Creating an advance healthcare directive allows you to control who can make healthcare decisions on your behalf and provide guidance on your healthcare preferences.
If you are a practicing Muslim and preparing to make your own advance healthcare directive, you may wish to know how Islamic principles guide the use of advance healthcare directives.
Doctor Kahf and the Islamic Organization in North America provide a detailed guide to writing your own advance healthcare directive in accordance with the basic tenets of Shari’ah law, which is publicly and freely accessible on Doctor Kahf’s website. For your convenience, we've summarized the process and the guide here.
Big Picture: How the Islamic Guide to Advance HealthCare Directives Works
There is no federal or state required form for advance healthcare directives. Nonetheless, many states provide recommended forms that walk through your options for nominating a trusted agent to make healthcare decisions for you and specifying your preferences surrounding potential end-of-life care.
Since your healthcare providers are accustomed to seeing advance healthcare directives in the state-recommended form, the Islamic Guide to Advance Healthcare Directives starts with each state's recommended form as a template and makes the necessary changes to comply with Shari’ah law.
What are the special instructions for meeting the Islamic requirement?
Starting with your state's recommended form, you'll make the following changes:
- Choose a fellow Muslim to serve as your healthcare agent
- Limit your agent's authority to making decisions on the basis of Islamic principles
- Strike or remove the end-of-life preferences block in your "Living Will"
- Declare that you wish to receive a funeral and burial
- Declare that under no circumstances are your reproductive organs to be part of any organ donation or other anatomical gift
Choose a Fellow Muslim to Serve as Your Healthcare Agent
Of all the decisions in an advance health care directive, choosing who to select as your agent under a medical power of attorney is the most important.
Although statutory advance healthcare directive forms can help you provide general guidance on your preferences, the reality is that it's impossible to predict and detail all future circumstances that might arise with regard to your health. Therefore, choosing an agent who you believe can interpret and represent your wishes in all the gray areas is paramount.
Choose a fellow practicing Muslim who knows you well and is prepared to follow your instructions.
Limiting Your Agent's Authority In Accordance with Islamic Principles
On most all state recommended advance healthcare directive forms, you'll see a section labelled "Limitations on Agent's Authority" or "Other Instructions for Agent." Here you can limit your agent's authority in accordance with Islamic principles by adding the following text in italics:
My agent shall make any decision regarding my healthcare on the basis of the Islamic principles. According to these principles, life is invaluable. These principles require the provision of healthcare as long as there is the slightest hope of life in the body. They also require minimization of pain.
If at any time I should have a terminal condition and am in a permanently unconscious state and two physicians, one of whom may be my attending physician and the other should be specialized in the area of my illness or injury, determine that there can be no recovery from such condition and my death is imminent and the application of life-prolonging procedures would serve only to artificially prolong the dying process, I direct that such procedures be withheld and/or withdrawn, and that I be permitted to die naturally with only the administration of medication or the performance of any medical procedure deemed necessary to provide me with comfort, care, or to alleviate pain.
I desire that nutrition and hydration (food and water) be withheld or withdrawn when the application of such procedures would serve only to artificially prolong the process of dying.
If two physicians determine that my brain died, any blood circulation or life prolonging procedures must be withdrawn unless they are needed for purposes of making anatomical gifts at death, subject to the constraints herein.
Removing the Standard End-of-Life Preferences Block
On your state's recommended form, you'll see a section titled "Living Will" or "End of Life Preferences."
This section walks through a number of hypothetical end of life scenarios and allows you to check whether or not you'd like to pursue a particular outcome. For example, the form will have a box to check yes or no to reveal your agreement with the following hypothetical, "If I have a terminal condition I do not want my life to be prolonged and I do not want life-sustaining treatment, beyond comfort care (treatment given to protect and enhance my quality of life), that would serve only to artificially delay the moment of my death."
Instead of completing this section, remove or cross it out. You already provided the guidelines that you want your agent to follow for these hypotheticals in the previous text you added under "Limitation of Agent's Authority" or "Other Instructions for Agent."
Declaring Your Funeral and Burial Wishes
The statutory forms present a few different options for end-of-life ceremonies, not all of which comply with Shari’ah law.
In this section, check the appropriate box indiciating you wish to have a funeral and your body buried, or write those instructions in the space provided.
Declaring Your Preferences for Organ Donation
Declaring your willingness to donate your organs in your living will is one of several ways that you may become an organ donor, and potentially, save a life.
Nearly 170 million Americans are already registered as organ donors, but only 3 in 1000 deaths accommodate the organ donation process. With more than 100,000 patients on the national transplant waiting list, every additional donor registration may help.
Should you decide to donate (if circumstances of your death allow), you may set your preferences on which parts you would be willing to donate and the permissible purposes (i.e., transplant, therapy, research, education, etc.).
To the extent that you wish to provide "any needed organs, tissues, or parts", make sure that you specifically exclude your reproductive organs (i.e., penis and testicles or vagina and ovaries) in order to comply with Shari’ah law.
Summary
Creating your advance healthcare directive is an essential part of creating a comprehensive last will or revocable living trust package.
Using your state's form as a template is a great starting point, but you must modify the form in a few key places to comply with Shari'ah law.
