The Humanistic Dimension of Medicine According to Islam
Additionally, we wish to draw the attention to another great dimension of medicine during the time of the Islamic civilization. This is the humanistic dimension and the general respect given to the human being per se. Islam is keen on alleviating the pain and suffering of any human no matter what his specific pain is.
It was common among the Muslim physicians to pay attention to this humanistic dimension while dealing with their patients. Islamic law is actually based on this outstanding ethical approach. Islam looks upon the patient as a human being in crisis, who needs someone to stand by his side, help him, ease his suffering, calm him down, and soothe his physical and psychological pains.
Lifting Crisis off the Patient
Islamic law aims at lifting crisis off the patient in every possible way and decreasing his burdens to the utmost extent. The patient is granted a license not to fast, and if his ill health hindered him from performing the pilgrimage he has the right not to undertake it. Also, the patient who cannot perform prayer in its regular manner may perform it in whatever position that suits him, sitting, sleeping or even merely with his eyes. The patient for whom water is harmful can substitute tayammum (dry ablution) for ablution with water. If he cannot do any of this for any reason then he may pray without either. In this case he is termed faqid al tohoorayn (bereft of the two purifications). Even in the times of Jihad, a patient is not obliged to fight. Allah (SWT) says in the Glorious Qur’an, “It is no restriction upon the blind, and it is no restriction upon the lame, and it is no restriction upon the sick” (TMQ, 24:61).
Psychological Care of the Patient
Islamic law did not stop at lifting some obligations off the patient or offering him licenses to free him of some acts of worship or duties. It actually focused a lot on being by the side of the patient and raising his spirit. Thus the Prophet (SAWS) made visiting the patient at his home or at the hospital a duty upon Muslims. Imam Muslim narrated after Abu-Hurairah that the Prophet (SAWS) said that the rights of one Muslim upon another are six. He mentioned visiting him when he falls ill as one of them, and said that paradise would be a reward for those who visit the sick. It has been narrated by Ibn-Majah after Abu-Hurrairah that the Prophet (SAWS) said that whoever visits a patient will be called upon from heaven, and he will be promised a place in paradise.
The Prophet (SAWS) ordered us to mention good news in the presence of the patient, and to lift up his spirit and to encourage him with glad tidings of getting better and living longer. Ibn-Majah narrated after Abu-Sai'd al-Khudry that the Prophet (SAWS) ordered us to encourage the patient and raise his hopes of a long life and good health, because this does not change destiny, yet it boosts the patient's morale.
Actually the Prophet (SAWS) raises a patient's spirit even higher when he tells him that this disease redeems his misdeeds and is a path to salvation in the hereafter if he exercises patience. Al-Bukhary narrates after Abu-Hurrairah that the Prophet (SAWS) said that whatever afflicts the Muslim of pain, sadness, or burdens even if it was a little thorn, Allah would redeem his misdeeds through it. The Prophet (SAWS) says in what al-Bukhary narrated after Anas that Allah says that if he gave a person a disaster like losing his eyes, for example, and this servant was patient, Allah would compensate him with paradise. In this way the patient's feelings are elevated and he would never feel incapacitated or neglected; rather, he gets the sense that the entire society is taking care of him.
The Patient is a ''Human Being'' Who Needs Help
This elevated Islamic outlook was not only directed towards Muslim patients, but also to every patient regardless religion. This is in keeping with the ayah which says, ''And indeed We have already honored the Seeds (Or: sons) of Adam” (TMQ, 17:70).
The human being is generally honored, and thus we are keen on taking care of him when he is ill, and treating him when he complains even if he is not a Muslim. The Prophet (SAWS) visited a Jew when he fell ill and al-Bukhary dedicated a special chapter in his Sahih to this issue and he called it “The Chapter of Visiting the Non-Believer.”
This humanistic dimension that was planted inside us by Islamic law made Muslim physicians through the eras of the Islamic civilization deal with the patient as a human being and not a senseless thing or a source of income. A patient was always treated as a human being in crisis, who needs someone to stand by his side, and not simply receive medical help. This help should be also psychological, emotional, social and economic.
Muslim physicians dealt with their patients with this noble spirit. High medical service was given to patients in the Islamic dynasty without differentiating between rich and poor, Arab and non-Arab, black person and white person, ruler or citizen, Muslim or non-Muslim. In many cases, the treatment was free to everyone and all patients received the same level of service regardless of their rank.
Complete Service from the First Moment
Let us examine together the system under which Islamic hospitals operated, which reflects the humanistic dimension that we mean. Once the patient enters the hospital, he is first examined in the external hall. If he is suffering from a simple illness, the treatment would be prescribed to him and given to him from the hospital's pharmacy. If it is necessary to admit him into the hospital, his name would be recorded, then he would be taken to the hospital bathroom to wash up. He would then take off his clothes to be put in a special closet and he would receive the hospital's special clothes. He would then be admitted to a ward of similar cases. A private, well-furnished bed would be assigned to him, and no other patient would be permitted to share it. This is contrary to what happened afterwards in the first European hospital that was in France and which was built seven centuries after the first Islamic hospital. There, the French used to put on a single bed three, four or even five patients together. The patients actually slept in the hospital's doorways and in non-hygienic atmospheres as well.
