Death is a subject that people often avoid to talk about, much less remember it. The Quran alludes to death at various places. A verse from chapter three called the Family of Imran (Aal ‘Imran) reads, “Every soul shall taste death and you will be paid in full only on the Day of Resurrection. Whoever is kept away from the Fire and admitted to the Garden will have triumphed. The present world is only an illusory pleasure” (Quran, 3:185).

What is life? Philosophers and thinkers have always been grappling with this question. Rather than discussing their speculative thoughts, it is best to know what God Himself says about life. “Bear in mind that the present life is just a game, a diversion, an attraction, a cause of boasting among you, of rivalry in wealth and children” (Quran, 57:20). This is generally, the reality of man’s perception about this worldly life, whether that person is a Muslim, a follower of another faith tradition, an agnostic, or even an atheist.

Even though death is something certain and inevitable, yet people tend to live as if they are going to live forever and not die. Death knows no age. Very often people die in the prime of their youth. It happens that sometimes the father has to bury his son. I had to do this. My son died at the young age of 33. The term of one’s life or appointed time is predetermined before birth and this is known only to God. “If God took people to task for the evil they do, He would not leave one living creature on earth, but He reprieves them until an appointed time: when their time comes they cannot delay it for a moment nor can they bring it forward” (Quran, 16:61). This mystery of life and death is not without purpose. Life of this world is a test from God. “Every soul is certain to taste death: We test you all through the bad and the good, and to Us you will all return” (Quran, 21:35).

In this worldly life, people will be constantly put to all types of tests. Believers are urged to be patient while facing trials and tribulations. “O you who believe, seek help through patience and prayer, for God is with the patient” (Quran, 2:153). “We shall certainly test you with fear and hunger, and loss of property, lives, and crops. But, give good news to those who are patient” (Quran, 2:155). When inflicted with illness, believers do not complain but resign themselves to God’s will. They remain patient in face of adversities knowing that they belong to God and to Him they will return. “Those who, when inflicted with a calamity say, ´We belong to God and to Him we will return.’ Those are the people who will have blessings and mercy from their Lord; they are the ones who are guided” (Quran, 2:156,157).

What is the reality of death? When it occurs, the spirit (ruh) leaves the body. We learn through prophetic traditions that a good soul comes out of the body with ease, while an evil soul, which resists leaving the body is taken out harshly by the angel of death. The two types of souls are accordingly honored and dishonored in their respective journeys to the heavenly dimensions and back to the grave when they are questioned. “Say O Prophet, ´The Angel of Death, who has been given charge of you, will take you back and then you will be sent back to your Lord’” (Quran, 32:11).

Some die suddenly while others may go through pain and suffering before they die. According to prophetic traditions, sickness is a source of mercy and a chance for forgiveness. In one saying Prophet Muhammad (Peace be upon him, pbuh) says, “For every misfortune, illness, anxiety, grief or hurt that afflicts a believer – even the hurt caused by the pricking of a thorn – God wipes off his sins and his sins fall away from him as leaves fall from a tree.” The Prophet (pbuh) informed us that, “If a servant of God falls sick or goes on a journey, he (continues) to be rewarded for the good deeds that he used to do when he was healthy or at home. This is God’s gift to the believer.

Visiting the sick by close relatives and friends is not only highly encouraged, on the contrary, it is an obligation because it gives the patient the desperately and much needed moral support. In this regards, the Prophet (pbuh) said, “A caller from heaven calls out to the person who visits a sick person, ‘You are good and your path is good. May you enter your residence in Paradise.’” He also mentioned, “When a Muslim visits the sick in the morning, seventy thousand angels pray for him, and they continue praying for him until the evening. When one visits the sick in the evening, the angels pray for him and continue to pray for him until the next morning. Moreover, he will be rewarded with the choicest fruits of Paradise.”

Visitors should pray for the recovery and health of the patient. The Prophet (pbuh) instructed, “When you visit a sick person, give him hope for a long life. This will not avert anything, but will please the patient and give him comfort.” When the Prophet visited patients, he used to say to them, “Do not worry! It is a means of cleansing (you) of sins, God-willing.” Unless desired by the patient, it is preferred to shorten the visits and to make them less frequent, lest they should become burdensome for the patient.

One may supplicate for the sick person the way the Prophet (pbuh) did, “O God, The Sustainer of mankind! Remove the illness, cure the disease. You are the One who cures. There is no cure except Your cure. Grant (us) a cure that leaves no trace of illness.” One may supplicate using his or her own words in any language he or she speaks.

