Social Responsibility and the State's Duty to provide Healthcare: An Islamic Ethico‐Legal Perspective

The United Nations Educational, Scientific and Cultural Organization's (UNESCO) Declaration on Bioethics and Human Rights asserts that governments are morally obliged to promote health and to provide access to quality healthcare, essential medicines and adequate nutrition and water to all members of society. According to UNESCO, this obligation is grounded in a moral commitment to promoting fundamental human rights and emerges from the principle of social responsibility. Yet in an era of ethical pluralism and contentions over the universality of human rights conventions, the extent to which the UNESCO Declaration can motivate behaviors and policies rests, at least in part, upon accepting the moral arguments it makes. In this essay I reflect on a state's moral obligation to provide healthcare from the perspective of Islamic moral theology and law. I examine how Islamic ethico‐legal conceptual analogues for human rights and communal responsibility, ?uqūq al‐’ibād and far? al‐kifāyah and other related constructs might be used to advance a moral argument for healthcare provision by the state. Moving from theory to application, I next illustrate how notions of human rights and social responsibility were used by Muslim stakeholders to buttress moral arguments to support American healthcare reform. In this way, the paper advance discourses on a universal bioethics and common morality by bringing into view the concordances and discordances between Islamic ethico‐legal constructs and moral arguments advanced by transnational health policy advocates. It also provides insight into applied Islamic bioethics by demonstrating how Islamic ethico‐legal values might inform the discursive outputs of Muslim organizations.     

WHAT DO ISLAMIC INSTITUTIONAL FATWAS SAY ABOUT MEDICAL AND RESEARCH CONFIDENTIALITY AND BREACH OF CONFIDENTIALITY?

Protecting confidentiality is an essential value in all human relationships, no less in medical practice and research.(1) Doctor-patient and researcher-participant relationships are built on trust and on the understanding those patients' secrets will not be disclosed.(2) However, this confidentiality can be breached in some situations where it is necessary to meet a strong conflicting duty.(3) Confidentiality, in a general sense, has received much interest in Islamic resources including the Qur'an, Sunnah and juristic writings. However, medical and research confidentiality have not been explored deeply. There are few fatwas about the issue, despite an increased effort by both individuals and Islamic medical organizations to use these institutional fatwas in their research. Infringements on confidentiality make up a significant portion of institutional fatwas, yet they have never been thoroughly investigated. Moreover, the efforts of organizations and authors in this regard still require further exploration, especially on the issue of research confidentiality. In this article, we explore medical and research confidentiality and potential conflicts with this practice as a result of fatwas released by international, regional, and national Islamic Sunni juristic councils. We discuss how these fatwas affect research and publication by Muslim doctors, researchers, and Islamic medical organizations. We argue that more specialized fatwas are needed to clarify Islamic juristic views about medical and research confidentiality, especially the circumstances in which infringements on this confidentiality are justified.     

THE ONGOING CHARITY OF ORGAN DONATION. CONTEMPORARY ENGLISH SUNNI FATWAS ON ORGAN DONATION AND BLOOD TRANSFUSION

Background: Empirical studies in Muslim communities on organ donation and blood transfusion show that Muslim counsellors play an important role in the decision process. Despite the emerging importance of online English Sunni fatwas, these fatwas on organ donation and blood transfusion have hardly been studied, thus creating a gap in our knowledge of contemporary Islamic views on the subject. Method: We analysed 70 English Sunni e‐fatwas and subjected them to an in‐depth text analysis in order to reveal the key concepts in the Islamic ethical framework regarding organ donation and blood transfusion. Results: All 70 fatwas allow for organ donation and blood transfusion. Autotransplantation is no problem at all if done for medical reasons. Allotransplantation, both from a living and a dead donor, appears to be possible though only in quite restricted ways. Xenotransplantation is less often mentioned but can be allowed in case of necessity. Transplantation in general is seen as an ongoing form of charity. Nearly half of the fatwas allowing blood transfusion do so without mentioning any restriction or problem whatsoever. The other half of the fatwas on transfusion contain the same conditional approval as found in the arguments pro organ transplantation. Conclusion: Our findings are very much in line with the international literature on the subject. We found two new elements: debates on the definition of the moment of death are hardly mentioned in the English Sunni fatwas and organ donation and blood transfusion are presented as an ongoing form of charity.     

