Islamic Doctrine for Hospital Islamic Doctrine for Hospital ChaplaincyChaplaincy

Dr. Faiz Khan MDDr. Faiz Khan MDDiplomate /Associate Professor- Internal Medicine / Emergency MedicineDiplomate /Associate Professor- Internal Medicine / Emergency Medicine

Vice-Chairman / Head of Academic Affairs – Department of Emergency MedicineVice-Chairman / Head of Academic Affairs – Department of Emergency MedicineChair- Medical EthicsChair- Medical Ethics

Nassau University Medical CenterNassau University Medical CenterImam/Author/Lecturer – Islamic DoctrineImam/Author/Lecturer – Islamic Doctrine

Chaplains may offer theocentric pastoral intervention and psycho-spiritual support

In a theocentrically pluralistic society – a chaplain may offer such support to adherents of various faith traditions-

Objectives:

1. Gain familiarity with relevant Islamic Doctrine (mini-Islam 101)

2. Understand ontological premises in relation to human health andphysiologic suffering

3. Discuss clinically relevant elements with regard to Islamic praxis

Concepts, Definitions, and Terms:

Islam and The Transcendent Unity of Religion…therefore intuitive familiarity

Allah

Islam – To be at Peace with…in submission to…no such thing as “new religion”; Muslim = one who strives for a state of IslamApplied to Prophets and Messengers

Prophetic line – Muhammad as Seal (6th century…Arabian Peninsula)

Parochialization of religion with regard to particular forms and exigencies, but not goal nor behavior

(Salvation and Divine proximity…escape from Samsaric cycle to Moksha)

The vehicles…if “driven sincerely” may lead to Grace **no Eschatologic exclusivism**

– Qur’an = Word made Recitation/Scripture ; (Christ = Word Made Flesh…Muhammad = Qur’an embodied).

*Revelation (Wahy)…liturgical act of recitation

-Prior Revelation (Vedas? Abraham, Psalms, Torah, Evangel, Qur’an)

*Qur’an trivia for interfaith fans•Christ = •“Spirit of God” and “Word cast unto Mary-The Blessed Virgin”

•Chapters (Sura) entitled: Noah, Abraham, Mary, Tablespread (reference to Jesus supper supported by Divine Plenitude in company of his apostles)

•Most often recurring Prophetic Narrative is Moses Struggle with Pharaoh and his own followers

• which of the following are mentioned and exalted in the Quran? Adam / Eve, Noah, Abraham, Lot, Isaac, Ismail, Jacob,Joseph, The Tribes, David, Solomon, Jonah, Job, Ezekiel, Moses, Aaron, The Blessed Virgin Mary, Jesus, John ?

ALL + some more

All prophets and messengers came with “Islam” – Krishna, Buddha, Confucius,Zarahustra – (Hammurabbi?) not explicitly mentioned in Qur’an but Islamic Tradition Does not exclude them as prophets/messengers

Muhammad – Final Messenger Mercy to Humanity Seal of Prophets Rejuvenator of Islam

Cardinal Doctrinal Differences: slandering Prophets of God - blasphemy (Noah, Lot, David, Joseph, Mary) Christology – Godly, but not God (Allah) Absolute Monotheism Idolatry / Iconization / visual rendition…almost paranoid rejection

Key Terms:

Hadith = Naratives/News (about Muhammads behavior and decision-making; also may be hadith of X,Y,Z apostle)

**NOT Qur’an in terms of preservation and authenticity

Sharia: Sacred Code of conduct / Canon Law/Dharma – ritual, ethics, human transactions with other humans, animals, environment

Fiqh: Figuring out parameters of Sharia…jurisprudence

Is the conduct/behavior/policy within a latitude of conduct/behavior/policy that Muhammad’s (*) capacity as Messenger of God explicitly or tacitly would encourage or explicitly or tacitly would not oppose.

So who is the vicar of Muhammad (Magisterial Function) ?

Good Question !!!! Depends on who you ask…NO Priesthood – but need for a pontifical human function acknowledged.

Conventional Doctrinal Schemes

- The Five Pillars:- The Witnessing (Shahaada)- Ritual Prayer (Salaat)*clinical relevance

- Tithe (Zakaat)- Monthly Fast (Sawm ul-Ramadan)

*clinical relevance

- Ritual Pilgrimage (Hajj) *clinical relevance

- Articles of Faith: God (Allah) ; Angelic Realm ; Scriptural Continuity; Prophetic Continuity; Divine Judgment; “Measuring Out /Constraint of Fortune/Misfortune *pastoral relevance

Underlying premises relevant to clinical decision making

- Theocentricity and Ethics – Boundaries Set by God ** latitude of human reflection within – (Categorical vs

Contingent) 1. Plurality of religious forms but unity in principles of ethics

2. secular humanisms basis of ethics (?) – progress(?) 3. Human faculties (Synderesis) + educated opinion

- State/Public Interventionalism versus private domain 1. some things ought to be between doctors and families – no need

to pry or “policy seek.” – casuistry (case based) 2. Sharia and Fiqh highly protective of privacy

- Gradation of actions – care not to shackle others or speak for God

1. absolutism rare

Civilizations colored by The Islamic Tradition had highly progressed medicalsystems – healing based on scientific understanding of patho physiology wasEmbraced (no dichotomy between Theocentricity and Science ) Khan, F. An Islamic Appraisal of Minding The Gap – Psycho-Spiritual Dynamics in the Doctor- Patient Relationship. Journal of Religious Ethics 36.1 Mar 2008.

