Euthanasia or Mercy Killing

Brain Death

Like many other medical issues, the issue of mercy killing is very controversial, whether in the scientific or religious domains, especially that the word brain was not used in the religious texts, which talked about the heart.

In this article, we view the opinion of the Religious Authority, Sayyed Muhammad Hussein Fadlullah, who clears all misunderstandings regarding this issue, and explains the Islamic position.

The mind and the brain in the Quran

The Glorious Quran did not analyze the organic or physiological tasks of the mind. It did not explain whether the brain is where the human being stores the information. The mind in our view is similar to the spirit in being an energy that man stores to organize the information it gets and studies them to produce a feeling here and a thought there… Thus the mind is not an organic matter. It is rather an unseen energy… a spiritual energy that develops through the information and experiences it processes by thinking.

If modern science has associated all the activities, awareness, thoughts and convictions with the brain, the Quran considers them some of the capacities of the heart.

“Have they not traveled in the land so that they should have hearts with which to understand.”

The Sayyed believes that talking about the heart in this verse is figurative, just as when he talks about Allah's face: “Everything (that exists) will perish except His own Face.” It is not talking about a physical face since Allah does not have a face. It is talking about Allah Himself.

About the jurisprudence view regarding brain death, which is considered by doctors as the real death, His Eminence says: We rule that if the brain without any doubt has died, the support system may not be installed, and it is not prohibited to remove it in case it was installed. But the Sayyed feels that the jurisprudent meaning of death is problematic, since there is no precise definition of death. When does a persona die? Is it when his heart stops or when his brain dies? Does the heartbeats after the death of the brain represent human life or cellular (plant) life? All these questions are the subjects of an ongoing debate.

The naïve public opinion considers death to be the cessation of the heart. Many doctors too, when they want to know if a person is dead or alive, they would take his pulse. If there is no pulse then he is considered dead. This is the human experience of death that everyone knows. As for the brain death, it is only known by specialists.

Thus we ask: Is death the death of the brain, since all body systems have stopped, and therefore, the body is no longer alive? We also ask about the pulse: where does it come from. Does it come from the respiratory system, or because the heart still has some cellular life on its own?

Some jurists say if the pulse is a result of artificial respiration, it means that the person is dead. However, this point is still a controversial one.

Another point is: the person might die and some cells may stay alive: for example, when we take out the eye and provide for it the necessary requirements it will stay alive for a long time. Another example is the snake that dies but the tail continues to move. This is cellular life or "plant life" .It is an artificial life and not a normal one.

But if we leave this dispute aside, we still have to ask: Is death the death of the brain or the death of both the brain and the heart?

Here a jurisprudential issue is raised: what is it that compels me to install the support system?

And what makes it prohibited to remove it? It might be said that I should install the support system because it is a duty to preserve the life of a living person, as when I see a person's life in danger I have to save this life.

Why is it prohibited to remove the support system? Because this is considered killing. There are some jurists who say that there is evidence in the Islamic law that there is a duty to preserve life. What is meant here is the life of the body, the life of the human being, even if he is paralyzed. But this form of life that depends on the support system, in such a way that if we remove, it the person will die is not the life that we should save. Therefore removing the support system is not killing; killing is the killing of stable life, even if only in half the body if the other half is paralyzed.

That is why we do not rule that the support system should be installed and we do not rule that it is prohibited to remove it.

Of course there are many reservations among some jurists. But when we study the issue and from what we understand of the medical information available we find that it is not a duty to install the support system if we are 100 per cent sure that the person concerned is in a state of brain death, and the life he is living is a cellular life. In such case, the installation of the support system is not a duty and removing it is not prohibited, since installing it will not be an act of saving life and removing it will not be an act of killing.

There is a difference between this death and the so-called mercy killing. There might be a man who is suffering from great pains and could die in 6 months or even a month. In this case, it is impermissible to kill him even if he or his family asks us to. We do not have an authority over a man's life, and the man himself is not authorized to end his life, for medicine can discover after an hour or a day…. something that can ease his pains or save his life.

Therefore, mercy killing is meaningless in such a case. It might be merciful at one particular moment, so if judged by the entire life. It could even be the opposite of mercy.

As for the end of life, and the cessation of treatment in fatal illnesses, we say that this means to leave the sick person to die without saving him, which contradicts the theory of respecting human life. You have to leave life to defend itself or terminate itself. And you do not have the right to end a human life, whether you were the doctor or the patient.

The point I would like to make concerning mercy killing from the point of view of medical ethics is that: In the Islamic ethical theory, and probably in Christianity as well, Religion not only protects man from others but also from himself. As it is impressible to kill someone else, it is impermissible to kill yourself. The principle is the same: To respect life in both cases. We are not talking here about dead people or even plants; we are talking about life. It is impermissible to kill a human being because it is impermissible to kill life.

Therefore, there is no difference between the life of the other and my own life.

I do not own this life, which is a gift from Allah that He has entrusted me with. Not only do I not have the permission to end my life , but also to cause myself any harm, physical or otherwise. This is what we explained in our Fatwa of prohibiting smoking that may cause cancer, even if after several years.

Morals cannot be divided. It is not only what you practice with others but also with yourself… Thus, when you do not treat a person of a fatal illness, you are killing him in a negative way. And there is no difference between negative killing and positive killing. You have to preserve the life of the others as you preserve yours.

I cannot understand how could killing be merciful. Death is by its physical nature cruel, because it takes your life and turns you into a thing. It confiscates yours life and your existence. Therefore, you do not have the right to kill yourself, because suicide is a sin:

“Nor kill (or destroy) yourselves” (4:29)

“…and make not your own hands contribute to (your) destruction”  (2:195)

It is impermissible for the patient to ask his doctor for a shot to end his life, just as it is impermissible for the doctor to respond to his plea, for he has no authority over his patient’s life.

Then, when those who talk about mercy killing justify it by the physical pains of the patient. If we legalize this we should also legalize it for those who have psychological pains and believe that death to them is better than life.

We also have to legalize for a girl who experiences an emotional shock or for the businessman who might be bankrupt.. etc. When we accept the principle we cannot confine it to one circle. A man who has physical pains is much the same as the one who spiritual or psychological pains. Moreover, psychological pains might inflict greater suffering than physical pains. Can we then legalize what ends the life of man?

On the other hand, why do we prejudge the potentials of medicine? Is it not possible that just one hour after a person's death, it will discover a treatment for the illness that caused his death, since all medical discoveries, before they were put in practice, were much needed by many fatally sick people. Let us leave life to defend itself.

If we live pain, we can resort to the spiritual values that would support us and ease our pains.