Senin, 07 Januari 2013

Masail Al-Fiqiyyah


EUTHANASIA IN VARIOUS PERSPECTIVE

A. Foreword


Health is a precious treasure in life in the world, to maintain the health medical science developing a lot of works to protect human kind from viruses and various diseases. And according to the Arabic wishword says
الصحة تاج لا يراها إلا المرض
Health is a crown, and no one can understand it except those who are sick.
Treatment as an attempt to maintain health is one of the form of tawakkal. When someone is sick, a form of tawakkal is done by finding drugs or go to the doctor to solve this health problems. And also mentioned in the hadith of Muslim that every disease must have its cure.
لكل داء دواء فإذا أصيب دواء الداء برأ بإذن الله عزوجل
Each disease there must be a cure. If the drug has been on the disease, it must be cured by the permission of Allah.
When someone is facing kinds of illness such a flu, cough, toothache, headache, etc.. Drugs given by doctors can be cure and heal patients immedeatly. But when someone is  facing  a severe disease and found no signs of healing from patient usually will stay in the hospital for hospitalization care. Some patients even settled over number of years due to the heavy disease.
Euthanasia is one of the bad way which taken by most people to end the pain suffered the patient. When a patient in a coma state for a long time, and have no signs of the coming recovery healing, some of family command doctors to end the lives of patients by injecting dead medicine.
In this discussion we will review the euthanasia case in the perspective of madzhahib mu'tabarah that similar to the criminal case. Because it eliminates the lives of patients who should still have the rights to life. And this is considered as murder. Moreover, patients do not want this death. The case is even become a case of premeditated murder and from fiqh perspective should give qhisas punishment and fines. But this case still done by some doctors. This discussion also will present any subject which related to this case, such as medical ethics and the declaration of human rights that support each opinion for allowing or prohibiting this case.

B. Discussion

1. Euthanasia Definition
Euthanasia is the intentional killing by act or omission of a dependent human being for his or her alleged benefit.[1]
Euthanasia (from the Greek: εὐθανασία meaning "good death": εὖ, eu (well or good) + θάνατος, thanatos (death)) refers to the practice of intentionally ending a life in order to relieve pain and suffering. The word "euthanasia" was first used in a medical context by Francis Bacon in the 17th century, to refer to an easy, painless, happy death, during which it was a "physician's responsibility to alleviate the 'physical sufferings' of the body."
Another definitions offered by the Oxford English Dictionary incorporates suffering as a necessary condition, with "the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma".
Euthanasia in general term devided into two categories:
a.       Active
An action which intentionally done by doctor or another medical care to take a shortcut terminating life of patient. This action can be done with giving a killing medicine, either through oral or injection.
b.      Passive
It stop giving medical aid which able to lengthen patient life intentionally. Or a condition where a patient refuse consciously to accept medical treatment, and know the deduction will terminate his life with shortcut.

          2. Euthanasia in Various Perspectives
There are disagreements between various perspectives which talking about euthanasia, its allowed or forbidden. it divided into two group:
a.       Group One: Full cons on euthanasia
This group are argue that euthanasia is devalues human life, Euthanasia can become a means of health care cost containment, Physicians and other medical care people should not be involved in directly causing death. In this group are Abu Hanifah, Malikiyah, Ibnu Qudamah,  Ja’far Shadiq, and  Association of doctors in indonesia,
b.      Group two: Cons on euthanasia active but Pro on euthanasia passive
This group are argue that euthanasia active is prohibited as same as mentioned in group one above, but this group allow euthanasia passive which is provides a way to relieve extreme pain, it also provides a way of relief when a person's quality of life is low, Frees up medical funds to help other people, and It is another case of freedom of choice if the patient choose euthanasia passive by themselves. In this group are Syafi’I opinion, al-Ghazali opinion, Yusuf Qhardawi, and regulation of declaration of human rights.

