[The value of life: A Case for discussion
Lila Ahmed is an intelligent, 40-year-old doctor suffering from severe form of Guillain–Barré’s
syndrome, a painful neurological illness that paralysed her for over 3 years. 10 months ago, it
was recognised by a team of neurologists that she was unlikely to be able to move or breathe on her own again because of the extent of damage to her nerves and muscles; She remains on a Ventilator.
You explained this to Lila and her husband in a gentle but clear manner the prognosis.
Last week Lila asked to speak with you privately. She told you that she had considered her options and decided that she no longer wanted to live. She said her life held no value for her if it meant being in constant pain and
Without the freedom to move or even breathes on her own. She told you that she has discussed this with her husband and her close family and that they have accepted her
wishes to have the ventilator removed.
What is you next step?

I'll do that but ligally

As doctors, we seek life and never introduce death, we treat our patient with all knowledge and skills we have, and we try as hard as we can not to keep the patient suffering but absolutely not by breaking our oath and turning from healers to killers.

The only case scenario in which I am allowed to take off and remove the patient’s life supporting equipments is in the total brain death, and even then, it is not my own decision to take, however, it is a group decision which includes highly experienced doctors, social workers, hospital board members and the family of the patient.

In the case of Mrs.Ahmed, she is fully conscious and aware. Her brain is still fully active and functioning properly. Thus, she is alive and if I positively respond to her request, then I am a murderer.
In medicine there is no such thing as Euthanasia (merciful killing); our job is to treat not to end. We are guardians of life not angels of death.

Therefore, my next step will be trying to convince Mrs.Ahmed to change her mind, not to lose hope in God merci, not to give up on science progress and I would assure her that we will do every thing possible to ease her suffering.

There is no way that I would deliberately (directly or indirectly) be responsible for someone’s death. Actually, I am very surprised of Mr.Shankool opinion on this matter (with all respect to him and to his opinions), how can any doctor dare and remove life supporting equipment from a patient whom you’re absolutely sure is still alive? Even if the patient was in pain and suffering, our main job is to prevent death not to prevent pain!

Let me here quote from the doctors’ oath- the Hippocratic Oath- “To please no one will I prescribe a deadly drug, nor give advice which may cause his death.”

Dear G.A.J
Let me clearify my opinion, I had said: "I'll do that legally" so there must be a law that give the patient the right-to-death, such a law is being discussed in UK or in USA, I think. This right is controled by a number of terms & conditions, However I don't support death and believe in God and Life.

What is the different between dead person (or with dead brain) and a person who cann't live without of ventilator?

However I see that you do manage the problem better than me.

Fianally & again I support life & Human Being not the death

Dear Shankool
About your question, i think that there are many differences between a brain-dead patient and a patient whom is always on a ventilator, on hemodialysis or on any other life-sustaining treatment.

The brain-dead patient is in fact totally and scientifically DEAD, the patient has no consciousness, his brain has no control over his body, if he is to be disconnected from life supporting equipments, he would die out of a total lack of brain innervation and coordination, not out of a system failure.

However, non-brain dead patients, those have a system failure, not brain function failure. Those patients have dreams, hopes, thoughts, opinions and logic.

The right-to-die is a very controversial topic, for example, an old lady came to the hospital in a total renal failure, she refused to start on hemodialysis and says : ‘I had a grate life, I am old now and I have nothing in my life to look for, I think I am ready to die’. Is this considered to be suicide? As a doctor, should you try or even force her to go on hemodialysis? Or just say ‘this is your own choice’?
Who knows?! While the patient is on a life-sustaining treatment, science might figure out a way to treat the patient, or a Miracle could happen (not that I totally believe in miracles).

However, the farthest thing that I might do to a terminally ill patient is to write on his chart DNR –do not resuscitate- and even then, these three letters would mean that I failed to do my job, that I have given up and that I lost the battle.

My questions to you my friend Shankool and to all doctors and medical students:
If there are laws which allow terminally ill patients to decide whether to stay on the life-sustaining treatment or to discontinue and stop the treatment, and the patient decided to stop the treatment, my questions are: can you do that yet not feeling any guilt? Can you do that without suffering in your conscience? Knowing that you caused the death of someone who could have a chance in living; will you be able to sleep deeply at night?

