veiled4allah: some Islamic views on removing life support

Although most Muslim scholars believe that euthanasia in the form of actively helping a person to die is religiously forbidden in Islam, many of them distinguish between that and removing an artificial means of sustaining life. Here are some views on this issue that I found.

Muzammil Siddiqui of the Fiqh Council of North America:

If, however, a number of medical experts determine that a patient is in a terminal condition, there is no hope for his/her recovery and all medication has become useless, then it could be permissible for them, through a collective decision, to stop the medication. If the patient is on life support, it may be permissible, with due consultation and care, to decide to switch off the life support machine and let nature take its own time. Under no condition it is permissible to induce death. As long as a person is alive, it is his/her right to be fed. Medical experts and relatives should not withhold nutrition from a living person. They should do their best to provide him/her with necessary nutrition by whatever method is possible.

Also:

Life support is a method for the treatment of a patient. If a patient is in a condition where the artificial life support can help improve his/her condition, then it should be used. However, if a group of doctors determine that there was no hope of any improvement in the condition of the patient or if the patient became brain-dead. In that case, if the doctors and the family members agree to take the patient off of the life support, then it can be removed. We should let nature take its own course and allow the person to expire according to their determined time by Allah.

European Council for Fatwa and Research:

As for facilitating death by withdrawing artificial resuscitating apparatus from the patient who is clinically regarded as "dead" or "practically dead" because of the damage to the brainstem or brain, with which human beings live and feel; if the action of the physician is merely stopping the treatment instruments, it will be no more than giving up the treatment, in which case his action is legal and permissible, bearing in mind that these instruments can preserve the apparent life of the patient - represented by breathing and circulation - though the patient is actually dead, for he cannot conceive, feel or be sensitive to anything because of the damage of the source of all that, namely the brain. Keeping the patient in that state would waste vital resources and would prevent other maybe curable patients from benefiting from the instruments being occupied for the practically dead patient.

Yusuf Qaradawi:

As for the suspension of medical treatment via preventing the patient from his due medication which is, from a medical perspective, thought to be useless, this is permissible and sometimes it is even recommended. Thus, the physician can do this for the sake of the patient's comfort and the relief of his family. Nothing is wrong in this, Insha' Allah (Allah willing)... ...But in cases when sickness gets out of hand, and recovery happens to be tied to miracle, in addition to ever-increasing pain, no one can say treatment then is obligatory or even recommended. Thus, the physician's act of stopping medication, which happens to be of no use, in this case may be justified, as it helps in mitigating some negative effects of medications, and it enhances death. But it's different from the controversial "Mercy Killing" as it does not imply a positive action on the part of the physician; rather, it is some sort of leaving what is not obligatory or recommended, and thus entails no responsibility.

To conclude, the physician can practice this for the sake of the patient's comfort and the relief of his family. Nothing is wrong in this, Insha' Allah.

If a patient is medically presumed dead through what is known as brain death, in the sense that he no longer has any feelings, switching off the life support may be permissible, with due consultation and care, especially when it's clear that the life support machine becomes of no use for the already-dead patient.

Pakistani scholar Moiz Amjad:

If a person can live only with the aid of artificial means, removing these artificial means, at the risk of the death of the individual, is not taking life - it is simply not sustaining it. Thus, if euthanasia means to stop sustaining life that can only be sustained through artificial means, then there is nothing wrong with it.

Abdul-Aziz Sachedina:

Similarly, in relation to withdrawing treatment, whether pursuant to a refusal of a death-delaying treatment or through a mutual and informed decision-making by patient, physician and other parties involved in providing care for the patient, although there is an intention to allow the person to die when it is certain that death will result from its omission, Islamic law regards it a non-culpable act. The reason is that delaying the inevitable death of the patient through life-sustaining treatment is regarded as being against the benefit of the patient. Moreover, the principle of `juristic preference' (istihsan=`to deem something preferable') protects the physician by authorizing departure from the already established ruling about the prohibition of allowing death to occur in order to avoid any rigidity and unfairness in recognizing the incurable preexisting conditions of the patient. Furthermore, by authorizing the removal of life-sustaining treatment in cases where it results merely in death-delaying procedure, the `juristic preference' serves the ideals of justice and public interest in a better way. In other words, enforcing the existing prohibition against allowing the patient to die could prove to be detrimental in certain situations, and a departure from it may be the only way of attaining a fair solution to a particular problem. Withdrawal of life-sustaining treatments in such cases is regarded as allowing inevitable death to take its natural course. Notwithstanding a fine line between having and not having an intention to cause the death in such omissions, Islamic law does not forbid withdrawal of the futile and disproportional treatment on the basis of the consent of the immediate family members who act upon the professional advice of the physician in charge of the case. Some Muslim jurists have recognized the validity of a competent patient's informed refusal of treatment or "advance directives" which allow the person to die under circumstances when there is no medical reason to continue treatment. However, even in such rare recognition of the patient's autonomy in Muslim culture, the law actually takes into consideration the patient's long term treatment relationship with a physician whose opinion, in the final analysis, serves as the grounds for turning off the respirator, for example. In this case, the death is regarded to have been caused by the person's underlying disease rather than the intentional act of turning off the respirator. The underlying principle in this ruling is that intention alone does not make an act culpable. The person's death is actually caused by the preexisting disease when the withdrawal of the treatment is justified through the expert opinion. In other words, the law does not regard withdrawal of the treatment as the cause of the person's death. This can be compared with giving a person a lethal injection. The injection is the sole cause of the person's death and is clearly regarded as the cause of this in fact and in law by Muslim jurists.

To the best of my understanding, this is the situation that Terri Schiavo is in; she has no higher brain function because the part of her brain that controls it has turned to fluid, and she is unable even to swallow food or water on her own so that artificial means of feeding her must be used. According to these scholars, to cease artificially sustaining life when there is no hope of recovery is permissible and may indeed be better for the patient and their family.

And Allah SWT knows best.

Added: I've added an additional quote above, from Sachedina. I found this via a post at alt.muslim, which notes that spokesmen for Muslim groups are failing to accurately convey the views of actual scholars on the issue but may be speaking from their own opinions.