1)      Sources from Group One
This group is taking sources from Quran, Hadith, Regulation, and Common Sense.
a)      Source from Quran
·         يَا أَيُّهَا الَّذِينَ آمَنُوا كُتِبَ عَلَيْكُمُ الْقِصَاصُ فِي الْقَتْلَى الْحُرُّ بِالْحُرِّ وَالْعَبْدُ بِالْعَبْدِ وَالْأُنْثَى بِالْأُنْثَى...(البقرة: 178)
·         وَلَكُمْ فِي الْقِصَاصِ حَيَاةٌ يَا أُولِي الْأَلْبَابِ لَعَلَّكُمْ تَتَّقُونَ (البقرة: 179)
·         وَمَنْ يَقْتُلْ مُؤْمِنًا مُتَعَمِّدًا فَجَزَاؤُهُ جَهَنَّمُ خَالِدًا فِيهَا ...(النساء: 4)
·         وَلَا تَقْتُلُوا أَنْفُسَكُمْ إِنَّ اللَّهَ كَانَ بِكُمْ رَحِيمًا (النساء: 29)
·         وَكَتَبْنَا عَلَيْهِمْ فِيهَا أَنَّ النَّفْسَ بِالنَّفْسِ وَالْعَيْنَ بِالْعَيْنِ وَالْأَنْفَ بِالْأَنْفِ وَالْأُذُنَ بِالْأُذُنِ وَالسِّنَّ بِالسِّنِّ وَالْجُرُوحَ قِصَاصٌ فَمَنْ تَصَدَّقَ بِهِ فَهُوَ كَفَّارَةٌ لَهُ وَمَنْ لَمْ يَحْكُمْ بِمَا أَنْزَلَ اللَّهُ فَأُولَئِكَ هُمُ الظَّالِمُونَ (المائدة: 45)
·         وَلَا تَقْتُلُوا النَّفْسَ الَّتِي حَرَّمَ اللَّهُ إِلَّا بِالْحَقِّ وَمَنْ قُتِلَ مَظْلُومًا فَقَدْ جَعَلْنَا لِوَلِيِّهِ سُلْطَانًا فَلَا يُسْرِفْ فِي الْقَتْلِ إِنَّهُ كَانَ مَنْصُورًا (الإسراء: 33)

i.                    Implication
Those ayah are representing that Allah respects human value, Allah gives punishment for the man who kill somebody with qisas, even in the small case they have their punishment of qisas. And euthanasia equally one of murder which very prohibited as have been said by Allah "And you don't kill any soul which precious by Allah". One of ayah also talking about suicide, as same as passive euthanasia which prohibited in this group.

b)      Source from Hadith
·         المسلمون تتكافأ دماؤهم (رواه مالك) .[2]
·         لا يحل دم امرئٍ مسلم يشهد أن لا إله إلا الله وأني رسول الله {صلى الله عليه وسلم} إلا بإحدى ثلاث الثيب الزاني والنفس بالنفس والتارك لدينه المفارق للجماعة (متفق عليه)[3]
·         لا يتمنين أحدكم الموت من ضر أصابه فإن كان لا بد فاعلاً فليقل اللهم أحيني ما كانت الحياة خيراً لي وتوفني إذا كانت الوفاة خيراً لي (متفق عليه)[4]

i.                    Implication
The main condition of Muslims are precious and prohibited to be killed by another Muslim. This prohibited condition are agreed by akhbar and consensus.[5] And the last hadith which supporting us for being a positive person is absolutely prohibited us for seeking dead.
c)      Source from Regulation

·         Article 7d of the medical ethics code in Indonesia
Each doctors should always remember their obligation to protect the lives of human beings.[6]
i.                    Implication
Each doctor had to defend and preserve human life. Because the strongest instinct in every animate creature, including mankind is to survive. For that reason, the people were given the ability to think and gather experience, so as to develop science and attempt to avoid the danger of death. Even its intentionally from the patient himself.
d)     Common sense
      Euthanasia is one of intentionally killing by using potion or medicine killing which can be interpreted by Abu Hanifah opinion as a strike using sword, and it must punished with qisas.[7]

2)      Sources from Group Two
The sources that will be mentioned are just the additional which supporting permission on euthanasia passive. Then, this group is taking sources from Quran, Hadith, and Common Sense.
a)      Source from Quran
·         وعلى الله فليتوكل المتوكلون
·         ومن يتوكل على الله فهو حسبه
i.                    Implication
These ayah informs that human being shall do tawakkal to the all natural accident, especially in the matter of getting disease. For those, moslem do not have to strain looking for medicine everywhere to look for recovering, because medicine is a matter which considered as mubah. And  all important matter is accepting all with the kindness respect to Allah.

b)      Source from Hadith
·         عن عطَاء بن أبي رَباحٍ ، قَالَ : قَالَ لي ابنُ عَباسٍ رضي اللهُ عنهما : ألاَ أُريكَ امْرَأةً مِنْ أَهْلِ الجَنَّة ؟ فَقُلْتُ: بَلَى ، قَالَ : هذِهِ المَرْأةُ السَّوداءُ أتتِ النَّبيَّ - صلى الله عليه وسلم - ، فَقَالَتْ : إنّي أُصْرَعُ(4) ، وإِنِّي أتَكَشَّفُ ، فادْعُ الله تَعَالَى لي . قَالَ : (( إنْ شئْتِ صَبَرتِ وَلَكِ الجَنَّةُ ، وَإنْ شئْتِ دَعَوتُ الله تَعَالَى أنْ يُعَافِيكِ )) فَقَالَتْ : أَصْبِرُ ، فَقَالَتْ : إنِّي أتَكَشَّفُ فَادعُ الله أنْ لا أَتَكَشَّف ، فَدَعَا لَهَا . (متفق عليه)[8]

