1. D.N.R. Islamic Perspective Javeed Akhter MD Director Pediatric Pulmonology, Advocate/hope Children ’ s Hospital Back to ISPI

2. Primary Sources Qur’an. Precepts of prophet Muhammad (pbuh) or Sunnah Words (Qauliya) Deeds (Filiya) Tacit approval (Taqririyah) Record of his words and actions is the Hadith literature. There is a careful attempt at documenting the identity and authenticity of the narrators.

3. Ijtehad The process of finding solutions to new problems based on old principles is called Ijtehad (progressive reasoning)

4. Tools Used for Ijtehad 1.Consensus (Ijma).Initially consensus of the Ulama. 2.Analogy (Qiyas) “ Should I do Hajj for my mother?” Prophet’s reply. “Yes. Would you not pay her debt?” Alcohol prohibited because it is an intoxicant. Drugs intoxicate therefore they should be prohibited

5. Tools Used for Ijtehad 3. For the greater good of the community (Maslaha wa Mursalah) Killing of a Muslim used as a human shield 4. Reasoning behind a directive, ratio legis, as a basis of a new ruling based on personal opinion (Rai)

6. Secondary Sources The edicts from both the primary and secondary sources together are documented in books of Fatwas that form the corpus of Sharia laws. The discipline of rules and logic that are used to formulate Sharia is the Fiqh.

7. Sharia The word Sharia in the Qur’an is used for “clear road” or “path” (Qur’an 43:13; 5:48; 45:18). In contrast to canon laws Sharia presupposes that the legislator is Allah. The concept of Sharia is holistic and includes both broad principles and specific edicts like punishments about crimes like theft, and detailed directives about inheritance.

8. The Sharia Rating System Obligatory: Fard Recommended: Mustahabb or Mandub Permitted: Mubah Discouraged: Makruh Forbidden: Haraam

9. Sharia Categories. Religious observances (Huquq-Allah) Affairs of the world (Huquq-Ibad) Criminal law Family law Transactional law (sale, debt, partnership)

10. Entities That May Give an Opinion or Fatwa Official Muftis National Fiqh council of ISNA. Unofficial Aalims and Muftis. Historical precedence of the piety minded independent scholar serving as a conscious of the community. Periodic conferences like that produced the Kuwait document: 1981

11. Human Life “If one slayeth another, for other than man-slaughter or spreading disorder in the land, it shall be as if he hath slain all mankind. But if one saveth a life, it shall be as if he hath saved all mankind.” Qur’an 5:32. “Every soul shall taste death” Qur’an 3:185.

12. Death: International Collective Of Islamic Jurists And OIC. Amman, Jordan 1986 Declaration of death: Heart and and breath have stopped and the condition is irreversible. Mental function has ceased and the condition is irreversible Responsibility of the physician

13. The Physician Physician called Hakim:Wise Person. Physician/Philosopher “A philosopher may heal only the soul while a physician can heal both the body and soul” Ibn Sina

14. DNR Permitted: Mubah. Consent or will of the patient if available or permission of the family.

15. Withdrawal Of Life Support Permitted: Mubah “It is the process of life that the physician should strive to maintain and not the process of dying”- Kuwait document; Islamic code of medical ethics 1981

16. Mercy Killing and Euthanasia Forbidden: Haraam “My subject hastened his end…. I (God) deny him paradise’- Hadith of prophet Muhammad