Q. Can Muslim patients take medicines which may contain alcohol or pig by- products?
A. No, Muslims should not take these medicines unless they are life saving drugs and no substitute is available.

Q. I am 3 months pregnant and doing fine. Can I fast during Ramadan?
A. It is preferable that you utilize God's granted exemption and do not fast. Your baby is dependent on you for his or her nutrition and hydration. Why do you want him or her to fast with you?

Q. Is use of placebos in clinical trial endorsed by Muslim Ethicists?
A. Yes, but make sure that the protocol is fully explained to the patient and by delaying the treatment, no worsening of his medical condition takes place nor his life is endangered.

Q. While fasting can a Muslim patient have a blood test (venous draw) or check his glucose with a finger stick?
A. Yes, if it is a medical necessity.

Q. While fasting can a Muslim patient take tablets, injections, inhalers or patches?
A. The general rules are:
(1) Sick patients are exempt from fasting.
(2) Any medicine of nutritional value or taken with water will break the fast.
(3) Patches and inhalers can be used.

Q. On Separation of conjoined twins, one dependent on the other, which one to save?
A. It is a difficult situation. The emphasis should be to save both lives and one cannot be sacrificed over the other. However, if one has to do so, the twin who cannot function on its own and acts as a vestigial organ of the other, may have to be sacrificed during the process of separation.

Q. Should a female patient only seek a female Gynecologist?
A. If available, same sex health care providers are encouraged but, if not available and in life saving situations, "necessity overrides the prohibition" - a rule of Islamic Sariah.

Q. Can a female Physician do genital/rectal examination of male patients?
A. Yes, but in the presence of a male nurse or male relative of the patient. The answer to the previous question also applies here.

Q. Should Muslim Physicians care for AIDS patients? Is this endorsing homosexuality?
A. We do not discriminate other patients because of their lifestyle (smokers, alcoholics, over eaters etc) nor should we do so for AIDS patients. We should care for them as we care for any patient, taking all the necessary precautions to protect ourselves. By the way, not all AIDS cases are due to homoxexuality.

Q. Should Muslim OB/GYN Physicians perform abortion, vasectomy or tubal ligation?
A. Such procedures are prohibited in Islam except to save the life of the mother. Thus, like Catholic Physicians, Muslim Physicians also may not perform them.

Q. We are getting married and can not afford to have children, as both of us are still students. What contraception measures are allowed?
A. All co ntraception measures between married couples for a valid reason and with consent of both are permitted if they are not irreversible (sterilization/tubal ligation), abortifacient ( RU 486, IUD ) or harmful ( oral contraceptives). That leaves only abstinence, condoms and the withdrawal method.

Q. My wife can not conceive. Can she use her ovum and my sperm to be fertilized in her sister's uterus?
A. No. Surrogacy is not permitted in Islam.

Q. We got married 3 months ago. My husband is in a coma after an auto accident and is expected to die soon. I love him very much. Can I save his sperm to have his baby after his death?
A. No. After his death, his sperm can not be used. All methods of assisted reproduction are allowed between husband and wife only during the intact span of marriage.

Q. I am pregnant and expecting delivery soon. Should I request my husband be present but no other male attendant during labor?
A. Yes. You can make such a request.

Q. My friend is in the hospital. He is to have a major operation and will require blood. Is blood transfusion allowed and should we select the donor?
A. Yes. Blood transfusion is allowed. Blood is routinely screened for HIV and other diseases. It would be nice if you could find a relative of your friend to match and donate his or her blood.

Q. At what stage of pregnancy does the termination become abortion, after 120 days or before?
A. According to Imam Ghazali School of Thought, to which I belong, life begins at conception, but other Islamic Jurists may have different opinions.

Q. Is post-mortem (autopsy) of a dead body allowed?
A. Yes, but only as a medical or legal necessity to ascertain the cause of death.

Q. What should be done to the products of miscarriage? Should they be destroyed or buried?
A. Preferably they should be handled with the same respect as another death and be buried if possible.

