GUIDELINES FOR USE OF NON-HALAL MEDICINES FOR MUSLIM PATIENTS
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1 GUIDELINES FOR USE OF NON-HALAL MEDICINES FOR MUSLIM PATIENTS Amrahi bin Buang RPh 581 MMPS Kuala Lumpur, Malaysia MPS SC Amrahi
2 Use of Non-Halal Medicine For Muslims Formulation of the guidelines References Al Quran, Al Hadis, Qias, Ijtimak Ulama Maqasid shariah Qawaid shariah For the use of healthcare professionals doctors, nurses and pharmacists etc MPS SC Amrahi
3 Halal Status Halal Mushbooh Haram MPS SC Amrahi
4 Al Quran references Surah al-baqarah - (2): O ye who believe! Eat of the good things that We have provided for you, and be grateful to Allah, if it is Him ye worship He hath only forbidden you dead meat, and blood, and the flesh of swine, and that on which any other name hath been invoked besides that of Allah. But if one is forced by necessity, without willful disobedience, nor transgressing due limits,- then is he guiltless. For Allah is Oft-forgiving Most Merciful. MPS SC Amrahi
5 Al Quran references Surah al-anaam - 145: Say, "I do not find within that which was revealed to me [anything] forbidden to one who would eat it unless it be a dead animal or blood spilled out or the flesh of swine - for indeed, it is impure - or it be [that slaughtered in] disobedience, dedicated to other than Allah. But whoever is forced [by necessity], neither desiring [it] nor transgressing [its limit], then indeed, your Lord is Forgiving and Merciful." MPS SC Amrahi
6 Al Quran references Surah al-maidah - 3: Prohibited to you are dead animals, blood, the flesh of swine, and that which has been dedicated to other than Allah, and [those animals] killed by strangling or by a violent blow or by a head-long fall or by the goring of horns, and those from which a wild animal has eaten, except what you [are able to] slaughter [before its death], and those which are sacrificed on stone altars, and [prohibited is] that you seek decision through divining arrows. That is grave disobedience. This day those who disbelieve have despaired of [defeating] your religion; so fear them not, but fear Me. This day I have perfected for you your religion and completed My favor upon you and have approved for you Islam as religion. But whoever is forced by severe hunger with no inclination to sin - then indeed, Allah is Forgiving and Merciful. MPS SC Amrahi
7 Al-Hadeeth references Narrated Usamah ibn Sharik: I came to the Prophet (peace_be_upon_him) and his Companions were sitting as if they had birds on their heads. I saluted and sat down. The desert Arabs then came from here and there. They asked: Apostle of Allah, should we make use of medical treatment? He replied: Make use of medical treatment, for Allah has not made a disease without appointing a remedy for it, with the exception of one disease, namely old age. Narrated AbuHurayrah: The Apostle of Allah (peace_be_upon_him) prohibited unclean medicine. MPS SC Amrahi
8 Al-Hadeeth references Narrated Tariq ibn Suwayd or Suwayd ibn Tariq: Wa'il said: Tariq ibn Suwayd or Suwayd ibn Tariq asked the Prophet (peace_be_upon_him) about wine, but he forbade it. He again asked him, but he forbade him. He said to him: Prophet of Allah, it is a medicine. The Prophet (peace_be_upon_him) said: No it is a disease. Narrated AbudDarda: The Prophet (peace_be_upon_him) said: Allah has sent down both the disease and the cure, and He has appointed a cure for every disease, so treat yourselves medically, but use nothing unlawful. Narrated Abu Huraira: The Prophet said, "There is no disease that Allah has created, except that He also has created its treatment. MPS SC Amrahi
9 Principles Cure of disease ONLY lies with Allah Man propose and Allah dispose Must be congruent with Islamic teachings non-syirik Ingredients must be halalan and toyyiban [halal and non-najs] except in dire needs Prevention is better than cure MPS SC Amrahi
10 Maqasid Shariah Maqasid is an Arabic word for goals or purposes. In an Islamic context, the term can refer to the purposes of Islamic faith, zakat (charity tax), pilgrimage, or of the Qur'an's and Sunnah's text. In terms of Shariah, there are five foundational goals (maqasid al-shariah). These are the preservation of: Religion / Faith (din) Life (nafs) Lineage / Progeny (nasl) Intellect ( aql) Property / Wealth (mal) [1][2] MPS SC Amrahi
11 Qawaid Shariah Intent good Belief non-ambiguity Injury level dan situational Dharurah emergency Norm Good Clinical Practice and evidence-based medicine MPS SC Amrahi