A patient who is going through severe pain and his days may be numbered is prohibited to wish for death. When the Prophet Muhammad (pbuh) found his ailing uncle wishing for death, he said, “O Abbas! O uncle of God’s messenger! Do not wish for death. If you do good and live long, your good deeds will multiply. Then that is better for you. If you are not well and your death is delayed, you may seek God’s forgiveness. That is better for you. So do not wish for death.”

Visiting someone who is on his deathbed is highly desirable. The Prophet said, “When you visit someone who is ill or is dying, say good things about him (or her). Indeed, the angels says “amen” to whatever you utter.” It is highly desired to have the patient or someone on his/her behalf or on behalf of a dying patient to do as much good deeds as possible. It makes the person dies on a state of goodness.

People will have to eventually expire. Man takes nothing with him in his grave. We learn through a prophetic saying, “When a man dies, his deeds come to an end except for three things: perpetual charity (Sadaqah Jariyah), knowledge which is beneficial; or a virtuous descendant who prays for him (the deceased).” Such admonitions remind us that we should hasten in doing good deeds lest our time is up and our book of deeds gets closed forever.

Being the most certain reality, a conscious believer prepares himself here in this world for the eternal and perpetual blissful life of the hereafter. The Prophet Muhammad (pbuh) in one of his sayings said, “Clever is the one who controls his passions and prepares for life after death.”

End of Life Situations

In medical and health institutions, end of life care refers to health care of patients who are on their last breaths or terminally ill with no cure available to them such as cancer or brain-dead patients. Once it is determined that the patient’s disease can no longer be controlled and is medically incurable the health care team will make sure that the patient is comfortable and is receiving the proper medications and treatments to control pain and other symptoms. Some patients may be treated in hospitals while others may be treated at hospice or home.

The patient (cancer patients) and family members should discuss their concerns of end of life with the health care team. The health care team will assist and address to the best of their abilities the patient’s and his/her family’s medical, psychological and spiritual concerns through experts in each field.

The often asked question that usually arises from patients and family members is, “How long is he or she going to live?” Doctors usually give their educated guess based on their knowledge and experience. Some doctors for fear of instilling false hopes refrain from answering. However, no one really knows for how long a person is going to live. At times doctors are surprised at how much a patient’s belief in some supernatural power affects the patient’s duration of life. Only God knows when a person is going to expire.

By law doctors and health care team are not allowed to make decisions on behalf of the patient or his/her family. They will, on the other hand, answer every question the patient or the family of the patient may have. They will be informed of all factors including but not limited to medical, technical, economic as well as bioethics in order for the patient and his/her family make the right decision. Ultimately, it is the patient and his/her family who decide about the end of life treatment or the removal of the life support equipment.

It must be understood that, as long as the heart is beating and the brain is functioning any decision taken to end one’s life because of pain, suffering or other reasons is un-Islamic and is considered as suicide which is a forbidden act in Islam. This practice of intentionally ending a life in order to relieve pain and suffering is called euthanasia. Muslims believe that all human life is sacred and only God determines its life-span. “Do not take life, which God made sacred except in the course of justice” (Quran, 17:33). Only God decides how long each of us will live. “When their time comes, they cannot delay it for a single hour nor can they prolong it by a single hour” (Quran, 16:61).

End of Life Decisions

One of the most commonly asked questions is, “What must one do if the patient is in coma and/or is brain-dead (i.e. vegetative-state), while his/her heart is still beating?”

There is a difference of opinion among Muslim scholars regarding what determines death. Is brain-dead a criterion for death? Secular institutions may agree that it is. Doctors may pronounce a person who is brain-dead as dead even though his/her heart is still beating. This is contrary to the common belief that when the heart stop or the lungs cease to function one is pronounced dead.

With the advancements in medical technology and scientific research, scholars and clergy among others from many faiths traditions are debating these new phenomena and exerting their efforts to come up with conclusions that are satisfactory and in accordance to one’s beliefs. And with stem-cell research and medical technology advancements, decisions are becoming more complex and harder to arrive at.

The following excerpt from an article published on BBC website entitled, End of Life and DNR (Do Not Resuscitate) Order, may help you and those involved in deciding on end of life situation,

“… the Islamic Code of Medical Ethics states “it is futile to diligently keep the patient in a vegetative state by heroic means… It is the process of life that the doctor aims to maintain and not the process of dying”. This means doctors can stop trying to prolong life in cases where there is no hope of a cure.

