Consultation is the epitome of engagement. It recognizes that human are unique. It catalyzes mutual understanding and promotes progress. Thus, it came as irony when The Malay Mail reported a statement from a group of lawyers proclaiming that the Minister of Health should not consult religious authorities to draft appropriate policies on abortion for mothers with Zika infection.
In medical field, consultation bring wisdom and humility. Because life is so precious and mysterious. Yet, human is of limited capacities and capabilities. So, we seek opinions and enlightenment from expert of various fields to guide us towards everyone’s best interest. Far from sign of weakness, seeking consultation is a measure of one’s attitude and maturity. To consult is to acknowledge one strength and potential of synergy.
Time has witnessed the evolution of doctor-patient relationship. Now, more than ever, autonomy and free will are central to medical ethics conundrum. Even the process by which doctors speak to their patients is being known as consultation. By consulting others does not necessarily implies that one has to explicitly obey and comply with what others has to say. Ultimately, every single being with rational mind is responsible for his or her own decision and action. Consultation is just a grown up process of being accountable.
Thus, when the Mufti of Wilayah Persekutuan issued his opinion and the Minister of Health insisted on a unified guideline from Islamic authorities, it just highlight the gravity and the complexity of the issue that requires further evidence and clarifications at institutional level. In the era of rapid expansion of information and technology, it is almost impossible for a patient or a medical practitioner to shoulder the burden of making an informed decision solely based on her or his own personal collection of analysis or experience. In the words of Atul Gawande, a surgeon and celebrated scientific writer, “The volume and complexity of what we know has exceeded our individual ability to deliver its benefit correctly, safely, or reliably”.
Furthermore, a lawyer will be able to function in court single handedly. But, medical field is not a one-man show. Teamwork and resources co-ordination are important. A staff may refuse to get involve in termination of pregnancy on various grounds. And, there is complication of the procedure that will require support from primary care straight to the intensive care. So, in drafting policies to provide termination of pregnancy services, it is only wise to listen to others and form a consensus. The only victim abdicated from these consultation is ignorance.
On setting the precedent, let it be known that this precedent has been set forth before the birth of this nation and its constitution. Religious teaching and cultural belief have always been an integral part of any societies since the dawn of civilization. The Ministry of Health and the religious authorities have always been cross referencing each other in dealing with medical dilemma ranging from prevention of diseases, provision of care and treatment, family planning, drugs ingredient and the list goes on. Hence, while there is still space for more interaction such as in the end of life care, seeking opinion from religious authorities is nothing new, but the presence of increasingly palpable discontent towards Islamic institution is unhealthy.
In the light of what has transpired, it is noteworthy to emphasize that the first verse of Al-Quran is read. It is not about rule of law, neither it is about enforcement nor punishment. It is an embodiment on the importance of seeking knowledge. Therefore, religious authorities should never only be seen as moral police. Its empirical role is to teach knowledge, explore questions and build understanding relevant to current needs. Empowering individuals and societies in the path of moderation will necessitate engagement as a crucial step that will shield us from extremism and ignorance.
Dr ‘Ariff Fahmi
Pertubuhan Amal Perubatan Ibnu Sina Malaysi
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