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End of Life – Between Religion and Medicine

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Adnan Rajeh

Channel: Adnan Rajeh

Episode Notes

With Dr. Ahmed Hegazy.

How are we, as Muslims, different from other faiths when it comes to end-of-life decisions? As Muslims, are we allowed to stop life support? The doctors say our loved-one is unlikely to survive. Are we allowed to make him a DNR? If your heart is still beating, can you still be “brain dead”?

Episode Transcript

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Doctors in

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sorry, one sec.

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All right, much better. He works in the intensive care unit.

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Which hospital, University Hospital under Allah. And Dr. Adnan

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is in the oncology department of which hospital? Victoria excellent Hamdulillah. That tells you about how much I know what the hospitals and the systems and the departments. So I will turn it over to Dr. Hamid, please introduce the topic to us. And then I'll ask them questions. And then they'll answer the questions and then you all can ask questions as well about the author.

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Mala Al hamdu lillah wa salatu salam ala Rasulillah. While Earl he will be on wala zircon, la Hi, Ron, everybody for coming tonight. It's a privilege and an honor to be here. Inshallah, as I had mentioned, the topic of today is end of life, between religion and medicine.

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And the end of life as we know it, or death is an inevitable outcome for everybody. We all know this. It's a day that is awaiting all of us, whether it be sooner or later.

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Yet despite it being the inevitable outcome of every single one of us, we are usually very ill prepared for this moment. We know very little about the rulings about what are we allowed to do? What are we not allowed to do? How should we prepare for this moment?

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And so what I'm going to what we are going to talk about today in sha Allah is two aspects of this very critical moment of our lives. The first aspect is the religious aspect. What are we allowed to do? What are we not allowed to do? And the second aspect is the medicine aspect.

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From a religious standpoint, we will try to derive all the rulings from the our authentic sources from the Quran and the sunnah of our Prophet sallallahu alayhi wasallam. And from the consensus of the scholar bodies,

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and in sha Allah from a nucleus, yes, in religious terms means drawing parallels, though, if you have something that was clarified to us by the Prophet sallallahu Sallam as being non permissible, and there is something that is parallel to it that we do nowadays, then the scholars draw parallels between both in issuing the ruling. From a religious standpoint, we will stick to these sources of legislation in sha Allah. From a medicine standpoint, Shannon and myself have our own experiences. He works in the oncology department, and I work in the intensive care unit. So both of us see patients who are nearing the end of their life very frequently. The way we're going to do this in

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sha Allah is through q&a. So there's a list of mandatory questions, I think, that are important for us to cover today. And then we'll open it after to the audience for any further questions in sha Allah, those origin so Allah is going to ask the question, and one of either myself or Shannon, will be addressing that question.

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Just like Hello, Dr. Hamid, I swear to Allah, I'm not checking the score or the Raptors game.

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If you were in the Imam Council, you should get the job. All right. The I'm just checking the WhatsApp messages and hamdulillah the Zoom call people online you can ask your questions on Zoom. I am not monitoring the Facebook questions or YouTube questions. If you have a question, please join the Zoom link and ask your question there. And that's where I will be looking at. Let's start with Dr. amateurism. Can you share with us Dr. Hamad? What are the ways of seeking cure?

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You know, your thoughts on this topic, expansive topic, please share your thoughts on that with us.

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As a collective So in summary, in sha Allah, we will break down this in very broad terms. How do we seek seek cure, from ailment from disease?

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The first and foremost way of seeking cure is through dua. We as Muslims turn to Allah. Whenever a calamity strikes whenever a disease hits, we don't turn to right or left we don't say this doctor or the other. We say oh Allah.

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And so making dua is the first and foremost way of seeking cure. And you can make dua, in whichever language you speak in whichever way you want. So longer this is pure for this for Allah subhanho wa taala. That is the first way. The second is

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Through medicinal and procedural ways. So, there are medicinal ways of seeking cure and there are procedural ways of seeking cure. And these medicinal ways can be and procedural ways can be either endorsed by modern day science or endorsed by the Quran and Sunnah of our beloved Prophet sallallahu alayhi wa sallam.

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The third title that we will say is a way of seeking cure is rockier

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and Rukia is a special dua that you make with a specific intention of seeking your

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Andrew Klear can be derived from the Quran and Sunnah. In fact, these are the only two sources of legitimate Rukia is from the Quran and the Sunnah of our beloved sallallahu alayhi wasallam.

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From the Quran, Allah subhanaw taala says well known as zero mineral Qurani man who has Schiefer or Rama to Lille meaning well is he to volley Mina Illa Hazara and we reveal from this Quran, what is a source of healing and cure for those who believe yet it increases those who are wrongdoing in nothing but loss.

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And so amongst the ayat of the Quran is a cure.

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And the prophets Allah Salam in his sunnah We have heard a lot about Rukia with Al Fatiha group here with my with that rope here with AYATUL kursi.

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And there are a dahlia in the Sunnah as well where we can see croupier through these Adalia or these dots. For example, there's a hadith where the Prophet sallallahu alayhi wasallam tells us, ma Rajan ma Mareeba Don Lemon. Yeah, blue jello.

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Bacala Alohomora balharshah Aldine Allahumma us Hola, hello, the rubble, Arusha. Aldine and yes, Fiocco Illa Alpha hula.

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And the Prophet SAW Selim describe to us in this hadith that if a man were to visit another who was sick and ill, and this sick person, his time has not yet come.

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If this visitor were to pray and make this dua for the for the diseased person for the patient, and say, Hola, hello Aldine Rob Bell Arcilla the Manish fear seven times. The prophets Allah Salam promises us and tells us, Allah subhanho que this person from his ailment.

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There are other Adalia in the Sunnah of the Prophet sallallahu Sallam which we can refer to. For example, there's this idea of this person who came to the Prophet sallallahu alayhi wasallam and told him, oh prophet of Allah, I have complained of pain in my body in this area for a very long time.

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Or since the day I converted to Islam, I remember complaining of this pain. So what did the Prophet sallallaahu Selim tell him? He told him put your hand on the area that ails you, that hurts you from your body? And say Bismillah three times, and then say, I will do below he will moderate he mean shall remain, Ajit whoa harder. I seek refuge in Allah's power and his ability

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from the ailment that I find in my body. And so this companion said, I did this, and the last patata cured me from my ailment. And I order my family and the people I know to do it.

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And so there are multiple rock layers that we can seek from the Quran and Sunnah.

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There is a Hadith of the Prophet sallallahu Sallam that describes to us

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the characteristics of 70,000 people from this ummah, who will enter Jannah Billa has been well other they will enter Jannah without being held to account for what they have done without any prior punishment. They will enter Jannah directly.

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And the prophets Allah Allah Selim describes them

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and describes their characteristics and therefore characteristics can be summarized in that they've put their full trust in Allah subhanho wa Taala

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let us sallallahu alayhi wa salam, O Medina la yester goon well yet apply your own while reactor wound while rob him yet our kiloohm

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so how do we reconcile this we mentioned the trochlea is a permissible way in fact, it is a good way of seeking cure.

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It is best if you do the rokeya for yourself.

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If you were to visit somebody, you can volunteer and make Rokia for that person.

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The scholars for example of new Tamia men

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means that it may be not as good if you were to seek out patient people specifically to come and make RealPlayer for you, because we in Islam have no intermediaries between us and Allah if somebody volunteers it and comes and makes dua for me, just say hello, hi Ron. If you ask somebody to come and make Rokia for you, it is permissible. There's nothing wrong with it, absolutely nothing wrong with it. However, it may Tamia mentions that it takes away a little bit from your direct connection from your Tawakkol in Allah subhanho wa taala. And that is why it is mentioned in the Hadith well as their own use their own means, they do not seek specific people to come and make this require for

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them. Even though it is permissible, it takes a little bit away from your Tawakkol. And so to summarize, this is a long winded answer to say that

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the ways of cure include dua include Rukia, and include medicinal and procedural ways of cure. And as I mentioned, these can be either approved by modern day science, or endorsed by the Quran and the sunnah of our Prophet sallallahu wasallam.

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Just before we proceed with the next question, I wanted to confirm the sisters is the TV on

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the TV on? Yes. Okay. And on the TV, you can see us here, right. Okay, great. Just wanted to make sure I don't want that to be the case. If that wasn't on. Thank you for confirming. Okay, Dr. Amnon, what is the ruling on seeking cure? In Islam? Is it an obligation? Is it recommended? Or is it permissible? How would you classify it? For us maybe even just give an overview quickly of the

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the the rule, the categories are really

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small? So this is an important question, because it this is what we're probably going to be talking most of the time, most of this talk is about regarding kind of end of life issues, and what are we obligated to do and when it comes to seeking cure for anything for any type of disease. So if you go back, and you kind of look at what the scholars have said, over over the many, many centuries, and what what the what the almost consensus around the matter exists, is that it is it is not only permissible, but it's recommended that people seek out cure for their disease now. Now, when I say recommended, that's where I think people kind of struggle with that's the point people struggle with

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a little bit they struggle with it, because because in our minds, it's, it's, it should be obligatory, because we all know that one of the objectives of Islam is hyndland nefs is actually is to preserve life. preserving life is one of the objectives of all of the rulings or the collective rulings of Islam is to is to preserve life and don't allow life to prosper and to thrive. So how is it you're saying that if someone's sick, it's only recommended for them to actually seek out?

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Check out cure? Well, in these rulings were put together many, many centuries ago, the the the actual quality of medicine at that time was much different than it is today, people didn't really understand what was happening for most diseases. And it wasn't really, the concept of germs and viruses wasn't something that was well, well understood. And medical procedures and medical science was not something that was well developed as as, as it is today. So today, if you actually go and take a cross section of all the Muslim scholars in the world, and there is there are actually published articles and some photo that you can you can access. modern scholars actually look at

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this, and they categorize it into into different looking at different categories, meaning if someone is has a reversible illness, that is life threatening, or it can cause a lot, you know, the loss of life or limb, because in hospital life or live, you can lose a part of your body, you're gonna die, then it's actually obligatory for this person to seek to seek cure, or to seek medicine or to seek treatment. Anyone who wouldn't do that, actually, if you look at it, look at the human experience would be someone who has, has a lot of other problems mentally, they're unstable, or they have, or they're incompetent to make decisions. And that's why in Islam, if someone if you have something

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that is reversible, and it could actually be Hello, life threatening, if you don't reverse it is seen as obligatory to do that, because a part of Islamic objectives is to preserve life itself. But then we come to other parts or other situations or scenarios not as clear cut, meaning it's not it's not very clear whether what you have is something that's life threatening is not clear whether it's reversible or not. It's not clear whether the treatments that we have actually make the difference or if they don't, and when it comes to that, to that area of life, it differs between being recommended in certain situations, permissible and other situations, you can understand how the

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logic goes here, meaning if there's a higher probability of there actually being Shiva, then it's recommended that you go for that. And if there's if it's unclear, then it's permissible to do it or not. And if there's actually a harm in it, then it's impermissible to do it. Or it's unreal commended me if this treatment is going to cause harm.

