PROTOCOLS AND FATWA IN MALAYSIA ON WITHHOLDING AND WITHDRAWAL OF LIFE-SUSTAINING TREATMENT IN INTENSIVE CARE UNITS: AN OVERVIEW

Abstract

For many Muslim patients, families and intensive care physicians, deciding on whether to withhold or withdraw life support remains challenging. This point of transition from active intervention to the palliation process requires a crucial decision-making process. The decision involves conveying information to families to be well prepared beforehand, especially during the process of withdrawing life-sustaining treatment. Once the final decision to withdraw life sustainment has been made, procedure on cessation of care, treatment withdrawal and nature of follow-up support will be informed to the family members. This is especially so considering that the relationship between Islamic ethico-legal guidance and clinical protocols on such matters remains scattered and difficult to interpret. In light of this gap, we conducted a short review to aggregate clinical protocols and rulings from Islamic fatwas on whether, and when, it is permitted to withdraw and/or withhold life-sustaining care. This article aims to explore relationship regarding decision in withholding and withdrawing life-sustaining treatment, based on guidelines by Malaysian intensive care unit protocol and the fatwa in Malaysia. The methodology chosen for this study is content analysis of the relevant published literatures. We found the decision for withholding and withdrawing life sustaining treatment in intensive care unit are correlated between the ICU protocol and fatwa in Malaysia. In addressing the withholding and withdrawal of life-sustaining measures, the Muslim health-care workers as well as families should take a more cohesive approach, as this is parallel to the fatwa in Islam.