Full Lecture Transcript (Cleaned)
The Default Ruling on Medical Treatment — 11:57
I have a parent on a ventilator and life support and I'm confused about what can be done. Our family is talking about the various options.
This is a very sensitive question, and please don't just listen to a generic response and do something. I'm going to give a generic response so you have background knowledge, but you should come to me or any shaykh and go into more specific detail.
Understand: medication of all types — the default is that medication is permissible. It is not wajib and will only be haram if the medication itself meets certain conditions. As a default, taking medicines, putting someone on a ventilator, engaging in chemotherapy, doing any treatment — it is mubah, not wajib, and not haram unless other conditions of haram are met.
Refusing Treatment Is Not Suicide — 12:28
This means if somebody says, "I don't want chemotherapy," that is permissible. If somebody says, "I don't want a ventilator put on me if I'm in that situation," that is permissible. You are not obliged. We don't believe that Allah required us to push life as much as we can.
No, we're not allowed to take our lives. Suicide means you do something that inevitably causes your death in a means that directly causes death. For you to not take medication — that is not suicide, because medication is not required. Suicide is jumping off a building, shooting yourself with a gun, taking poison. That is suicide. But to say, "I don't want to do chemotherapy" — that's not suicide. Chemotherapy is a tactic to cure a disease. If you choose not to do it, that's your right. Putting on ventilation is a tactic.
The Conscious Patient's Right — 13:25
So if the person is conscious and he's asked, "Listen, you have breathing difficulty. Do you want to be put on a ventilator or not?" — he says no, he has the right. He says yes, okay, put it on, no problem.
When the Patient Is Unconscious — 13:43
But what if he's not conscious? What if he cannot make a decision? Then the family needs to make a collective decision and nobody can intervene. The wife, the mother, the parents — everybody there, they make a decision amongst themselves. Of course, according to the law of this country, the law assigns one particular person, generally the spouse. So that person will decide, but wisely, it is the family's decision. They will do what is in the best interest of the person.
No Obligation for Artificial Life Support — 14:18
It is not obligatory to provide food, water, and air above the natural way that we usually take food, water, and air. What do I mean by this? We are breathing with our lungs. If you take a pillow and put it on a person's nose and mouth, you have deprived them of the normal mechanism to breathe — this is murder. But if somebody cannot breathe and their lungs collapse, you are not obliged to put a ventilating machine and some artificial pump. That's above and beyond what Allah gave them. You're not obliged to do this.
We must drink water. But if a person cannot eat food and drink water anymore and you must put a needle or something — and they say, "I don't want that" — that is their right. Or if the family says, "He is clinically dead, we don't see the point in putting this on" — that is their right. You are not obliged to go above and beyond what Allah created you upon.
Yes, if a person is hungry and you deprive them of food, that is murder. But if a person is unconscious and the doctor is saying he's clinically dead — should we put some tube on him? You do not have to, because this is not the same as giving food and water.
Quality of Life and the Scholarly Position — 15:51
The councils of fiqh have basically said: look at a number of things. First and foremost, quality of life. The goal of the Sharia is not that you just live for the sake of living. If a person is a vegetable — there's no dhikr, there's no ibadah, there's no salah — what is the purpose of keeping a vegetable alive?
If a person is not conscious, completely almost brain dead, just lying there, and the family says, "Oh, I just want to wait for a miracle" — miracles can happen whether you do something or not. We do not plan miracles. We do not logistically schedule miracles. If Allah wants to cure him, He'll wake him up immediately and he'll start running and jumping. Allah will cure him. You do not plan miracles.
The Majority Fatwa — 16:42
So if the doctors say, "I'm sorry, but he's basically brain dead. It's up to you — do you want to keep him on life support or not?" — most, in fact all of the fatawa that I have read, are basically that if there is little to no chance of survival, if there is little to no chance of coming back to normal, then the better thing to do is to let them go on their journey. Because now they're in an awkward state between life and death. Neither can they reach their destination, nor can they worship Allah in this world. So of what benefit is it to do that?
As a default, if chances are minimal and they're in a vegetable state, it is best to let them go. And if chances are good and the doctors say, "They've had a heart attack but insha'Allah we're optimistic, we can resuscitate" — then yes, bismillah, if you feel like that is the case.
We look at age, we look at statistics, we look at quality of life, and we make a collective decision that is in the best interest of the person. The goal is: what do you think this person would have wanted? And you make a decision based upon that.
Conclusion — 18:02
Bottom line: if the doctors say there's little chance of coming back and they're basically in a semi-vegetable state, then in reality there is no need. Generally speaking, in the cases I've come across in this regard, it is complete end of life — they are not able to breathe on their own, they are not conscious, they're quite literally just a heartbeat and a vegetable with no cognitive function. What is the point and purpose of this life? You are prolonging a torturous time frame.
If you were to remove the plug, this is not considered murder in the slightest. They're not able to breathe. You're not obliged to keep on physically pumping them.
Now, if the person's young and there's a good chance of survival, it changes everything. And if the person's elderly and it's end of life with very little possibility — again, we're not working miracles into the equation — it is permissible to pull the plug and let Allah's qadr take effect.