On the Islamic authority of the Indonesian state: responsibility,suspicion, and acts of compliance

This article examines how the Indonesian state's efforts to style itself as an Islamic authority have influenced the behaviour of its Muslim citizens. I present cases in which Muslims in Indonesia's Riau Islands comply with Islamic state directives in order to transfer responsibility for their actions to the state, showing how such a mode of practice can support Islamic governmentality, bolster nationalism, and constrain civic activism. Interestingly, compliance may occur even when citizens harbour deep misgivings towards a directive, leading me to query whether suspicion is necessarily inimical to authority. I conclude that a pronouncement's Islamic authority hinges on how Muslims relate to their suspicions regarding it, and that, for Riau Islanders, suspicion's urgency has been tempered by cultural models of personhood, individual subjectivity, and the moral murk of post‐Suharto Indonesia.     

Reexamining the Prohibition of Gestational Surrogacy in Sunni Islam

Advances in reproductive medicine have provided new, and much needed, hope for millions of people struggling with infertility. Gestational surrogacy is one such development that has been gaining popularity with infertile couples, especially those unable to benefit from other reproductive procedures such as In Vitro Fertilization. For many Muslim couples, however, surrogacy remains a nonviable option. Islamic scholars have deemed the procedure incompatible with Islam and have prohibited its use. This paper examines the arguments presented for proscribing surrogacy arrangements in Sunni Islam in particular. These include preservation of lineage, exclusion of third parties in reproduction, upholding the rights of the child, and protection from the negative effects of surrogacy arrangements. The rationales for banning surrogacy are subsequently refuted utilizing Islamic law “Sharia”, bioethics, and medical evidence. The paper also presents reasons for why surrogacy is not only consistent with Sunni Islamic teachings, but is also both ethically justified and medically necessary. Lastly, Islamic scholars are urged to take into account the arguments presented in this paper and reconsider their rulings on the permissibility of surrogacy.     

Organ transplantation: contemporary Sunni Muslim legal and ethical perspectives

The problems that organ transplantation poses to the Muslim mind may be summarized as follows: firstly, a Muslim believes that whatever he owns or possesses has been given to him as an amanah (trust) from Allah. Would it not be a breach of trust to give consent for the removal of parts of one's body, while still alive, for transplantation to benefit one's child, sibling or parent? Secondly, the Shari'ah (Islamic Law) emphasizes the sacredness of the human body. Would it not then be an act of aggression against the human body, tantamount to its mutilation, if organs were to be removed after death for the purpose of transplantation? In this paper I attempt to illustrate how the Muslim jurists have tried to resolve the dilemma of Muslims by providing them with certain guidelines based on the original sources of Islam, namely, the Qur'an and the Prophetic tradition. In order to assist the followers of other religious traditions to grasp the gravity of the problem posed by organ transplantation to the Muslim mind, I begin by discussing the opinions of Muslim jurists on the issue of utilization of human parts. Thereafter, I touch upon the resolutions taken by the various Islamic Juridical Academies on the issue in question. Finally, I shed light upon the inclusion of organ donation in a Muslim Will and the enforceable nature of such a will.     

