ISLAMIC BIOETHICS

Helmin elyani
 BIOETIK ialah ….

Istilah bioetika  Van Rensselaer Potter, (Bioethics: Bridge to the Future)

yang membahasa tema yang berhubugan dengan penekanan tanggung jawab para
ahli biologi dalam menjamin kelangsungan kehidupan di bumi ini dan dalam
menciptakan syarat-syarat untuk meningkatkan kualitas kehidupan.

istilah bioetika menjadi meluas namun tetap memiliki batasan yaitu:

1. Bersifat interdisipliner, yaitu suatu analisa keilmuan yang membahasa suau
aspek dari berbagai ilmu yang berhubungan dengan kehidupan yaitu ilmu-ilmu
biomedis, teologi, hukum, sosiologi dan filosofis.
2. Bersifat internasional, yaitu pembahasan suatu masalah yang berhubungan
dengan kehidupan tersebut dibahas tidak sekedar menggunakan pandangan yg
dipengaruhi budaya setempat melainkan pandangan yg mendunia.
3. Pluralistis/terbuka . artinya perbedaan budaya,
aliran pemikiran yang berbeda-beda didengarkan tetapi diterima melalui dialog
secara rasional
Dalam dunia medis…..

bioetika lebih cenderung fokus terhadap isu etika yg muncul di

di bidang kedokteran dan ilmu biologi, terutama dalam area :

1. Hubungan antara pasien dan pelayanan kesehatan yang

professional
2. Keadilan dalam layanan kesehatan
3. Isu yang muncul akibat kecanggihan ilmu pengetahuan biologi
dan tehnologi
(Dan Brock, Brown University,1999 dalam Bertens,)
LATAR BELAKANG PERLUNYA BIOETIKA ISLAM

PERMASALAHAN 1
masalah dibidang kesehatan yang dialami oleh kaum muslimin  permasalahan yang
menyangkut aspek kehalalan suatu aktivitas. Kasus semacam : aborsi, euthanasia, cloning, KB
atau yang lainnya memerlukan kajian hukum islam baru karena kasus tersbut tidak dijumpai di
zaman Rasulullaah dan para sahabat.  wilayah ijtihadiah

PERMASALAHAN 2
Konsep bioetika secara universal pada kasus etika medis selalu dibahas secara biologi  jarang
di verifikasi secara eksperimental.
Konsep etika (latin ethos = makna ‘behavior,’-perilaku- ‘customs,’-adat- and ‘morals’ –moral-) 
Adat dan perilaku merupakan bahan pembentuk budaya, sedangkan budaya yang berbeda akan
melahirkan konsep moral yang berbeda-beda. Konsep etika menjadi sulit di universalkan
(A. S. Weber, 2010)

PERMASALAHAN 3
BIOETICHAL REASONING yang selama in sering menjadi acuan dalam bioetika barat
 WESTERN / UNIVERSAL BIOETHICAL REASONING

Kaidah dasar bioetika (Beauchamp and Childress, 2008)

1) Respect for autonomy – respecting the decision-making capacities of autonomous persons;

2) Nonmaleficence – avoiding the causation of harm;
3) Beneficence – providing benefits and balancing benefits against risks and costs;
4) Justice – distributing benefits, risks and costs fairly.

Kaidah hipokrates
yang menyebutkan kewajian dokter terhadap pasien harus mengacu kepada sikap
dokter yang baik.  dokter yang bercirikan keadilan, Confidentiality dan beneficence.
“Decorum (PERI EUSHMOSUNHE), The Law (NOMOS), The Physician (PERI IHTROU), and Precepts (PARAGGELIAI) (Littre, 1839–63)
 WESTERN / UNIVERSAL BIOETHICAL REASONING

3. Konsep Kant (Immanuel Kant)

Kant meyakini bahwa hanya ada stu kewajiban moral yang disebut “ Categorical
Imperative”  autonomy and rights-based ethics in health care ethics

4. Konsep Katolik.
Modern Christian apologists attempt to align biomedical innovations with holy
scripture, and patristic biblical exegesis.