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To the body or to the mind, then it's actually undocumented. And you can see the logic is very is very simple and very clear. But that is something that the scholars have talked about for many, many, many years. Now, the point that I want to make at the end, which is the important point here is that if someone doesn't want to seek treatment,

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someone who was in there, and they're seen state of mind, they're not depressed, and they're not unstable, and they're competent to make a decision. And they understand the severity of their disease. And all the options of treatment have explained been explained to them. And they say, I don't want to seek any more treatment, I'm happy with is not permissible. Islamically The answer is a unequivocally is yes. 100% is within your right, if you don't want to seek treatment, so you've accepted that this is Allah subhanaw taala is decree upon you. And that if if this is the end of your life, then you're okay with it. And if it's not, then you'll you'll you'll be granted by Allah

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subhanaw taala that is your right to make that decision. And no one can take that away from you. Islamically you can never be you can ever be shamed. No, you should have no, I do but the but the exceptions I already made to the rule.

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Me some exceptions, something very clearly reversible, and it's life threatening or slim threatening? Or the person is incompetent? Or is someone who's extremely young and as mentally unstable, for whatever reason, then in that case, no, then it's actually obligatory to go for it. But in the scenarios that we're going to be talking about today, we're talking about end of life type of situations, if someone decides that they don't want to go forth, for more treatment that's within their rights Islamically there's nothing wrong with that. You don't have to fight till the bitter till the bitter end. Because as Muslims, we know that there actually, isn't it. So those are

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the that's kind of the based, the basic breakdown of what is permissible was not permissible, was obligatory was recommended. If it's a bit confusing, that's okay. Because it's something that actually, I don't not everyone is expected to know all the details about it, what you're expected to know is that generally speaking, is recommended and in many cases obligatory to seek cure, but it is a person's right in many situations, to say I don't want to go with further treatment, that's their right, they're not obligated to do that. And then the doctor gave examples of some of the Hadith. And it's known as historically many of the sahaba. And many of the scholars, when they got the old

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they decided I'm good, I don't want any of your any of your any of your medicine and in the world that I were working in, which we'll talk about in a little bit later. It's very common for that to be the case. And it's very reasonable actually, for that to be the case because what we give is sometimes be very, very heavy on the body.

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Like just a quick addition to what's been mentioned so far. Just a maybe mentioning a bit of an evidence from the Quran and Sunnah as to why you're okay not to pursue treatment.

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We all know the story of the lady who came to the Prophet sallallahu wasallam, who had a seizure disorder. He had epilepsy, and came and told the prophet Sallallahu Sallam in the Austro, where in the Atticus chef, federal law, Holly came to the Prophet and told him, I have the seizure disorder, I get these epilepsy fits. Make dua for me, oh prophet of Allah, so that Allah may cure my disease. And so the Prophet sallallahu Sallam gave her two options,

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I can either make dua to Allah subhanaw taala, and he will completely cure you from your disease. Or you can be patient

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and you will be given Jana.

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And so this woman when faced with the two options, I have the option of going after complete cure. And I have the option of having patients over my disease, with a guarantee from the prophets, Allah Salam of Jannah he chose the hereafter. She made her choice.

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And she said, Well prosper, I will have patients are prophet of Allah. And then she might ask the prophets of salaam call it in the cache of I when I get the seizures, I fall down and the clothes get off me and get uncovered. Whether hola hola, hola taka chef, make dua for me or prophet of Allah, so that I don't get uncovered when I get these. And the prophets, Allah made dua for her. And in one narration, he never used to get the seizures unless she was within the confines of her home. And so this is endorsed by our prophetic tradition, that you are within your right not to seek full cure for your ailment. And in fact, a lot of the predecessors as Shannon mentioned, like a worker

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Sadiq at the end of his life, when he was asked, Should we bring to you a physician, and he said, my healer said is will will prevail, meaning that Allah subhanaw taala is will will prevail over me, don't bring me a physician, I do not seek any treatment. And none of the scholars and the companions and the predecessors who have not sought treatment have been criticized. In fact, these are our predecessors that we follow. And so you are within your right not to seek treatment but as our shift eluded and expanded is recommended, and sometimes it can be an obligation to do so.

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fotografico I just want to remind the folks who are joining us online that please join the Zoom Room if you have questions, because that's the place that are monitoring for questions and you can ask the questions in the chat in zoom. I will not be monitoring the questions on Facebook or YouTube yet. Next question for either of YouTube. Okay, maybe both of you can like chime in as in fact, actually, I think that's a better way to go about it.

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Does, seeking cure

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Shiva, right? Either way,

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through medicine through Rukia or other means, the seeking cure change Allah's other or his divine decree.

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This question was asked by a Sahabi of the Prophet sallallahu sallam, he came to the Prophet and said our Ayatollah Rasul Allah, broken master key her. What do we attend? Now who do her Okemah call?

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what to call it and Netta Tia

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to her Jiro mencoder Illa he che, he came to the Prophet asking him a prophet of Allah.

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Do you see that these record that we make to heal or to seek Allah's cure? And the medicine that we take seeking cure? And the avoidance of sickness? Does it change from Allah's divine decree? Does it change from Allah? And the Prophet answer was the lady who settled him. He had been Cadila it is from the color of Allah. It is from the Allah's divine decree that you will do this, Allah has destined you to do this before the creation of the heavens and the earth, Allah.

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Gonna look at

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what is a substitute decision maker?

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This is not like a technical question. All right. So what is it substitute decision maker is a different from a power of attorney? And what role do they play in this process?

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of trauma? Do you want to take that question?

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So when you have a loved one who is critically ill in the intensive care unit, if they are incapable of making decisions for themselves, ie they are on a breathing machine, the under the effect of the sedation or the are in coma for any reason,

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we turn to the next of kin for decision making. And we call this next of kin, the substitute decision maker. And what we expect from the substitute decision maker is to convey to us as a medical team, what this person would want, if he were to know the situation that he was in right now. So we are the experts in the medicine. The family is the expert in him as a person or her as a person. And so we turn to them to understand, what would he or she accept in this situation? Would he or she accept being indefinitely on life support on a machine in the ICU? Would he or she accept the quality of life? That is, in an institution like a long term care home? And so the substitute

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decision maker is filling in, are that sick person? That's really all they're doing? We're not asking them to convey to us their own personal values and beliefs. We don't we don't that's not what we're asking. We're asking them to fill in for the patient who is sick, who cannot speak for themselves? What would this patient want in this situation? How is that different from a power of attorney? Power of attorney is somebody who has a legal document that says that he is he or she is a power of attorney, or health care, or for personal care is the proper name. And so if you have a legal document, then that trumps everything, and you would be the person we turn to for decision

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making. If you don't, then we go to the spouse first. If it's not the spouse, then it's the children and the parents. And if not, then it's a relative. If not, then we go to a Public Guardian and Trustee

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does.

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Of course,

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I'm just gonna add the technical part after that. So So let's say that someone hello you're you're a power of attorney or an SDM or a substitution substitute decision maker for somebody you love. And they are in a situation where they can't answer for themselves. Something happened it was really quick as well, you swift they were taken and you didn't weren't able to speak to them after what after the incident occurred. And now you're in a position where you're being asked by doctors and you're surrounded like 15 Doctors everyday, a couple of more of them and you're getting very confused by all the medical terminology that's being thrown out.

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You and you're looking at your loved one and it doesn't they don't seem very happy and you're hearing a lot of words that seem to be very grim in nature. And you're asked this question, what do we do? And of course, you're like, why? That's not asking me I have no idea. I don't even know what this person has, but really what they're looking for, but you don't panic, what they're looking for is your information, or your personal experience with this individual with this loved one who is May Allah preserve all your loads and see me inshallah all of us are doing well, and have Alfie Insha Allah, but they're looking for your understanding of what that person would have won because we all

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know that the command is to do well what about Allah, Hiva and Allah but Allah Allahu Allah, Allah, Allahu Dawa, and Ilhan ever, you should all seek any treatment, everything that every illness has a has a cure, except aging, or dying in the process of dying. So what they're asking you for is with this person that you love, in this situation, want to continue with all these treatment options, or is this person, the type of person is saying I'm good, I don't need all of this. And if it's my time, I'm ready to go, I don't need to be hooked up to vault to all these different machines. And that is really what their job is, at that moment, you're not actually making the decision for this

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person to live or die. You're just conveying the will of your loved one to the doctors. And isn't that Islamically acceptable? It is definitely exciting. It's not acceptable. It's actually your ethical obligation from an Islamic perspective to to do so. And of course, we elaborate more about that Inshallah, as we move along.

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By the way, if you have to chime in, just chime in, grab the mic and speak to both of you, please. You don't have to like say, can I? Answer by default is yes. Okay.

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All right.

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What forms of resuscitation can medicine provide? Dr. Hammond, I would like to start with you that question.

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So there are several levels of resuscitation that we can provide as health care providers. So going all the way up from the very aggressive things that we do to somebody when their heart stops, including chest compressions, CPR, electricity, to less aggressive things, which are still considered invasive, like putting a breathing tube in putting somebody on a breathing machine, putting them up to medications to support their blood pressure,

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or providing them with positive pressure ventilation through a tight fitting mask, something that we call BiPAP. And so these are all levels of resuscitation. And there are even more heroic measures of resuscitation and include things like putting somebody in a heart lung machine, we had a lady on a heart lung machine, for example, for three weeks, and hamdulillah made a complete recovery. And so there are multiple levels of resuscitation, and treatments and interventions that you can provide. The heroics include, as I said, the chest compressions and electricity, things that you see on TV shows, and the less heroic things are include intubation, drugs, and potentially dialysis as well.

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A technical term heroic and non heroic, is that we use it with families all the time. Do you want us to do the heroics? Or do you want us to do the standard?

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Okay, Okay, interesting. This was this nice 100. Okay, doctrine that my loved one is in the ICU, and the physicians are telling us that there is no hope for their survival.

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There's no hope for their survival as Muslims. Are we allowed to stop life support? Oh, she's there to answer that one. Because he's the ICU guy. I'm not the ICU person. But in general. So the interesting part of this talk for me is that I thought I'm gonna get hammered. And I have two different experiences with the same problem. He sees people who are acutely ill who got acutely ill very quickly, what happened suddenly, was tragic, the person is now attached like, and 15 tubes, and out, and the family is standing there, and they're not sure what to do. For me, I thought I talked to people within within a clinical room. And it's a very slow process, you can see the end of the

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dark tunnel, just a couple of months away, we got to figure out how we're going to get there. What we're going to do on in the meantime, it's the same thing though. The interesting part is that it's the same thing. And inshallah we'll come to a point where the questions about the point that I want to walk you make sure we everyone walks away with here today is the importance of, of understanding death. This, there's no age that you're too young to understand death. It doesn't exist. The moment a person can comprehend anything, the moment you're 60, you should understand, life begins. And it also ends there's nothing depressing about it. There's nothing scary about it. There's every man and

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woman before you have died. Every man and woman alive today will die. Every man and woman who will ever live in the future will die. There's no it's not depressing, and it's not saddening, it's just a part of life. And it's important understand, so example that she gave I'm going to ask the doctor I'm going to answer that question specifically because it's his scenario, and then you'll give it to me and I'll answer it in my scenario just so that I'm not unless you want to answer the oncology part yet.

