. 5, p. 551; Najafi, *Jawahir al-Kalam*, vol. 43, p. 153.</ref> Based on this, if a physician does not treat a patient and they die as a result of withholding treatment, although the physician has committed a sin, they are not liable, and the deceased's heirs do not have the right to retribution or blood money.<ref>Ansari Qomi, "Mercy Killing," p. 141.</ref>

It is said that most Sunni jurists have considered killing a patient out of compassion to be an instance of intentional murder, for which retribution is established.<ref>Abu Zahra, *Al-Jarimah wa al-'Uqubah fi al-Fiqh*, p. 389.</ref> Of course, some jurists are of the opinion that the patient's permission forfeits retribution—but not blood money—because there is an element of doubt (*shubha*), and doubt forfeits retribution.<ref>Abu Zahra, *Al-Jarimah wa al-'Uqubah fi al-Fiqh*, p. 389.</ref> According to others, the patient's permission not only forfeits retribution but also blood money; because the murdered patient, by their permission, has waived their right to their own blood.<ref>Abu Zahra, *Al-Jarimah wa al-'Uqubah fi al-Fiqh*, p. 389.</ref>

*The book "*Qatl az ruy-i Tarahhom (Utanazi) dar Ayineh-ye Fiqh*" (Mercy Killing (Euthanasia) in the Mirror of Jurisprudence), by Sayyed Mohsen Mortazavi: After conceptualizing the term euthanasia, stating its types and history, it examines its jurisprudential ruling in Shia and Sunni jurisprudence. The book has been published in 143 pages by the Imam Khomeini Institute.

*The book "*Baz'andishi-ye Qatl-e Tarahhom-Amiz (Utanazi) dar Fiqh-e Islami va Huquq-e Mozu'eh*" (Rethinking Mercy Killing (Euthanasia) in Islamic Jurisprudence and Positive Law), by Kazem Khosravi: It first examines the concept of euthanasia and provides a history of the discussion, then examines the legal and jurisprudential foundations of euthanasia. The book has been published in 116 pages by Razavi University of Islamic Sciences.

*The book "*Al-Qatl al-Rahim: Dirasa Muqarana bayn al-Shari'a al-Islamiyya wa al-Qanun al-Wad'i*" (Mercy Killing: A Comparative Study between Islamic Sharia and Positive Law), based on a thesis, written by Kulthum al-'Ammari and Sa'ida Ben Hami. After a general overview of the definition of euthanasia, its types, and history, the book examines the jurisprudential ruling of the issue from the perspective of Sunni jurisprudence and compares it with the laws of Algeria.