A fatwa related to removing respirators from some patients, as well as stopping treatment of patients whose recovery is unfortunate, and about the ruling on performing surgery with poor success .. From Abdulaziz bin Abdullah bin Baz to the honorable brothers / Dr. Saleh Al-Olayani, a consultant newborn. Head of Neonatal Division Dr. Essam Al-Shail, Consultant Neurosurgery.
Dr. Abdel-Latif Rijal, a consultant neonatologist.
Doctors at King Faisal Specialist Hospital and Research Center. May God grant them success.
Peace be upon you and God''s mercy and blessings be upon you
I refer to your referendum dated 7/8/1419 AH. What was stated in it was: We now have the baby girl ... who is three months old, who was transferred to us from the yard due to her fracture in the cervical vertebrae of the spine during childbirth, and several medical examinations have proven that: The spinal cord is completely separated with the fifth cervical vertebra, and she also proved to be completely paralyzed, which includes diaphragm paralysis - which forced her to completely rely on a ventilator, and tests also proved: that her brain function was limited to the head area only, her case Discussed at the level of specialists in King Faisal Specialist Hospital, and also outside the kingdom, and the decision came unified, which is: the futility of surgical and medical intervention, and that it will remain on the ventilator until God wills, and its presence in central care occupies a bed, others need it And the specialist doctors considered: removing the resuscitation machines from them.
A: We advise you: if the reality is what you mentioned, then there is no objection to removing the resuscitation equipment from it, but it is necessary to wait long enough after removing the devices from them until the death is realized.
And I ask God to guide me and you to that which He loves and which pleases Him, and to help everyone to do all that is good, for He is Hearer and Near. Peace, mercy and blessings of God .
Lifting devices off the patient
Q: A Muslim girl from Indonesia had an accident in the car on 9/19/1993 AD, which led to her brain being shattered and her legs broken, and now she is in the hospital, and she is breathing through a device placed for her, and the doctors say: If this device is taken from her, she will die Immediately, and can not continue its life without putting this device. Note that the cost of treatment for one day is equivalent to twelve thousand Australian dollars, and she has no source to pay this amount. Is it legally permissible to withdraw this device? Please answer this question or direct it to the specialists.
A: And after studying the referendum, the committee replied: If the matter is as mentioned, there is no objection to removing the respiratory system from it, if two doctors or more have decided that it is in the judgment of the dead, but after removing the devices from it, it must wait for an appropriate period until its death is realized.
And God is the Grantor of success, and may God bless the Prophet Muhammad, his family and companions, and peace.
Ruling on removing the respiratory system from a patient who is terminally ill
Q: God Almighty had blessed me with a newborn on 2/16/1410 AH, but the power of the Almighty God caused that child to have a brain disease that doubled until it destroyed the breathing cells in the brain as they called the doctors, and I asked the doctors about the cause of that disease except They answered me: It is a normal condition, and it may provoke some cases, and unfortunately there is no treatment for such a case except God willing, and this is also what they reported to the doctors.
Honorable Sheikh: The child is under artificial respiration, and if he withdraws from that oxygen he will die after a period of ten minutes, and everything is in Allah''s hand and he has his knowledge, as it was reported to you: that the doctors in the hospital have allowed me to see this on the ground, and indeed they withdrew The child did not breathe oxygen at all, and when they returned the oxygen to him, he returned to life with an abnormal breathing.
The owner of the virtue, my question is: I tried to get the child out of the hospital on my responsibility, whether he lives or dies, but my fear that he will catch me a sin in taking him out and causing his death if God destined him to die. Or death or remains in the hospital under artificial respiration?
Honorable Sheikh, please advise me. May God reward you with the bearer of my message to you, a written statement. This and may God reward you with the best reward, for he is capable of everything and may God take care of you.
A: And after studying the referendum, the committee replied
That if the matter is as mentioned, then there is no objection to removing your child''s respiratory system if two doctors or more have decided that it is in the judgment of the dead, but it must be looked after removing it from him for an appropriate period until his death is realized.
And God is the Grantor of success, and may God bless the Prophet Muhammad, his family and companions, and peace.
The rule of resuscitation in the event of the death of the patient
It is not suitable for resuscitation or it is not treatable
Q: The explanation of the Islamic Awareness Officer at the Armed Forces Hospital in the Northwestern came to us on 3/13/1409 AH. Based on the letter of the Deputy Chief Physician of the Armed Forces Hospital in Northwestern, dated 3/12/1409 AH. And in which a fatwa is requested about the failure to implement the recovery measures in the points and circumstances mentioned in the work policy guide and the attached procedures, we hope that you will kindly take what you want to issue a fatwa permitting these points or not, and notifying us in light of that work according to it in the Forces Hospital Armed Northwestern. This, and God preserves you, and may God’s peace, mercy and blessings be upon you
This and the cases mentioned in the work policy and procedures guide are the following
First: If the patient arrives deceased.
