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Immunisation From The Perspective Of Maqasid Shari’ah

The Maqasid Shari’ah is the highest objectives of the Shari’ah(Islamic Law). As the true and authentic compass of the entire corpus of Islamic legal prescriptions, the Maqasid Shari’ah defines the cardinal purposes of the Muslim’s individual, societal, national and global life experiences.

It is these higher objectives of Shari’ah that dictate the Muslims’ participation in civil society, political governance, health-related programmes and similar activities in their mutual quest for rahmah (mercy), adl (justice)and falah (success)in the worldly life for all mankind.

The success of humans is reflected in the well-being of society which is nurtured and protected by the comprehensive preservation of the five essentials in human life, namely faith and morality (deen), life (nafs), intellect (‘aql), progeny (nasl) and wealth (mal)’ (see Quran, 2:189; 3:130; 3:200; 5:35; 5:100; 24:31; 28:67; 24:51).

Three of the priorities of the Maqasid Shari’ah are directly related to health, while the first (faith and morality) and the fifth (wealth) are indirectly but intimately associated.

“The success of humans is reflected in the well-being of society which is nurtured and protected by the comprehensive preservation of the five essentials in human life.”

This implies that in the realm of medicine and healthcare, any health intervention programme must lead towards a healthy and morally upright being, prevent premature and inappropriate deaths, protect from intellectual and physical disabilities, promote safe reproduction and proliferation of the human progeny.

Allah says in Surah Al-Maidah; 5:32:

“And if anyone saved one life, it would be as if he had saved mankind entirely”

The higher objectives of the Shari’ah is the promotion of the common good and benefit (jalb al-masalih) and the prevention and protection from harm (dar´al-mafasid).

Embodied in the Maqasid Shari’ah are a few cardinal principles in relation to medicine and healthcare. These include the close interplay of the concepts of:

    1. Adlwa-Ihsan (justice with fairness and mercy)
    2. Islah(continuous transformation towards the society’s well-being)
    3. La DararawalaDirara( non-maleficence and beneficence)
    4. Amanah (individual autonomy) and Maslahahammah (public interest and benefits)

Justice with fairness and mercy is reflected in the Quranic message that orders both adl and ihsan to be executed in tandem in all aspects of human life. (Al-Qur’an 16-90)

Towards addressing equity in global child health, if all of the basic vaccines in the EPI program and more of the newer vaccines is made available to the developing countries, there is an opportunity to save more lives and preventing disabilities.

The efforts (islah) of world health agencies to combat the ravages of infectious diseases has been rewarded with the eradication of small pox in 1980. The world is now virtually free of polio, which is endemic in only two countries in the world. The WHO is up-scaling strategies towards the elimination of measles and congenital rubella syndrome.

The principle of beneficence potentially demands more than the principle of non maleficence, because as healh care providers (HCP), we must take positive actions to help others, not merely refrain from harmful acts. More specifically, HCP should undertake all efforts to prevent harm, remove harm and do or promote good.

“The higher objectives of the Shari’ah is the promotion of the common good and benefit (jalb al-masalih) and the prevention and protection from harm (dar´ al-mafasid).”

Any medical intervention is bound to be associated with some degree of risk. The potential adverse effects of immunisation must be carefully weighed against the individual, societal and economic benefits accrued from World Health Organisation’s (WHO) Expanded Program of Immunisation (EPI).

It is not logical to avoid any form of medical intervention solely to avoid risks. This paradigm of thought is irrational because even doing nothing is associated with risks, namely the increased risk ofepidemics and pandemics of diseases, increased and prolonged hospitalisations, increased utilisation of expensive treatment, increased deaths and increased physical and intellectual disabilities.

Similarly the benefit risk ratio unequivocally favours immunisation. Our children and our society enjoy monumental benefits (maslahah pl. masalih) compared to the small risks associated with vaccinations. The most common side effects of immunisations which may be considered as ‘mafsadah’are mild and transient only.

On the other hand, vaccine-preventable diseases can be serious, or even deadly.

The healthcare professional may have the greater knowledge of vaccine-preventable diseases, of possibilities, risks, treatment, outcomes and the options of prevention with immunisations. Nonetheless, the principle of autonomy (amanah) as in usulfiqh respects and values the individual (or the parents or legal guardians) as the one who makes the self-defining choices upon which he then acts and for which he is accountable.

This, however needs to be considered within the context of the wider public interest and benefits. Thus the principal Islamic legal maxim (al-Qawa’id al-Fiqhiyyah) which stipulates; “the individual right may have to be sacrificed in order to protect the public interest.” It is this vein that medical interventions, such as the global immunisation programs that have been proven to promote and protect the general health and well being of the public, have priority over the considerations of the individual interest.

The maqasidic method in looking into issues concerning health represents a comprehensive, holistic and universal approach towards Shari’ah. Following a maqasidic scrutiny, the global Expanded Programme of Immunisation has been shown to be a very safe, effective and cost savings global child survival strategy.

We should therefore not be gullible or easily persuaded by irresponsible groups which spread rumours in the media that immunisation is harmful and not effective.