Sunday, January 15, 2012

Life with Respirator? the Reality & the rights under Shari'ah

There may be a question arising, for instance, if a person is admitted to a hospital with an unconscious life threatening condition at 9:00 a.m. The doctor in charge confirms an hour later at 10:00 a.m that, the patient may no longer survive naturally with heart and breathing functions, unless a respirator (life support machine) is administered to the patient.  15 minutes later, the respirator is set up, which subsequently prolongs the heart and breathing functions of the patient. Upon knowing the patient’s critical condition, one of his (the patient) heirs goes to visit him and on the way he meets an accident at 11:00 a.m, and dies on the spot, while the patient is still breathing with the life support machine.

The issue here, the patient in the said- example, could have naturally died (according to the doctor’s presumption) between 10:00 a.m and 10:15 a.m, but because of the life support machine the patient’s heart and breathing functions were sustained for a longer period. If we consider the death of the patient a natural one, then it could be concluded that, the actual death of the patient took place earlier than the death (at 11:00 a.m) of his heir and therefore, the heir shall hold a property right or insurable interest over the deceased’s wealth, since the heir was alive at the time of the death of the patient. But, if we consider the heart and breathing functions of the patient sustained through the artificial method (respirator), then we may conclude in the above example that, the death of the heir took place during the life time of the patient, since the patient was still breathing when the heir died in the accident and, therefore the heir may not have beneficial interest over the deceased’s wealth, since the heir was not alive during the lifetime of the patient. What could be the solution to the conflict of methods (in the above example) in determining the actual moment of death of both the deceased and his heir?

It was a classical understanding that, one’s death could be confirmed only when his / her breathing and heart functions ceased. The death of the brain is the final test of one’s death.  Because of rapid advancement of technology, one’s brain alive with heart and breathing functions, may be sustained artificially through a ventilator or respirator (life support machine), which enables a patient remains alive (with breathing and heart functions only) for a longer period  than what might otherwise occur naturally.

It is, therefore submitted that, the presumption of one’s death would take effect only when the death of one’s brain (without breathing and heart functions is confirmed, regardless of whether one’s brain death occurs naturally or its (death) occurrence is delayed due to the aid of a respirator.

This is because, the life and death of the creature are in the hands of almighty Allah (s.w.t.), who is the most powerful and knowledgeable as to the soul's functions of his creatures. Even though a respirator assists a patient to sustain the heart and breathing functions a longer period, it is a mere mediating cause, which has no power to guarantee one’s actual life. This is indicated in the words of Allah (s.w.t.):

إن الله عنده علم الساعة وينزل الغيث ويعلم ما في الأرحام وما تدري نفس ما ذا تكسب غدا وما تدري نفس بأي أرض تموت إن الله عليم خبير 

 “Verily the knowledge of the hour is with Allah (alone). It is He who sends down rain, and He who knows what is in the wombs. Nor does anyone know what it is that he will earn on tomorrow; nor does anyone know in what land he is to die. Verily with Allah is full knowledge and He is acquainted with all things.”

Relying on this analysis it may be remarked that, one’s life would be presumed during the time his / her brain is alive (with breathing and heart functions), regardless of whether one is able to maintain these two elements (breathing and heart functions) naturally or through an artificial method (respirator).

Therefore, the determination of the property right or insurable interest of a heir in the above example depends on the moment when the brain death (without breathing and heart functions) of the deceased has actually occurred. If, therefore, the brain death of the deceased occurs earlier than the death of the heir, then the heir in such a situation, may have beneficial interest, but if the heir's death occurs earlier than the deceased’s brain death, the heir may lose the right of beneficial interest over the deceased wealth, in which situation, the benefits over the wealth would be distributed among the existing beneficiaries accordingly (Faraidh).

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