Paper presented at workshops on medical ethics at various campuses in England 09-31 December 2006 by Dr Omar Hasan Kasule Sr. MB ChB (MUK), MPH (Harvard), DrPH (Harvard) Professor of Epidemiology and Islamic Medicine at Universiti Brunei Darussalam
INTRODUCTION TO THE ISLAMIC INPUT CURRICULUM
The main motive of IIMC is to resolve the crisis of duality or dichotomy manifesting as teaching Islamic sciences separately from medical disciplines by different teachers and in different institutions. IIMC resolves the crisis of duality by insisting that Islamic concepts should be taught by the same people who teach medical disciplines. All lecturers in the Kulliyah of Medicine go through a Diploma in Islamic Studies (DIS) whose modules are exactly the same as the modules of IIMC. This prepares them to be effective teachers of IIMC.
The teaching material of IIMC has been prepared and tested over the past 7 years. Synopses of all lectures for years 1 -5 are available at http://omarkasule.tripod.com.
Since the start of the Kulliyah in 1997, we have worked towards integrating Islamic values and concepts in the teaching and examination of basic and clinical medical sciences. The expectation is that our graduates will be able to integrate Islamic moral and legal values in their practice of medicine because they went through an integrated education system.
IIMC follows the Islamic paradigm of reading 2 books, the book of revelation, kitaab al wahy, and the book of empirical science, kitaab al kawn. Both books contain signs of Allah, ayaat al llaah, and must be read together. It is a mistake to read one of the books and neglect the other. The solution to the crisis of duality in the ummah starts from joint reading of the 2 books, al jam ‘u baina al qira atain. Thus medical scientists who are involved in IIMC read the signs in both books.
The vision of IIC has two separate but closely related components: Islamization and legal medicine. Islamization deals with putting medicine in an Islamic context in terms of epistemology, values, and attitudes. Legal medicine deals with issues of application of the Law (fiqh) from a medical perspective.
IIMC has 5 main objectives: (a) introduction of Islamic paradigms and concepts in general as they relate to medicine, mafahiim Islamiyat fi al Tibb. (b) strengthening faith, iman, through study of Allah’s sign in the human body (c) appreciating and understanding the juridical, fiqh, aspects of health and disease, al fiqh al tibbi. (d) understanding the social issues in medical practice and research and (e) Professional etiquette, adab al tabiib, from the Islamic perspective.
We feel that IIC helps the future physician prepare for the heavy trust, the amanat of being professionally competent. He must be highly motivated. He must have personal, professional, intellectual, and spiritual development programs. He must know the proper etiquette of dealing with patients and colleagues. He also must know and avoid professional malpractice. He needs to be equipped with leadership and managerial skills to be able to function properly as a head of a medical team.
DERIVATION OF MEDICAL ETHICS FROM THE MAQASID AL SHARIAH
In my view the most significant aspect of IIMC is the derivation of medical ethics from Islamic sources as an alternative to western sources. The full impact of this will be appreciated in due course when these ideas become widely adopted.
Secularized European law denied moral considerations associated with ‘religion’ and therefore failed to solve issues in modern medicine requiring moral considerations. This led to the birth of the discipline of medical ethics that is neither law enforceable by government nor morality enforceable by conscience. On the other hand, Islamic Law is comprehensive and encompasses moral principles directly applicable to medicine.
The theory of medical ethics in Islam should be based on the 5 purposes of the Law, maqasid al shariah, that are also considered the 5 purposes of medicine, maqasid al tibb. The 5 purposes are preservation of religion and morality, hifdh al diin; preservation of life and health, hifdh al nafs; preservation of progeny, hifdh al nasl; preservation of intellect, hifdh al ‘aql; and preservation of wealth, hifdh al maal. Any medical action must fulfill one of the above purposes if it is to be considered ethical. If any medical procedure violates any of the 5 purposes it is deemed unethical.
