Islamic Perspectives on Implementing Advance Medical Directives in Malaysia
Journal name: The Malaysian Journal of Medical Sciences
Original article title: Honouring Wishes of Patients: An Islamic View on the Implementation of the Advance Medical Directive in Malaysia
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Mohammad Mustaqim Malek, Shaikh Mohd Saifuddeen, Noor Naemah Abdul Rahman, Aimi Nadia Mohd Yusof, Wan Roslili Abdul Majid
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: Honouring Wishes of Patients: An Islamic View on the Implementation of the Advance Medical Directive in Malaysia
Year: 2021 | Doi: 10.21315/mjms2021.28.2.3
Copyright (license): CC BY 4.0
Download the PDF file of the original publication
Summary of article contents:
Introduction
An Advance Medical Directive (AMD) is a legal document that allows competent individuals to outline their preferences regarding medical treatment in case they become unable to make decisions due to incapacitation. This practice is particularly significant in end-of-life care, emphasizing the rights of patients to refuse treatment while also addressing the cultural and religious contexts that may influence these decisions. The article examines the legitimacy of AMD within Islamic jurisprudence, exploring critical aspects such as patient autonomy, decision-making rights, and the ethical implications for medical practitioners.
The Validity of AMD in Islamic Jurisprudence
In Islamic tradition, the concept of consent (idhn al-ṭibb) is paramount, mandating that healthcare professionals obtain patient approval before any medical intervention. The article establishes that Islam does not prohibit the use of AMD, interpreting it as a mechanism to honor the choices of patients regarding their medical care. Key considerations highlighted include the initial cognitive status of the patient when drafting an AMD, the input from medical experts, family involvement in decision-making, and the extent of the patient's autonomy in such matters. Furthermore, while patients may refuse futile treatments, Islam maintains strict boundaries regarding certain medical decisions, such as euthanasia and the refusal of life-sustaining measures, asserting the sanctity of life.
Conclusion
The application of AMD within the context of Islamic principles provides a framework for respecting patient autonomy while recognizing ethical obligations of medical professionals. As Malaysia grapples with the complexities of AMD implementation, it becomes crucial to foster discussions that involve multiple stakeholders, including healthcare practitioners and religious scholars. With the projected increase in palliative care patients, integrating AMD into the Malaysian healthcare system is essential, ensuring that patients' rights and religious values are upheld in decision-making processes about their health care at the end of life. The article emphasizes the necessity for further research and public awareness regarding AMD, aligning it with Islamic values for its successful adoption within the community.
FAQ section (important questions/answers):
What is the purpose of an Advance Medical Directive (AMD)?
An Advance Medical Directive (AMD) is a legal document allowing patients to express their healthcare preferences in case they become unable to make decisions. It empowers patients to refuse or accept specific medical treatments, especially in end-of-life situations.
How does Islam view the validity of AMD?
Islam does not prohibit the use of an AMD. It respects patients' wishes and emphasizes seeking their consent prior to medical procedures. Islamic jurisprudence acknowledges the importance of honoring patient preferences regarding treatment choices, especially at the end of life.
What limitations exist for patients' decisions in AMD?
While patients can express treatment preferences in AMD, Islam prohibits choices that contradict its principles. This includes euthanasia, refusal of life-saving treatments, and denying basic care such as artificial nutrition and hydration aimed at hastening death.
What role do family members play in decision-making for AMD?
Islam encourages involving family members during the AMD decision-making process. This ensures that family understands the patient's wishes and rationale behind their choices, aiding in holistic decision-making that respects both patient autonomy and family values.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Islamic Perspectives on Implementing Advance Medical Directives in Malaysia”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Life:
Life is the biological condition of living organisms characterized by growth, reproduction, and response to stimuli. In the context of healthcare and medical ethics, it is pivotal in discussions on Advance Medical Directives (AMDs) and end-of-life care, guiding decisions on how to respect a patient's wishes towards the preservation or termination of life.
2) Family:
Family denotes a group consisting of parents and their children, or all the descendants of a common ancestor. In medical decision-making, particularly regarding AMDs, family involvement is essential as they often act as surrogate decision-makers, reflecting shared values and beliefs that influence patient care and preferences.
3) Death:
Death signifies the end of life, marking the cessation of biological functions that sustain a living organism. In discussions of medical ethics and AMDs, death is significant, as many patients express preferences on how they wish to be cared for as they approach the end of life, balancing autonomy with ethical considerations.