After the patient enters the Islamic hospital, he is given the medicine that the physician prescribed to him. Special food, suitable for his condition, is given to the patient in appropriate amounts. They never restricted the types of foods to be given to patients but actually gave them the best kinds of food. Patients' food used to include lamb, cow, bird and chicken meat. Also, the amounts of food were never restricted. A sign that the patient is getting better was that he would eat a whole loaf of bread and a whole chicken in a single meal.
When the patient is in rehabilitation, he is admitted to the special ward of the rehabilitated until he gets completely cured. Then he would be given a new room that is completely free of charge. Not only that, but he would also be given a sum of money that can support him until he became capable of working. This is to ensure that he will not feel obliged to work during his rehabilitation period to avoid any relapse. Thus you can never doubt the complete serenity a poor man would feel in the Islamic society in which he is sure to get such a medical service free of charge, whenever he falls ill. This is, additionally, without feeling that he has to humiliate himself or look for recommendations or beg for money to receive the medical attention he deserves.
It was tremendous when Abu-Bakr ar-Razi advised his students to make their main goal to cure patients rather than to make money. He also advised them to treat the poor patients with the same enthusiasm and attention with which they treat the rich and the aristocratic. In addition, they should make patients believe that they are recovering even if there is no solid evidence. The body responds to what the soul feels.
High Standard of Medical Care to All Patients Equally.
This high level of health care was not only in big cities but also in all regions of the Islamic dynasty. This was accomplished through the mobile hospitals that went to all the villages, mountains and faraway places. This proves that all Muslims were looked upon as equal when it comes to health care regardless of their economic or social status.
Actually, the compassionate Islamic view of patients encompassed all the social levels, all the way to prisoners who harmed their societies. Those, as well, received adequate health care because they are humans and belong to the society after all, and what they receive of imprisonment and punishment is intended to help them and not to kill them slowly like prisoners of these days. The minister Ali Ibn-Issa Ibnul-Garrah wrote to Sannan Ibn-Thabet, the head of Baghdad's physicians, ''I thought about the situation of the prisoners, and it came to me that they must be exposed to many diseases due to their great number and bad atmospheres. Thus you have to appoint them physicians to visit them daily, take to them drugs and food, move around different prisons and treat the ill among them.''
Charitable Endowments: A strive to outdo others in generosity
This extreme humanity may not have continued along the Islamic ages had it not been for the generosity of Muslim nations along with the support of the country itself. We mean here the system of charitable endowments and the role it played in offering the patients good care. Entire high-rank hospitals would depend on the income of an endowment given away by one of the Muslims- including the governor himself to cover all the requirements of the hospital, including patients, physicians, furniture, food, medical herbs and medicine. It went all the way to paying for the medical students who got trained in that hospital. One of the great examples of this is the big Mansouri hospital that was founded in Cairo by King Mansour Seif ad-Deen Ibn-Qalawoon (in 683 A.H), and he endowed upon it what would cover its annual expenses (as we mentioned earlier).
Also regarding the charitable endowments and their role in covering the humanistic side of medicine, we have to mention here some of the unprecedented examples of dealing with the psychology of the patient. The income of some endowments was dedicated to appointing two who can move around the hospital daily, and speak to the patient in a low, soothing voice, which a patient would hear without seeing them and believe he is getting better. It was known as the ‘endowment of patient deception’ and this was to elevate his spirit and help him get well.
This humanistic dimension in dealing with the patients was not a personal attitude adopted by some physicians, nor was it a common urge for doing good and showing compassion. It was rather a public, widespread attitude enacted through the governmental policies and adopted by individuals, rulers and citizens alike. The Caliph or the Prince frequently checked on patients personally and supervised the treatment process, making sure it was well done. It should be mentioned that al-Mansour al-Mowahedy (the King of the Mowahedeen dynasty in Morocco) had a weekly visit to al-Mansouri hospital in Marrakech after the Friday prayer, in which he was personally reassured concerning the patients' conditions.
Flexible Protection of the Patient's Sanctity
There is a very important humanistic side of Islamic medicine in dealing with patients. This is what Islamic law encouraged of manners that would protect human dignity and ensure the progression of examination and treatment stages without violating privacy. For example, it is not allowed to uncover the patient's private parts except for extreme necessity and in the amount desired in the examination or the surgery. Also the patient's examination is not allowed to be witnessed by anyone who is not directly involved in the medical process, and especially members of the opposite gender. In addition, a male physician is not allowed to be left alone with a female patient unless one of her male family members or another female person as the nurse, for instance, is present. The hospitals in the Islamic dynasty were also keen on separating between men’s and women’s wards, respecting of the privacy of each gender.
Also among the humanistic characteristics of the Islamic approach to dealing with patients, is the respect paid for the patient's right to treatment. It allowed the male physician to treat a female patient and vice versa. This is applied when there is not an efficient alternative from the same sex who can do the job perfectly and thus it will not deprive the patient whether he is a man or a woman from adequate treatment. Islamic law also allowed the Muslim patient to look for treatment with non-Muslim physicians if he could not find a physician who can offer him treatment among the Muslims, in order to preserve the patient's health and life.
All these and many other Islamic regulations and manners deliver a divine principle, as Allah (SWT) says, “And indeed We have already honored the Seeds (Or: sons) of Adam” (TMQ. 17:70). From the realm of abstract theories to the realm of real application, so as to elevate human life above other forms of life, Exalted be He Who sent down upon us a law that is that perfect.
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