i.                    Implication
Related to the source of Al-Quran above, source of hadith which taken as source by this group also suggest moslem for being tawakkal. And the Conclusion that made medicine  as matter which considered as mubah, then to accept disease are more important for them also become fundamental solution of this hadith. Because when an old woman come to prophet gripping her disease of epilepsy, Prophet do not order her to look for medicine, but ordering her to bear with it.[9]
c)      Regulation
Declaration of human rights no. 3
Everybody have their rights to live, to be free and to be safe.[10]
i.                    Implication
With this declaration of human rights, everybody who owning their freedom and the rights to live also have their freedom and rights to choose it, with their suffered in disease, are they wish to continue their life or not. Hence, passive euthanasia is allowed, because of the intention of the patient themselves for not willing to continue their medical treatment.
d)     Common sense opinion
Depend  on providing a long time of media treatments by taking medication, injections, infusions, etc. or use breathing apparatus and other modern medical equipment for so long, but the disease still has no change, then resume treatment is not mandatory nor sunnah anymore.
Thus facilitating process of death (Taisir al-death) these conditions there is no expectation that is often termed qatl ar-rahma (let the journey towards death due to mercy), because in this case found no active actions of doctors and others . But the doctor or other concerned people to be patient just leave something obligatory or not the law is sunnah, so not to be liable to punishment under sharia or positive law. Act of passive euthanasia by doctors in this condition is allowed but not required (may) and Shari'ah justified if the patient's family allowed him to relieve suffering and burden of patients and their families.[11]

3. The Chosen Opinion
By presenting various perspectives which related to euthanasia above, by considering this era which have more development along with problems of society and not only see the view of religion, the opinion of group two is more rational and suitable for this era. Because this group that prohibited an active euthanasia which is  clearly interpreted as murder, this group also lighten passive euthanasia as kind as maslahah for the somebody who really trapped in problem of health, economic and family. And this condition related to one of qawaid fiqh, that said:
المشقة تجلب التيسير
An existing difficulties are generating a simple dispensation.

C. Conclusion

Euthanasia is the intentional killing by act or omission of a dependent human being for his or her alleged benefit. Euthanasia in general term devided into two categories:
a.                 Active which intentionally done by doctor or another medical care to take a shortcut terminating life of patient.
b.                 Passive which able to lengthen patient life intentionally. Or a condition where a patient refuse consciously to accept medical treatment.
There are two group in this discussion:
a.       Group One with their Full cons on euthanasia, and
b.      Group two which just Cons on euthanasia active but Pro to euthanasia passive.
Both group have their opinion and sources to be taken as basis of thinking. They take the conclusion from Quran, Hadith, Regulations, and their common sense. And by looking to their opinion, and comparing it to the problem exist nowdays. The chosen opinion is the group two, which see through consideration of social, economic, and family problem.

D. BIBLIOGRAPHY

Declaration_of_Human_Rights.Pdf 
http://media.isnet.org/islam/Qardhawi/Kontemporer/Eutanasia.html, accessed at 5 Desember 2012
Kode etik kedokteran.pdf
www.euthanasia.com/definitions.html, accessed at 5 Desember 2012
ابن قدامة , أبو محمد موفق الدين عبد الله بن أحمد بن محمد, المغني, الجزء الثامن عشر (موقع الإسلام)
الحميدي, محمد بن فتوح, الجمع بين الصحيحين البخاري ومسلم الجزء الأول, (بيرت: دار النشر)
الغزالي, أبو حامد محمد بن محمد, احياء علوم الدين, الجزء الرابع (بيروت: دار المعرفة)
 القرطبي, أبو عمر يوسف بن عبد الله بن محمد بن عبد البر بن عاصم النمري, الكافي في فقه أهل المدينة المالكي, الجزء الثاني (الرياض: مكتبة الرياض الحديثة).
الفحل, ماهر ياسين, المنتخب من صحيح السنة النبوية (المكتبة الشاملة)
الكتاب –فقه حنفي , الجزء الأول (المكتبة الشاملة)
عفانة , حسام الدين, فتاوى يسألونك (المكتبة الشاملة)



[1] www.euthanasia.com/definitions.html, accessed at 5 Desember 2012

[2] أبو عمر يوسف بن عبد الله بن محمد بن عبد البر بن عاصم النمري القرطبي, الكافي في فقه أهل المدينة المالكي, الجزء الثاني (الرياض: مكتبة الرياض الحديثة) 1095
[3] محمد بن فتوح الحميدي, الجمع بين الصحيحين البخاري ومسلم الجزء الأول, (بيرت: دار النشر) 116
[4] حسام الدين عفانة, فتاوى يسألونك 239
[5] أبو محمد موفق الدين عبد الله بن أحمد بن محمد ابن قدامة, المغني, الجزء الثامن عشر (موقع الإسلام) 276
[6] Kode etik kedokteran.pdf
[7] المكتبة الشاملة, الكتاب –فقه حنفي , الجزء الأول , ص 128
[8] ماهر ياسين الفحل, المنتخب من صحيح السنة النبوية, 5
[9] أبو حامد محمد بن محمد الغزالي, احياء علوم الدين, الجزء الرابع (بيروت: دار المعرفة) 290
[10] Declaration_of_Human_Rights.Pdf

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