Second: If the patient’s file is sealed with a sign: Resuscitation procedures are not performed based on the refusal of the patient or his representative in the event that the patient is not eligible for resuscitation.
Third: If three doctors decide: that it is inappropriate to resuscitate the patient when it is clear that he suffers from an incurable disease that is not treatable, and that death is certain.
Fourth: If the patient is in a state of definite mental or physical disability, or both, and in a state of mental lethargy with a chronic disease, such as: impotence-causing stroke, advanced cancer, severe chronic heart and lung disease, or wasting diseases and Repeated heart and lung stops.
Fifth: If the patient has evidence of intractable brain damage after suffering heart and lungs stopping for the first time.
Sixth: If cardiopulmonary resuscitation is not feasible and is not appropriate for a specific situation according to the opinion of the lecturing doctors, the patient''s self-opinion does not matter, and doctors are not obligated to perform CPR, and the patient''s family is not entitled to request this type of treatment if it is not Glory.
A: And after studying the referendum, the committee answered the following
First: If the patient arrives while he is dead, there is no need to use the resuscitation device.
Second: If the patient’s condition is not suitable for resuscitation, according to the report of three trusted specialist doctors, there is also no need to use resuscitation.
Third: If the patient’s disease is incurable and cannot be treated, and death is certain, according to the testimony of three specialist doctors, Al-Thiqab - there is also no need to use resuscitation.
Fourth: If the patient is in a state of disability, or in a state of mental lethargy with a chronic disease, or advanced cancer, or chronic heart and lung disease, with repeated cardiac and pulmonary stoppages, and three trustworthy specialist doctors decide - there is also no need to use resuscitation .
Fifthly: If the patient has evidence of brain damage that is difficult to treat, according to the report of three trusted specialist doctors - then there is no need to use a resuscitation device, because there is no benefit in that.
Sixth: If cardiopulmonary resuscitation is not feasible and is not appropriate for a specific situation according to the opinion of three trusted specialist doctors - there is no need to use resuscitation machines, and the opinion of the patient’s parents in placing or lifting resuscitation machines is not considered, because this is not within their competence.
And God is the Grantor of success, and may God bless the Prophet Muhammad, his family and companions, and peace.
Ruling on performing cardiopulmonary resuscitation procedures
In some hopeless cases
Praise be to God, and may blessings and peace be upon the Prophet after him, his family and companions, and after:
The Council of Senior Scholars in its forty-ninth session, held in Taif, starting from 4/4/1419 AH. Given in the book dated 9/4/1416 AH. From the head of the pediatric department at the College of Medicine in Abha affiliated to King Saud University, which includes six questions about the ruling on performing cardiopulmonary resuscitation procedures in some hopeless cases, including the text:
First: If the patient is severely disabled - such as: cerebral palsy - so that he does not rub his leg or hands, and suffers from severe mental retardation - and there is no hope of a cure, are three doctors entitled to make the decision not to perform resuscitation, knowing that he may live for years? But the same as before?
Second: If the doctors decided not to resuscitate in the previous case, and the parents refused to do so, then what is the ruling? And what is the judicial procedure if the parents complain to the doctors that they caused the death of the child?
Third: Is it permissible to prevent treatment - such as antibiotics - for a child who complains of severe weakness in the muscles of breathing, and there is no hope of recovery, and he often dies like him in the first months of his life, and the use of antibiotics may benefit temporarily, but it does not affect The final result ?
Fourth: Do doctors have the right to make a decision not to resuscitate in the first case, when the parents are not present and the patient is a minor?)
And he reviewed the report of the Minister of Health No. (9745/3796/26) on 7/28/1417 AH regarding the report of the medical committee in charge of discussing the issue of CPR for patients whose disease is desperate, upon the request of His Eminence, the Grand Mufti of the Kingdom of Saudi Arabia, Chairman of the Council of Senior Scholars By his book No. (3796/26) on 7/28/1417 AH.
After research and deliberation, the council decided the following
The answer to the first question: If three or more specialist doctors decide to remove the resuscitation equipment for the patient whose condition is described in the first question - then it is permissible to adopt what they decide to lift the resuscitation equipment, but it is not permissible to judge his death until he knows that by the visible signs of his death, but the death of the brain is not He depends on him to judge his death.
The answer to the second question: If specialized doctors decide to remove the devices in the case mentioned in the first question, he does not notice the parents ’opposition.
The answer to the third question: If the specialist thinks that the medicine will benefit the patient and not harm him or benefit him more than harm him, then it is prescribed for him to continue his treatment, even if the effect of the treatment is temporary, because God Almighty may benefit him with a continuous benefit, contrary to what doctors expect.
The answer t