12 Syariah Compliance In Use Of Medicine Haram if involves haram and najs ingredients In emergencies, haram and najs ingredients can be use with following conditions: Healthcare professional is a honest and trustworthy (amanah) person In situation where there is no halal medicine available Restricted and rational use Intended to be use (under clinical conditions) in lifethreatening situations MPS SC Amrahi
13 Muslim Patients Rights Right to have Halalan Toyibban medicine Right to have non-najs medicine Right to be informed of halal status of medicine Right to choose medicine Right to give consent for use of non-halal medicine MPS SC Amrahi
14 Medicine Use Cycle Prescribing Monitoring PATIENT Dispensing Administering MPS SC Amrahi
15 Ruling on Using Clexane and Fraxiparine Medicines Decision: The 87th Muzakarah (Conference) of the Fatwa Committee National Council of Islamic Religious Affairs Malaysia held on 23rd-25th June 2009 has discussed the ruling on using clexane and fraxiparine medicines. The Committee has decided that: Islam prohibits using medicine derived from unlawful sources as a cure, except in a situation where there is no other lawful sources and the amount used according to the prescribed dosage only. The haram based medicine is only permitted to be used limitedly. The permissibility (of using haram based medicine) is annulled when the halal alternative is found. Thus, as regards to clexane and fraxiparine that are urgently needed by patients who are in critical condition to prevent sudden clotting of the blood, the Committee has decided that the medicines are forbidden. It is due to the availability of alternative medicine namely arixtra that is produced from lawful sources which has the same function and efficiency as clexane and fraxiparine. MPS SC Amrahi
16 GUIDELINES FOR USE OF NON-HALAL MEDICINES FOR MUSLIM PATIENTS #1 : Treatment with this medicine is critical to the welfare of the patient. e.g For DVT, a halal heparin should be use if available instead of a non-halal heparin OR Fondaporinux should be used instead of clexane or faxiparine MPS SC Amrahi
17 GUIDELINES FOR USE OF NON-HALAL MEDICINES FOR MUSLIM PATIENTS #2 : Absolutely no other compounds from halal sources are available for use and this medicine must be clinically proven choice in treating the patient s condition. Class 1 recommendation with level A evidence. e.g For DVT, clexane can be used if faxiparine or fondaporinux is not available at point of use based on clinical condition MPS SC Amrahi
18 GUIDELINES FOR USE OF NON-HALAL MEDICINES FOR MUSLIM PATIENTS #3: Prescribing of this medicine is restricted to Muslim physicians well versed in Islamic laws. A non-muslim physician needs to refer to the above-mentioned physicians regarding the use of this medicine; or the attending physician may refer to previous cases regarding the use of this medicine on Muslim patients. MPS SC Amrahi
19 Panel of experts for the use of non-halal medicines for Muslim patients. Consists of experts from: Medical Department Surgical Department Obstetrics & Gynaecology Department Paediatrics Department Orthopaedics Department Orthorhingology Department Emergency medicine Department Pharmacy Department MPS SC Amrahi
20 GUIDELINES FOR USE OF NON-HALAL MEDICINES FOR MUSLIM PATIENTS #4: The patient or relative must be given a very clear explanation by the attending physician regarding the use of this medicine. The patient or relative s consent is absolutely essential. If necessary, a consent form must be filled and filed in the patient s notes. Alternatively, it can be recorded directly on the patient s notes. MPS SC Amrahi
21 Consent Form MPS SC Amrahi
22 GUIDELINES FOR USE OF NON-HALAL MEDICINES FOR MUSLIM PATIENTS #5: This medicine may only be used for a specific period of time as per attending physician s recommendations. e.g For DVT, clexane can be used during time of unavailability of fondaporinux or faxiparine. Time to be specified. MPS SC Amrahi
23 GUIDELINES FOR USE OF NON-HALAL MEDICINES FOR MUSLIM PATIENTS #6: During life-threatening medical emergencies, the attending physician may use this medicine without first obtaining the patient s consent. e.g For DVT, clexane can be used in the event fondaporinux is contra-indicated for use as in renal failure for Muslim patients. MPS SC Amrahi
24 MPS SC Amrahi
25 MPS SC Amrahi
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