PROBLEMS OF TERMINAL ILLNESS AND SUPPORTING SPOUSE OR LOVED ONE

PROBLEMS OF TERMINAL ILLNESS AND SUPPORTING SPOUSE OR LOVED ONE

ASSEMBLED BY MALLAM ABBA ABANA, KUBWA, ABUJA, NIGERIA

http://variousislamicdawadocuments.blogspot.com

https://web.facebook.com/abba.abana

emails:gonidamgamiri@yahoo.com; abba.abana@gmail.com

MONDAY 14 AUGUST 2017 CE AND 22 DHUL QADA 1438 AH

 

Bismillah Walhamdulillah Was Salaatu Was Salaam 'ala Rasulillah. As-Salaam Alaikum Wa-Rahmatullahi Wa-Barakatuhu. Praise be to Allaah; we seek His help and His forgiveness. We seek refuge with Allaah from the evil of our own souls and from our bad deeds. Whomsoever Allaah guides will never be led astray, and whomsoever Allaah leaves astray, no one can guide. I bear witness that there is no god but Allaah, and I bear witness that Muhammad (Sallalhu alaihi Wasalam) is His slave and Messenger.

PREAMBLE

The purpose of medicine is to search for cure and provide the necessary care to those afflicted with diseases. The primary obligation of a Muslim physician is to provide care and alleviate suffering of a patient. Decisions about ending the life of a terminally ill patient at her/his request is beyond his moral or legal obligations.

The Qur'an reminds Muslims that "it is not given to any soul to die, save by the leave of God, at an appointed time." (Holy Quran Chapter 3:145) Moreover, "God gives life, and He makes to die. (Holy Quran Chapter 3:156) And, hence, "A person dies when it is written." (Qadar, # 11)

Death, then, comes at the appointed time, by God's permission. In the meantime, humans are faced with the suffering caused by illness. How is suffering viewed in Islam? Is it part of the divine plan to cause suffering? With what end? These general questions about meaning and value of suffering should lead us to appraise the suffering caused by prolonged illness to an individual's personal and family life.

 

SECTION 1: CURRENT MEDICO-LEGAL AND MORAL ISSUES AND THEIR ISLAMIC PERSPECTIVE

The Right To Live And To Die:

The care of the terminally ill is becoming very expensive. It is costing millions to keep patients alive in a vegetative state in intensive care units. The concept of euthanasia (mercy killing) is Islamic or non-Islamic? In 1987, 23,000 cases occurred in Holland. The question is who determines (the unconscious patient, the family, or the doctor) that the plug should be pulled and the life support system be stopped? What is the definition of death? Is the living will justifiable? Is stopping the life support system an act of mercy, a medical decision, a murder, or just a financial decision?

The Islamic Perspective: Islam does not believe in prolonging life as everyone has been created for a certain life span. Scientists are to assist, but not replace God in the creation of death of human beings. Islamic morality starts in the womb and extends to the tomb. Islam places great emphasis on the sanctity of life and the reality of death. "If anyone killed a person, unless it is for murder or spreading mischief on earth, it would be as if he killed all of mankind. And if anyone saved a life it would be as if he saved the lives of all mankind" (Holy Quran Chapter 5:35). "Every soul shall have a taste of death" (Holy Quran Chapter 2:35). "No soul can die except by God's permission" (Holy Quran Chapter 3:185).

Thus, while Islam gives importance to saving lives (medical treatment or otherwise) it makes it clear that dying is a part of the contract (with God) and the final decision (of term) is up to God. The quality of life is equally or more important than the duration of living.

Islam is categorically opposed to euthanasia (mercy killing) and regards it as an act of murder. We do not see the difference between the gun used by a husband or wife for his or her dying wife or husband and the syringe used by the physician for his dying patient. Both are weapons of death, no matter what the intentions of the killer was.

 

SECTION 2: TERMINAL ILLNESS: SUPPORTING A TERMINALLY ILL LOVED ONE

Written by Mayo Clinic Staff

1. When terminal illness affects a loved one, it isn't always easy to know how to react. Find out how to offer support and deal with grief.

Knowing how to offer comfort and support to a loved one who has a terminal illness can be challenging. What can you say or do? How can you help your loved one cope? How will you deal with your own grief? Get the facts about supporting a loved one who is terminally ill.