In practical detailed situations, legal axioms called Principles of the Law or qawa’id al shariah need to be used to resolve mostly situations of apparent conflict between maqasid or to assist logical reasoning. Principles of the Law, qawa’id al shariah, when applied to the medical area can also be referred to as Ethical Principles of Medicine, qawa’id al tibb. The basic ethical principles of Islam relevant to medical practice are derived from the 5 principles of the Law, qawa’id al shariah, that are: intention, qasd; certainty, yaqeen; injury, dharar; hardship, mashaqqat; and custom or precedent, ‘aadat. The maqasid and qawa’id are used in a synergistic way. The basic purpose of qawa’id is to provide robust rules for resolving situations of conflict between or among different maqasid.
The challenge before Muslim physicians is to liberate themselves from confusing and inconsistent European ethical theories and principles and instead to work hard to develop specific regulations for various medical interventions, dhawaabit al tibaabat, by a renewal of ijtihad. This ijtihad will be based on primary sources of the Law (Qur’an and sunnat), secondary sources of the Law based on transmission, masaadir naqliyyat (ijma and qiyaas); secondary sources of the Law based on reason, masaadir ‘aqliyyat (istishaab, istihsaan, & istilaah); the purposes of the Law, maqasid al shariah; principles of the Law, qawa’id al fiqh; as well as regulations of the Law, dhawaabit al fiqh.
In the early period of medical jurisprudence (0-1400 H) most issues could be resolved by direct reference to the primary sources. In the middle period (1401 – 1420 H) issues were resolved by using ijma, qiyaas, istishaab, istihsaan, & istilaah. In the modern period (1420 - ) medical technology is creating so many issues whose resolution will require a broad bird’s eye-view approach that can only be found in the theory of maqasid al shariah.
APPENDIX #1: TOPICS OF IIMC IN 2004/2005
YEAR 1 | YEAR 2 | YEAR 3 | YEAR 4 | YEAR 5 |
BLK 1: ‘AQIIDAT | BLK 1: LIFE & HEALTH | BLK 1a: ELEM CLINIC | BLK 1: MED TECHN | BLK 1: FORMATION |
Intro to Islamic Input | Life, al hayaat, | History Taking | Assisted Reproduction | The study circle |
Islam, Iman, & Ihsan: | Death, al mawt | Physical Exam & Investigation | Contraception | Self study of Qur’an, |
Tauhid | Health, al sihhat | Adab: Patient & Families | Reproductive cloning: | Motivation in Islam |
Risalah | Disease, al maradh | Adab Health Care Team | Abortion | Medical Education |
Akhirat | Disease treatment, al tibaabat | Adab: with the Dying: | Artificial Life Support | Personal Development |
Qadar | al tasawwur al Islami | Euthanasia | Skill Develop Program | |
‘Ubudiyyat | BLK 1b:LAW/ ETHICS | Organ Transplant | Quality Culture | |
Tazkiyat al Nafs | BLK 2: GROWTH | Over-view | Stem cell transplant | |
Ithm & Ghufran | Intra-uterine Life, : | Sources of the Law | Cosmetic Surgery | BLK 2a: LEADERSHIP |
Kufr & Shirk | Infancy & Childhood: | Purposes and Principles | Animal Research | Basic characteristics: |
Al Milal wa al adyaan | Youth | Purposes & Principle of Medicine | Human Research | Attributes and functions |
