Fatwa: # 47097
Category: Jurisprudence and Rulings...
Country: India
Date: 5th April 2021

Title

Removing Brain Dead Newborn from life support

Question

I am currently in India and need your urgent assistance in the following matter.

Girl child was born in India, brain dead.  Was not breathing nor crying and had to be resuscitated and put on ventilator and shifted to Child Hospital.  No movement of the body and no sound.  Doctors checked and declared her brain to be 90% dead.  Even if she lives she would be in a vegetative state with no functioning of her body parts.  On day 5 she is shifted to regular hospital where she is now breathing without ventilator on day 7.  However, she cannot intake milk without a feeder tube through the nose.  Her legs have hardened, no sense of hearing or sight (not opened eyes yet) since birth.  Has not cried.  Doctors state that even if she lives she would be a vegetable.

Grandmother of the child is in a dilemma as to what to do. She is poor and has already expended a lot of her savings at the Children's hospital for the child for the ventilator and medicine, etc.  Should the feeder tube be taken away and let the child pass away?  Only her heart is pumping and she is passing urine.  I do not have information if she is passing stools also. 

Please inform what should be done?  Can the feeder tube be stopped and let the child pass to the next world?  The doctors tell her to take the child home to the mother and let things take whatever course they will take.  Grandmother is reluctant to do so as being with the child will only cause mental anguish for the mother who is in the postpartum period recovery period right now. The groom's family as well as the mother of the child have given up on the newborn girl and do not want the child in the state that it is as it would be difficult for them to look after it 24/7.  It would take up all the time of the mother, disrupt her newly married life (child was born during first year of marriage and mother is only about 20), cause constant grief and anguish, taunts from the in-laws and others, etc, etc, etc.  You are well aware of the societal issues in a place like India.  It is only the grandmother who is reluctant regarding pulling off the feeder tube too on moral grounds.  She realizes that the girl has no feelings or functioning of senses but does not know what to do.

Please give your ruling into the matter ASAP along with the justification so that I can relate the matter to the grandmother and the mother of the child along with the in-laws.  If you need any further information please let me know.

JazakAllah

Answer

In the Name of Allah, the Most Gracious, the Most Merciful.

As-salāmu ‘alaykum wa-rahmatullāhi wa-barakātuh.

We thank you for providing further clarity to us. Our previous Fatwa was based on the information provided which said, the child is 90% brain dead.

For further information, kindly consider the following.

Brain death is defined as the irreversible loss of all functions of the brain, including the brainstem. The three essential findings in brain death are coma, absence of brainstem reflexes, and apnoea. An evaluation for brain death should be considered in patients who have suffered a massive, irreversible brain injury of identifiable cause. A patient determined to be brain dead is legally and clinically dead.

The difference between brain death and a vegetative state, which can happen after extensive brain damage, is that it is possible to recover from a vegetative state, but brain death is permanent.

Someone in a vegetative state still has a functioning brain stem, which means:

  • some form of consciousness may exist.
  • breathing unaided is usually possible.
  • There is a slim chance of recovery because the brain stems core functions may be unaffected.

Someone in a vegetative state can show signs of being awake. For example, they may open their eyes but not respond to their surroundings.

In light of the above, and with due consultation with medical experts, if the state of the child is such that at present, she is unable to breathe on her own, and has been determined to be brain dead, passive euthanasia will be applicable. 

However, if the child has not been determined to be brain dead, and there are hopes of life and recovery, even though it may result in the child living in a vegetative state, it will not be permissible to withdraw the treatment required for her survival. 

Islam considers human life sacred. Life is to be protected and promoted as much as possible. It is neither permissible in Islam to kill another human being, nor even to kill one’s own self (suicide). Killing is only permitted in open war or as court ordered punishment for some crime. However, there is no provision in Islam for killing a person to reduce his pain or suffering from sickness. 

Furthermore,  it is not definite that should the child live, she will be in a vegetative state. We understand that the medical experts know better and have given the probable outcome. Despite that, cure is in the hands of Almighty Allah, and one should turn to Him for help. 

It will not be permissible to induce death within the child simply to avoid taking care of her should she end up in a vegetative state. One should consider this to be a test from Almighty Allah. If one were to persevere, the rewards that await one are infinite. 

To reiterate, should the child currently be determined to be brain dead and unable to breathe on her own, it will be permissible to passively euthanize. However, if she has not been labelled as brain dead, and may potentially be able to breathe on her own, albeit end up in a vegetative state, it will not be permissible to passively euthanize. The child must be given all the help required to survive. 

 

And Allah Ta’āla Knows Best

Bilal Yusuf Pandor

Student Darul Iftaa

Lusaka, Zambia


Checked and Approved by,
Mufti Ebrahim Desai

 

 

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