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So

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Is it permissible Islamically for me

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to say, No, my loved one would not want this.

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We can stop.

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So this question has been looked into by multiple scholars. And in fact, when it comes to levels of evidence, you want to break it that way. And we use that term in medicine as well, when it comes to levels of evidence when you have a scholarly body, examining a certain question that carries more weight than an individual scholar attempting to answer that question, because that scholarly body came together with hundreds of scholars with experts in the fields, debated and eventually issued a verdict on this that is agreed to by the entire body. And so we turn in this to the fatwa of Majumdar alphacool Islami. And this is a fatwa that was issued by a huge scholarly body, where they

00:31:02--> 00:31:13

said, Is it allowed to stop life support, if somebody is non salvageable. So they said, it is allowed

00:31:14--> 00:31:26

on conditions, it is allowed, if there is an expert consensus amongst the physicians, that this patient will not recover.

00:31:27--> 00:31:38

And by expert consensus, they define that as three or more expert physicians positions in the field, agree that this person has no chance of recovery?

00:31:39--> 00:31:45

And so is it permissible according to the scholars of our OMA, it is permissible for us to do that?

00:31:47--> 00:31:52

So how do we do it, and maybe that was what we wanted to talk about.

00:31:54--> 00:32:06

You basically stop it, basically make sure that they're comfortable first, that they're not feeling any pain, that they're not looking that they're grimacing, or in any form of discomfort, and that we can give medications to, to basically promote comfort.

00:32:08--> 00:32:30

And once we're happy with that, we basically stopped life support, it's as simple as that, we stop the medications that are bringing up the blood pressure, because essentially, at this stage, a lot of these patients are not really maintaining even their own circulation on their own, they're on medications to support their blood pressure, who stopped these, and usually doesn't take long before they pass away.

00:32:31--> 00:33:11

You also take out the breathing tube. And so basically, stopping life support is what you do, how quickly they pass away, we don't know, Allahu Allah, some will pass away within seconds, some will pass away within a day, we don't know. But if that's the will of your loved one, then it is absolutely permissible to do that. And essentially, when we turn as Shannon was mentioning, we returned to families, for example, they don't know what their loved one wants, they really don't, they have no clue. They've never spoken about a situation like this before. So they're expected in that situation to be at acting in their best interest to the best of their knowledge. And that's

00:33:11--> 00:33:28

really what we fall back on. They need to be willing and available to the healthcare team to act on the best interest of their loved one, you know, possible. So I'll kind of add a little few more points to that scenario. So you don't know what that your loved one wanted.

00:33:29--> 00:34:04

You're being told that this person has an irreversible problem in the ICU and there, there's something breathing for them, there are medications pumping their heart for them, there's really nothing that they're doing on their own anymore. And they're asking you that maybe we should stop life support. Now the problem I've seen and I haven't worked in the ICU as much as Dr. Ahmed by by any means. But the few times where I was in the ICU when I had to deal with families, and some of them were Muslim families. They always they always equalizer equivalent between Brian withdrawing life support and actually killing somebody. They think that they're equal terms. And medically, they

00:34:04--> 00:34:07

are not an Islamically. They are not.

00:34:08--> 00:34:47

When you came to this world, you're expected to live on your own, you're not expected to live your life on life support. Right now we're sitting here and none of us are hooked up to a ventilator, we're just we're able to exist on our own. This is the natural state. This is the normal state. Withdrawing life support. Really all that means is putting the person back into their natural state. If Allah Subhana Allah has decreed for them to survive, they will. And if he's decreed for them, not to them, they won't. Withdrawing life support is not actively killing somebody is just taking away artificial artificial additions, that is prolonging their life in a way that is not even well

00:34:47--> 00:34:59

understood for us to us ourselves to medicine, whether that's going to be of any benefit to them in the long term or if it is not. And that is where the Islamic ruling comes in that yes, it's irreversible.

00:35:00--> 00:35:30

and the patient is not going to get out of this or the patient is willing was I do not want to be hooked up to the ventilators. Some people will say that and I don't want to be hooked up to anything. If something happens to me, don't hook me I don't want to be, I don't wanna have a tube down my throat for him, then he's slamming you, that is totally fine. Who will say we're gonna withdraw? It's hard. Don't get me wrong here. We're not sitting here saying, Oh, this is fine. It's the most difficult thing you will ever have to do in your entire life. May Allah not put you in that situation. So yeah, I mean, May you never have to be in that situation, it is one of the most

00:35:30--> 00:35:51

difficult things you ever have to do. But if that is where you were for a moment in time, that's I'm on holiday. And this is what you need to know about this. Right? Withdrawing a lot life support for patients who have irreversible chronic disease is not is not killing them, it's putting them back into their natural state, especially when doctors are telling you, we don't we can't reverse any of this anymore. This is

00:35:52--> 00:35:55

the only reason this person got this far was because of modern medicine. Correct.

00:35:56--> 00:36:29

Modern medicine brought you this far. So then when you want to make a decision, you also have to listen to modern medicine. And here's what you have to see if Modern medicine is gonna come and say yeah, and this is as far as we can go, we can't go any farther than you lean on your religion, your religious understanding of life itself, and make a decision and that and that shouldn't be a problem. For my scenario is a little bit different. My scenario is an elderly person, maybe not even elderly sitting in a clinic, taking a couple of different types of treatments on chemo, their body is as beat, they are tired. Some of them actually are so tired that they can't even think straight

00:36:29--> 00:36:50

anymore. So they have their substitute decision maker is sitting in the room with them or their power of attorney and they're making decisions on their behalf. And they can't even comprehend most of what I'm explaining to them. And the question is, well, this is not working, the disease is spreading even more, what do we do? And I have been in such a lot of situations with unfortunately, this is why I think this is important talk for us because unfortunately with Muslim families always difficult.

00:36:51--> 00:37:20

You may be surprised always it's the most difficult one. The most difficult people with dealing with these things have been my, my experience has been with Muslim families. We do not for some reason understand or accept death. Which is which is which is which blows my mind that I don't know what else you can take from Islam. Besides that, besides just accepting that, yeah, it's going to end wrong. We're all moving on. You know, that's how it is. It's just it's gonna happen one time, or maybe it happens a little bit earlier for one person, the other but we're all going there, We'll all meet at the at the finish line. It's just a matter of time. And it's not that long of time, to be

00:37:20--> 00:37:50

honest. But there's a struggle with it in terms of saying, Okay, we're not going to offer Jani this person need more treatment. So what you're gonna kill them? No, I'm not going to kill them. We're not offering any more treatment, because it's futile, because medically, I know it's not going to do anything for them. Because we follow the medical evidence and making decisions. And it's okay, yeah, that means this person is going to pass away, and that's fine, everyone's gonna pass away at some point, it's not killing them. It's not doing people fear that we're not, we don't love our we don't, it's gonna seem as if we don't love our loved ones, by not giving them all the treatment that's

00:37:50--> 00:37:58

available doesn't mean that sometimes in most cases, if you really love them, you don't push them to do more treatment that can actually harm them and make life more difficult for them.

00:37:59--> 00:38:22

But a lot of it is just guilt and the person sitting beside the patient, or it's fear from them. It's not if you are in that situation is not your decision to make. It's important to understand that we're not here to make decisions on behalf of our loved ones. We're here to enforce their will within the limitations of what Allah subhanaw taala has made access acceptable for us. We should be explained. We very clearly explained the show at the beginning. If this question is more regarding them, then we're happy to answer.

00:38:24--> 00:38:27

There's a follow up on that. Is that

00:38:28--> 00:38:47

what they determine? You said that someone who is not salvageable, right? What does that mean? What is not salvageable as a person? If you can please expand on that maybe even talk about what is death medically dynamically and brain dead? What what are these terms if you can please expand on that.

00:38:49--> 00:38:58

So by not salvageable, I mean, somebody who will not essentially regain a quality of life,

00:38:59--> 00:39:05

where they can resume their activities of daily life take care of themselves, for example,

00:39:06--> 00:39:52

or basically spend the remainder of their time in the ICU, hooked up to machines. And we know from modern medicine that we can keep people going that way, for days and weeks. Will that add anything to their eventual outcome? A lot of times the answer is absolutely nothing. And as Shannon mentioned, prolonging life, I like to call it prolonging death, to be quite honest, because at the end of the day, the purpose of us being here is to do good deeds, to obey Allah Subhana Allah and His messenger and if there is absolutely no hope that you will return to the state where you will be ever held accountable. Again, you are in coma in the ICU in machines on machines for days on end,

00:39:53--> 00:39:59

then you're not really prolonging life rofan column on 30th There is nothing that you will do in the state. They will

00:40:00--> 00:40:03

get you any closer to Allah, what has been done has been done.

00:40:04--> 00:40:23

And so this is what a lot of Muslim families, a lot of Muslim families, unfortunately, and I would agree exactly with what you had mentioned, don't understand, and don't basically think of this as killing somebody, we're not killing somebody, we're all we're doing is setting limits.

00:40:24--> 00:40:33

These are the limits of modern medicine, we cannot get you back to where you were, we cannot add any meaningful quality of life beyond this point.

00:40:35--> 00:40:44

And we know from a lot of a lot of research, a lot of a lot of experience where that line happens.

00:40:45--> 00:41:05

And the scholarly body said, if there's a consensus of opinions, if there's a consensus amongst physicians, that you're at that stage, at least three or more expert physicians have agreed, this is it, there is no recovery from this. And it is permissible to set the limits and stop the life support what is death, but death has two meanings, right?

00:41:06--> 00:41:13

There's one meaning that we know of as Muslims. And that is when the soul leaves the body.

00:41:14--> 00:41:39

So this is the religious definition of death when the soul leaves the body. What is the soul? This is a divine secret. Whereas rune, a kind of rule, pull Roho, when Emily Robbie, when I ot to mineral, Elmy, Illa kalila, they ask you what is the soul? Day The soul is an affair of my Lord. And you have not been given knowledge, except very little, as humans in general.

00:41:40--> 00:41:56

And so you can, you can reconstruct the human body with all its chemicals, you will not have life without the soul without this divine secret from Allah subhanaw taala. And so this is the shutter definition, or the religious definition of death. From a medical standpoint.

00:41:58--> 00:42:20

They lose their, there's circulatory death. And there's neurological death, which is the question that should highlight you mentioned, the circulatory death means that their heart is not beating, that they are no longer breathing at their and that their body functions have completely seized, their body starts to become cold, and starts to become stiff. And that is the medical process of dying.

00:42:21--> 00:42:29

The other diagnosis here is brain death, what is brain death. And that is also another area where a lot of Muslim families struggle.

00:42:31--> 00:42:38

The brain death means in technical terms, complete cessation of blood flow to the brain,

00:42:39--> 00:42:44

this patient's brain is no longer receiving any blood whatsoever, zero.

