When I was a medical student, one of the classes that I most enjoyed was Medical Ethics. Love it!
There were no right or wrong answers. All that mattered was your ability to justify your views.
I remember how much I really loved one of the ethical issues being discussed during my Obs&Gyn rotation. It was about abortion.
The way the western think about abortion is way different than the way the average Muslim medical student think about abortion. Sexual freedom is taught to be their legal rights as consenting adults. Even though the legal age for sex in Australia is 16, a 14 years old can consent to medical treatment. Thus, in the western country, you can write a whole thesis centered on the debate that has been going on about abortion between those who are pro-life to those who are pro-choice.
In the ethics class they would create certain scenario and ask you to give your response and justification. One of the example of such scenario was something like this:
You are a GP in Tumba Rumba. One day a teenager aged 15 years old comes to you requesting for oral contraceptive as she has become sexually active. Even though you know that teenagers can consent for medical treatment at the age of 14, you are also fully aware that the legal age for sex is 16. Would you prescribe oral contraceptive for her? (this is when we will argue ad nauseam about whether we will prescribe the OCP or not. She is 15, so she can consent to medical treatment. However she is not yet legal for sex. After arguing for half an hour over the best course of action, the scenario would be continued)
You then decide not to prescribe oral contraceptive for her. Two months later she came to your practice crying about being pregnant and blaming you for not prescribing oral contraceptive for her. She would like to have an abortion. What would you do? (This is when argument becomes more heated. Sometimes you can almost see who are the Muslims – well, we are the obvious ones with our hijabs – who are the practicing Christians, who are the non-practicing Christians, who are atheist, and who are the non-conformists, just by hearing the way they give their opinions. It was very interesting, I assure you. Oh, I miss my Ethics class)
Do you think she should keep the baby? (This is when we get to talk about the rights of the unborn baby vs the rights of the mother. We can talk about whether abortion can be classified as murder. We can talk about at what gestational age would an unborn baby have any rights?)
Would you tell her parents? (Of course, confidentiality issues would be a MUST in all our Ethics scenarios.)
The issue of teenage pregnancy was being openly discussed in our O&G ethics class. When I was doing O&G rotation in Australia, I happened to keep track of the news in Malaysia…about the rampant discarding of newly born babies that was going on in our streets. Most SHAMFUL! I wonder what would the Western say about our so-called Muslim values if they know about these abominable acts committed by our teenagers.
I was a 4th year at that time when I blogged about that issue here:
I almost forgot all about that issue once I have left my O&G rotation and moved on to Paediatrics.
However one day, when I had been back in Malaysia for over 1 year, I came across ANOTHER article about discarded baby. This time, it happened in my home town. It came out in Metro. The baby was being put in a bundle and placed under a tree at Klinik Kesihatan Bandar Alor Star. Alhamdulillah, the baby was still alive and well.
The news shook me to the core. I wonder about WHAT would my Australian friends think if they knew about these incidents that are taking place in our Muslim country?
They would take one look at the article I had written in my O&G portfolio and snickered at it. In my O&G Portfolio I had written my opinion on abortion, giving it the Islamic flavor that would reflect my upbringing. Below was what I had written, quite a sharp contrast to what I was taught in my Ethics class. But the thing I love about studying in Australia is, the freedom of having an opinion that is dissimilar to that of your teacher. As a Muslim studying in a Western country, people EXPECT me to have a different opinion in Ethical issues and most of the time, they can accept our views as long as we are prepared to defend it. So I wrote on Abortion, hoping that my professor would understand that as a Muslim, whatever was taught in the ethics class will have to be filtered through the eyes of Islamic Jurisprudence. I could not simply agree to the western ethical stand each and every time. Besides, I was not planning of practicing in Australia.
My professor actually commented on my portfolio saying ‘Excellent reflective process.’ It truly made my day. So here it is, my take on Abortion when I was a Muslim student in a foreign country. (Be warned, that I was writing for a western audience, so do expect some things to be out of the Malaysian context)
ABORTION: A Muslim Perspective
The fact is such that the only perfect contraception is saying NO.
While Islam permits preventing pregnancy for valid reasons, it does not allow doing violence to it once it occurs. However, if the pregnancy poses a risk to maternal health, then abortion must be performed.
