An Islamic Medical and Legal Prospective Of Do Not Resuscitate Order In Critical Care Medicine

Abstract

Background: Autonomy is respected in all medical management. Competent patient my give informed consent, but incompetent patients like children or unconscious adult patients need the informed consent of their guardians or surrogate mangers. A well in formed competent patient has decision-making capacity; it is generally, in all societies, has the right to refuse medical therapy, including treatment that will sustain life artificially. During critical illnesses and in case of sustained coma such decision would be taken on his behalf by physicians and or next of kin or a manger that are following his advance directive. If the patient has made a decision to receive life-sustaining therapy, or if circumstances have arisen in which such therapies were initiated, the patient is free, supposedly, at any time to decide whether to have such treatments continue or be withdrawn. There are legal, economical and ethical issues governing such decision, all physicians would support the right to live. But the right to die is not well defined or accepted in most societies. In Islamic societies euthanasia and assisted suicides are forbidden. But the wishes of patient not to have his dying prolonged artificially with the presence of hopeless prognosis are well preserved. Such wishes may be declared in advance directive or accepted standing Do Not Resuscitate (DNR) order in certain hopeless medical conditions. There is no relevant distinction between withholding and withdrawing life-sustaining treatment. In this paper summarized (ICU) current practice in intensive care unit regarding initiating DNR order and Islamic advance directive sample for managing dying process in dignity.