According to the Islamic Medical Association of America (IMANA) “When death becomes inevitable, as determined by physicians taking care of terminally ill patients, the patient should be allowed to die without unnecessary procedures.”

IMANA say that turning off life support for patients deemed to be in a persistent vegetative state is permissible. This is because they consider all mechanical life support procedures as temporary measures.

While turning off a life-support is allowed, hastening death with the use of certain pain-killing drugs is not allowed as this would equate to euthanasia.” 1

According to many scholars of Islam and schools of thought, it is pointless to keep the patient in a vegetative state by whatever means available. At this stage, where the patient is in a vegetative state (i.e. unable to make a decision on his/her own), the family of the patient will have to decide on his/her behalf.

The family is urged to contact and consult with Islamic bioethics experts before making decisions. Such professionals may include but not limited to, Muslim physicians and professional organizations, Muslim Jurists, Imams, Muslim chaplains, or perhaps Muslim lawyers when necessary.

One thing that must be kept in mind is, according to Muslim Jurists, life-saving equipment cannot be turned off unless the physicians are certain about the inevitability of death.2

In the case of brain death, the jurists ruled that if three attending physicians attest to a totally damaged brain that results in an unresponsive coma, apnoea, and absent cephalic reflexes, and if the patient can be kept alive only by a respirator, then the person is biologically dead, although legal death can be attested only when the breathing stops completely after the turning off of life-saving equipment. 3

Conclusion

The human life is a divine trust and cannot be terminated at one’s own will. It is possible through consultation with health care providers, attending physicians, Muslim jurists, among others to judiciously make an end of life decision. Health care providers must do everything they can to preserve life and avoid premature death. In some cases the removal of life-sustaining equipment or treatment is considered as allowing death to take its natural course. Death does not happen without the express permission of God. Everyone will have to face death. It is the supreme true reality.

Tips on what should a dying patient and family members do as well as after death.

What Should a Dying Patient and Family Members do?

The following are the most essential things a dying person may do while on deathbed:

1. Repentance: The time of death is a time of repentance. The Prophet of God, Muhammad (pbuh) informed us that God accepts His servants’ repentance anytime even minutes before one is overtaken by death, as long as the spirit does not reach the throat. One must turn to God with utmost sincerity and beg for forgiveness.
2. Charity: In addition to asking God to forgive one past sins, one must give in charity, for charity expiates sins. Prophet Muhammad (pbuh) reminds us, “Charity extinguishes sinful deeds just as water extinguishes fire.”
3. Supplication: The best way to depart from this world is the way Joseph (Yusuf, pbuh) did. He supplicated, “[O God] You are my protector in this world and in the Hereafter. Let me die as one who has surrendered to You and join me with the righteous” (Quran, 12:101).
4. Declare the shahadah (Testimony of faith): The dying person who is going through the agony of death and is able to speak is advised to recite the shahadah, or the declaration of faith, “I bear witness that there is no god except Allah (God) and that Muhammad is the messenger of Allah (God.)” A dying person who can hardly speak may be assisted by someone to frequently say, “La ilaha illal-lah” there is no god but Allah (God). Prophet Muhammad (pbuh) reminds us, “He whose last words are: La ilaha illal-lah, enters Paradise.” This method is called talqeen. The Prophet (pbuh) advised, “Prompt your dying people to say, ‘Lailaha illal-lah’.”
5. Pray for the dying person: Relatives among other visitors prays for the departing soul. They supplicate, “O Allah (God)! Forgive him/her, have mercy on him/her, and cause him/her to enter Your Paradise. Indeed, You are the accepter of prayers.”
6. Recite surah Ya Seen (chapter 36 of the Quran ): The Prophet (pbuh) informed the believers, “Ya Seen is the heart of the Quran. Whoever recites it seeking the pleasure of God and the hereafter will receive God’s forgiveness. So recite it to your dying person.” He also said, “If any person is on his deathbed and Ya Seen is recited to him, God makes his suffering easier.” This can be done by immediate family members. If they are unable to recite it in Arabic, they may ask someone close to the deceased who can, otherwise one may ask a Muslim Chaplain or an Imam.
7. Will and Testament: Prophet Muhammad (pbuh) instructed the believers, “It is not permissible for any Muslim, who has something to bequeath, to stay for two nights without having his last will and testament written and kept ready with him.” Family members should urge the dying person to prepare a written will and testament if he/she hasn’t done so already. Civil courts will not divide the inheritance of the deceased among the heirs according to Islamic guidelines. Civil courts, however, will honor wills that are prepared according to Islamic guidelines. The court will not interfere in the deceased’s decision regarding the distribution of his/her wealth or property as long as it is specified in the will. It is best and fair for the beneficiaries to divide the shares according to the divine law of inheritance. For assistance and guidance in this matter one may contact a Muslim Chaplain or an Imam of an Islamic Center or Mosque.
8. Allowable Charity: According to the established prophetic tradition, the departing soul may not exceed one-third of his/her property to be given to charitable causes. He/she may assign certain percentage of the one-third amount to different charitable organizations or individuals. This should be included in the will and testament.
9. Debts: It is the duty of family members to ensure that the dying person is debt free. The Prophet (pbuh) said, “A believer’s soul remains in suspense until all his debts are paid off.” The debt should be paid out of the property that he/she leaves behind. While elaborating on the subject the Prophet (pbuh) said, “If anyone takes other people’s money with the intention to repay it and then he or she should die without settling the debt (unable to pay it), God will pay the debt on his behalf. And if anyone takes money or property (of others) with the intention of destroying it (intending not to pay), God will destroy him.” Death by itself does not annul one’s debt or other responsibilities to the living. The survivors may pay the debt of their deceased from their own pocket and if they are poor the debt may be paid from the public out of the zakah (compulsory charity) funds specified as the portion for the people in debt. This is one of the prescribed categories of zakah recipients.
10. Forgiveness: If the dying person wronged anyone, he/she must ask for their forgiveness before departing this world, otherwise those who were wronged will demand justice on the Day of Judgment and the dying person may be setting himself up for disaster.