- psycho-spiritual interventions are acknowledged as having physiologicEfficacies Khan F. Miraculous Medical Recoveries and the Islamic Tradition - Special Section: Spirituality/Medicine Interface Project. Southern Medical Journal 100(12) Dec 2007

- ideological issues about life, death, suffering, duty – were alldiscussed.

- polymath versus human unit of care delivery - ?ethicist

- most modern medical ethical issues are not really modern except that technology allows us into situations never seen.

- divergence in decision making based on parochialism respected

Some observations and precedents:

-traditional / theocentric and modernist reactions to misfortune.

-importance for pastoral concerns

a) Defining spiritual health and healthy coping ? Psychological stability ? Exoteric understanding of Metaphysics

and religion

-Religions “functional utility” a) A vehicle Dunya (this world) and Akhiraa (afterlife)

Islamic Doctrine and Human SufferingIslamic Doctrine and Human Suffering

Reconciliation of Suffering in the Face of The Divine

-Metaphysics and Ontological Schemes**explanations not same as proof, nor coping**limits of articulation and language

- Imperfection woven into fabric of existence (Ghayr-ullah)- Expression of Attributes (Necessity of expression)

a. The Divine All-Possibilityb. Divine Justice; Divine Forgiveness; Divine Omnipotence

- Species of Evil: Shar – Spiritual/Psychic/Conscious

Balaa – Affliction / Trial Museeba – Hardship / Calamity / Trial Dhulm – Darkness, Wickedness, Criminal,

Qadar: The Measuring Out

Quranic and Hadith Sampling:

-We have created the human being within [a matrix of] pain and toil. Qur’an 90:4

-And most certainly shall We try you through peril and hunger, and through loss of worldly goods, lives, or fruits of labor Qur’an 2:155.

-Utilize your health and strength [for acts of goodness, beauty, and virtue] before incapacitation befalls you. hadith

-All of life is a couple of days; one is in your favor, one is against you . Hadith of Ali (Muhammads apostle)

Coping and exhortations (glad tidings) with the earthly condition:

Oh Lord, You did Not Create this in vain/folly/without meaning – Glory be to You, and Save us from The Fire. Qur’an

And so with every hardship comes ease,Indeed, with every hardship comes ease. Qur’an 94:5-6.

Oh human being, you have been [through life] toiling toward thy Sustainermeet with Him thou shall Qur’an 84:6.

I never allow to go to waste the efforts of any among you. Qur’an 3:195.

No soul can fathom what bliss lies in wait for them as a reward for all that they did. Qur’an 32:17.

Coping: Exhortations and Glad Tidings: Hadith

The believer will see in his record, on the Day of Resurrection, somemerits he knew he did not earn, nor know anything about the good deeds responsible for them. He will be asked, “Do you recognize these?” So he will say,” I do not know how I came by these.” Then he will be told, “These are compensation for the supplications you madeduring your earthly life [which were not fulfilled in the manner you desired}

One submitted to God (a Muslim) who suffers discomfort, even that of a pricking of a thorn, Allah elevates his standing and effaces sins.

One conscious of God (a believer) cannot suffer hardship, illness, grief, or mental worry unless sins are expiated with it.

Be moderate and stand firm in the face of trouble that falls into your lot as one submitted to God (a Muslim), since this is expiation; even in stumbling on a path or being pricked by a thorn.

One day’s fever expiates a year’s worth of sin.

(+other explicit illnesses / physiologic burdens: pregnancy, seizure, burns,abdominal pathology are mentioned viz a viz spiritual compensation)

- The Afferent Human experience: “Differential diagnosis” and further perspectivesOn affliction…and elation!

1. Moses and Khidr

2. And it may well be that you hate a matter while it is good for you, and it may well be that you love a matter while it is harmful for you. Qur’an 2:216.

3. Defining Success via spiritual growth…The famous 11.

By the Sun, (1) and by its radiance (2)By the Moon, (3), as it follows (reflects) itBy the day (4), and its revealing of itBy the night (5), and its enshrouding of itBy the sky (6), and that which built it (7)By the earth (8), and that which spread it forth (9)By the nafs (soul), (10) and that which has fashioned it (11)And allowed for it to debase itself or its ascend to Taqwa (God-Consciousness) .

He who purifies [his nafs]succeeds,And he who corrupts [his nafs] fails. Qur’an 91:1-10.