4) Medicine:
Medicine is the science and practice of diagnosing, treating, and preventing illness or injury. It plays a critical role in healthcare decision-making and is interlinked with discussions on AMDs, ensuring that interventions align with patients' values and wishes, especially concerning end-of-life care and the right to refuse treatment.
5) Bioethics:
Bioethics encompasses the ethical implications of biological and medical procedures and technologies. It is highly relevant in formulating guidelines for AMDs, where ethical dilemmas arise regarding patient autonomy, informed consent, and the moral responsibilities of healthcare providers in respecting patient wishes at the end of life.
6) Field:
Field refers to an area of study or practice. In this context, the field signifies the domain of healthcare and bioethics, where AMDs are increasingly recognized as essential tools for empowering patients in making informed decisions related to their medical treatments and end-of-life care, navigated within ethical frameworks.
7) Discussion:
Discussion represents an exchange of ideas or debate on a particular topic. In the context of AMDs, discussion is crucial for assessing the perspectives of various stakeholders, including patients, families, and healthcare professionals, ensuring that diverse viewpoints are considered, aligning medical practices with ethical and cultural sensitivities.
8) Attending:
Attending refers to healthcare professionals in charge of a patient’s care. The attending physician plays a vital role in facilitating conversations about AMDs, ensuring that patients’ preferences are understood and respected, and providing necessary clinical assessments about treatment options, especially concerning life-sustaining measures.
9) Cancer:
Cancer is a disease characterized by uncontrolled cell growth that can lead to death. It often raises complex issues regarding treatment options and patients' wishes in end-of-life care, making discussions about AMDs particularly relevant as patients may prefer to refuse aggressive interventions when facing terminal diagnoses.
10) Food:
Food refers to any nutritious substance that people or animals consume. In medical contexts, particularly end-of-life care, the provision of food and nutrition becomes a significant ethical issue, especially when discussing artificial nutrition and hydration versus natural dietary preferences, which can impact a patient’s quality of life.
11) Knowledge:
Knowledge signifies the information, understanding, and skills acquired through experience or education. In the context of bioethics, it emphasizes the importance of informed consent and the need for healthcare professionals to understand ethical frameworks to guide patient-centered care, especially in complex decisions regarding AMDs.
12) Suffering:
Suffering denotes the experience of physical or emotional pain. In healthcare, alleviating suffering is a priority, particularly in palliative care settings where discussions around AMDs address patients’ rights to refuse treatment that prolongs suffering, thus focusing on quality of life rather than merely sustaining life.
13) Disease:
Disease is an abnormal condition affecting the body or mind, often leading to a range of health issues. Within the context of AMDs, discussions about disease highlight the importance of patient preferences regarding treatments, especially for chronic or terminal conditions where the focus may shift towards comfort and dignity.
14) Shari (Sari):
Shari refers to Shari'ah, the Islamic law derived from the Quran and Hadith. Its relevance in AMD discussions lies in guiding ethical medical decision-making in Muslim communities, ensuring that healthcare practices align with Islamic principles, particularly concerning patient rights and end-of-life care choices.
15) Water:
Water is essential for all known forms of life, serving as a key element in hydration. In the context of medical care and AMDs, the provision or withdrawal of hydration through artificial means raises ethical questions, particularly in end-of-life situations where quality of care and patient preferences are paramount.
16) Study (Studying):
Study refers to the examination or investigation of a subject in detail. In this context, studying AMDs involves analyzing their implications within medical ethics and Islamic jurisprudence, assessing their validity, implementation, and impact on patient autonomy in decision-making regarding end-of-life care.
17) Mental health:
Mental health encompasses emotional, psychological, and social well-being, influencing how individuals think, feel, and act. In the context of AMDs, it is crucial for understanding the patient’s capacity to make informed decisions, as mental health issues can impair judgment and affect wishes regarding treatment options.
18) Developing:
Developing refers to the process of growth or progress. In healthcare policy, developing frameworks for the implementation of AMDs is essential for ensuring that patients’ rights are upheld and that cultural and ethical considerations are integrated into healthcare practices, enhancing overall patient care and autonomy.