00:42:45--> 00:43:02

And how that affects the person is that their brain functions, these, including the brainstem, the basic functions of controlling your breathing. So a brain that person will never be able to breathe on his own. Again, his brain is dying, it's not receiving a single bit of blood.

00:43:04--> 00:43:12

How do you make that diagnosis, there's a clinical gold standard, there are multiple tests that we do to see if a patient is brain dead.

00:43:14--> 00:43:41

If you don't, if you're not able to fulfill all these clinical standards, we go for imaging tests. And what I mean by imaging tests, things like CT scans and MRIs, to demonstrate that there is absolutely no blood flow going to the brain. And if the test shows that there's absolutely zero blood flow going to the brain, you basically diagnose them as being reversible, the brain cannot tolerate lack of blood flow for more than three minutes. And so will this patient ever wake up? Never.

00:43:42--> 00:44:02

And so Brain death is an irreversible state of brain. Basically, death, as it may, were legally, as per the law of Canada, he's, once you've made the diagnosis of brain death, you actually write a death certificate for that patient.

00:44:04--> 00:44:27

You call the families, you let them know, your loved one has passed away. They walk into the room. What do you mean doctor? There's, we see a tracing. There's no flat line on the screen. Like no, he's brain dead. And so basically, what we do is we call families we ask them to say their goodbyes, and we ask them to let us know when they're ready for us to stop the machine.

00:44:29--> 00:44:59

Is this permissible? From a shadow standpoint? Again, as per the consensus of the scholars of mud, malfa college learning, and a lot of other scholarly bodies, when I was researching preparing for this, I found that pretty much every institution, religious institution in Muslim countries has gone through this exact same debate, and all of them have reached the same conclusion. If there is consensus, that this patient's brain is irreversibly gone, and it is permissible to stop

00:45:00--> 00:45:04

But like support and stop the machines. So these are the multiple definitions of death.

00:45:08--> 00:45:15

And then when I just just as something else regarding this, we'll we'll come back to the, you know, some of the questions that people are asking and whatnot.

00:45:17--> 00:46:03

I think both of you have said, it's very hard to have this conversation with Muslim family. And you've said this to me before this session, and I was thinking about this as well. Is it perhaps that a Muslim family is thinking that death is the departure of the soul? It's not a it set of tests that you have done to prove the person is dead? And perhaps there is a disconnect in their mind that until the soul has departed, I don't care what you say, the person is alive. I'm not condoning that behavior. Right. But what are your What are your thoughts on that? And can you obviously pull your roll from an umbrella be the sole is, you know, Allah's pantallas secret? It is Allah subhanaw taala

00:46:03--> 00:46:03

is

00:46:05--> 00:46:11

command, and it is something that he is kept it for himself. The interesting thing here is that, could you

00:46:13--> 00:46:14

maybe hypothesize

00:46:15--> 00:46:19

a point where you say this is perhaps where the soul is departing.

00:46:21--> 00:46:23

Maybe you should come down, you start on this.

00:46:31--> 00:46:34

So of course, there's no way for us to ever be able to tell

00:46:35--> 00:47:03

with confidence when the soul leaves, we can only do as much as we can in terms of, of our medical evidence, and how we've been observing many, many, many people go through the same process and kind of pick up on the pattern. But what I've what most scholarly bodies and scholars have talked about, at least over the last two decades, regarding the actual departure of the soul, and they defined that as as being branded, that's the definition that they've moved to now the from.

00:47:05--> 00:47:38

Because when it comes to circulatory death, doing compressions and bringing things that can happen, but if the brain is not getting it, there's no brain activity whatsoever. And there's no blood making into the brain. That's basically that's basically the soul departing the body, as far as we can tell, we still will never understand the essence of the soul, or the essence of how it entered or how it will leave. That is very clear to us. We accept that as Muslims as human beings, but that is the closest we can come to in terms of an acceptable definition. Now the question is, do you think that's do I think that's why it was? No, I don't. I don't think that's the cause at all. I

00:47:38--> 00:48:03

don't think it's an issue of where this the soul is in or out. I actually think it's something very different, which is why any decision came up, I was like, Yeah, we should talk about this. I wasn't looking forward to it. But it's something needs to be talked about, because I feel like there's something else going on in the background for us. I think there's some degree of denial that we're that we're we live through, that we're kind of hit with the end that that kind of hit takes us by surprise. And there's lack of preparation online and only Adorama. TV and you can comment if you'd like

00:48:04--> 00:48:29

I would I would concur with the fact that I feel like it's not necessarily them, waiting for the soul to depart from the body. It's It's the it's the denialism I'll be quite frank. And it's unfortunate because you would think that we as Muslims, are the most prepared people for death. We know what we're waiting for. I see patients in the ICU.

00:48:30--> 00:49:13

who don't believe in religion, don't believe in Allah subhanaw taala, who are brave when it comes to this decision, and say, I don't want anything further. I've had a good life. This is enough. For me. The struggle that I perceive with Muslim families is the putting limits and the stopping life support. And I feel like that is where most Muslim families struggle. Are we allowed to put limits? Are we allowed to stop life support? Is this akin to committing suicide? I've heard that once. I've heard that from a family who said well, it's just like, what what's the difference between this and committing suicide? There's a huge difference, both from Masada, your perspective and from a medical

00:49:13--> 00:49:16

perspective, they are completely different.

00:49:17--> 00:49:38

Committing suicide is the active process of taking your life away. And it is defined in the Sharia and multiple Hadith of the Prophet sallallahu sallam, whether it be by slashing your wrist, whether it be by taking in a poison, whether it be by throwing yourself from a balcony, you are actively in an act of ending your life.

00:49:39--> 00:50:00

Stopping life support, putting limits is nowhere close to that is completely different. is basically saying this is enough. I will allow ALLAH SubhanA decree and ALLAH SubhanA decree will prevail regardless of whether we allow it or not. But I will allow my life to go when Allah wants it to go and that is basic

00:50:00--> 00:50:06

Really what we are discussing, we're not discussing any process of active

00:50:07--> 00:50:24

ending of life, it's basically stopping where we are right now, and allowing Allah subhanaw taala to end the life, not that it is within our capability to allow or disallow, but basically we are talking about allowing the likes to take his course exactly, along.

00:50:26--> 00:50:32

So, we are allowed as Muslims to put that have to have to a limit on medical interventions.

00:50:33--> 00:50:35

percent that is correct, and it is not.

00:50:37--> 00:51:19

There is no equivalency of suicide, and putting limits to resuscitation. There is absolutely no equivalency. And this is defined in the Sharia very clearly, by the prophets, Allah, Allah has a lot where he mentioned that a man come Apollyon you cannot call if you love the a man that has stabbed himself with a metal, a piece of metal will be in hellfire, stabbing himself with this piece of metal. On the Day of Judgment, a man who was thrown himself from a height will be throwing himself from the height on the Day of Judgment, a man who was consumed the poisoned to end his life, we'll be doing that on the Day of Judgment. This is an active process of ending life. And this is

00:51:19--> 00:51:53

absolutely not what we're talking about here. We're talking about stopping putting limits, and allowing the person to pass away below. And then anybody who has these difficulties, these very terrible thoughts. You know, like, we really, really, I'll just encourage you, when we will insist that you seek help in this matter. These are difficult things, this is not something that we brushed under the carpet. If someone has suicidal thoughts, they help must be sought and must be solved immediately. You could actually start lining up for questions if you'd like with them. We're almost at the end of our QA. I'm going to ask Jeff and then a question about

00:51:54--> 00:52:04

both of you can chime in, of course, but about coming back from the state of being brain dead? Has that happened? Have you seen it? Back to

00:52:06--> 00:52:10

the mic for that, ever. So there's so

00:52:11--> 00:52:56

when you have somebody who basically has, and I mentioned this because people get to people confuse these together, when you have somebody who say have been submersed in cold ice water in the season that we're in right now, and presents to the hospital hypothermic with a temperature of say 20 degrees, we resuscitate them until they're warm. And once they're warm, if they still have no pulse, then we declare them to have passed away to have died. So there's a saying in medicine, you're not dead until you're warm and dead. Because there are people who may have a cardiac arrest situation in this situation where their brain is protected. Because of the cold temperature, their metabolism is

00:52:56--> 00:53:13

so slow, that they are protected to some degree from the lack of circulation. And then when to warm them again. If they start resuming their circulation and things look good, then hamdulillah if not, then they are dead. Nobody has come back from the dead.

00:53:16--> 00:53:25

I'm going to ask one more question here. And then we will start to go through the questions from the audience and the questions from the folks online that are asking questions as well as Shaula, which is

00:53:27--> 00:54:10

how are we as Muslims different? When it comes to the end of life? Both of you can chime in on this. I said what actually am I meant to? Sorry? First this one, how are we different? And like you talked about how difficult it is? I was surprised frankly speaking when I heard this, but you know, obviously, you guys are the ones who see this. How are we different? Or if you want to say how should we be? In a way you know, if less than Hello in this situation? How should we be acting as boasting about living in China? I mean, there's there's a technical part, which is no try to get someone to say Shahada before they pass away und die we have a certain procedures we do we close the

00:54:10--> 00:54:41

eyes, they go through a certain hosel into the burial and all that stuff in writing the we'll see even beforehand. There. By the way, if you haven't done it yet, you should do it a year ago, almost to the date, I got COVID and for a week I was stuck in our house and I couldn't go downstairs anymore. I couldn't breathe properly. And I thought to myself towards the fourth day that this was I'm going to die from this because I couldn't I couldn't I couldn't go to the bathroom. I couldn't downstairs and I couldn't do anymore. So I was sitting, I was sitting on the fourth step in my house. And I'm like, Okay, this is not going well. I should probably rent my will. So I stayed, went

00:54:41--> 00:55:00

to bed and I lay down and I started writing my book I never did my my will before and my wife wakes up and sees me on the phone like what are you doing? Like go to sleep I'm fine. Just Just go to sleep and I keep my recommendations like what are you doing? It's not doing anything it's go to sleep I just I need to write this stuff down. I have no assets by the way so I have nothing to give anybody when I die besides debt and a lot of headache but but

00:55:00--> 00:55:29

It really the will is not just that it's also anything that you anything you know, you want it to say, in life that you are never able to say. Sometimes there are things that you wish you could say you can't say for whatever reason you want, you want it to be documented. This is what you feel, or this how you think the writing that down is a part of the will and any advice you want to leave the people behind you leave you I wrote like my will was basically just a message to my kids. It's, you know, what I, you know, who I tried to be or I failed to be who I hope they'll be and it's very therapeutic is very helpful. So we'll see is a big, big thing. I think everyone, I think there were

00:55:29--> 00:56:00

some efforts in this community to teach people to do it. And I hope that those efforts are still running. But I think it's important that everyone does it, because it's actually more it's very therapeutic for us to do that. But then the actual part where we should differ is is the you know, what Donnelly's you'll get brought up in a couple of times so far, is that is the acceptance of it? The acceptance of it. Look, Who here wants to die? Not knowing you're not supposed to know no one's supposed to want to die. So it's in the Quran we'll see. But the remote is called will sleep is called one of the worst calamities that occur. The prophets I send them said, the best thing to ask

00:56:00--> 00:56:31

for is if yours is to be well, you never ever hope for death and even those who are asking Allah, can I ask for death, he's like, No, but if you have to say something, if there's so much pain, you can say Allahu macchine mechanically. But a funny man merch and I did offer to hire only allow me to live as long life will bring the higher end take me to you, if it's not going to bring me any more high. That's the best you could that's as far as you can go. So we never actually are looking forward to death. We're not celebrating death. I'm not happy with death. Death is sad. Death is a horrible moment that there's a moment to mourn. We don't, we're not enjoying somebody passing away.

