Bioethics in Faith and Practice, Volume 3, Number 1

30 Swazo ⦁ Non-voluntary Euthanasia 30 approximately 30 years (assuming reasonable medical management of their condition). Further, while there is no possibility of cure for their DMD, there is some prospect of alleviation of their affliction through medication (corticosteroids), assistive devices, and physical therapy (this is only to say such alleviation is to be acknowledged, not to say that Mr. Hossain might afford such care or otherwise have it provided by governmental, NGO, or charity options). On point number 3, Mr. Hossain is sole surrogate decision maker, since the wife is mentally challenged and cannot contribute to decision; and, clearly, Mr. Hossain’s request is evidence of his explicit (if not fully informed) consent to an act of non-voluntary active euthanasia for both younger son and grandson. Points 4 and 5 would, of course, depend on legislation or professional standards put in place to assure Mr. Hossain’s request would be handled appropriately to satisfy these two conditions. In any case, under such a protocol governing non-voluntary active euthanasia, Mr. Hossain is not justified to pursue such action for his youngest son and grandson. D. The Islamic Ethical View It is important to understand that “religious pluralism in a secular society influences the content and method of moral argumentation on active euthanasia by religious traditions.” 35 Yet, as noted earlier, Bangladesh is a Muslim-majority country with Islam designated the religion of state, despite constitutional protections for religious diversity and secular values. As such, most Bangladeshis understand and accept the prohibition of suicide and, by extension, an expected prohibition of any action characterized as active euthanasia, whether voluntary, involuntary, or nonvoluntary. The cleric’s comments cited earlier are illustrative of such an opinion. This opinion is consonant with the general view that, “Islamic jurisprudence, based on a convincing interpretation of the Holy Koran, does not recognize a person’s right to die voluntarily,” thus ruling out voluntary euthanasia . 36 However, there is a close relationship between law and morality in Islamic thought even as there is a distinction of the two, thus Islamic jurisprudence proper ( usul al-fiqh ) and Islamic ethics proper ( (’ ilm al-akhlāq ). One may consider here, e.g., Abdulaziz Sachedina’s reminder that, “The importance attached to the issue of the quality of life has sometimes led Muslim scholars to evaluate suicide (in Arabic expressed as intihār , and halākat al-nafs ) in very ambiguous ways. On the one hand, there is unanimity in declaring the act [of suicide, intihār ] as irrational and impermissible; on the other hand, some interpretations in classical sources intimate a degree of extenuation, especially when coping with circumstances.” 37 Dariusch Atigetchi observes similarly that, “the positions [on euthanasia] tend to oscillate between two polarities. On the one hand theoretical statements which in general condemn euthanasia (not well defined); on the other several medical-clinical pronouncements that seem to leave room for ‘interventions’ aimed at terminating or shortening the life of the patient who is in hopeless and very undignified conditions.” 38 Further, Islamic law and ethics recognize a child’s transition to an age of maturity (arbitrarily set, e.g., at age 15) and right to make decisions. Thus, e.g., Kamyar M. Hedayat and Roya Pirzadeh, both pediatricians, counsel from a Shi’a Islamic perspective that, “When there are 2 equivalent treatments, and an intellectually mature teenager chooses one and his father chooses the other one and they cannot be reconciled, the physician may respect the decision of his patieht (Ayatollahs Sistani and N. Makarem-Shirazi, personal communication, June 1999). ” 39 Whether such a view applies in the Sunni Islamic setting of contemporary Bangladesh would require further evaluation in relation to the dominant Hanafi and Salafi perspectives now influencing jurisprudential decision among religious authorities. Conclusion Our foregoing analysis leads to the conclusion that: 1. It is morally impermissible for Mr. Hossain to consider either (a) involuntary active euthanasia in the case of his elder son or (b) non-voluntary active euthanasia in the case of his youngest son and grandson. The argument here is deontological , i.e., duty-based, rather than utilitarian.