19) Relative:
Relative refers to family members or relations. Within healthcare, particularly when discussing AMDs, relatives often play a significant role as surrogate decision-makers, influencing treatment choices based on shared values, beliefs, and the patient's previously expressed wishes, thus embedding familial context in medical decisions.
20) Roman (Roma):
Roman pertains to the historical context of Roman law, which has influenced many legal systems. In discussions of healthcare ethics and AMDs, understanding Roman legal principles can provide insights into historical precedents for patient autonomy and rights, shaping modern interpretations and applications in contemporary practice.
21) Bakri:
Bakri is a surname that may refer to scholars or individuals involved in Islamic jurisprudence. In the context of bioethics and AMD discussions, referencing figures like Bakri emphasizes the importance of scholarly input in shaping the understanding and application of Islamic law regarding medical decision-making.
22) Evolution:
Evolution signifies gradual development or change. In medical ethics, the evolution of practices surrounding AMDs reflects shifting societal attitudes towards patient autonomy and rights, driving the need for ongoing dialogue and reform to align healthcare practices with contemporary ethical standards and cultural values.
23) Epilepsy:
Epilepsy is a neurological disorder characterized by recurrent seizures. In the context of medical decision-making, discussions about epilepsy may involve considerations of patient capacity to understand their treatment options and wishes, especially relevant in the context of AMDs, where cognitive function plays a pivotal role.
24) Indian:
Indian refers to anything related to India, including its culture, religion, and social practices. Understanding the Indian context in healthcare decision-making, particularly in relation to AMDs, highlights the importance of integrating cultural values and religious beliefs into patient care practices within diverse healthcare systems.
25) Pasha (Pasa):
Pasha is an honorific title historically used in the Ottoman Empire. In bioethical discussions, figures like Pasha may symbolize the integration of historical doctrines in modern medical practices, particularly regarding the interpretation and application of ethical principles in healthcare within Islamic contexts.
26) Raja:
Raja is a title often associated with royalty or governance in various cultures. In bioethics, discussions of authority figures such as a Raja in healthcare ethics highlights the importance of leadership and governance in implementing policies related to patient rights and advance medical directives.
27) Line:
Line refers to a boundary or distinction. In medical ethics, drawing lines regarding what decisions patients can make through AMDs is essential. It clarifies the extent of autonomy permitted while ensuring the basis of patient care aligns with ethical and legal standards in medical practice.
28) Pain:
Pain is an unpleasant physical sensation often associated with injury or illness. In the context of healthcare and AMDs, managing pain is a primary goal, emphasizing the need for effective communication about patients’ wishes, particularly in end-of-life care where alleviation of suffering is crucial.
29) Wolf:
Wolf in this context refers to a notable figure in medical ethics, possibly a researcher or author whose work may influence discussions on patient rights and bioethics. Asserting authority in ethical teachings, figures like Wolf contribute to shaping contemporary understanding of AMDs and patient autonomy.
30) Chan:
Chan could refer to an individual contributing to the discourse in healthcare or bioethics, providing context-specific insights. Understanding perspectives such as those from Chan is vital in developing culturally sensitive approaches to AMDs in diverse communities, ensuring that local values inform medical practice.
31) Hinduism:
Hinduism is one of the world's oldest religions, encompassing a diverse range of beliefs and practices. In discussions of AMDs and healthcare, acknowledging Hindu principles and cultural contexts helps to respect and integrate patient values, promoting patient-centric approaches in end-of-life decision-making.
32) Training:
Training refers to the process of preparing individuals for specific roles or tasks. In healthcare, training for medical professionals regarding ethical treatment, patient autonomy, and the implementation of AMDs is crucial for ensuring that they can effectively honor patient wishes within ethical and legal frameworks.
33) Teaching:
Teaching involves imparting knowledge and skills. In healthcare settings, teaching emphasizes the importance of educating medical staff and patients about AMDs, enhancing understanding of their rights and responsibilities while fostering informed decision-making processes that respect patient autonomy and preferences.
34) Buddhism (Buddhist tradition):
Buddhism is a spiritual tradition emphasizing mindfulness and compassion. In the context of healthcare ethics, understanding Buddhist perspectives can enhance the discourse on AMDs, particularly regarding end-of-life care, by promoting principles of compassion, mindfulness, and respect for individuals’ wishes and peace in dying.