In Islam we are allowed to use any contraception to prevent pregnancy, but Islam also recognizes that this contraception is not totally perfect. So, the guideline is, if you fall pregnant regardless of the use of contraception, you should not abort the baby, unless there’s a specific harm to the mother medically. In the case of rape, it can be optional, depending on what the mother wants and depending on whether the mother’s mental health would be affected by bearing the baby of her rapist. But all rape victims should take all the necessary precautions, for example, taking the morning-after pill.
According to European Council for Fatwa and Research:
“Indeed abortion is forbidden in Islam whether it be in the earlier stages of pregnancy or otherwise. The extent of sin incurred varies according to the stage of pregnancy, so that less sin would be incurred if the abortion took place during the early stages, while it becomes increasingly haram (unlawful) as the pregnancy advances. When the pregnancy reaches 120 days old, abortion becomes totally forbidden and is deemed a form of murder.
However, the only condition under which abortion is allowed is when there is acual threat to the life of the mother confirmed by an official medical report that if the pregnancy advances any further, the mother may die.”
If I ever become an O&G specialist, I shall never ever perform an abortion unless it specifically poses a medical problem to the mother.
If you got pregnant because you have been careless enough and foolish enough to not use contraception, why are you crying now? You know that every action has its own consequences and part of being a good responsible adult is to bear them with dignity.
I believe that there are consequences that you have to bear out of your freedom of choice. I find it amusing that a lot of people talk to me about how Muslim women are oppressed and they couldn’t choose their own course of action, yadda, yadda, yadda…
What they don’t know is that there are reasons why we don’t choose a particular action:
1)Because the action is against our belief. So in the first place, we choose to believe.
2)Because we know that there are great consequences that you need to bear out of your action.
So, if you think you can’t carry the responsibility of being a mother just yet, or that the father was not the ‘right man’ (whatever THAT means) or that this is not the ‘right time’, then why didn’t you take steps to prevent the pregnancy from happening in the first place.
Granted that sometimes despite of everything that you do, despite of all the contraception that you use, accidents happen.
But you KNOW that there’s a chance of that happening. Your doctor would have told you all the estimate percentage of failure of the contraception that you had chosen. Yet, you had used your freedom of choice to choose to take that risk.
And now that you have to bear the consequence, again you choose to exercise the same exact ‘freedom of choice’ to abort. When does this freedom of choice end? People use the same expression ad nauseam to justify every action they do (bad or otherwise).
Our freedom is limited by other people’s freedom. Our rights are limited by other people’s rights.
This is exactly when our freedom of choice ends. Now that you have borne a child, your rights are limited by the rights of the unborn child.
Now they get into the debate of whether or not an unborn child has any right. And if an unborn child has any rights, at what gestational stage?
Really, who is the best person to determine all that? To those who are religious, they would say God is the best person to determine that since He created us all. To those who are atheist, they would use another justification and their reasoning varies and their answers would range from the very beginning of conception to the start of implantation, to 20 weeks of gestational age.
You are getting into a gray area, a muddy water. In these circumstance, people then choose whatever they want to believe based on their own private justification. There’s no uniformity and no consistencies.
So, people should think twice before they say that all the religious restriction on a woman’s sexual expression is limiting their freedom of choice. In Islam, we prefer to prevent than cure. You don’t have to deal with all these mind-boggling issues if you choose to follow the guidelines in the first place, (though some might prefer to call it restrictions) i.e to be married before you have sex and to make sure that you are ready to bear children before having sex.
But problems arise when people don’t want to follow what they call as ‘restriction’ and when bad consequence happens as a result of them not following the initial restriction, they start thinking that the bad consequence is ANOTHER restriction that they need to escape from. This cycle would go on and on until we stop and realize that we should take responsibility from our choice.
Sometimes a teenager knows better. No matter how much people frown on teenage pregnancy in Australia, I applauded their decision to carry the pregnancy through, regardless. At least, THEY know the concept of taking responsibility for their choice. Responsibility is the first lesson of adulthood.
For all these reasons, I choose to never perform an abortion without any valid reasons other than ‘the pill doesn’t work’, and ‘this is not the right time’, or ‘I was not with the right man’. You knew coming in that no contraception is 100% effective, yet you chose to take that risk anyway, so bear the consequence in a mature adult manner (of course my whole behavior and intonation will be adjusted accordingly as a health professional who has to counsel these cases in a sensitive, empathetic style.)
Friday, 9 March 2012
19:45 Afiza 1 comment