In the Name of Allāh,

the Entirely Merciful, the Especially Merciful

Praise is due to Allāh, Lord of the worlds, may the blessings and peace be upon our master Muḥammad, the last of prophets, on his family, and all his companions.

Resolution No. 184 (10/19) Consent for Emergency Surgeries

The Council of the International Islamic Fiqh Academy of the Organization of the Islamic Conference, holding its 19th session in Sharjah, United Arab Emirates, on 1–5 Jumādā al-Ūlā 1430h (26–30 April 2009),

Having considered the Academy resolution no. 67 (5/7) issued in its 7th Session, held in Jeddah, Kingdom of Saudi Arabia, on 7–12 Dhū al-Qi’dah 1412h (9–14 May 1992), regarding rulings of medication and its resolution no. 172 (10/18) issued in its 18th Session, held in Putrajaya, Malaysia, on 24–29 Jumādā al-Akhira 1428h (9–14 July 2007), regarding performing necessary medical pro- cedures in case of urgent medical aid (Emergency Medicine), and in continua- tion of the postponed issue of urgent disease cases,

Having examined the research papers submitted to the Academy concerning

Consent for Emergency Surgeries,

Having listened to the discussions on the subject,

Resolves

1. Urgent cases refer to sickness cases that require prompt medical treatment or surgical intervention due to the severe state of the patient and in or- der to save his life or avoid damage of an organ of his body. Such cases include, for instance:

   1. Cases that require performance of cesarean section to save the mother or baby’s life or both. They also include the case when the umbilical cord surrounds the baby’s neck or the case of a mother facing uterine rupture during delivery.
   2. Cases that require an urgent surgery such as an inflamed appendix.
   3. Cases that require a specific medical treatment such as kidney lavage and blood transfusion.
2. If the patient is in full capability and consciousness and has the ability to assimilate and make the decision without being forced, and physi-

cians decide that his case is urgent and his need for medical treatment or surgical intervention has become a necessity, it becomes the duty of the patient to give permission for his treatment; otherwise, he will be com- mitting a sin, according to Shariah.

It is permissible for a physician to perform necessary medical intervention to save patient’s life based on Shariah rulings on “necessity.”

3. If the patient is not in his full capacity and consciousness and his guard- ian refuses to give permission for his treatment while medical treatment is urgent, refusal of guardian should be ignored and right of permission shifts to public guardianship represented by its competent
4. When the cesarean section is necessary to saving the life of the baby or the mother or for both, and parents or any of them refuses to give per- mission for the operation, such refusal should be ignored, and the right of permission shifts to public guardianship represented by the state body authorized to do the

5. Medical intervention in urgent cases is subject to the following conditions:

   1. Physicians should explain to the patient or his guardian the importance of medical treatment, the severity of the sickness case and the consequent dangers of his refusal. When the patient and his guardian insists on refusal, the physician should document this state of
   2. Physicians should make every possible effort to convince the patient and his family that patient should withdraw his refusal and give permission to avoid deterioration of his situation.
   3. A team of no less than three consultant physicians other than the treating physician should make sure of diagnosis and proposed treatment, prepare minutes signed by the team members, and inform the hospital administration about the case.
   4. Treatment should be free, or an independent body may be entrusted with estimating its cost.

Recommendations

• Governments of Muslim countries should prepare and enact legislations that organize practicing of medical work in all rescuing and urgency cases, in the light of the Academy resolutions on medical

• Promoting health awareness among patients to avoid such situations and preserve patients’ lives.

Indeed, Allāh is All-Knowing.