2. My loved one has been diagnosed with a terminal illness. How might our relationship change?

Your relationship with your loved one might not necessarily change because he or she has a terminal illness. If you're concerned, try to build on your relationship's strengths. It's also important to be open to new possibilities. A loved one's terminal diagnosis might improve your relationship. Or unresolved conflicts might present new challenges.

Remember that your loved one is still the same person and will still have the same needs and desires as he or she had before the terminal illness. Many people facing terminal illness want to be treated as normally as possible, without always focusing on the illness.

3. How can I help my loved one cope with a terminal illness?

Let your loved one know that you're willing to listen to his or her concerns — and never underestimate the value of your presence. Even if it feels as if you're not doing anything, your presence sends an important message. Don't, however, try to be a counselor.

4. Is there a typical emotional process that a person who has a terminal illness experiences?

Dying isn't a science. Don't assume that a loved one who has a terminal illness is going to go through a methodical process of coming to terms with death. It might not happen that way.

Acceptance or accommodation might be the most desirable outcome of the grieving process — learning to live as fully as possible while accepting the presence of a terminal illness.

But does your loved one have to accept that he or she has a terminal illness? Does your loved one have to accept that he or she is going to die before he or she expected? No. There's no right or wrong way to come to terms with death.

5. How do you help a loved one who's in denial about his or her impending death?

Denial is an important coping mechanism. Your loved one might be in denial because reality is too frightening, too overwhelming, or too much of a threat to his or her sense of control. Denial is a form of natural protection that can allow your loved one to let reality in bit by bit and continue living as he or she contemplates death.

As long as denial isn't causing your loved one significant harm — such as causing him or her to seek out painful treatments of no therapeutic value — then denial isn't necessarily bad.

Your loved one might be afraid of pain. Perhaps your loved one is afraid of losing control of his or her bodily functions, mind or autonomy. Your loved one might also fear failing family or becoming a burden to others.

To provide emotional and spiritual support to your loved one, invite him or her to talk about his or her fears. Sometimes, however, it's easier for a dying person to share what he or she fears and explore it with someone other than a family member, such as a spiritual counselor.

6. When is denial harmful?

If denial is interfering with a dying person's necessary tasks or plans, you might need to take action.

If, for example, a single parent's denial of his or her illness is stopping him or her from planning future care for a child, then it might be necessary to intervene. This can be most effectively handled by a professional who has expertise in the care of the dying. Examples of professionals in this area include hospice, palliative care nurses, physicians and social workers.

Clergy or Islamic scholar may also be of great help or important to the patient at this moment.

 

SECTION 3: THINGS TO DO WHEN A PERSON IS DYING

We pray to Allah that the following reminder would clear up any misconceptions regarding the preparation of the deceased, and that it serves great benefit to our Muslim community particularly Nigeria.

1. TO INVITE RIGHTEOUS PEOPLE TO BE AROUND THE DYING PERSON.

The advantages of having a righteous person around the dying person are to:

a. Remind him of Allah, for those who are righteous are above average in knowledge and are closer to Allah.

b. Pray for him and those who are around him and remind them of them of supplications (du’aa) from the Quran and the Sunnah of the Prophet peace be upon him, and the angels would say Amen to their supplications insha’Allah.

c. Give patience to the dying persons family. Some family members get emotional and need to be reminded about the virtues attained through patience.

2. TO REMIND HIM THAT HE SHOULD HAVE MORE HOPE THAN FEAR

Often when a person is close to death, they begin to fear all of the sins they have committed during their life. It is possible that person had lived a lifestyle where they’ve procrastinate repentence and they were struck with the reality of the hereafter before they had a chance to turn back to Allah. It is normal for a person in these last moments to have all kinds of fear. Anas ibn Malik may Allah be pleased with him narrates:

“The Prophet (peace be upon him) entered on a young person dying, and said “how do you find yourself?” he said “I seek hope from Allah, and I fear my sins O Messenger of Allah,” so the Prophet peace be upon him said “They are not combined in the heart of a believing slave at this time except that Allah gives him what he wants and protects him from what he fears” (Ibn Majah, 4231)

While it is natural for the person to have some fear, this fear should not overcome the hope a person has in Allah. At these moments, it is our duty to remind the person of the mercy of Allah, and that they should have more hope in the kindness of Allah than fearing His wrath. Nothing comforts the soul more than reminding them of the saying of the Prophet peace be upon him:“None of you should die except having good thoughts about Allah.”(Muslim, 7412)