00:56:31--> 00:57:04

Even if someone who dies as a Shaheed somewhere, you're still not celebrated. But this is, this is a sad moment for the people who love this individual. The people who loved you will remember you, when you go on, they'll be sad that the day that you leave, it's just how life works. But as Muslims, the acceptance of it, accepting that it's coming, it's a part of this journey, it's a part of this deal you were given, you know, you were given this very interesting deal of living on this green and blue planet where you can go walk out and you can, you can breathe in fresh air, and you can see all the beauty around you and you can be a part of it and embracing it, but at the end is going is going to

00:57:04--> 00:57:34

end. And that's the only fact that we have about it, to be honest. And as Muslims, we're being told it's coming. It's on its way it's close. You know, make sure you're ready for it, make sure you prepared for it, make sure you're prepared for what comes after it. So as Muslims, we should be more prepared and equipped. Well, even if you're young, even if it's and I had to learn that like when I'm telling you this story and bring the will but really that that week for me was just watching myself, man, I wasn't ready. I wasn't. And I've been preaching this I wasn't ready at all like I've been I've been lying to myself I needed. I needed. It took me a week to come to a point where Oh,

00:57:34--> 00:58:04

yeah. And it is not the first time it happened to me. I was in jail once and I was ready to die as well. And it wasn't ready then either. And it takes time for us to come to that point. But it's very important that we do that you take time to think about what would i What do I need to do? What do I need to change in my life today? What am I what am I not doing right that if I were to die tomorrow morning, I'd be very upset that I didn't do already, then get up and start doing that stuff so that you're ready so that when it comes you're accepting of it, you'll still be sad, you'll still try to fight it, your loved ones will too. But at least on a on a very subconscious and deep and important

00:58:04--> 00:58:19

level. You're okay with it. There. It's coming and I will deal with it. When it comes, no one's gonna live forever. And that has to be a part of who we are. And that's exactly what Islam teaches us. And it's very, very surprising to me sometimes. I'll tell you, I'll tell you a story. I'm sorry, I'm taking a bit more time to a story of

00:58:20--> 00:58:52

having a number of times with this. I'll never forget this one very elderly man. And I remember this guy, Jani. The moment I came on team, I was told by my by the by the CTU team at the Addison team, this family is a mess, and they're very difficult and blah, blah. So I look at the name and the name. It's a It's my sauce. So I'm like, Okay, I'm the I'm the senior on the team. Like I'll take care of this family. No one see the fallacy. So I go to this gentleman just started speaking to him. And he's a maybe 85 year old gentleman he had cirrhosis. He was very, very ill he wasn't there mentally at all. He hadn't been there for years. And he had every every disease on the book, his

00:58:52--> 00:59:26

heart wasn't working properly. His kidneys died a couple of weeks before he was very, very ill and trying to explain to the son that look this this gentleman is everything he has is irreversible. He's passing away. The more antibiotics I pump into his body and the more medications I give him, just prolonging his suffering really what we should be doing is giving us something to make them list give them less stress, take away the distress and the pain and allow nature to take its course just pick and take him back to the natural natural state being in the natural state is not suicide is not dying. Being natural taking away all the artificial medication that's being pumped into you

00:59:26--> 00:59:58

is totally fine. You pass away with that then you pass away with that. And I it took me a week conversing with this son every single day. And this person knew me from the message like they like oh, you I've seen you on the on the harmonic perfect. This will be very easy. Now he knows I know. I know little bit about Islam, and still I got nowhere. It wasn't and it wasn't about the deen. It was the gentleman not ready to let go. It was just a family member who wasn't ready to let go. He didn't want to let go of his dad and I don't blame him. Of course it's your father. I can't imagine how difficult that is. I don't want to imagine I don't want any of you to go through that. But we have

00:59:58--> 01:00:00

to as Muslims we have to be

01:00:00--> 01:00:29

be able to comprehend the difficulty of a moment like that and to be able to deal with it maturely knowing that we're all going to meet at the heart of the process that I settled on one day, you truly believe that if you truly believe that in living your life that way, then you have no problem. Okay, you're going ahead of me, I'm close behind just a couple of decades, what is what are a few decades, a few, you know, if you rise around the sun, the sun has been there for billions of years, we're just going to spin around it a bit in that regard, as well. But there's lack of preparation from that sense. And that's something that I think as Muslims, we should talk about more, again, our

01:00:29--> 01:00:49

massages and our hope and our gurus, we have to discuss this more often so that we mature and come to the point that the Prophet alayhi salam was himself and the Sahaba the acceptance of it, we don't wish for it, we don't want it we, we mourn it. We were standing, we cry when it occurs. But we're okay. You know that this is a part of life, it will happen. And not

01:00:50--> 01:01:07

taking someone back to the natural state where we're not pumping them with artificial. Any medication or doing heroic measures or hooking it up to machines is not suicide, it's not killing them. It's allowing the natural nature to take its course, which is which is completely acceptable and very useful. Amick I hope that was beneficial.

01:01:09--> 01:01:32

Let's take a question from the audience. I'm actually I'm gonna defer my question to a later time I want to start with Brother Osama. To start us off. Can you turn on the mic, please? Perfect. It's not like, which is like a little home for being here. I know, you guys have busy schedules. So just thank you for coming out and being available. So my question is, you're saying it's very difficult for Muslim families to deal with this, as with any other family?

01:01:33--> 01:02:07

Personally, I think that stems from when we're younger, we're taught that Allah subhanaw taala is capable of anything. He's capable of someone's sick and making them better. And just as Dr. Hayes, he was mentioning earlier, that there's Rokia and the power of Allah and Daya is there, and it can make someone better, who's sick. So I'm not talking about someone who's brain dead because they're dead. I'm talking about someone who's sick. So what are your thoughts on that? And especially since we know Medic, Medic, we don't know that we are very knowledgeable in medicine, we don't know a lot. A couple of years ago, someone could have been said that they were brain dead, but they were

01:02:07--> 01:02:20

actually locked in and they were still there. So medicines constantly changing. So what are your thoughts on that? And what is the position of broccoli and diet and the hope that Muslims have when they're nearing the end of life.

01:02:24--> 01:02:25

So

01:02:27--> 01:02:57

it's a very powerful point that you make. So we as Muslims, believe in miracles. And in fact, in our profession, we see this all the time, where somebody may look like things are not heading in the right direction. But by Allah's Will, when we see the effect of dua, things turn around, and they're all of a sudden heading in the right direction, with no physical or medicinal means in place. Allah subhanaw taala is all capable 100%.

01:02:59--> 01:03:01

But what we're talking about here is

01:03:03--> 01:03:14

when it's when it's all said and done, like I will reflect the maybe on another experience that I've had, with also a family of, you know, Muslims of our own faith is one of us.

01:03:15--> 01:03:46

The patient was as was described, he was in the ICU. What was different is he was hooked up to all types of machines. He was on a breathing machine. He was on music medications to support his blood pressure, he was on a dialysis machine, he was in complete coma, without any sedatives, like his brain was shut down. But he was not brain dead because brain death as a certain list of criteria. He was not brain death, but he had gone into irreversible multi organ failure, liver, kidney, breathing, and circulation.

01:03:47--> 01:03:49

So the family comes in, and I say,

01:03:50--> 01:04:02

and we're reaching the end of what we can do, this is the limits of medicine here. Unfortunately, there is nothing that we can do that will that will bring him back to a meaningful life.

01:04:03--> 01:04:16

And so the family said, No, we believe in miracles like so do I. But really, that's not my job here. If you want to continue making, continue making dua that's well and good. And they did, masha Allah and we all did.

01:04:18--> 01:04:36

And then when the time came, and his heart stopped. I said, That's it, unfortunately, I'm sorry for your loss. And they said, Aren't you going to do anything? I said, I can't do anything. Aren't you gonna do CPR? If you want me to break his ribs? I can do that. But it's absolutely futile.

01:04:37--> 01:04:59

And so, at the end of the day, when you do make to Allah subhanaw taala will give you one of three things with this dua, and that is what we all believe in. We either see the effect of this die in our life right now. That's the first option. The second is, we see the reward from Allah subhanaw taala on the day of judgment, and in fact, there is

01:05:00--> 01:05:45

A one of the narrations that was that the people who have made dua to Allah and their dua did not materialize in this life will come on the Day of Judgment wishing that they had made more dua, and that none of the die had materialized from the reward that they see from the die that they had made in their life. And so there is a huge reward for making dua in and of itself, whether we see it materialize in this life or you don't. And the third option for making dua, is that Allah subhanaw taala will ward away from you evil that is equal to the good that you have prayed for. And so Allah is all capable 100% Will everybody will anybody live forever? No, a emitter? For whom will Holly

01:05:45--> 01:06:20

dune? The Allah tells us Prophet sallallahu sallam, if you the best that I have created, the best of men that have walked this earth will die? Will they live forever? Nobody will live forever. And that is the inevitable truth in life. I hope that attempts to answer the question, I'll just make a small comment for you. So there's to look around at the beginning, if you heard he made, he said, there's two ways to basically two ways to seek here. One is to improve and you should be doing that all the time. You should be doing that all the time. Don't bring me balls of water to tell me to read or I'll do it for you. But that's not how this is supposed to be happen. You should be doing this all

01:06:20--> 01:06:47

the time. Like someone's sick in your house, you go you sit beside them, you read Quran for them. That's a no, that's a no brainer. I didn't know how it wasn't a no brainer until recently. Like that's what you do. When you're home with everyone that you love in your family, you make draw for them all the time, you should be making draw for your for your family members every day if they're sick than than the only family member that gets until someone else gets to do and you go into it. Okay, anyone says we're on for them. Now that's a part of the of the that's the part of metal of cure seeking that you're doing. Now, when you came to medicine, when you brought them to the

01:06:47--> 01:07:16

hospital, you do come from miracles? No, you came from medicine, right? So we as the medical doctors took them in, and then provided medicine. And then at the end, we said look, we provided every piece of medicine we can we have nothing else to provide. But other take them back to their natural state and continue to do another europea you believe in a miracle. That's where the miracle will happen. It's not going to happen in medicine, because you have to kind of differentiate medicine is going to get that you're going to the science, you're going to get the logic of of how life works, we'll do that. And then the DUA and the rakia is what Allah subhanaw taala will do. Whether we understand it

01:07:16--> 01:07:47

or not, whether we want it we don't know is something so beyond us that we're so small in front of it, you'll continue to do so asking medicine to perform a miracle is just halt. It's just confusion of both know that you ask the miracle medicine is not going to do that medicine just offers the the treatment, the medications, miracles are gonna come from a different door altogether, meaning what Allah subhanaw taala will offer somebody's going to happen. So when we say okay, we have to withdraw life support, we can do anything more medically. If you believe in miracles, you think we should be fine with that, make a DUA and do your work. And if Allah subhanaw taala is going to grant them let

01:07:47--> 01:07:54

them to grant them life and that differentiation is very, very important. And I feel that's where the problem sometimes occurs. That kind of makes sense to you. Okay.