35) Quality:
Quality refers to the standard or degree of excellence of something. In healthcare, particularly concerning AMDs, focusing on the quality of care ensures that patients receive appropriate attention and respect for their preferences, leading to better patient outcomes and enhanced dignity in end-of-life situations.
36) Dealing:
Dealing involves managing or handling a situation. In the context of AMDs, dealing with complex ethical decisions regarding end-of-life care requires healthcare professionals and families to engage in sensitive communication, ensuring decisions align with patient values and legal rights while navigating moral dilemmas.
37) Killing (Killed):
Killing is the act of causing death. In bioethical discussions, particularly within Islamic and medical contexts, the act of killing, including euthanasia is heavily scrutinized as it raises significant moral questions. Consulting ethical frameworks helps guide decisions regarding end-of-life care while respecting the sanctity of life.
38) Nausea:
Nausea is an unpleasant sensation often leading to vomiting. In medical contexts, managing nausea is vital, especially for patients in serious illness or palliative care. It highlights the importance of considering comfort measures in AMD discussions, ensuring patients’ quality of life is prioritized.
39) Nature:
Nature pertains to the inherent qualities or characteristics of something. In the context of AMDs, understanding the nature of illness and suffering informs ethical decision-making, allowing healthcare providers to develop empathetic, effective care strategies that align with patient wishes during critical health crises.
40) Reason:
Reason refers to the mental capacity to think, understand, and form judgments logically. In discussions surrounding AMDs, reasoning is critical when assessing a patient's competency in making informed choices about their treatment options, ensuring that healthcare decisions respect autonomy and legal rights.
41) Debate:
Debate involves a formal discussion on a particular topic. Within healthcare, debates surrounding AMDs encompass ethical, legal, and moral perspectives, fostering dialogue among stakeholders to ensure that diverse viewpoints inform practices that align with patient rights and improve decision-making in medical care.
42) House:
House can refer to a governing body or establishment. In medical ethics, particular 'houses', like health and legal organizations, are responsible for establishing policies and guidelines regarding AMDs, shaping the framework within which medical professionals operate in respecting patients' autonomy and rights.
43) Muda:
Muda may refer to notable figures involved in Islamic scholarship or bioethics. Engaging with scholars like Muda enriches the dialogue on ethical frameworks pertaining to AMDs by providing deeper understanding and adherence to cultural and religious beliefs within the context of patient care.
44) Sah:
Shah denotes a title commonly used in monarchies in some cultures. In bioethical discourse, references to figures with royal titles like Shah highlight the influence of leadership on fostering understanding and acceptance of AMDs, ensuring that policies reflect community values and ethical considerations.
45) Pose:
Pose refers to the act of presenting or putting forth an idea or question. In discussions regarding AMDs and patient autonomy, the ability to pose relevant queries or challenges enhances dialogue, prompting deeper exploration and understanding of ethical dilemmas faced by patients and healthcare providers.
46) Post:
Post refers to a position or role. In the context of healthcare and AMDs, posts held by professionals influence the effectiveness of decision-making processes, ensuring that ethical and legal standards are met while honoring patients' rights and preferences as they approach end-of-life care.
47) Nish (Nisa, Nis, Nishe, Nisha):
Nisā refers to a chapter in the Quran that addresses issues related to women and moral guidance. In the context of discussing AMDs, referencing Nisā emphasizes the importance of Islamic teachings in informing ethical considerations and patient rights, particularly for female patients in the healthcare system.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Islamic Perspectives on Implementing Advance Medical Directives in Malaysia’. Further sources in the context of Science might help you critically compare this page with similair documents:
Ethical dilemma, Medical treatment, Cognitive capacity, Medical practitioner, Medical ethics, Palliative care, Effective treatment, Ethical code, Informed consent, Medical care, Prophet Muhammad, Sound mind, Clinical efficacy, Cognitive impairment, Patients consent, End-of-life care, Cognitive ability, Nasogastric tube, End-of-life decisions, Medical intervention, Medical device, Healthcare professional, Healthcare management, Patient-Centred Care, Aspiration pneumonia, Medical procedure, End of life decision making, Family involvement, Patient's preference, Islamic Jurisprudence, Medical decision making, Family member, Patient autonomy, Medical professional, Healthcare service, Palliative care patients.
Concepts being referred in other categories, contexts and sources.
Sanctity of life, End of life, Mental capacity, Medical experts, Life support, Religious value.