3. TO MOISTEN HIS FACE AND LIPS

It is from the Sunnah of the Prophet peace be upon him to moisten the lips and throat of a dying person so that he can pronounce the Shahada. The mouth becomes more dry during the last moments of death. Ayesha may Allah be pleased with her used to say:

“The Prophet peace be upon him had a can of water with him. So he would enter his hand in the water and then he would wipe his face and say “There is no God but Allah. Death has its intoxications” (Bukhari, 6145)

4. TO DICTATE THE SHAHADAH TO HIM WITHOUT ASKING HIM TO REPEAT IT

This should be done as gently as possible, as not to anger the person and cause him to curse. The Prophet peace be upon him said: “Dictate to your dying people La ilaha illa Allah” (Aljami, 8550)

5. PRAY (MAKE DU’AA) FOR HIM, AND DO NOT SAY ANYTHING EXCEPT GOOD

There is no specific du’aa to say at the time of death. The people around the person can pray with whatever comes from their hearts in the language they speak. An example of this would be to pray that Allah gives him patience, makes his death easy, protect him from the test of the grave, grant him paradise, protect him from hellfire, give his family patience, and any such good things. The Prophet peace be upon him said: “If you approach the sick or dead person, then only say good, as the angels are saying Ameen to whatever you say” (Muslim, 2079)

6. TO PLACE THE DYING PERSON IN THE MOST COMFORTABLE POSITION

A common mistake that people often make is to position the dead person facing Makkah when he is dying. This action is based on a very weak narration that was mentioned in the book of Al-Bayhaqi (6396) in which Abu Qatada narrated that Al-bara’ ibn Ma’roor had willed at his death that they would make him face Makkah. This reached the Prophet peace be upon him, so (it was narrated) he said: “he has hit the Fitra.”

In addition to not being part of the Sunnah, this adds an extreme hardship on the dying person and should be avoided at all since there is no sound proof for this action.

7. TESTING TO SEE IF THE PERSON HAS INDEED DIED

It is important to emphasize this particular point, hundreds of people are misclassified as dead around the world on a daily basis (stories of people waking up to find themselves inside a closed grave are not uncommon). In the United States alone, more than 400 people are misclassified as dead yearly, and more than 2000 in the past 20 years in the city of London alone (Source: Death and its Causes, by Carrington and Mider).

The following are some ways to test if a person has died until a doctor arrives:

1. Testing for a pulse: This is probably what most people think of when testing for death, but it may not be the most effective since some patients may have a very faint pulse that eventually (appears) to come back to life. This method must be supplemented with other methods as listed below.

2. The pupil test: Umm Salamah narrated that the Prophet peace be upon him said: “When the soul leaves the body, the (faculty of) vision follows it” (Aljam, 8554)

8. CLOSING HIS EYES

It is the Sunnah of the Prophet peace be upon him to gently close the eyes of the person after they die. Aperson’s pupil becomes very wide and is unpleasant to people who are around. Umm Salamah narrated:

“The Prophet entered on Abu Salamah when his eyes have opened. He then closed it and said ‘When the soul leaves the body, the (faculty of) vision follows it’” (Aljami, 8554)

9. SAYING THE PROPHETIC DU`AA

When Abu Salamah died, the Prophet peace be upon him said the following words:

“O Allah forgive Abu Salamah (substitute the name of the person) and raise his degrees with those who are guided, and replace those whom he has left behind (with benefits), and forgive us and him O Lord of worlds. Make his grave wide for him, and light it for him.” (Muslim, 2080)

10. TO WRAP HIS JAWS

When a person dies, their mouth stays open either widely or slightly, and odors will come out. Therefore, one should gently wrap the jaw of the person using a soft string or a piece of cloth. Do not put too much pressure when tying as this may leave a mark on the face of the person

11. TO LOOSEN HIS JOINTS

As mentioned earlier, when blood circulation stops in the body, the joints become stiff within a few minutes due to the trapped blood. This will make it very hard to wash or shroud the person and perform other burial rites. By loosening the joins of the person shortly after they die, this makes it easier to perform funeral rites. This is done by gently bending the joints of the person shortly after their death (the arms, legs, fingers, shoulders, etc.)

