Classification of non-cases are curable .. Infectious diseases without treatment. Sick patients in the intensive care unit and people with severe neurological diseases led to their total disability

This topic was discussed at the Islamic Fiqh Academy in its previous session in Jeddah (1412H) and issued the following decision:
"(A) It is necessary for the Muslim belief that sickness and healing is in the hands of God Almighty, and that medication and treatment are the reasons that Allaah has placed in the universe, and that it is not permissible to despair of the spirit of God or despair of his mercy. In caring for and relieving his or her psychological and physical suffering regardless of whether or not he expects recovery.
(B) What is regarded as a hopeless condition of treatment is, according to the doctors' assessment, the potential of medicine available at any time, place and according to the conditions of the disease. "
Accordingly, the Islamic Jurisprudence Academy has left the appreciation of these cases to doctors and the available medical possibilities.
Incurable cases include many cases involving:
First: Patients with incurable diseases and no treatment and known as the gradual aggravation that ends in death near or far. For example, a widespread, untreated cancer, which is medically known from similar cases, will end in death within months.
Second: Patients who are in the intensive care unit and who have failed with all the means of treatment available to improve their health, they ended up in a semi-final state. They are closer to death than they are to life and are dying. For example, a patient with severe sepsis in the blood, who did not use artificial respiration, dialysis and various medications to stop the development of the disease (this is called medically the case of multiple organ failure).
Thirdly, patients with severe neurological diseases, which resulted in their complete inability to intellectually medically hope for improvement. An example of this is the Sheikh of the pyramid who is severely demented in a manner that is unknown to those around him, unable to perform his needs and does not control urine and feces.
Fourth: Patients with persistent plant conditions, which means the injury of the cerebral cortex permanent permanent injury with some functions of the brain stem intact. Such a patient in a complete absence of consciousness and awareness, but he breathes and digests food and opens his eyes and closes them and therefore he lives a life closer to the life of the plant to human life. Such cases are seen in some accident victims.
The concept of incurable cases does not include brain death. Brain death is defined as the disruption of all functions of the brain irreversibly and irreversibly. The ruling of this patient - as decided by the Islamic Fiqh Academy - the ruling of the deceased. The discussion of this case is beyond the scope of this research.

Directories used to determine that the patient has an incurable condition .. Some types of treatment-resistant leukemia end in death within four to six months

Doctors report that the condition is not curable for what is known as medically similar cases. They also rely on their personal experiences in this field. For example, some resistant cancer cells end up dying within four to six months. The doctor therefore determines that the patient's condition is expected to have a similar fate.
It is clear that such an opinion is based on the assumption of certainty and it is impossible to confirm it in a certain manner. Accordingly, such estimates may be subject to error.
In order to reduce the possibility of this error, the fatwa issued by the Standing Committee for Scientific Research and Ifta issued on 3/6/1409 e required that the case of non-recoverable three doctors competent specialists. This condition was adopted by a number of major hospitals, including the internal administrative policy of King Fahad National Guard Hospital on 5/9/1420 AH, as well as the guide for health practitioners on the ethics of the medical profession issued by the Saudi Commission for Health Specialties.
Although the requirement of a three-consultant agreement reduces the chances of a false expectation of incurable cases, it does not deny it at all.

The definition of intensive care and its capabilities.. Excessive fatigue and strain on the patient to develop breathing tubes, nutrition, urine and intravenous nutrition