01:07:56--> 01:07:57

Thanks so much. I like that.

01:07:59--> 01:08:01

expression there. Medicine, no miracles.

01:08:03--> 01:08:08

Awesome political figures. I'm going to ask the sisters is question their assistance, you're gonna come up a little bit.

01:08:09--> 01:08:20

Just a little bit. Yes, perfect. I just want to make sure that the receiver can catch the perfect Assalamu alaikum. It is not okay for giving the

01:08:21--> 01:08:22

topic.

01:08:24--> 01:08:26

In defense of people.

01:08:28--> 01:08:40

You think this is Dr. Ahmed, on the right side, on my right side. i He did say that there was a patient who was hooked up three weeks and she survived and she lived

01:08:41--> 01:09:00

for people, they can't really differentiate between that kind of patient and a patient that may not live. So I mean, you have more experienced than I do, but I think it's not. When they see this, they think maybe this is going to be their father or their mother or their daughter.

01:09:02--> 01:09:44

You have given three scenarios to simplify and correct me if I'm if I'm wrong. One is, is a core hooked up to machines. So the second categories, the brain is alive, but there have multiple injuries. Right? So in that category if the brain dies that goes to the category of brain dead, and do you really need permission from the patient from anybody for that? I don't think so. Right? Yeah. So that person is that anyway. So now we left with the category. If this person is going to be saved, walk away, like you said in three weeks, he was hooked up to

01:09:45--> 01:09:56

heart and lung machine eventually walk away. And then the other category which is not going to be thought, how do you how do you address this to the patient?

01:09:57--> 01:09:59

Do you understand my question like people

01:10:00--> 01:10:08

need to clearly state whether this person has a possibility to walk? And this may not walk? You know what I mean?

01:10:10--> 01:10:16

That's a very good question. So it all falls back to the medicine side of things.

01:10:17--> 01:10:34

We see patients, where we are the ones that are pushing for aggressive interventions. Because we know from the knowledge that Allah Hunter has given us through our practice of medicine, through research, through our clinical practice,

01:10:36--> 01:10:41

that this person has a reasonably good chance of pulling through and pulling through to a good quality of life.

01:10:43--> 01:11:30

On the flip side, there will come patients who have very little to no chance of pulling through. And that is when we find sometimes that families will struggle. And I can understand if a family wants a second opinion, that's totally fine. And in fact, as I mentioned, the scholarly body said, if there's a consensus of opinions amongst expert physicians, that this situation is not salvageable, then it is acceptable to stop life support. And that's, that's basically one situation. And we know it that this patient, for example, had multiple comorbidities, he was elderly, his entire body systems have shut down. And there was absolutely no hope, from a medical science standpoint, that

01:11:30--> 01:12:11

this person will recover. The other situation was a young lady, who was completely healthy, who developed an inflammation of her heart, led to her heart stopping was put on a heart lung machine for three weeks, was completely healthy prior. And we knew that this lady wants the viral infection wears off, has a reasonable chance of getting back to a good quality of life. And so we were pushing for fully aggressive measures. And every time we were speaking with family, who were saying, give it time, give it time, they have every right to say that you would not have accepted this. But from a medical standpoint, our job is to give them the information and the information and the status, the

01:12:11--> 01:12:31

data, the science shows that she has a good chance of pulling through. Whereas in the other situation, our assigned says they have no chance of pulling through follow up question to the same scenario, I if if the relatives would say, take her off the machine, but the doctors would take it off, take her off,

01:12:33--> 01:12:34

they would be

01:12:35--> 01:13:00

obligated to if the next of kin or substitute decision maker was able to demonstrate to us that this is in fact her will, or her wishes when she was alive and well, that you would not have wanted this. And that he is asking or he or she is acting in their loved ones best interest. If they're able to demonstrate that to us, we would be obligated to comply.

01:13:01--> 01:13:25

But on the other hand, you would recommend that you have a booth? Exactly our recommendation would be to keep going absolutely. People should know this and trust them. The second question related to this is of when you say a medical assisted suicide. And that's when people think that this is suicide or something. So you, essentially, so that

01:13:26--> 01:13:28

there are lots of questions.

01:13:30--> 01:13:45

I think that would clarify. Excellent question. Exactly. Well, thank you very much, so much. I'll see I'm glad that we have attentive members in the audience handed in. Because I think it's an excellent question. I'm just gonna quickly go through a question online. I just want to answer this question. Oh, sorry. I'm sorry.

01:13:47--> 01:14:03

So. So yes, we do advocate for patients, when we do feel that the odds are in his favor or her favor, we do push for people to keep going. And so it's not a you know, it's basically an approach that is based on medicine that is based on science.

01:14:04--> 01:14:22

The sister was asking about medical assistance in dying, that is a completely different topic. So medical assistance in Dying is an active process, where the physician is asked to administer medicine to hasten death.

01:14:24--> 01:15:00

So it's an active process, not a passive process. But when I was talking about restricting life support, taking away machines, this is all passive. Medical Assistance in Dying is a process where a sane person and before they request that they have to be subjected to tests to make sure that they have the competence and the capacity to be asking for this. And so if a sane person comes and asks a physician, life is not worth living. I want to go I'm requesting, quote unquote, made it's called medical assistance in dying. This is completely different than what we are talking about medical assistance and dying

01:15:00--> 01:15:11

ng involves basically making sure the person is comfortable and then injecting medications that will lead to this person passing away. These are completely different.

01:15:17--> 01:15:32

Most standard, we'll just repeat the question about so this is medically assisted assist medical assistance and dying. What is the ruling on this? What you both have? So from what I can see from most scholarly bodies that I have read,

01:15:34--> 01:15:38

say that this is not permissible, either this is not alone. Hold on.

01:15:42--> 01:16:19

Let me take a question online. We spoke about how that must be, you know, we must be preparing for it Shannon spoke about that, and how these conversations have to happen. And this is just one of those conversations. And perhaps a writing of our CEO or a will, is a process where we can prepare ourselves for our death. And this is an important one, because we don't want to think about this. Quite often. These are questions that are asked online, I'm just repeating the answer from for the benefit of keeping addressing those questions. But there's one specific one, asking about this scenario where the doctors have a consensus that the person will not survive. Do you mean that they

01:16:19--> 01:16:32

will not survive independently without medical intervention? Like left support? Is that what is intended by that? Okay, the answer to that question is yes. Handle. All right, question order. Okay, so

01:16:33--> 01:16:40

my question is about near death experiences, which is when basically a person is about to embrace death,

01:16:41--> 01:16:49

they start seeing like maybe a family member that already passed away, and they start talking to them. Or some people reported that they're,

01:16:50--> 01:16:54

their soul kind of left their body and they start seeing stuff around the room.

01:16:55--> 01:17:09

So my question is, it's two parts. So what have you guys seen in the hospital? Like, what stories have you heard? And what have you seen? And how do we explain that, from the Islamic paradigm? Are because we do know that in Islam,

01:17:10--> 01:17:17

the Prophet alayhi salatu, Salam told us that angels would come down and whatnot. So that's my question, our philosophy come.

01:17:21--> 01:17:33

So from what we've seen, from patients who have had near death experiences, they somebody whose heart has stopped and was successfully resuscitated with chest compressions and electricity, and all that.

01:17:34--> 01:17:37

If these patients were to pull through, and some of them will,

01:17:39--> 01:18:17

they have absolutely zero recollection of that time in their life. What we have seen is, these two weeks of my life that was in the ICU, I remember nothing of them. And you'll come back and say, okay, and some of the patients will say, this three months of my life that I was in the ICU, I remember nothing of them, zero. And it's, it's very distressing for a lot of patients to look back and say, you know, from September to December, I have no clue what happened. I'd have no recollection of this time period in my life, it can be very distressing, and some patients will have some PTSD from that. The other thing that will actually truly cause PTSD to a lot of our patients,

01:18:17--> 01:19:03

unfortunately, is when they are conscious in the ICU, and aware that they are dependent on care, that they are dependent for a nurse to turn them, they're independent, that somebody is walking in on them every hour to inject them to give them medications, to turn them in bed to take their vital signs. And being in that state of extreme helplessness in a bed for days, weeks, and sometimes be associated with very unpleasant recollections, potentially nightmares, potentially even a full blown PTSD disorder. So there is psychological trauma that can happen from a protracted prolonged ICU admission. So these are these are things that families sometimes will not put in mind when they're

01:19:03--> 01:19:13

trying to consider these discussions. A prolonged ICU length of stay is not without its its burden is not without its risk. No.

01:19:15--> 01:19:53

I'm going to gonna cap it at 10 more minutes because that will give us an even hour and a half inshallah. And mashallah, thank you all for sticking around. All this time. I'm going to take a question online and then come to the sisters and then go back to the brothers. Can I leave instructions with a trustworthy friend or relative, that when I am of an advanced age, and or with terminal illness and suffering much pain, I would welcome death, as that would put me out of my misery, and hence there is no point in putting me on life support, but instead I shouldn't be allowed to die with dignity and naturally.

01:19:59--> 01:20:00

Adnan says up

01:20:00--> 01:20:05

Totally I say 100% All right. That's excellent. fotografico sisters

01:20:10--> 01:20:20

Salam Alikum. I apologize this question late to the talk, but I have tried researching and if you can kindly just keep the mic closer to your mouth, please. Yes. Thank you.

01:20:22--> 01:20:44

I apologize if this question doesn't relate to the talk, but I have tried researching and still haven't found an answer. My question is when a family member dies, is it okay to visit them frequently? And if so, like in the grave? And if so, is it okay to talk to them through the grave? Like, talk to them about your day? Things like that? And also, do you condone death anniversaries?

