Lecture for medical students in the Medicine
block King Fahad Medical City Riyadh on October 15, 2014
DEFINITION OF QUALITY OF LIFE
· Human life must
have some quality. It is not enough to eat and breathe or maintain the
vegetative functions only. A human cannot live like a plant or an animal.
·
The physical
criteria are: absence of disease, comfortable environment, and basic
necessities.
·
The mental
criteria are: calmness, absence of neurosis and anxiety, and purposive life.
·
The spiritual
criteria are mainly correct relation with the creator.
QUALITY OF LIFE and BIOTECHNOLOGY 1
·
Issues of
quality of life have been raised in the recent past because of advances in
terminal disease care and the stresses of technological development. Many
patients who used to die of cancer and other debilitating diseases can now
survive.
·
Both the
disease and its treatment cause considerable changes to their lifestyle. The
life under these debilitating conditions is of low quality. Both the original
disease and the treatment contribute to this low quality; the treatment in some
cases has a more contribution.
QUALITY OF LIFE and BIOTECHNOLOGY 2
·
Specialized
methods have been developed to be able to assess the quality of this life
empirically. These indices take into considerations performance status on
physical tasks in addition to social or psychological parameters.
·
Industrial
society has given rise to environmental pollution and mental stress that affect
the quality of life. Decision-making on allocation of health care resources
depends on quality of life assessment.
TRADITIONAL MEASURES OF QUALITY OF LIFE
·
Traditional
measures of the quality of life use anatomical, chemical, and physiological
indices. They indicate general goals and are not good measures of actual
quality of life. Their interpretation is often subjective.
·
In cancer
patients physical, psychosocial and general assessments are made with reference
to activities of daily living (ADL).
·
Among
traditional indices used are: survival duration, impairments (signs,
self-reported disease, physiological measurements, tissue alterations, and
diagnosis), and functional status (physical, psychological, and social).
NEW MEASURES OF QUALITY OF LIFE 1
·
The new QOL
indices are predictors of the goals. They are based on instruments that are
validated and whose reliability is tested empirically. Some are general whereas
others are specific. Assessment of QOL may be by indices or by profiles;
indices being more popular.
·
The indices are
standardized but it must be remembered that each individual is unique.
NEW MEASURES OF QUALITY OF LIFE 2
The indices
used in clinical trials and clinical practice include.
·
McMaster Health
Index Questionnaire: physical, social, and emotional parameters
·
Index of
Health-related Quality of Life: physical, psychological, and social adjustment
·
Euroqol Quality
Life Index: mobility, self-care, usual activities, pain/discomfort,
anxiety/depression parameters
·
World Health
Organization Health-related Quality of Life (WHOQOL) is being developed.
NEW MEASURES OF QUALITY OF LIFE 3
The commonest
profiles of QOL used in clinical practice are:
·
Quality of
Well-being Index: combines morbidity and mortality parameters
·
Sickness Impact
Profile: physical and psychological dimensions
·
Nottingham
Health Profile: perceived health status with no direct questions on health
TOWARD AN ISLAMIC QOL INDEX
·
The definition
and use of QOL indices reflects the cultural and philosophical background as
well as the worldview of the Judeo-Christian and Greco-roman traditions.
·
Islam being a
separate civilization has its own world view and this affects the formulation
of QOL indices.
·
Unfortunately
Muslims have not yet worked on defining QOL from the Islamic context.
VALUE OF LIFE
·
Life as a gift
·
The right to
life
·
Sanctity of
life
·
Material worth
of life
·
Moral worth of
life
LIFE AS A GIFT 1
·
Human life is a
gift from Allah, ni’imat al hayat[1]. Humans must be grateful to Allah
for the gift of life by worshipping Him, ibadat[2]
·
The gift of
life can be appreciated from several vantage points: statistical probability,
good health, sustenance, and social relations.
·
The statistical
probability of being alive is low. Those who have life are a select few. A
fertilized ovum that eventually grows into a human being is a very small
statistical probability. One male ejaculate has millions of sperms and only one
of them succeeds in fertilizing the female ovum. In many cases fertilized ova
do not grow into fetuses but are aborted early.
LIFE AS A GIFT 2
·
The prophet
said that good health, sihhat, and well-being, ‘aafiyat, are two
bounties that many people do not enjoy[3]. Few people are healthy in all their
organs and at all times.
·
Allah gives
humans the gift of life and also gives them sustenance, rizq, is a
manifestation of the continuation of rububiyat.
·
Social aspects
of life as a gift can be visualized in the form of offspring, relatives and
spouses. Children are a bounty to parents, ni'mat al dhurtiyat[4].
Relatives in the extended family are a source of psychological support. Spouses
give both psychological and physical comfort[5].
THE RIGHT TO LIFE
·
Each human has
an inalienable right to life from Allah, haqq al hayat. This life cannot be
taken away or impaired by any human being except in cases of judicial execution
after due process of the law.
·
The laws of
marriage ensure that every child is born in a family in order to get physical
protection.
·
Nafaqat is
compulsory for a pregnant and nursing woman even if divorced to ensure proper
nutrition for the fetus and later infant.
·
Breast-feeding
is obligatory for the first 2 years of life. Feticide, infanticide, and
homicide are prohibited to protect life.
SANCTITY OF LIFE
·
Life is sacred.
The sanctity of life, hurmat al nafs is guaranteed by the Qur’an[6]. The
life of each single individual whatever be his or her age, social status or
state of health is important and is as equally important as the life of any
other human[7].
·
Protection of
life, ‘ismat al hayat/hifdh al nafs, is the second most important purpose of the shariat
coming second only to the protection of the diin. It has priority
over any other mundane consideration.
·
Because of its
importance some jurists have put it in the first position above hifdh al
diin because diin cannot survive in the absence of life.
MATERIAL WORTH OF LIFE
·
No material
value can be put on human life.
·
Legal
compensation for bodily damage or homicide is replacement of lost earnings and
not paying for the value of life.
·
The
compensation is a legal provision to provide sustenance to surviving relatives
in case of death. It also provides sustenance to the person whose organ was
severed and therefore cannot work to support himself.
MORAL WORTH OF LIFE
·
Every life is
as important as any other life.
·
Destroying the
life of one person is equivalent to destroying the life of all humans[8].
REFERENCES
[1] (16:78, 67:23)
[2] (2:21-22)
[3] (Bukhari K81 B1,
Tirmidhi K24 B1, Ibn Majah K37 B15, Darimi K20 B2)
[4] (3;38, 6:84, 14:39,
19:5-7, 19:19, 21:72, 21:90, 25:74, 29:27, 38:30, 42:49)
[5] (7:189, 30:21)
[6] (2:84-85, 4:29,
5:32, 6:151, 17:33, 18:74, 25:68)
[7] (5:32)
[8] (5:32)