Concept of cUbudiyyah: | Middle Age | Medical Procedures: | Research Practice | Diseases of leaders |
Old Age | Research Procedures: | BLK 2a: TRANSACT | Communication | |
BLK 2: ‘ILM | Physician Conduct: | Medical malpractice: | Negotiation | |
Nature of Knowledge | Professional Misconduct: | Marriage | Value-based Leadership: | |
Crisis of Knowledge: | BLK 3: BIO MIRACLE | Divorce & annulment: | BLK 2b: LEADERS | |
Method of Knowledge | Perfection in Anatomy | Inheritance | The Prophet | |
Classical Islam Sciences | Perfection in Physiology | BLK 2:FIQH ‘IBADAT | Sales | The righteous khulafa |
History of Med Sciences: | Perfection in Biochemistry | Taharat: | Personal Loans | Political leaders |
Islamization of Med Science | Control & Homeostasis | Rulings on Salah | Investments | Social role models |
Islamization: Other Disciplin | Interaction with the Environ | Physical Acts of Salah | Endowments | Scholars and reformers |
Islamic Educ in SE Asia | Epidemiology & Statistics: | Special Types of Salah: | BLK 2b: CRIMES | Multicultural society |
Modernization: | Salah in Difficulties | Crimes | BLK 3a: MGMT | |
Saum | Legal competence: | Principles and concepts | ||
BLK 3: TARIKH | BLK 4: STRU & FUNC | Zakat | Pleas, & evidence | Strategy |
Creation of the Universe I | Alimentary System | Hajj | Judgment, conviction, | Planning & implementation |
Creation of the Universe II: | Locomotor System | BLK 3: SOC INSTITU | Control and evaluation | |
Creation of the Human I: | Protective Systems | BLK 3: NORM CONDIT | Family 1: Gender | Decisions & Problems |
Creation of the Human II: | Genito-urinary System | Menstruation | Family 2: Marital Relationship | BLK 3b: RES MGMT |
Khilafat I: | Cardio-respiratory System | Human Sexuality | Family 3:rels & Child | Time Management |
Khilafat II: | Sensory System | Pregnancy and Delivery: | The Masjid | Financial management |
Taskhiir | Nervous System | Breast feeding | Takaful | Information Management |
Imarat al Ardh | Globalization | Hygiene | Shuura | Organization management |
Era of Risaalat: | Foods & Drinks | Maal | Personnel management | |
Era of Khilafat Raashidat, | Activity, Rest, and Sleep: | BLK 4a: COM PROB | ||
Islam in the Malay World: | Lifestyle | |||
BLK 4: PATH CONDITI | Sexual perversions | |||
BLK 4: CIVILIZATION | Uro-genital system | Addictions | ||
Concepts of Civilization: | Cardio-respiratory system: | Poverty | ||
Ancient Civilizations | Connective tissue system: | Violence | ||
Cycle of Civilization | Alimentary system: Dr | BLK 4b: SOC ACTS | ||
Umayyad Era: | Sensory systems: | Dawa: | ||
Abbasid Era: | Gen systemic conditions: | Amr & Nahy | ||
Osmanli Era: | Psychiatric conditions | Social Change | ||
Other Muslim Civilizations: | Neurological conditions: | Professional orgs | ||
Achievement of Islamic Civilization | Age-related conditions: | Welfare and Disaster | ||
Tajdid & Islah | ||||
A Common Civilization |
NB: Teaching material can be accessed at http://omarkasule.tripod.com
APPENDIX #2
CURRICULUM FOR YEAR 1
THEME I: ‘AQIIDAT
MODULE 1.0: Usuul Al Diin
1.1 Islam, Iman, & Ihsan
1.2 Tauhid
1.3 Risaalat
1.4 Aakhirat
1.5 Qadar
MODULE 2.0: Aspects of ‘Aqiidat