Regards

المشاركة الأصلية بواسطة G.A.J

Dear Shankool
About your question, i think that there are many differences between a brain-dead patient and a patient whom is always on a ventilator, on hemodialysis or on any other life-sustaining treatment.
The brain-dead patient is in fact totally and scientifically DEAD, the patient has no consciousness, his brain has no control over his body, if he is to be disconnected from life supporting equipments, he would die out of a total lack of brain innervation and coordination, not out of a system failure.
However, non-brain dead patients, those have a system failure, not brain function failure. Those patients have dreams, hopes, thoughts, opinions and logic.
The right-to-die is a very controversial topic, for example, an old lady came to the hospital in a total renal failure, she refused to start on hemodialysis and says : ‘I had a grate life, I am old now and I have nothing in my life to look for, I think I am ready to die’. Is this considered to be suicide? As a doctor, should you try or even force her to go on hemodialysis? Or just say ‘this is your own choice’?
Who knows?! While the patient is on a life-sustaining treatment, science might figure out a way to treat the patient, or a Miracle could happen (not that I totally believe in miracles).
However, the farthest thing that I might do to a terminally ill patient is to write on his chart DNR –do not resuscitate- and even then, these three letters would mean that I failed to do my job, that I have given up and that I lost the battle.
My questions to you my friend Shankool and to all doctors and medical students:
If there are laws which allow terminally ill patients to decide whether to stay on the life-sustaining treatment or to discontinue and stop the treatment, and the patient decided to stop the treatment, my questions are: can you do that yet not feeling any guilt? Can you do that without suffering in your conscience? Knowing that you caused the death of someone who could have a chance in living; will you be able to sleep deeply at night?
Regards

Thank you very much for your contribution to this sensetive debate
Philip Hardo

For general informatio.
Regarding your question, following is the fatwa issued by the prominent Muslim scholar Sheikh Al-Qaradawi on this issue:
Euthanasia or Mercy Killing is the act or practice of ending the life of an individual suffering from a terminal illness or an incurable condition, through lethal injection or the suspension of extraordinary medical treatment.
This act is Islamically forbidden for it encompasses a positive role on the part of the physician to end the life of the patient and hasten his death via lethal injection, electric shock, a sharp weapon or any other way. This is an act of killing, and, killing is a major sin and thus forbidden in Islam, the religion of pure mercy.
As for the suspension of medical treatment via preventing the patient from his due medication which is, from a medical perspective, thought to be useless, this is permissible and sometimes it is even recommended. Thus, the physician can do this for the sake of the patient’s comfort and the relief of his family. Nothing is wrong in this, Insha’ Allah (Allah willing).
It is highly stressed here that medical treatment is deemed non-obligatory by the majority of Muslim scholars and the founders of the famous schools of Islamic Jurisprudence. Rather, to them, it is permissible. Only a few number of Muslim scholars maintain that it is obligatory, as said by some followers of Imam Ahmad and Ash-Shafi`i. Also, others maintain that applying medical treatment is commendable and preferable.
Moreover, some scholars disputed over which is better for the patient: treatment or showing endurance. Some who maintain that showing endurance is far better base their judgment on the narration of Ibn `Abbas in the two Sahihs that `Ata’ Ibn Abu Rabih said: Ibn `Abbas said to me: “‘May I show you a woman of Paradise?’ I said: ‘Yes.’ He said: ‘Here is this dark-complexioned woman. She came to Allah’s Messenger, peace and blessing be upon him, and said: ‘I am suffering from epilepsy and convulsive seizures make me naked; supplicate Allah for me.” Thereupon, the Prophet, peace and blessing be upon him, said: ‘You can show endurance and win entry to Paradise, but if you like, I’ll pray to Allah for your recovery.’ She said: ‘I am prepared to show endurance but I get naked due to convulsions, so supplicate Allah to spare me getting naked.’ And the Prophet, peace and blessings be upon him, did pray for her.’” (Al-Bukhari and Muslim)
These are the views of the scholars of the Ummah on treatment and medication; most of them maintain that it is permissible; some maintain that it is recommended; and a few number of them deem it obligatory. I myself agree with those who deem it obligatory in case the pain gets unbearable, and the illness is curable, by Allah’s Grace.
This is also compatible with the guidance of Prophet Muhammad, peace and blessings be upon him, who sought treatment for himself and ordered his honorable Companions to seek treatment as well; this is confirmed by Ibn Al-Qayyim in Zad Al-Ma`ad (Provision of the Hereafter).
But in cases when sickness gets out of hand, and recovery happens to be tied to miracle, in addition to ever-increasing pain, no one can say treatment then is obligatory or even recommended. Thus, the physician’s act of stopping medication, which happens to be of no use, in this case may be justified, as it helps in mitigating some negative effects of medications, and it enhances death. But it’s different from the controversial “Mercy Killing” as it does not imply a positive action on the part of the physician; rather, it is some sort of leaving what is not obligatory or recommended, and thus entails no responsibility.
To conclude, the physician can practice this for the sake of the patient’s comfort and the relief of his family. Nothing is wrong in this, Insha’ Allah.
Switching off the life support:
If a patient is medically presumed dead through what is known as brain death, in the sense that he no longer has any feelings, switching off the life support may be permissible, with due consultation and care, especially when it’s clear that the life support machine becomes of no use for the already-dead patient.