1. The Role of Sabr - A vehicle for Spiritual purification.

And most certainly shall We try you through peril and hunger, and through loss of worldly goods, lives, or fruits [of labor],and give glad tidings to those who maintain a state of sabr: those who when calamity befalls them say, “Indeed we belong to God, and to Him is our return.” It is they upon whom their Sustainer’s blessings and grace are bestowed, and it is they who are guided. Qur’an 2:155-57.

And the ones who maintain sabr in misfortune, hardship, and peril: those are the sincere and the pious. Qur’an 2:177.

And those who maintain sabr and are forgiving of others: indeed, this is the heart of things/ focus for the heart. Qur’an 28:80.

You who have attained consciousness of God – Exhibit Sabr when meeting adversity, and vie with one another in Sabr Qur’an 3:100.

Seek support through sabr and prayer. Qur’an 2:153.

And bear with sabr whatever may befall thee. Qur’an 31:17

God is with those who maintain Sabr. Qur’an 2:249.

God loves those who maintain sabr. Qur’an 3:146.

- the human needs affliction to manifest Sabr – doesn’t sit well with modern culture.

Illness as Remembrancer (Mudhakkir)

-Tasawwuf (Sufism): Tazkiatul -nafs Qabd and Bast

Kibr and Ghaflah

- Rumi and the veiled bride

- Al Gilaani - The Soul, its safe keeping lay in trials.

- dhikr al mawt (terminality of life)

..addressing Satanically inspired delusionary arrogance that obstructs the humility and honesty necessary to recognize the human condition in relation to God and Ontological precedents…

Would you, now, look down with disdain upon this message [i.e. the Qur’an],

and make it your [soul’s] daily bread to reject it and call it a lie ?

Why then, when [the final breath] reaches the throat [of the dying] while you are at that moment looking on,

and when We are closer [ to the dying] than you are though you do not see:

why then, if you are “exempt from reckoning,” can you not cause [the departing soul] to return, if you [and your claim] are truthful?

Qur’an 56:81-87.

Thus it is, when the Lord rescues man from affliction, he imagines himself self sufficient – truly man is prone to heedlessness. (Qur’an)

Despair and misinterpretations of trials:

When [his Sustainer] tries [a human being] with a straightening of his sustenance, he says, “My Lord has disgraced me!” Qur’an 89: 16.

The Prophet went to visit a sick Bedouin. Whenever the Prophet went to visit the sick, he would often say “Don’t worry, if God wills, this will be expiation for your sins.” The Bedouin quipped, “You say expiation? No, it is but a fever that is boiling and harassing an old man and will lead him into his grave against his will.”

Muhammad replied “Then it is so.” hadith

Addressing “The Why” …what’s behind the why??

Indeed, through the remembrance of Allah

Do hearts find true peace. (Qur’an)

Patient Interface Perspectives - Patient Interface Perspectives - Abiding by The Sharia in Abiding by The Sharia in modern medical systems:modern medical systems:

Issues:Issues: - Demographics : Fastest growing religion in US ? New Age Makes same claim.- Demographics : Fastest growing religion in US ? New Age Makes same claim.

a. All Over Globally – Indian Subcontinent, Malaysia, Indonesia are where a. All Over Globally – Indian Subcontinent, Malaysia, Indonesia are where majority of muslims live (10% are arab)majority of muslims live (10% are arab)

b. US – India/Pakistan/Bangladesh > African-American > Arabsb. US – India/Pakistan/Bangladesh > African-American > Arabs **Nation of Islam – not considered orthodox by doctrine **Nation of Islam – not considered orthodox by doctrine

– Gender Gender – Trans-Religious Pastoral InterventionTrans-Religious Pastoral Intervention– Specific Rites: Specific Rites:

- perinatal (first words, circumcision)- perinatal (first words, circumcision)- routines, rituals (chapel info)- routines, rituals (chapel info)- Ramadan / Fasting- Ramadan / Fasting

1. dispensation vs. adjusting doses (the diabetic, 1. dispensation vs. adjusting doses (the diabetic, seizure patient, diuretics, antibiotics, parentral routes)seizure patient, diuretics, antibiotics, parentral routes)

2.incidence of self-management… ?anticipatory 2.incidence of self-management… ?anticipatory guidanceguidance

- The Hajj (rigor, vaccinations)- The Hajj (rigor, vaccinations)– Medicinals (pork / alcohol)Medicinals (pork / alcohol)

• Non-Allopathic modalitiesNon-Allopathic modalities

• Sex Ed and anticipatory guidanceSex Ed and anticipatory guidance

•AbortionAbortion •Perimortal practices / Advanced DirectivesPerimortal practices / Advanced Directives

• Brain Death (movement of the dead/slain)Brain Death (movement of the dead/slain)

• Autopsies / Organ Donations Autopsies / Organ Donations

•Access Issues:Access Issues:•Fear of PrejudiceFear of Prejudice•Health Insurance Health Insurance