What is Intensive Care and what are its capabilities?
Intensive care is defined as part of the hospital where there are enough nursing and medical personnel and accurate monitoring devices to monitor the patient in a precise and continuous manner, in which microbiological treatments such as artificial respiration, blood pressure medications and others can be offered.
In this regard, the following points should be taken into account:
1. The expected benefit of hypnosis in intensive care varies greatly depending on the patient's condition. A young patient with severe asthma is expected to benefit greatly from intensive care. This means that the patient's hypnotism in intensive care usually ends in healing and returning to normal, and that deprivation of it may end with his death. While it is expected that the benefit of a large elderly patient with malignancies, kidney failure, skin ulcers and blood poisoning is much less. This is likely to mean that such a patient will die despite all the treatments provided, and that if he improves, such improvement is likely to be only temporary and does not lead to return to normal.
2. Intensive care is very expensive given the equipment and equipment and the cost of the staff. In some hospitals, such as the King Fahd National Guard Hospital in Riyadh - where a nurse or nurse supervises one patient, a room in intensive care needs to employ five nurses. Some studies estimate that intensive care units in hospitals consume up to 30% of the hospital budget.
3. Due to the scarcity of specialized staff and high cost, the number of intensive care beds in any hospital is limited. The number of patients requiring intensive care services is often greater than the available capacity. How many patients in critical need of intensive care waiting in the emergency department, and how a patient in a serious condition is treated in a hospital in a way that is not commensurate with the seriousness of his condition is expected to have a bed in the appropriate hospital, but to no avail, and how many patients postponed his surgery days Or weeks because there is no bed in the ICU, resulting in serious risk.
4. More complicated is the fact that fewer or more beds of intensive care are occupied by patients with incurable conditions, depriving others who are relieved of this important service. In one hospital, I saw more than a third of the intensive care beds busy with patients with severe, uncooperative injuries, and one had been in intensive care for more than 10 years. It is no secret of the waste of public funds of Muslims.
5. Treatment in intensive care is a great strain on the patient. An intensive care patient needs breathing tubes, nutrition, urine and intravenous nutrition. Artificial respiration is also accompanied by great difficulty due to the pressure of the air from the breathing apparatus inside the chest, not to mention that the patient is often away from his family and mixed with the night and day. These should be taken into account in the case of a patient with a condition that is not to be cured and to determine if the short-term benefit of intensive care in such patients justifies such hardship for the patient in his or her death.

The role of the doctor in intensive care.. Providing medical assistance to the individual patient as an individual. The use of intensive care resources optimally so as to provide the best services to the total patients

The ICU has two responsibilities that may sometimes conflict:
First: The doctor is entrusted to provide medical assistance to the patient as an individual.
Second: The doctor is entrusted with the use of intensive care resources to provide the best services to the total patients.
The inconsistency between these two responsibilities lies in the fact that the doctor oversees the unlimited provision of services to an incurable patient, which leads to the enrichment of these services and depriving others of them. For example, a severely curable cirrhosis patient with severe bleeding requires blood transfusion in very large amounts that may consume most of the blood bank, depriving others who may need a small amount to save their lives as accident patients.
The same applies to a patient who can not be healed to the only remaining bed in the intensive care unit, and that is denied to another patient whose chances of healing may be great if he is given proper treatment.
A number of ICUs have decided that "patients with terminal illnesses are not likely to be cured and are unlikely to benefit from intensive care. They should not be admitted to intensive care departments."

Cardiopulmonary resuscitation.. Place an oral tube into the lungs and help the heart by repeatedly pressing the chest with medication

Doctors resort to heart failure to do so called CPR. This usually involves calling a full medical team quickly and then doing breathing assistance by placing an oral tube to the lungs and helping the heart by repeatedly pressing the chest with different medications. Electric shocks or pacemakers may be used.
This recovery is very important in patients who have been in good health prior to cardiac arrest and then have had an emergency and have stopped the heart. For example, a 50-year-old man has a heart attack that has stopped his heart. Such a patient is expected to respond to CPR.
In other cases, when the patient has multiple organ failure, the recovery benefit may be much lower, so that in some cases the recovery benefit is close to zero. For example, an intensive care patient on respirators, dialysis and severe hypotension despite multiple blood pressure medications, the patient's response to recovery is virtually nonexistent.
It is no secret that the recovery is a great hardship on the patient's body and such hardship justified if it will save his life. If the recovery is useless and ends with the death of the patient, does it justify resuscitation at the same time, leading to hardship for the dying patient such as repeated electrical shocks?