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Suicide and Assisted Suicide

By:
Abul Fadl Mohsin Ebrahim
Source:
The Encyclopedia of Islamic Bioethics What is This? A comprehensive reference work covering the major issues in Islamic bioethics, including medicine, clinical practice, genetics, theology, and Islamic law.

Suicide and Assisted Suicide

Introduction

Suicide is a deliberate attempt to end one’s life. Social and personal conditions such as failed relationships and financial loss may precipitate the taking of one’s life (Jonsen, et. al., 2006, p. 155–156). According to the World Health Organization (WHO) one person dies by suicide every 40 seconds somewhere in the world (International Suicide Statistics: www.suicide.org/international-suicide-statistics.html). In assisted suicide, a physician or some other professional provides the necessary means to take his or her own life (Baergen, 2001, p. 161). This is usually in the context of a terminally ill patient whose quality of life has become severely compromised. While the prerogative to bestow and terminate life according to all divine religions rests with God alone, jurisdictions in certain countries allow assisted suicide. For example, Swiss law permits private suicide facilitation. A private group, namely, Dignitas, facilitates most Swiss assisted suicides. Wesley J. Smith (2003), an attorney and consultant for the International Task Force on Assisted Suicide, points out that as a result of this development in Switzerland, “Switzerland has become a destination for “suicide tourists” who travel there not to ski, but to receive a poison cocktail.

For the adherents of the religions that subscribe to the belief in life after death, suicide and assisted suicide also have theological repercussions. Specifically, a believer contemplating suicide must consider the pain they are experiencing alongside the possibility of an afterlife and the moral teachings of scripture and tradition.

Suicide

Rosenthal (1946, p. 243) concedes that due to the ingenuity of the mufassirūn (interpreters of the Qurʾān), the Qurʾānic verse (4:29): “And do not kill yourselves. Indeed, God is to you ever Merciful” prohibits Muslims from taking their own lives (Al-Ṣābūnī, 1981, vol.1, p. 281) also interprets this verse to mean that Muslims are not to kill one another as well as not to commit suicide. Ibn Kathīr (1969, vol. 1, p. :480) commenting on the above Qurʾānic verse, mentions an incident involving the great Muslim general ʿAmr ibn al-ʿĀṣ. While on an expedition to Dhāt al-Salāsil (629), he did not perform the ghusl (obligatory bath) after nocturnal emission, but instead resorted to purifying himself by making tayammum (with clean sand) fearing that if he bathed he would have placed his life in danger. Hence, when the Prophet was informed about that he summoned ʿwit, who justified his action by quoting the above Qurʾānic verse. It is said that the Prophet smiled. Hence, this verse came to be interpreted as a prohibition of suicide and that can be confirmed by the fact that Ibn Kathīr, after relating the incident of ʿAmr ibn Al-ʿĀṣ, includes several Prophetic reports that pertain to suicide. For example, Abū Hurayrah quotes the Prophet as saying: “Whoever kills himself with a steel instrument will be punished in the same manner in the life hereafter and will dwell in hell fire eternally forever” (Ibn Kathīr, 1969, vol. 1, p. 480). It is important to note here that many scholars do not interpret the punishment as lasting forever, since a Muslim by virtue of his belief in tawḥīd will one day enter Paradise. Some of the most influential scholars of ḥadīth (e.g., al-Nawawī, 1972, part 18, vol. 2, p. 125) explain that the term “eternally forever” in the above mentioned ḥadīth as follows: A person who deliberately committed suicide, knowing that it is forbidden, is considered a disbeliever and as such will be punished in hell. On the other hand, if that person was unaware that suicide was unlawful, then the ḥadīth could mean that, God, out of His infinite mercy, will allow him to enter paradise.