Q. After a massive brain hemorrhage, my mother is in a coma and is on artificial life support. Her Physician says there is no hope of her surviving and wants to pull the plug. We love her very much. What should we do?
A. Islam does not encourage prolonging misery in a vegetative state and patients should be allowed to die naturally when nothing more can be done. You should agree with the medical decision , maybe seek second opinion, but insist that hydration and nutrition be maintained.

Q. Question from a medical student: "As a Physician, when I find out that my patient has a terminal illness and will die very soon, should I tell the truth to my patient and his family as soon as I know it myself?
A. You should always tell the truth but do not be dogmatic about it. You can explain the diagnosis and natural history of the disease process but do not give a time limit as you do not know for sure when the patient will die.

Q. My grandfather never took care of his diabetes. Now he has developed gangrene in his foot. Doctors recommend amputation to save the rest of his leg. He refuses. What should we do?
A. You should talk to him again and again that God entrusted him with care of his body and if he does not do what Doctors recommend, his condition may worsen and he will be questioned about it on the day of judgement in addition to having additional suffering in this life.

Q. My sister, who is pregnant, found out the baby has the congenital defect, Down's syndrome. Should she abort the fetus or carry it to term and spend her life caring for a disabled child?
A. Carry to term. There is extra reward in going through this test from God in caring for such a child.

Q. For a patient who has cancer with bone metastasis and is in constant pain, is it better that he takes strong pain killers all the time or be in pain and remember God?
A. He should take pain killers as God does not want him to suffer. In severe pain he may not have the strength to remember God.

Q. I am on a heart transplant waiting list. Should I accept a heart from a criminal or an atheist?
A. Yes, and pray that God changes your new heart to adopt it to your pious body.

Q. Should the pregnancy resulting from rape be continued to term or aborted?
A. Carried to term unless the life of the mother is in danger. Why commit another crime?

Q. Is patient's autonomy (i.e. right to not seek treatment) equal to planned suicide? If so, should it be allowed?
A. Patient's autonomy involves a sound mind while suicide decision is made in severe depression. One can refuse treatment because of side effects, but to kill yourself is against the will of God.

Q. I am a Muslim female medical student who does hijab (head cover). How can I scrub before surgery without removing my head cover and pulling up sleeves?
A. You should do Masah (wadu) over the head cover, or remove in the presence of a female co-worker only.

Q. Is gene therapy and genetic manipulation to cure diseases allowed? Can we use embryonic stem cells for this?
A. To seek cure for a disease is mandatory. Thus, gene therapy is allowed and stem cells from spontaneously miscarried embryos can be used. However, it is wrong to conceive or create an embryo just to harvest cells and then destroy it.

Selected Readings

1. Holy Quran - Yusuf Ali Translation - Amana Publication, MD
2. Sahih - AL - Bukhari - Arabic - English (Dr. M M Khan) Dar al Arabia - Beirut
3. Hassan Hathout, Islamic Perspective in OB/GYN - out of Print 1986
4. Hassan Hathout "Thus Shall I Stand Before God" - ATP-Indianapolis, 2000
5. Hassan Hathout "Reading the Muslim Mind" - ATP-Indianapolis, 1994
6. Athar, Shahid "Islamic Perspective in Medicine" - ATP-Indianapolis, 1993
7. Athar, Shahid "Health Concerns for Believers" - Kazi Publication, Chicago, 1995
8. AFM Ebrahim, BioMedical Issues in Islamic Perspective-Open Press-Ontario, 1993
9. AFM Ebrahim, Abortion, Birth Control and Surrogate Parenting -ATP-Indianapolis, 1993
10. Fazlur Rahman, "Health and Medicine - Islamic Tradition Crossroad-N.Y., 1987
11. AMA, Code of Medical Ethics, 1997
12. R.H. Williams " To Live and To Die" - Springer-Verlag, 1973
13. Ted Peters " Playing God" - Routledge, 1997
14. Islamic Code of Medical Ethics - Kuwait-Document by International Organization of Islamic Medicine.

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