Guidelines For Use of Non-Halal Medicines For Muslim Patients

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GUIDELINES FOR USE OF NON-HALAL

MEDICINES FOR MUSLIM PATIENTS

Amrahi bin Buang


RPh – 581 MMPS
Kuala Lumpur, Malaysia

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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

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Halal Status

 Halal
 Mushbooh
 Haram

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Al Quran references
Surah al-Baqarah - (2):172 – 173

 172. 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.
 173. 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.

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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."

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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.

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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.

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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.

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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

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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]
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Qawaid Shariah

 Intent – good
 Belief – non-ambiguity
 Injury – level dan situational
 Dharurah – emergency
 Norm – Good Clinical Practice and evidence-based
medicine

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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 life-
threatening situations

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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

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Medicine Use Cycle

Prescribing

PATIENT
Monitoring Dispensing

Administering
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 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.

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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

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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

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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.

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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

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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.

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Consent Form

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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.

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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.

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https://www.facebook.com/amrahi.buang

[email protected]

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