Islamic preaching and women’s spectatorship in West Java

In the urban villages of Bandung, the capital city of the Indonesian province of West Java, many Muslim women routinely attend between four and six oratorical and/or pedagogical events per week. This article analyses this participation by observing the forms and patterns of these women’s spectatorship, specifically observing their mobility, the interaction between their life‐cycles and their participation habits, the gendered embodiment of Islamic knowledge they display, the effect of hegemonic masculinities, and preaching performances which treat them not only as Muslims intent on increasing their Islamic knowledge, but also as pleasure‐taking subjects. The article concludes that the conduct and management of preaching events intended for mixed audiences are highly sensitive to women’s spectatorship and warns against the assumption that Islamic practice is a punishing sphere of patriarchy. In fact, when the influence of women’s spectatorship on the conduct and management of such preaching events is appreciated, West Java’s preaching events appear as a feminised domain.     

Ritual Efflorescences in a Sri Lankan Muslim community: The interplay of local,national and pan‐Islamic identities

This article examines the interplay of local, national, and international historical and contemporary processes as manifested in a Sri Lankan Muslim village festival. The author shows that the festival is a product of the historical isolation of the village and its attempt to establish a distinct Muslim social identity. In contemporary Sri Lanka a separate Muslim identity is no longer in doubt and the festival has become a focal event for competing and, potentially, mutually exclusive social identities as exemplified by Sufism, Sri Lankan nationalism, and pan‐Islamic fundamentalism.     

Muslim Youth in Canadian Schools: Education and the Politics of Religious Identity

This article provides an ethnographic analysis of the schooling experiences of Muslim youth in Canada who are committed to maintaining an Islamic lifestyle despite the pressures of conformity to the dominant culture. Little attention has been paid to how religious identity intersects with other forms of social difference, such as race and gender in the schooling experiences of minoritized youth. Using a case study often Muslim students and parents, this article demonstrates how Muslim students were able to negotiate and maintain their religious identities within secular public schools. The participants' narratives address the challenges of peer pressure, racism, and Islamophobia. Their stories reveal how Muslim students are located at the nexus of social difference based on their race, gender, and religious identity. The discussion further explores the dynamics through which these youth were able to negotiate the continuity of their Islamic identity and practices within schools despite the challenges that they faced. Building upon existing theories of identity maintenance and construction, this research demonstrates how the interplay of the core factors of ambivalence, role performance, and interaction and isolation are implicated in the way Muslim students negotiate the politics of religious identity in their schooling experiences.     

A veil (hijab) as a public symbol of a Muslim woman modern identity

In this article the author explains the social role of Muslim woman in a postmodern society through a public symbol of her identity--the veil. The article's thesis is that the Muslim women's manifestation of their Islamic denomination through veiling and wearing appropriate clothes (in the case of men through growing beards and wearing clothes considered appropriate for them) signifies an expression of a new, Islamic shaped identity. This is a postmodern identity based on modernity rather than a fundamental reaction to modernity. The veil, a public symbol of Muslim identity, is often given a different meaning by its observers than the person actually wearing it. Therefore, the intention of this article is to analyze the elements of a particular, postmodern identity that a Muslim woman's veil, as a public symbol, represents.     

‘Minority’ as a sociological concept

This article considers how a Muslim cultural discourse of ‘propriety’ has influenced Muslim Arab Sudanese ethnic identity in two locations and time periods in an expanding diaspora. Focusing in particular on women and their embodied practices of whitening and propriety in Egypt in the nineties and the United Kingdom a decade later, I argue that the recent turn towards Muslim expressions of Sudaneseness is a form of resistance to racial labelling. While Sudanese have rejected being labelled ‘black’ in Egypt and in the UK, their renegotiation of a Muslim religious identity in the diaspora nevertheless confirms a racialized Sudanese ethnicity. This study contributes to the rethinking of ethnicity in a transnational space where ethnic nationalism and globalized Islamic discourse intersect with local histories and hierarchies of race and gender.     