In the Islamic juridical context, the one who kills himself commits a major sin and is termed an open sinner (fāsiq) by the jurists (fuqahāʾ) (al-Zaylaʿī, 1895, vol. 1, p. 250). To illustrate this, there is a ḥadīth which mentions that the Prophet refused to pray the ṣalāt al-janāzah (funeral prayer) over the body of a man who had killed himself (al-ʿAynī, n.d., vol. 8, p. 192). Muslim jurists explain that the Prophet’s refusal to pray over that person was meant to impress upon his followers the gravity of the sin of suicide. However, it is to be noted that many Muslim jurists are of the view that suicide does not cause corruption (fasād) within a community in the same way murder or other crimes do. Thus, many scholars argue that, this particular example notwithstanding, a person who commits suicide must still receive a proper ghusl (ritual bath) and funeral prayer. These scholars note that while the Prophet refused to pray in this case, nowhere is it mentioned that the companions of the Prophet also abstained (Ibn ʿĀbidīn, 1992, vol. 2, p. 212).

Assisted Suicide

The suffering which a terminal patient undergoes can sometimes be the reason given for physician-assisted suicide (PAS). In other words, the role of the physician is to provide the means of ending the life of the patient, and the patient in turn completes the act (Mason, et. al., 2002, p. 535). According to Sachedina (2009, p. 98) in Islamic theological parlance all forms of suffering, including illness, serve two purposes: “(a) a form of punishment that expiates sins and (b) they are a test and trial to confirm or reinforce a believer’s spiritual status.” In fact, the Qurʾān (2:155–156 and 29:2) alludes to the trials that human beings would be subjected to, but reassures humans that they would not be taxed beyond what they can bear (2:286). In the ḥadīth literature, Muslims are cautioned against wishing for death in the midst of experiencing trials and tribulations (Ṣaḥīḥ al-Bukhārī, “Kitāb al-Ṭibb,” vol. 3, p. 156).

According to the Islamic philosophy of life, there is a transcendental dimension to pain and suffering. The Qurʾān states that those who claim to believe in God will not be left alone after proclaiming their belief, but that they will be tried with affliction (29:2; 2:115–116). There is, therefore, no explicit scriptural justification to end one’s life so as to relieve oneself of pain and suffering.

Contemporary Muslim jurists cite the following ḥadīth to lend support to the view that assisted suicide is a sin: There was a man before you who was wounded. The pain became unbearable and so he took a knife and cut off his hand. Blood began to ooze out profusely leading to his death. Almighty God said: “My servant hastened himself to Me and so I made Paradise unlawful for him” (Karim, 1939, vol. 2, p. 514).

Insofar as PAS is concerned, while it is true that the intention (niyyah) of the physician is beyond the jurisdiction of the court of law, that the physician’s intention cannot escape the ever-watchful supervision of God, a concept that is clearly articulated in the Qurʾān (40:19): “God is aware of the most furtive of glances, and of all that hearts conceal.” Hence, that physician would nevertheless be answerable to God for his/her part in assisting to end the life of a terminally ill patient (Ebrahim, 2008, p. 174).

It is pertinent to note here that all Muslim-majority countries criminalize PAS and penalize physicians facilitating it. However, taking into consideration the patient’s repeated request to be assisted to end his/her life, the punishment is typically commuted from capital punishment to imprisonment and revocation of his/her medical practice licence (Abulgawad, 1986, vol. 4, pp. 762–777). The Islamic Fiqh Council (of the Muslim World League, Saudi Arabia) in its resolutions dated May 1992, strongly rejected all forms of ending the life of the terminally ill (suicide and assisted suicide). It further resolved that terminally ill patients ought to receive appropriate palliative care and medication. Moreover, doctors should do their best to support their patients, morally and physically, regardless whether the measures are curative or not. No one should be despaired of God’s Mercy. The Islamic Medical Association of North America (IMANA) also articulated its opposition to assisted suicide and all forms of ending the life of the terminally ill (al-Bar and Chamsi-Pasha, 2015, p. 258).

Bibliography

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