01:20:47--> 01:21:11

To be honest, I didn't actually condone what? death anniversaries, condone death, anniversaries. Okay, so you can just, yeah, so the question was, can I visit my beloved one who would died? Can I talk to them in their grave? And is it okay to have death anniversaries, so you can visit them, of course, you can visit them and go, you can make dua for the movie for them for them. Scholars have generally

01:21:12--> 01:21:45

not recommended standing there and speaking to the deceased, at least not for a prolonged period of time, at least not forever. There's difference of opinion on this issue. And even when he look at the at the psychological aspect of it, when you speak to psychologists to kind of talk about, you know, be dealing with with, with loss and grief, there are different opinions, I tend to say that maybe in the within the first month, you know, speaking to the person who passed away, if you have specific greed, regrets, or if you have certain things that you wish you had said, and you're saying them out loud, is therapeutic for you, it's helps you, they may be hearing they may be they may,

01:21:45--> 01:22:11

they may not, if you look at the evidence that we have in Islam, there is a lot of difference of opinion on it. Like there's there's lack of clarity on this issue. So depending on who you speak to, you'll get a different answer. depending on who's sitting here and you'll get a different opinion on the matter. That's why I'm not going to go into the details of it. But I'll tell you, what I think is the best approach for it is that if someone passes away within the first maybe a couple of weeks, if you go when you visit, and you you feel like the things you would like to see, then that's fine, go ahead and say that but then that has to stop, you should stop doing that and then you go and

01:22:11--> 01:22:44

visit you go on you make dua for them, you run for them, you do something, you just kind of do something for you know, for their for the sake of there has nothing to add to their yo yo mafia, it's definitely not recommended for there to be a death anniversary, it's probably nice borderlining it's up there with with what I would call a bit of our haram, that's something that doesn't have a it, there's no benefit in it whatsoever. For the for the person, I mean, there's no therapeutic benefit at all, from a psychological perspective or social perspective, it has never been done in Islam, and actually goes against a lot of how we're supposed to deal with, you know, with the basics

01:22:44--> 01:23:13

of how we're supposed to deal with death. So we'll definitely these, you know, 40 days, and then I was like, that's not what happened to my country, we just do 40 days, and then they used to do six months. And they would feed people and you know, it's remembering people's important and you know, making the offer them doing good deeds on their behalf and learning from their experiences. These are all important stuff, but don't add any celebrations or don't add specific ceremonies and then that becomes a social norm and people are expected to do it. And it turns into a whole new part of a religion that never existed in the first place. And to be honest, we also have to get we have to

01:23:13--> 01:23:34

think about what people require from a therapeutic perspective. And there's no benefit in that but speaking to the person who just passed away, I think in the first couple of weeks is not is not completely unreasonable. But but it has to come within limitations because it can get out of hand in terms of something that's not that's not helpful anymore below it. And definitely asking them for any for anything is not acceptable, which I think everyone here understands in general.

01:23:36--> 01:23:39

Yeah, man. Nah, man, they come.

01:23:41--> 01:23:45

Thank you for coming and giving your time. And my question is

01:23:46--> 01:24:00

some people like when someone dies, someone like that sometimes they go crazy and about it and they don't innovate. And they make a big problem of it. And I'm asking what should we do if people go oh, crazy about it?

01:24:05--> 01:24:19

question you're asking about family members, right? Yeah. So this is something that has always existed historically the prime Malleus loves them talked about this and there was always there was these bad habits that the the pre Islamic Arabs used to

01:24:20--> 01:24:52

engage in Latin Munia which are used to just you know, shock the fear they would go and and I saw this with my own eyes I in the Middle East where I came from i This used to happen all the time they were there ladies, and forgive me, but I used to see it. The only time I saw it was it was a lady had done it, but men do it as well. But what I have seen where she was ripping her clothes and she was slapping her own face and she was saying all this stuff and men do it as well. And this action is completely is haram. It is not acceptable. And actually there is evidence in the deen that actually can be harmful to the person who passed away it can cause them some grief and the grief as

01:24:52--> 01:24:59

well. How do we deal with it? Well, the way we deal with it is by properly preparing for this beforehand, again

01:25:00--> 01:25:36

Did this doesn't happen to someone who is ready for the concept of death occurring to themselves and to those around them. And that takes, of course, a certain degree of depth and searching into your own understanding of mortality and understanding of Islam. And where you are in your life to achieve a certain degree of comfort develops comfort with the concept of this occurring at some point so that when it does happen, you're able to deal with it properly. Now, what is your job if you know all this doesn't mean anything you're like, Well, I have you found them to do it anyway, your job is to be there to support them and help them and stop them from harming themselves, stop them from

01:25:36--> 01:26:08

doing things that can can be seen as haram or being doing or doing things that can harm the deceased, that would be your job. And if you know someone in your family is very vulnerable, and whenever someone passes away, they don't know how to deal with it, then you should have that on your radar and make sure that you because we had a guy have a great aunt who was like that then. And that's why we you know, whenever she is going to know about someone dying is going to be in a very secure and well controlled environment. And there are people around who are going to make sure that they offer her enough support that she doesn't hurt herself or hurt other people or say things that

01:26:08--> 01:26:32

are haram because also, you know, you can say stuff. And a big problem when people pass away. He's saying things that you know, later on will be helping us to Milty Emma, you said something that had Cooper in it or something that was you're objecting to God or you're refusing the reality in front of you so so supporting people and knowing who is vulnerable and making sure that you're there to help them through the process, it will be your your best, your best bet. And then as your question.

01:26:33--> 01:26:48

Hello, have a go to a question online then come to the sisters on the palliative service, we frequently give narcotics and sedatives to provide comfort, knowing that this may eventually suppress their breathing, and cause that is this permissible.

01:26:51--> 01:27:04

So you this, this is a well known thing in medicine, that when you do give a medication, or a certain effect, you may see side effects. And this is something we see all the time.

01:27:06--> 01:27:32

And so call it a double edged effect, I suppose, but what you are giving it to when you're giving narcotics or when we're giving opioids, or try trading to comfort and that is what you're titrating, this medication to you are not titrating this medication to anything else. And that's what we do in the ICU as well. When we are stopping life support, we are titrating to comfort this patient looks should look that he's comfortable, he's not grimacing is not in any form of pain,

01:27:34--> 01:27:59

as a side effect of opioids, their breathing will slow down a bit. And so that is acceptable, your intention giving it is not to slow down their breathing, your intention is to prevent any form of perceived pain. And so that is completely acceptable. And we know this from medicine that, you know, this is this is an acceptable side effect. It's not something that you are intending harm, by in any way or form.

01:28:01--> 01:28:32

Just kind of echo that is the intention of what why we're giving a medication, we're giving this medication not because we want the person to die quicker. We're giving them medication because they're in pain. And our job is to relieve pain. Now doing that that may have a side effect of them dying quicker. But that wasn't the intention of giving it so that's permissible Islamically now the example that are the question that sister has asked is when you're giving a medication with the intention of of actually ending their lives. So maybe a side effect of that is they feel less pain, but it doesn't matter that's on permissible that's haram because you're basically the intention of

01:28:32--> 01:29:00

doing this, the reason that you're giving the medication is that you're trying to end life and that is completely unacceptable. And it's haram, by all means in all measures. But when you're giving a medication to relieve pain, but you're like, well the side effect that they may die, that's fine, because we're weighing risks and benefits with with this type of approach. And we're doing it with the intention of someone who has a lot of pain there. You know, if you don't give it to him, they're gonna be screaming out in pain, they may go into into a coma, there is so much pain that you give it to take away the pain. And if that leaves for them to dying maybe a couple of minutes earlier or for

01:29:00--> 01:29:16

them to stop, then that that is the side effect of the medication. Every medication we give every medication even like Tylenol, everything you take has the risk of causing harm, but we give it because we have the intention of benefit and we know that the benefit will outweigh the risk. Generally speaking,

01:29:18--> 01:29:25

our time is up but I can see this plenty of questions left. I will ask for like a five minute like overtime period. How

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much are you okay with that?

01:29:33--> 01:29:33

I'm Ashlyn was right there.

01:29:37--> 01:29:40

All right. We'll go to sisters, please

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come over cattle which is late on. I was just that. Let's say there is a terminally ill patient, stage four cancer and they decided enough with the treatments. Do they have to accept the pain? Or can they do palliative care is it outwardly or not get as much as your for

01:30:00--> 01:30:16

Going to palliative care. And in palliative care there is mind altering medications. I've seen patients may saw they are psychotic, sometimes they see things on the wall. But they are happy they are in a state where they're not necessarily experiencing as much pain as before.

01:30:17--> 01:30:49

What's the verdict on that? Is that? So that's the that's the exact example that if you remember at the beginning, Dr. Ahmed and I were talking about, is it permissible to seek here is not permissible. This, these are the examples that existed back then back then there were no antibiotics to take for infections, most of most of the procedures that existed back into the profit audience last time, we're palliative, meaning we're there to actually relieve pain. And that's why some people it was permissible. If you're going to do that, go ahead and do that. If you don't want to do that. If you and you feel like you know, you don't want to, I need to do take a medication to mask

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the pain you want to go through it. That's your choice. Is it cowardly? Definitely not. There's there's nothing cowardly about it whatsoever. Because sometimes you can be in so much pain that you you actually put yourself at risk of saying things or doing things or feeling things that are wrong, you don't want to do that. So so there's nothing wrong going out to palliative care. And I see this all the time, because that's what I deal with almost daily people who have been individuals may Allah grant your RV and shoulder Germaine Aloma, I mean, it will have terminal cancers and and certain types, certain types of cancer can be extremely painful, being situated in places that it's

01:31:19--> 01:31:47

just very, very painful to deal with going on the palliative care is not cowardly, is excitement, Islamic, completely acceptable. If someone chooses for some reason not to go down that route, that's fine. But they should have that option always available for when they want to change their mind. Because every person I've seen, I've seen it before, who said I don't want to take pain medications for something like this have changed their mind. Eventually. I've changed their mindset. At some point. They're like, Give me something I can't. And that's totally fine. Because Because pain can come to a point where it's non tolerable anymore. And it's not something not something that you can

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actually deal with me unless I had the reserve all of you mean, but no, there's nothing wrong with that. If that's your question, and it's totally permissible Islamic is not cowardly.

01:31:55--> 01:31:59

I was just coming around to the listen. Sorry. Could you please go ahead.

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Thank you guys for being here.

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I just wanted to see like, ask if you guys believe that, like when a family chooses to keep the patient on life support, even after you guys told them that there is no hope that they come back? Do you think it's just a matter of emotional satisfaction?

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Because they can't like, let go of that person? A satisfy themselves?

01:32:31--> 01:32:37

That's very important, an important question to ask when you are trying to navigate these difficult discussions with families?

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Are we being selfish here? Are we keeping this person alive because of ourselves? Because we want them to be alive. There's absolutely no hope for this person to regain any quality of life. But I can't see him go. And so these are the questions that are difficult sometimes to discern. And we need to explore them with families, and we need to come around to discuss what are we trying to achieve here?

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Is it because you're not ready to let go? Or is it truly His wish to be maintained indefinitely on life support, and if it's just you not being ready to let go, and we try to emphasize and explain to families that your role here is not to make the decisions on your own behalf? You're making the decisions on his or her behalf? You tell us what he would want in this situation? You are not the one that is leading this? He is you're an expert in him or her you tell us what he would want? And so yes, we do face this sometimes. And these are challenging conversations to have.

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They take time. And, you know, unfortunately, some will end up

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in the right direction being basically, yes, this is what any reasonable person would do, including my loved one, and others will sometimes need to be escalated, if we feel that the person is not asked acting on the best interest of their loved one. There is a mechanism in Ontario where the situation can be escalated to the consent and capacity board of Ontario, in which case they appoint legal representatives for both the family and the health care team. And we go through this, we see what is the end point of what we're doing here. And there's an arbitrator and the consenting capacity board decision is the one that is binding at the end.