ORGAN TRANSPLANTATION: CONTEMPORARY SUNNI MUSLIM LEGAL AND ETHICAL PERSPECTIVES

The problems that organ transplantation poses to the Muslim mind may be summarized as follows: firstly, a muslim believes that whatever he owns or possesses has been given to him as an amānah (trust) from Alla¯h. Would it not be a breach of trust to give consent for the removal of parts of one's body, while still alive, for transplantation to benefit one's child, sibling or parent? Secondly, the Sharā'ah (Islamic Law) emphasizes the sacredness of the human body. Would it not then be an act of aggression against the human body, tantamount to its mutilation, if organs were to be removed after death for the purpose of transplantation? In this paper I attempt to illustrate how the Muslim jurists have tried to resolve the dilemma of Muslims by providing them with certain guidlines based on the original sources of Islam, namely, the Qur'n and the Prophetic tradition. In order to assist the followers of other religious traditions to grasp the gravity of the problem posed by organ transplantation to the Muslim mind, I begin by discussing the opinions of Muslim jurists on the issue of utilization of human parts. Thereafter, I touch upon the resolutions taken by the various Islamic Juridical Academies on the issue in question. Finally, I shed light upon the inclusion of organ donation in a Muslim Will and the enforceable nature of such a will     

Milk banks through the lens of Muslim scholars: one text in two contexts

When Muslims thought of establishing milk banks, religious reservations were raised. These reservations were based on the concept that women's milk creates 'milk kinship' believed to impede marriage in Islamic Law. This type of kinship is, however, a distinctive phenomenon of Arab tradition and relatively unknown in Western cultures. This article is a pioneer study which fathoms out the contemporary discussions of Muslim scholars on this issue. The main focus here is a religious guideline (fatwa) issued in 1983, referred to in this article as 'one text', by the Egyptian scholar Yūsuf al-Qaradāwī who saw no religious problem in establishing or using these banks. After a number of introductory remarks on the 'Western' phenomenon of milk banks and the 'Islamic' phenomenon of 'milk kinship', this article analyses the fatwa of al-Qaradāwī 'one text' and investigates the 'two contexts' in which this fatwa was discussed, namely, the context of the Muslim world and that of Muslim minorities living in the West. The first context led to rejecting the fatwa and refusing to introduce the milk banking system in the Muslim world. The second context led to accepting this system and thus allowing Muslims living in the West to donate and receive milk from these banks. Besides its relevance to specialists in the fields of Islamic studies, anthropology and medical ethics, this article will also be helpful to physicians and nurses who deal with patients of Islamic background.     

Dream narratives of Muslims' martyrdom: Constant and changing roles past and present.

Dreams of martyrdom experienced by alleged Muslim martyrs, their families, and friends are considered highly significant within Muslim societies. They are frequently understood as God-given veridical dreams that can show the true status of the martyr and predict the future. The author examined the narratives of these dreams in both early Islamic and contemporary sources and explored the roles that they have played, whether ongoing and constant or changing in response to new conditions. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The balancing of virtues—Muslim perspectives on palliative and end of life care: Empirical research analysing the perspectives of service users and providers

In this paper, I will share findings from a qualitative study that offers a thematic analysis of 76 interviews with Muslim patients and families as well as doctors, nurses, allied health professionals, chaplains and community faith leaders across the United Kingdom. The data show that for many Muslims, Islam—its texts and lived practice—is of central importance when they are deliberating about death and dying . Central to these deliberations are virtues rooted within Islamic theology and ethics, the traditions of adab (virtue) and aqhlaq (proper conduct). Themes analysed include theological and moral understandings around the virtues of hope and acceptance. The study provides an analysis of these themes in relation to the experiences of Muslim patients and families arriving at meaning making around death and dying and how this interfaces with their interaction with biomedicine and healthcare. The study shows that the juxtaposition of different values and moral frameworks require careful negotiation when Muslim patients and families encounter the healthcare system. The study also describes how healthcare professionals and staff of other faiths and no faith encounter Muslim beliefs and practices, and the challenges they face in interpreting virtues and values rooted in faith, especially when these are perceived to be mutually opposed or inconsistent.     