2.1 ‘Ubuudiyyat
2.2 Tazkiyat al nafs
2.3 Ithm & Ghufran
2.4 Kufr & Shirk
2.5 Milal
THEME II: ‘ILM & MA’ARIFAT (KNOWLEDGE)
MODULE 3.0: Theory of Knowledge, nadhariyyat al ma’arifat
3.1 Nature of Knowledge, tabi’at al ma’arifa’at
3.2 Crisis of Knowledge, azmat al ma’arifat
3.3 Methodology of Knowledge, manhajiyat al ma’arifat
3.4 Classical Islamic Sciences, al ‘uluum al islamiyyat al taqliidiyyat
3.5 Problem-based Learning in the Qur’an, asbaab al nuzuul fi al qur’an
MODULE 4.0: Islamization of Knowledge, islamiyyat al ma’arifat
4.1 Concept of Islamization, mafhuum islamiyyat al ma’arifat
4.2 Islamization of Medical Sciences, islamiyat al ‘uluum al tibiyyat
THEME III: KHALQ (CREATION) [0.85 MB, 126PP]
MODULE 5.0: Creation of the Universe, khalq al kawn
5.1 Nature, tabi’at al kaun
5.2 The Ultimate Questions, al as ilat al nihaa iyyat
5.3 Signs of Allah in the Universe, aayaat al llaah fi al kawn
5.4 Allah’s Will, iraadat al allah
5.5 Order, Change and Permanence
MODULE 6.0: Creation of the Human, khalq al insan
6.1 Creation of the Human Being, Khalq Al Insan
6.2 Nature of the Human, Tabi'at Al Insaan
6.3 Superiority of Humans, Afdhaliyyat Al Insaan
6.4 Mission of Humans on Earth, Risalah Al Insan Fi Al Ardh
6.5 Diversity of Humans, Tafaawut Al Bashar
THEME IV & V: TAARIIKH
MODULE 7.0: Khilafa, Taskhiir, ‘Imarat al ardh
MODULE 8.0: Cycle of Civilizations, dawrat al hadhaaraat
MODULE 9.0: The Golden Era, ‘ahad al risaalat & ‘ahad al khilafat
MODULE 10.0: Era of Dynasties, ‘ahad al muluuk
10.1 Achievements of Muslim Civilization, injaazaat al hadharat al islamiyyat
CURRICULUM FOR YEAR 2
THEME VI: HAYAT, SIHHAT, & NUMUW (LIFE, HEALTH, & GROWTH)
MODULE 11.0: Life and Health, al hayat wa al sihhat
11.1 Life, hayaat
11.2 Death, mamaat
11.3 Health, sihhat & ‘aafiyat
11.4 Disease, maradh
11.5 Treatment of Disease, tatbiib
MODULE 12.0: Growth and Senescence, numuw wa al shaykhuukhat
12.1 Intrauterine period, fi al rahim
12.2 Infancy and Childhood, tufuulat
12.3 Youth, shabaab
12.4 Middle Age,
12.5 Old Age, shaykhuukhat
THEME VII: JISM al INSAN (THE ORGANISM: STRUCTURE & FUNCTION)
MODULE 13.0: The Biological Miracle, mu’ujizat al jism al insani
13.1 Perfection, Optimality, Incomparability, kamaaa al khalq
13.2 Control and communication,
13.3 Homeostasis, ‘I’itidal
13.4 Interaction with the Environment
13.5 Pathological Processes: Repair & Restoration of Equilibrium
MODULE 14.0: Human Organ Systems
14.1 Alimentary system, ma idat
14.2 Locomotor Systems and Protective Systems, harakat al jism wa himayatuhu
14.3 Genito-urinary and cardio-respiratory systems, al qalb & tanaffus
14.4 Sensory system, al hawaas
14.5 Nervous Systems, al jihaaz al ‘asabi
CURRICULUM FOR YEAR 3
THEME VIII: USUUL al SHARIAH (FOUNDATIONS OF THE LAW)
MODULE 15.0: Sources, Purposes, Principles of the Law
15.1 Over-view
15.2 Sources of the Law, masadir al shariah
15.3 Purposes of the Law, maqasid al shariah
15.4 Principles of the Law, qawa’id al shariah
15.5 Regulations of the Law, dhawaabit al shariah
MODULE 16.0: THE OTHMANI LAW GAZETTE, majallat al ahkaam al adliyyat
THEME IX: AKHLAAQ al TIBB (ETHICS OF MEDICINE)
MODULE 17.0: Purposes, Principles, and Regulations of Medicine
