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Is Withdrawing Life Support Haram?

18 August, 2024
Q What is the withdrawal of life support and nutrition from patients suffering from incurable diseases with no hope of recovery?

Answer

In the Name of Allah, Most Gracious, Most Merciful. 

All praise and thanks are due to Allah, and peace and blessings be upon His Messenger.


In this fatwa:

It is permissible, with the consent of the patient or their guardians, to withdraw life[1]sustaining treatment if the doctors see that the therapeutic procedures are futile in achieving recovery or maintaining a dignified life, and that they only serve to prolong the suffering of the patients and their families.


Answering your question, The Assembly of Muslim Jurists of America, states:

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The default ruling regarding seeking medical treatment is that it is recommended or permissible according to the majority of Muslim scholars, including the jurists of the four Sunni schools of thought and others. Some have said it is obligatory, and contemporary scholars have applied this to cases where the illness is harmful, the medicine is safe, and recovery is hoped for, which is a sound position.

It is permissible, with the consent of the patient or their guardians, to withdraw life[1]sustaining treatment if the doctors see that the therapeutic procedures are futile in achieving recovery or maintaining a dignified life, and that they only serve to prolong the suffering of the patients and their families.

The patient or their guardians are permitted to choose not to resuscitate the heart and lungs (DNR) in cases of terminal illnesses with no hope of recovery. They may choose to give permission for this, and to delegate the doctor to choose what is best for their condition in light of weighing the benefits and harms based on the patient’s health status.

Artificial nutrition and hydration (fluid hydration) are forms of treatment, and their ruling should not be considered in isolation from the patient’s overall condition. The Islamic legal rulings on treatment apply to them; this includes the permissibility of refraining from them when they are deemed futile.

If the patient’s condition reaches a stage where recovery of life is despaired of according to medical standards, there is no harm in removing life support devices or in keeping them. The decision in this regard should be left to the patient’s heirs, in consultation with their medical team, if the patient has not left any instructions regarding this matter. They should act according to what is most compassionate for the patient.

It may be disliked to keep the devices if it is expected to cause pain to the patient or waste money and resources without benefit. The dislike may increase, and it may even reach the level of prohibition, if there is another patient in need of the intensive care unit or life support devices (such as a ventilator) while it is highly probable that this other patient will benefit from them.

It is recommended as a condition to have the testimony of three experts to judge a medical condition as being incurable, and likewise for making a judgment on anything that would justify the permissibility of stopping life-sustaining treatment procedures.

If some treatments, such as resuscitation devices and the like, have been initiated and then it is decided that they are futile, and there is no prior permission from the patient to stop them, or their agent or guardian refuses to issue permission, then it is necessary to resort to dispute resolution mechanisms such as referring to a neutral third party like the hospital’s ethics committee or the judiciary.

If the patient’s guardians insist on continuing the treatment while bearing the financial consequences, the doctor then has the option to continue the treatment or to refrain from it if another doctor is available to undertake it

Almighty Allah knows best.

Source: AMJA Online

About AMJA
Permanent Fatwa Committee of the Assembly of Muslim Jurists of America (AMJA)