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And you're right that 99% of the time it's it's a lack of ability to let go. It's some underlying guilt is underlying fear is something to do with the actual family not to do with the patient. And that's your examples. Most of the time. My examples are different because usually the person is still able to talk to me in the clinic, but in an ICU most of it is just the families weren't ready for it. We're never ready for it and lack the ability to make decisions.

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that are in line with or in keeping with what the medicine is saying and also in keeping with what the dean is saying as well. And that's, that's, that's the biggest.

01:35:08--> 01:35:17

That's the biggest challenge of all and you're correct follow on him. That's a good point. Let me do a couple of buzzer beaters here quickly, can a female visit the grave?

01:35:19--> 01:35:25

Yes. And a can a Muslim make dua for their deceased parents who are not Muslim.

01:35:27--> 01:35:33

Can a Muslim make dua for the deceased parents who are not Muslim? Okay, so here's here's a nice little

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pickle. People don't agree on this. I'll tell you the most liberal

01:35:42--> 01:35:50

opinion that exists that I know of that I that I think is reasonable. We have very clear, Quranic evidence that we don't do is too far.

01:35:52--> 01:35:53

We don't make it so far.

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Am I kind of still a follow up on him and it'd be editing for limited Bayona? And no, I do we'll elaborate about what I mean who

01:36:03--> 01:36:39

we don't make any we don't make stuff up. It's too hot, a specific, it's asking for forgiveness of sins. Why? Because the person in order for to be forgiven for a sin. A few things have to be tough to exist, that deceased person had to acknowledge that there was an authority that said this is sinful. And this is isn't that didn't exist. The person who was deceived has to acknowledge that this action is actually a sin, the person deceased had to have actually wanted that sin to be forgiven, none of that exists. So making dua was meaningless because that's what they wanted. However, the part that is acceptable Allahu Allah, and this is my opinion, and you know, feel free

01:36:39--> 01:37:14

to disagree with me on this one is when it comes to a llama is asking for general mercy. Because what it meant to us the article Lushy everything is encompassed by Allah subhanaw taala has mercy. And this deceased person is a part of shape. So he's encompassed by mercy as well. So using the term of Rama, for me is more is is generally acceptable. Again, it's a very controversial issue. I mean, this is not the hill I wanted to die on tonight. But if that it is, and then it is, Brahma, anything beyond that, no, because you're making dinner that is specific that requires a buy in from the person who passed away me the person has to have bought in to the basic understandings of the deen

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in order for this door that you're making to apply to them in the first place. But Rama which is general mercy and compassion from Allah subhanaw taala applies to everybody. So using that term for music, so we'll have to add on. I hope the pun was unintended there.

01:37:29--> 01:38:08

The one thing I would say also, just to add to Shannon's point is eSATA Simon says on the Day of Judgment into our home for a nomadic winter, winter film for in Cantonese will Hakeem that statement in the end of cinema Ada, if your parents are the ones who passed away, they were not Muslim, or the message of Islam did not reach them. This is important, right? This is the dua you can make for them because this is the dua isa less time is making for his people. After he's asked, Did you tell them to worship Me and my mother, right? So Allah Allah, that is something also that I would say, a sister and brother, can we make this one quick? Because we're in double overtime now? One, then one,

01:38:08--> 01:38:10

and we'll add each other sister please. Yeah.

01:38:13--> 01:38:56

Prophet Muhammad, Salah Salem was even something was Prophet given something before he passed away. And he said not to? Does anybody know that? Like when he was going to when he was going to meet his Lord. And time? He asked, like, I think it was Aisha. He asked if they wanted to give him something to help him but there's no good evidence that a prophet basil salaam was offered anything. First of all, they didn't even know what he had celluloid syndrome. So offering anything would be kind of just a shot in the dark. So that was a part. We don't have evidence that he actually refused anything that was given to him, that Allah and he's like to sell them. So no, we don't have evidence

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that he refused any type of treatment that was available to him. I think.

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There is an I felt in some of the books of Ceylon that something was offered. But it's a very weak point and doesn't really have any authenticity to it. So I never I never mentioned it, I don't I don't accept it used as evidence in this type of situation. Everything that is authentic from that time, which is well documented, by the way, like his last few hours, because a lot of people were there. A lot of people were involved. A lot of information came to us from that point, and nothing really refers to that will go on

01:39:25--> 01:39:25

rather

01:39:27--> 01:39:55

than what my question was regarding the conversation, I guess that was earlier mentioned between miracles and medicine and you want miracles mixed? If you want medicine, go to medicine. I feel like this kind of implies that they're contradictory or they're they're mutually exclusive. Part of it is asking what part of medicine do we count as well as Bab like taking the means before a miracle or before Allah looks towards your right and say you've done what you can talk about Allah and I'll do the rest of it.

01:39:56--> 01:39:59

This comes in comes into play for example, and

01:40:00--> 01:40:41

oncology cases where it's like, okay, the guy can or the person can take, continue on taking medication. And maybe if they just took enough or they waited long enough, something would start turning the right way. And the same with the example you gave with the lady that had the surah. I still I didn't, I wasn't able to connect or to reconcile that hadith, the, the general Islamic direction of less Bob and doing what you can to resolve the problem, and then leaving it for a while afterwards. So they're not exclusive. But the word that I'm using the what does that how does that translate into English is using the worldly manners, right? worldly means the worldly means that's

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what medicine is. It's everything we were able to come up with. So who are you going to listen to? Regarding these worldly means? The people who actually did all the research, the scientists who actually did all this, so they'll tell you, this is what is available to this person. So you start doing that, you come to a point, the same people who offered it say, this is no longer futile. There's nothing to offer here. So it's no longer beneficial, beneficial, it is futile, we can offer it anymore. So for you to say no, keep on going.

01:41:06--> 01:41:33

What is that? Exactly? Because it's not your it's not your domain. This is not You're not the scientist. If you are, then that's fine. If you are a, you know, let's say you're an ICU physician, and you're making that decision based on your information on the science that you have, then that's fine. But if you're not, you're coming to medicine, asking for the best worldly means for cure. That's what you're asking for. So we say you're listening to the physician that you trust, if you don't trust them, you find physicians that you do trust, because trust is a problem, by the way, in the system in general is trust a lot of people send in a doctrine, they don't trust them. That's a

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whole different problem. We didn't talk about that today at all. That's a different issue. So let's say you trust a doctor and they're telling you this is what we can offer the offer it and they come to appointment, we offered everything that we have we have nothing else left to offer. You said why can't you give them this? Like give them this? Like I saw medication there that you can give them this? No, that's not how this works. There is a process that we go through, here's the evidence, here's what we can give when we're done. If you respect the respect, then there's a there's an end to it.

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But if you understand how the universe works, and what Allah subhanaw taala, does, you know that at any point in all of this he can grant you for

01:42:05--> 01:42:42

sometimes against the worst of odds people get better. And sometimes the best of odds they I've seen it like especially in Canada, you see, you see that the paradoxes? You see, the complete paradox isn't the examples people will have? Well, I have I have a breast, breast cancer patient with they've had metastatic bone disease, they've had cancer in their bones for over 15 years. They were given usually, and they have medicine, their brains were at least for at least four. Usually, if it makes it the bones is two years tops that makes it the brain has three months, even for 15 years. We give them the medicine we do. We do what we can now you see people who have like stage one is taken

01:42:42--> 01:43:14

out, everything is cleaned to come back two months later and there and he passed away within three. We don't We can't control this stuff. We just offer we just offer the best evidence, the evidence based medicine, the best of it all, the best of all of it, when someone starts asking for more than that. See, that's what they're asking for miracles within medicine, you know, ask for miracles from Allah because medicine doesn't offer miracles, medicine just goes by the evidence, ask Allah for Allah subhanaw taala, except the evidence based medicine that we're offering now. And the issue usually comes to trust is that we're saying, you have nothing else to offer? Like no, no, there's

01:43:14--> 01:43:40

nothing else to offer yesterday, there's nothing else we can offer. Now, if it was your daddy would have been more we actually have Allah who was me, there's nothing else to offer. There's all we got, we have nothing else. But there's lack of trust here. And then there's what the brother said, there's an emotional attachment to it. We all believe that Allah subhanaw taala is, that's why we're here, we believe that he can do whatever he wants to do. And I'm just a tool being used to offer people some relief of pain and try to offer them whatever, whatever, whatever I can offer them whatever support I can offer. At the end, he will make that decision. They're not exclusive, but

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they have to be treated with the proper logic, you have to go down that proper thought process below on them. Just sorry, a point to that I'm not necessarily talking about the cases where the doctor has is in support of the decision of hey, we've done everything we can, I'm talking about the cases where the person there is still potential cure ahead by taking some means of medical,

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whatever it may be, but the patient chooses to cut it early and say, I'll just let things take the natural path. When does it transition from your your lack of less Bab to Okay, that's, that's sufficient. You've taken sufficient Akanbi less Bab and you're allowed to let it go now. So when it comes to

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hearing disease, you have the right as a Muslim not to do you have a right Islamic right to say I don't want to pursue treatment. Now I talked about at the beginning, that there are exceptions to that rule. If it's a reversible life or limb and the person is young or a person is not mentally competent or they have severe psychological problems in that case then is but if someone is of a certain age, and they're totally with it, and this is reversible, but they're like you know what, somebody is going to kill me at some point. If this is what I got right now like I a person who was like 90

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For example, he gets pneumonia. Pneumonia is are usually pretty well, they're reversible. He gives them antibiotics to get better. He's like, You know what, I'm good. I'm good. I don't want to get the antibiotics but it'll make you better I know but I'm going to die at some point. If this is what's gonna kill me, may it be this I'm happy, I'm I'm ready to move on. This is a disease I got, I accept it, except I'm going to I'm going to also vote if ALLAH SubhanA grasped me she thought without anything that I take it if not, then I pass away and move on to him is that Islamically problematic not at all. It's not problematic at all for you, him to make that decision. But there

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are some caveats. So some limitations you have to make sure that the person is able to make that decision properly. And there's there are some surrounding circumstances that are usually pretty well taken care of in every in every every given situation. But but but you're not held accountable if you decide that you got sick and you just didn't want to pursue treatment unless of course not pursuing treatment is going to you know, is contagious is going to harm someone else, for example, that would be a problem as well. But if it's something that's you know, it's a personal decision, and Allah subhanaw taala is not forcing you to take anything artificial. That's the beauty of it.

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What's your natural state is your natural state, if you stick to it, you can never be faulted. If you stick to your natural state, no one can fault you if you want to take something extra that's fine but if you're like I want I'm just gonna stick to natural state I'm not going to add anything to myself That's within your rights no one can hold you accountable for that without data and I'm gonna talk a little bit

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I just started I just I feel like the people want to know like, again, I believe I just Yeah, so I think let's wrap up with the excellent answer. Zack was here doctor had tried that this was so beneficial hamdulillah by thank you all for being here all the time. Please do sit on a chair like you know, you don't have to sit on the floor the whole time, please. Yanni. This is without. And now I tell you

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forgive me for that. Next Friday. We have the city and Dr. Gibran coming to talk to us about the joy of parenting. It will be an excellent session as well. Please come out of the paddock alone.