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Fatawaa


Fatwa Number : 3539

Subject : Ruling on Refraining from CPR in case of Cardiac Arrest

Classified : Medicine & seeking treatment

Fatwa Type : Search Fatawaa


Question :

What is the Islamic ruling on refraining from CPR in case of cardiac arrest based on prior request by the patient or one of his close relatives?


The Answer :

Praise be to Allah the Lord of the Worlds.

Islamic Sharia encourages making use of medical treatment since the Prophet (PBUH) says, " 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."{Abu Dawoud}. It is incumbent upon a patient and his/her family to make use of lawful medical treatment-concerning cardiac resuscitation-so as to preserve life. Also, doctors should conduct all medical procedures that help resuscitate patient`s organs, such as the heart and the lungs. Allah the Almighty says, "take not life, which God hath made sacred, except by way of justice and law.'{Al-An`am, 151}. He also says, "Nor kill (or destroy) yourselves: for verily God hath been to you Most Merciful!"{An-Nisa`,

However, if doctors thought that it is most probable that recovery and cardiac resuscitation are hopeless, then they may refrain from conducting any procedure on that patient. This is included in Resolution No. (117) by the Board of Iftaa`, Research and Islamic Studies, which reads as follows:

"The Board is of the view that it is permissible not to place a cancer patient on life support equipment, or a respirator, or a dialysis machine if the treating team is absolutely certain that such procedures are hopeless(1)*. This is provided that this decision is supported by a report of an expert medical team comprised of three specialized, honorable and trustworthy doctors, at least.

This is because placing the patient on these devices, or administering direct renal dialysis doesn`t help in his recovery, and will not hasten or delay his death, because death is in the Hands of Allah alone. Allah The Almighty says {What means}:“But never will Allah delay a soul when its time [of death] has come. And Allah is acquainted with what you do.”(Al-Munafiqun/11).

Evidence on the permissibility of refraining from treating such hopeless cases is what happened to Umar Bin al-Khattab (May Allah be pleased with him) when he was stabbed in the mosque. A drink made from dates* was brought to him, which he drank, but it came out of a wound in his abdomen, then milk was brought to him, which he drank, and it came out of a wound in his abdomen as well, and then the people knew that treating him was hopeless because he was considered dead, and so they gave up on him. This indicates that when a patient is in a state of clinical death, he takes the ruling of a dead person. And Allah the Almighty knows best."

In conclusion, it is permissible for the patient-if conscious-to sign a certain form in which he requests not performing CPR on him in case of cardiac arrest. But, in case the patient is conscious, his close relatives are permitted to recommend not performing CPR on him if trustworthy doctors confirm that such procedure is hopeless. And Allah the Almighty knows best.



(1) *The patient himself has the right to abstain from treatment if he is content with what Allah has decreed for him (namely, death), and prefers patience to treatment, but it is not permissible for a doctor to withhold treatment from a patient under the pretext that it is useless, since life and death are in Allah's Hands.

*Water sweetened with dates (Non-intoxicating).




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