5. Aristotelesisme.
Konsep etika menurut aristoteles sering diistilahkan dengan sebutan “virtue ethics”
yaitu suatu konsep tentang bagaimana melakukan segala hal dalam bingkai
persahabatan, nyaman, bermartabat dan sejahtera utk terwujudnya kehidupan baik
yang diimpikan
 WESTERN / UNIVERSAL BIOETHICAL REASONING

6. Libertarian.
Konsep otonomi individu yang dimaknai bahwa sikap disebut baik jika seseorang
respek (bertanggung jawab) atau seseorang tidak dibatasi kebebasan individunya. Ada
yang menyebutkan bahwa libertarian adalah bentuk dari sikap individualis yang
berlebihan.

7. Utilitarianism or Benthamism. Jeremy Bentham (1748–1832)

utilitarian adalah baik jika ia makin menimbulkan keuntungan yang lebih besar bagi
masyarakat  maximizes pleasure, and minimizes pain.
Bentham’s disciple John Stuart Mill wrote: “the greatest happiness principle holds that
actions are right in proportion as they tend to promote happiness; wrong as they tend
to produce the reverse of happiness” (Mill, 1863).

8. Casuistical Reasoning (Casuistry).

Casuistry represented a form of case-based moral reasoning grounded in real cases
rather than abstract principles or theories. Much of the practical day-to-day
biomedical reasoning (such as disciplinary actions by hospital ethics boards) is broadly
casuistical in nature, being a case-based endeavor. Casuistry is one of the primary
foundations of English common law.
 Pentingkah bioetika keislaman itu ?

1. Many Muslims incorporate their religion in almost every aspect of their lives.
They invoke the name of God in daily conversation and live a closely examined life in
relation to the Qur'an and the traditions of the Prophet, believing that their actions
are very much accountable18,19 and subject to ultimate judgement.

2. Islamic bioethics emphasizes the importance of preventing illness,

but when prevention fails, it provides guidance not only to the practising physician but
also to the patient.6 The physician understands the duty to strive to heal, acknowledging
God as the ultimate healer. Islamic bioethics teaches that the patient must be treated
with respect and compassion and that the physical, mental and spiritual dimensions of
the illness experience be taken into account.

3. In Islam, life is sacred: every moment of life has great value, even if it is of poor quality.
 Pentingkah bioetika keislaman itu ?

4. Islamic bioethics is an extension of Shariah (Islamic law), which is itself based on 2

foundations :
the Qur'an (the holy book of all Muslims, whose basic impulse is to release the greatest
amount possible of the creative moral impulse10 and is itself "a healing and a mercy to
those who believe"11)
the Sunna (the aspects of Islamic law based on the Prophet Muhammad's words or acts).
Development of Shariah in the Sunni branch of Islam over the ages has also
required ijmaa (consensus)
and qiyas (analogy), resulting in 4 major Sunni schools of jurisprudence. Where appropriate,
consideration is also given to maslaha (public interest) and urf (local customary precedent).12

5. Islami bioetio os not a "grey zone" stigma on ethics

 How Ethical Decisions Are Made in Islamic Bioethics?

A. Main Sources:

1- Koran's verses are the most powerful evidence, because we believe that Allah
said them
2- Sunna: which includes all what Prophet Muhammed (PBUH) said, did, declined,
or approved. This is in turn divided into sub-evidence in a range from Sahih
(Authentic Hadeeth), i.e. what is confirmed to be said or done by the Prophet,
down to Dhaif and Mawdaou (Weak and abandoned Hadeeth), which are
confirmed to be not said or done by the Prophet. Evern more, there are different
methodologies that were developed by the scholars of Hadeeth to classify
whatever they hear attributed to the Prophet. The most known methodologies are
what we refer to as the (Six Correct Books) of Albukhari, Muslim, Al-Tirmizi, Ibn-
Maja, Abu Daoud, and Al-Nisaie. Other methodologies and classification of
religious evidence were developed by Imam Malik (in his book Al-Muawataa),
Imam Ahmed (in his book Al-Musnad), and Alhakim (in his book Al-Mustadrak)
 How Ethical Decisions Are Made in Islamic Bioethics?