Is consanguineous marriage religiously encouraged? Islamic and Iranian considerations

Consanguineous marriage has had considerable attention as a causative factor in the prevalence of genetic disorders. Iran, with its majority Muslim population, has a high rate of consanguineous marriage. In Iranian tradition, first cousin marriage is an acceptable and appreciated custom. However, there seems to be no encouragement of consanguineous marriage in the Islamic context; it is merely mentioned as a traditional and common custom. This paper may help medical professionals providing premarital genetic counselling, who are regularly asked about consanguineous marriage, especially in Islamic communities. Increased public awareness via the mass media would seem to be a priority.     

The "amazing" fertility decline: Islam, economics, and reproductive decision making among working-class Moroccan women

Often it is understood that Islam prohibits family planning because the Qur'an does not explicitly address contraception. Public health and development officials have recently congratulated the Muslim world for decreases in fertility given the supposed constraints placed on reproductive healthcare by Islam, while popular culture writers have warned the West of threats by young Muslims if the population goes uncontrolled. This article draws on data collected through interviews with working-class women seeking reproductive healthcare at clinics in Rabat, Morocco, and with medical providers to challenge the link between Islamic ideology and reproductive practices and the correlation among Islam, poverty, and fertility. Morocco, a predominantly Muslim country, has experienced a dramatic decrease in fertility between the 1970s and today. I argue that patients and providers give new meanings to modern reproductive practices and produce new discourses of reproduction and motherhood that converge popular understandings of Islam with economic conditions of the Moroccan working class.     

Magico‐spiritual power,female sexuality and ritual sex in Muslim Java: Unveiling the kesekten of magical women

This article argues that in practice, concepts of magico‐spiritual power (Javanese: kesekten; Indonesian: kesaktian) are linked with sexuality, particularly female sexuality, in some segments of contemporary Central and East Javanese Muslim society. Few scholars have turned attention to the interconnectedness of these seemingly contradictory topics. Feminist studies tend to focus on the ways in which women locate themselves within and critique Sharia‐based discursive and social orders, without considering the roles that magico‐spiritual power and associated practices play in these Islamic systems or in Islam in a more general sense. Similarly, male scholarship that considers the cultural relevance of Islam and magic rarely refers to gendered and sexual dimensions as praxis from a feminist perspective. By drawing on examples of ‘magical women’ including the Javanese spirit queen of the southern ocean Gusti Kanjeng Ratu Kidul, the historical Hindu figure Ken Dedes, and contemporary ritual sex practices at a Muslim saint's grave, we show how women, female spiritual beings and female sexuality, and sexuality in general, can be considered sources of magico‐spiritual power in Muslim Java. Our arguments conclude that in Javanese Islam, transgression of Sharia sexual norms can be both a sign and a source of magico‐spiritual power.     

‘This is a gathering of lovers’: Islamic self-help and affective pedagogies in contemporary Singapore

In Singapore, the proliferation of Islamic classes drawing from self-help rhetoric, popular culture, the Qur'an, and Hadith allude to the increased appeal of affective pedagogies to Muslim youth. Taught by Singaporean Al-Azhar University graduates, the classes predominantly attracted university-educated, minoritized Malay Muslim women. Through the use of affective pedagogies, the teachers reframed Islamic piety to foreground three forms of love: self, divine, and romantic. Extending scholarship on racialized affect, this article interrogates the ways in which the teachers’ affective pedagogies mediated young women's anxieties within a neoliberalizing context, and the latter's negotiations of their newly acquired religious knowledge as they contended with quotidian precarities. While anthropology's foregrounding of lived materialities complicates some of the theoretical presuppositions of affect theory, the latter expands our understanding of piety projects as not merely concerned with ethical self-discipline, but entangled with broader racialization processes – especially for minoritized subjects whose capacity to transform becomes constitutive of a will to improve. By placing anthropological theory on Islamic piety in a dialogical tension with affect theory, I highlight the forms of affective religious sentiments that circulate through difference and negation, and are integral to particular sites of minoritized Muslim subject formation.