Aligning Medical and Muslim Morality: An Islamic Bioethical Approach to Applying and Rationing Life Sustaining Ventilators in the COVID-19 Pandemic Era

Aasim I Padela,Asim Yusuf,Mansur Ali

doi:10.1163/24685542-12340061

Abstract

Abstract The COVID-19 pandemic has spurred policymakers and religious leaders to revisit age-old questions about the ethics of pandemic control, the just allocation of scarce resources, and preparing for death. We add to these conversations by discussing the use of mechanical ventilation for COVID-19 patients. Specifically, we address the following: For Muslim patients/families when is it permissible to forgo mechanical ventilation? For Muslim clinicians, what circumstances justify the withholding or withdrawing of mechanical ventilation from patients? And for policymakers, is there an Islamically-justifiable rubric for allocating mechanical ventilation to patients in times of scarcity? Our Islamic bioethical analyses connect biostatistical data and social contexts with ethico-legal constructs to bridge the epistemic theories of biomedicine and the Islamic legal tradition. They reveal that forgoing mechanical ventilation is permissible for Muslims, that there are several conditions that allow for Muslim clinicians to justify withholding and withdrawing mechanical ventilation, and also several policy rubrics for ventilator allocation that would be justifiable.

Highlights

After the year 2020 was rung in, the COVID-19 virus spread beyond China to become a global health issue
Observing social norms in different Muslim lands leads to the conclusion that there is no unified Muslim practice (Anjum 2007; Geertz 1971). Recognizing this inherent plurality and multiplicity to Islamic/Muslim ethical discourse, we offer an Islamic moral perspective on three practical ethics questions related to COVID-19 and end-oflife care
We will address the following three questions: At the Muslim patient-level, is it morally permissible to forgo mechanical ventilation and associated therapies when stricken with COVID-19? At the Muslim clinician/hospital-level, under what conditions is it morally justified to withhold mechanical ventilation and associated therapies from COVID-19 patients? And at the state policy-level, what is a justifiable rubric by which to allocate mechanical ventilation and associated therapies to patients in times of COVID19 scarcity? We will address these questions by drawing on Sunnī uṣūl al-fiqh frameworks

Summary

Introduction

After the year 2020 was rung in, the COVID-19 virus spread beyond China to become a global health issue. We will address the following three questions: At the Muslim patient-level, is it morally permissible to forgo mechanical ventilation and associated therapies when stricken with COVID-19? At the Muslim clinician/hospital-level, under what conditions is it morally justified to withhold mechanical ventilation and associated therapies from COVID-19 patients?

Results

Conclusion