B. Secondary Sources:

Many of the issues that Muslims faced after the death of the prophet were not
clearly mentioned in Koran or Sunna; thus, the scholars tended to come up with
new methodologies to come up with decisions (mainly jurisprudential, Fiqhi).
These methodologies included:
1- The deeds of the Prophet's companions
2- The unanimous agreement of trusted scholars (Alijmaa)
3- The opinion of the majority of scholars (Raiyoul jomhour)
4- Measurement (Alqiyas): i.e. to measure a newly faced issue to a similar case that
has precedence before
5- Remediation (Istishab)
6- Public interest (Almasleh Almorsala)
7- The custom (Al-ourf): what people in the given community used to do or accept
as normal, and that is not prohibited in Islam.
The scholars have agreed on measurements and standards to tell whether a
deed is right or wrong from Islamic perspective, agreed on:

A. The 5 Goals/purposes of Islamic law and morality:

For any act to be said permissible or not, in other words ethical or not, it
is measured against these five goals. If the deed fulfills them; it is
ethically acceptable. If not, then it is not. The more goals it fulfills, the
more advisable to comes to be done. These main goals of Islamic Law
(and Morality) are summarized as follows:

1- Preservation of Religion;
2- Preservation of Soul
3- Preservation of Mind;
4- Preservation of Wealth; and
5- Preservation of Progeny.
B. The 5 Grand Principles: and C. Many sub-rulings under each Grand Principle:

The Grand Principles are guiding principles that should be applied and followed when measuring
any issue

1- The principle of Hardship (Al-Mashaqat):

This principle is based on the concept that Islam does not mean to cause any hardship to humans.
For example, although ALL Muslims should pray standing up, and fast; patients and weak ones are
allowed to pray sitting or laying down, and not to fast Ramadan to not to cause them further
hardship.

2- The principle of Intention (Alqasd): This means each action is judged by the intention behind
it. To illustrate, if someone holds a knife and cut someone's abdomen; he could be either
punished or rewarded according to his intention. If he intended to kill him by cutting his abdomen
(e.g. a thief or murderer), he'll be punished, while a surgeon doing almost the same act will be
thanked and rewarded.

3- The principle of Certainty (Yaqeen): For example, if there is doubt about whether a patient is
alive or dead; he is considered alive UNTIL there are cardinal definite signs of death.

4- The principle of Injury/Harm (Dharar): Its main sub-rulings are "Injury should be relieved
(Aldhararo yuzal)"; "An individual should not harm others or be harmed by others (La Dharara
wala Dhirar)"; "
The judicial decisions (fatawa)  revealed a general lack of interest in using
scientific data to guide legal-ethical deliberations

There was a cultural disconnect about what these physicians had learnt in the
secular environment and what they found in their own religiously sensitive
Muslim culture

Authoritative guidance  consisted of varied opinions ascribed to prominent

jurists, which functioned as the authoritative and authentic guidance in a
number of clinical situations that demanded religious resolution

Muslim jurisprudence was, and remains, essentially religious-text based with

the assumption that what God commands is good and permissible, and what
God forbids is evil and must be avoided.

It need bioethics centers in Muslim countries will assume the critically needed
new leadership role in facilitating a global religious ethics of care and
compassion.
 What should we do ?

1. using scientific data to guide legal-ethical deliberations

2. physicians must learnt in the religious / islamics environment and what they
found in their own religiously sensitive Muslim culture

3. Authoritative guidance  from muslim thinker/ physicians thinkers

4. Muslim jurisprudence was, and remains, essentially religious-text based with the
assumption that what God commands is good and permissible, and what God
forbids is evil and must be avoided.
ANY QUESTION