What Should be Done when a Loved One Dies?

The following are the specific Islamic rites honoring the deceased:

1. Closing the eyes of the deceased: The Prophet (pbuh) said, “When a soul is seized, the eyesight follows it.”
2. Covering the deceased: Covering the deceased is a way of respecting and preserving the dignity of the deceased.
3. Donation of organs: Donate any organ or part of the body only if the deceased requested in his/her will and testament or is registered as a donor. Family members have no rights to donate organs or part of the body without the prior consent of the deceased.
4. Arrangements for burial: Family members may contact any Islamic funeral director in the area to handle the burial procedures including the funeral prayer and prepare for burial without delay.
5. Informing relatives and friends: It is desirable to inform relatives, neighbors, friends and co-workers of the deceased about his or her death so that they may share in the reward of participating in the funeral prayer.
6. Washing the body: The guardian of the deceased should wash, wrap and arrange for the funeral prayer prior to burial. The funeral director may assist in case the guardian is unable to do so.
7. Funeral prayer: The funeral prayer or salat al-Janazah is a collective duty upon the Muslim community. The funeral prayer may be performed at a mosque or any public community hall. The prayer is led by a local Imam or preferably by the male guardian, son or any person the deceased may have designated.
8. Burial: It is recommended to bury the deceased in the town where he or she dies. The deceased is to be buried in a Muslim cemetery unless one is unable to locate one. If circumstances allow, the deceased is placed in the grave on his/her right side facing the direction of Mecca (qibla) where one directs his or her face in the daily prayers. After the grave is covered with dirt, an Imam, a Muslim chaplain, or a recognized pious person may lead the crowd in supplications (dua).
9. Weeping over the deceased: Weeping over the deceased is permissible while wailing and shouting phrases, beating of chest and cheeks, tearing hair and clothes among other things are prohibited. The Prophet wept over his son Ibrahim (Abraham) at his death saying, “The eyes shed tears and the heart feels pain, but we utter only what pleases the Lord. O Ibrahim! We are aggrieved at your demise.”
10. Mourning: It is generally accepted among the schools of thought that it is permissible for loved ones and relatives to mourn for a period of three days on the death of a near relative. During such period the family of the deceased mourn, receive visitors and condolences. The mourning period for a widow, on the other hand, is extended to four months and ten days. This waiting period is called the iddah and it is mandated by God as it appears in the Quran. To learn more about mourning check with a local Imam or a Muslim chaplain.
11. Execution of the will: The family of the deceased may if necessary consult a lawyer, preferably a Muslim lawyer, that understands the Islamic inheritance laws and help in the execution of the deceased’s will and testament.
12. Visiting the grave: Family members are requested to frequently visit the grave of the deceased and pray for him or her.
13. Praying for the deceased: Loved ones and dear friends of the deceased are requested to frequently pray to God to save the deceased from the torment of the grave and the difficulties of the hereafter.

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