17.1 Purposes and Principles of Medicine
17.2 Regulations of Medical Procedures, dhawaabit al tatbiib
17.3 Regulations of Research Procedures, dhawaabit al bahath
17.4 Regulations of Physician Conduct, dhawaabit al tabiib
17.5 Regulations about Professional Misconduct, dhawaabit al inhiraaf al mihani
MODULE 18.0: Etiquette of the Physician, adab al tabiib
18.1 Etiquette with Patients and Families, adab al tabiib ma’a al mariidh
18.2 Etiquette with the Dying, adab al tabiib inda al ikhtidhaar
18.3 Etiquette with the Health Care Team, al adab fi al fariiq al tibbi
18.4 Etiquette of Research on Animals, adab al bahth ‘ala alhayawaan
18.5 Etiquette of Research on Humans, adab al bahath ‘ala al bashar
THEME X: FIQH al ‘IBAADAAT (PHYSICAL ACTS OF WORSHIP)
MODULE 19.0: Taharat & Salah
19.1 Taharat
19.2 Rulings of salah, ahkaam al salah
19.3 Physical Acts of salah
19.4 Special Types of salah
19.5 Salah in difficult circumstances, salaat ahl al a’adhaar
MODULE 20.0: Physical ‘Ibadat
20.1 Saum
20.2 Zakat
20.3 Hajj
20.4 Tilaawat al Qur’an
20.5 Jihad
THEME XI FIQH al MU’AMALAAT (TRANSACTIONS)
MODULE 21.0: Civil Transactions, mu’amalaat madaniyyat
21.1 Marriage, fiqh al munakahaat
21.2 Divorce & annulment, fiqh al talaaq & fasakh
21.3 Inheritance, fiqh al mawariith
21.4 Agency, wakalah
21.5 Competitions, sibaaq
MODULE 22.0: Financial Transactions, mu’amalaat maaliyyat
22.1 Sales, buyuu’u
22.1 Personal Loans, Quruudh
22.2 Investments
22.4 Endowments & gifts, awqaaf & hibat
22.5 Other transactions
THEME XII FIQH AL ‘AADAAT (PHYSIOLOGICAL CONDITIONS)
MODULE 23.0 Reproduction, izdiyaad
23.1 Menstruation, al haidh
23.2 Human Sexuality, shahwat al jins
23.3 Pregnancy, al haml
23.4 Delivery, wadhau al haml
23.5 Breast-Feeding, ridha’a
MODULE 24.0 Activities of Normal Living, ‘aadaat al ma’ishat
24.1 Hygiene, al nadhaafat
24.2 Foods, at 'Imat
24.3 Drinks, ashribat
24.4 Activity, nashaat
24.5 Sleep and Rest, nawm & raahat
THEME XIII FIQH AL AMRAADH (PATHOLOGICAL CONDITIONS)
MODULE 25.0 Conditions of Organ Systems
25.1 Uro-Genital System, jihaaz bawli & jihaaz tanaasuli
25.2 Cardio-Respiratory System, qalb & jihaaz al tanaffus
25.3 Connective Tissue System,
25.4 Alimentary System, jihaaz al ma idat
25.5 Sensory Systems, al hawaas
MODULE 26.0 Other Disease Conditions
26.1 Patho-physiological Disturbances
26.2 General Systemic Conditions
26.3 Psychiatric conditions, amraadh nafsiyyat
26.4 Neurological conditions, amraadh al a’asaab
26.5 Age-Related Conditions, amraadh al ‘umr
CURRICULUM FOR YEAR 4
THEME XIV: FIQH MUSTAJIDDAAT al TIBB (MODERN MEDICINE)
MODULE 27: Reproductive & Genetic Technology
27.1 Assisted Reproduction, taqniyat al injaab
27.2 Contraception, mani’u al haml
27.3 Reproductive Cloning, al istinsaakh
27.4 Abortion, isqaat al haml
27.5 Other Technologies
MODULE 28.0: Medical and Surgical Technologies
28.1 Artificial Life Support, ajhizat al in’aash
28.2 Euthanasia, qatl al rahmat
28.3 Solid Organ Transplantation, naql al a’adha
28.4 Stem Cell Transplantation, naql al khalaayat
28.5 Change of Fitra, taghyiir al fitrat
THEME XV: FIQH AL MUHAAKAMAAT (JUDGMENTS)
MODULE 29.0: Civil and Criminal Cases
29.1 Crimes Jinaayaat
29.2 Legal Competence, ahliyyat
29.3 Etiquette of the Judge, adab al qadhi
29.4 Pleas & Evidence, da'wa & shahadat
29.5 Judgment, Conviction, and Punishment, qadha & ‘uquubat
MODULE 30.0: Legal Medicine, tibb shara’e
30.1 Forensic Evidence in Transactions
30.2 Forensic Evidence in Homicide
30.2 Forensic Evidence in Body Injury
30.4 Forensic Evidence in Sexual Crimes
30.5 Medical Malpractice
THEME XVI ARKAAN al JAMA’AT (PILLARS OF THE COMMUNITY)
MODULE 31.0: The Family Institution, al bayt
31.1 Gender
31.2 Family as a Natural Social Unit
31.3 Marriage
31.4 Parents and Relatives
31.5 Children
MODULE 32.0: Community Institutions, muassasaat al jama’at
32.1 Masjid
32.2 Ukhuwwat
32.3 Takaful
32.4 Shuura
32.5 Maal
THEME XVII HUMUUM al JAMA’AT (COMMUNITY CONCERNS) [0.91 MB, 139 PP]
MODULE 33.0: Community Problems, mashaakil al jama’at
33.1 Life-Style. namt al hayaat
33.2 Sexual Perversions, inhiraaf jinsi
33.3 Addiction, idmaan
33.4 Poverty, faqr
33.5 Violence, ‘unf
MODULE 34.0: Community Action, al ‘amal al ijtima’e
34.1 Dawa
34.2 Enjoining the good and forbidding the bad, amr & nahy
34.3 Social change, taghyiir ijtima’e
34.4 Professional and Occupational Organizations, munadhamaat mihniyyat
34.5 Social Welfare and Disaster Relief Organizations, ‘awn ijtima’e & ighaathat
CURRICULUM FOR YEAR 5
THEME XVIII TAKWIIN al TABIIB (FORMATION OF THE PHYSICIAN)
MODULE 35.0: Basic Islamic Education
35.1 The Study Circle
35.2 Qur’an Study
35.3 Hadith Study
35.4 Ma’athuurat Study
35.5 Fiqh Study
MODULE 36.0: Motivation, Education, and Development
36.1 Concept and methods of motivation in Islam, al tahfiiz fi al islam
36.2 Medical education, al ta’aliim al tibbi
36.3 Personal Development, al tanmiyat al shakhsiyyat
36.4 Skill Development, tanmiyat al mahaaraat7
THEME XIX: QIYADAT (LEADERSHIP)
MODULE 37.0: Leadership Skills, mahaaraat al qiyadat
37.1 Leadership: Basic Characteristics, sifaat al qiyadat
37.2 Attributes and functions of leaders, sifaat wa masuliyaat al qaid
37.3 Disease of Leaders and Followers, amraadh al qiyaadat
37.4 Communication in leadership, fan al ittisaal fi al qiyaadat
37.5 Negotiation in leadership, fan al hiwaar fi al qiyadat
MODULE 38: Model Leaders
38.1 The Prophet, al rasuul
38.2 Righteous Khulafa, khulafa raashiduun
38.3 Political and Military Leaders, qiyadaat siyasiyyat wa ‘askariyyat
38.4 Social Role Models, qiyadaat ijtima’iyyat
38.5 Scholars and Reformers, ‘ulama wa muslihiin
THEME XX: IDAARAT (MANAGEMENT)
MODULE 39.0: Management Skills, mahaaraat al qiyaadat
39.1 Principles and Concepts of Management,
39.2 Strategy, al istratiijiyat
39.3 Planning and implementation, takhtiit wa tanfiidh al masharii’e
39.4 Control and Evaluation, al muraaqabat wa al taqwiim
39.5 Decision-making and problem-solving, al qaraaraat wa al mashaakil
MODULE 40.0: Resource Management
40.1 Time Management, idaarat al waqt
40.2 Financial Management, idaaral maal
40.3 Information Management, idaarat al ma’alumat
40.4 Organizational Management, idaarat al munadhamat
40.5 Personnel Management, idaarat al bashar
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© Professor Omar Hasan Kasule December 2006
© Professor Omar Hasan Kasule December 2006