12. TO TAKE HIS OUTER GARMENTS OFF

The companions peace be upon them asked: “Should we uncover the Prophet –peace be upon him- just like we uncover our dead people?” (Ibn Hibban, 2156)

This indicates that this was the practice with other dead Muslims. This also makes it easier for the person performing the washing and shrouding, as it becomes harder to take off the clothes when the joints become stiff. This is done for both males and females by their respected gender or their spouse (according to the opinion of the majority of scholars).

13. TO COVER HIM COMPLETELY

Once his outer garments are removed, it is only natural to cover the person. This is also the practice of Islam as narrated by Ayesha may Allah be pleased with her: “The Prophet –peace be upon him- was covered with a thin cloth when he died.” (Nasa’i, 7117

14. THE PERMISSIBILITY OF KISSING THE DECEASED

It is human nature that a person may want to kiss his dead family member one last time before he is buried. It is from the abundent mercy of Allah that this practice is not only permissible in Islam but from the Sunnah. Ayesha may Allah be pleased with her narrates: “The Prophet –peace be upon him- used to kiss Uthman ibn Math’oon when he died, until I saw the tears fall on his eyes.” (Tirmidhi, 1000)

Also, Ibn Abbas may Allah be pleased with him narrates: “Abu Bakr- may Allah be pleased with him- used to kiss the Prophet peace be upon him after his death.” (Bukhari, 1241)

15. TO HASTEN THE ACT OF PAYING HIS DEBTS

It is enough to mention that the Prophet peace be upon him did not pray on a person until his debts were paid as narrated by Abu Qatada may Allah be pleased with him:

“They brought a (dead) man to the Prophet peace be upon him, so he asked “Is there a debt on him?” They said “Yes, two gold coins.” So he was slowed down and did not pray on him. So Abu Qatada said “I will take care of the two gold coins O Prophet of Allah,” so the Prophet – peace be upon him- replied “It is the right of the lender.” (AlHakim, 2/58)

16. IT IS AN OBLIGATION TO SPEED UP HIS BURIAL

Finally, we must end this list by mentioning that it is not permissible to delay the burial of a person except for a necessity, or if some family members are arriving within a few hours. This is clear from the words of the Prophet peace be upon him:

“Hasten the funeral, as if it was a good soul, then it is a favour you are doing him, and if it was other than that, so it is an evil that you are lifting from around your necks.” (Bukhari, 1252)

 

SECTION 4: READ THIS BEFORE DIVORCING YOUR MENTALLY ILL PARTNER (WIFE OR HUSBAND)

Written by Teresa Atkin an Expert who says it’s important to know the whole story before calling it quits:

The heartbreaking realities of divorce include the high split rate for people with mental illnesses.

A multinational study of mental disorders, marriage and divorce published in 2011 found that a sample of 18 mental disorders all increased the likelihood of divorce — ranging from a 20 percent increase to an 80 percent increase in the divorce rate. Addictions and major depression were the highest factors, with PTSD (Post-Traumatic Stress Disorder) also significant.

Elsewhere, researchers have shown a strong link between personality disorders and elevated divorce rates, with antisocial personality disorder and histrionic personality disorder having the highest rates. The authors accepted that there was insufficient research on narcissistic personality disorder to quantify its effect on divorce, although anecdotal evidence strongly suggests a link. With the reported increase in narcissistic traits in the U.S., we are likely to see this as an increasing category.

From Teresa Atkin’s observation, the estimated that 80 percent of the people who attend his divorce recovery classes suffer from a mental illness or disorder, or have dealt with a partner with one or more mental health conditions.

The challenges of being married to a person with a mental illness or disorder are often made considerably worse during the divorce process, and an individual with a mental health challenge will see their symptoms worsen during divorce.

Many people with mental health concerns have additional barriers to achieving intimacy and have trouble consistently engaging in behaviors that support a marriage.

Studies report major depression and addictions as the top two mental health conditions that contribute to divorce. In addition, bipolar disorder seems to relate to divorce by virtue of how long and how severe the depressive episodes are, and the amount of life stress associated with a manic episode (for example: debt incurred or partner betrayed by cheating).

Anxiety is another mental health condition that can severely affect a relationship. Someone with chronic anxiety tends to seek a high amount of emotional support from a spouse, and Teresa Atkin seen an increase in impatience from the non-anxious spouse. Some anxious clients also seem to experience an increase in their personal stress levels just by being in a relationship, and some decide to end the relationship themselves to relieve that tension.

Depression seems to affect the divorce rate by virtue of lack of engagement in the relationship, as well as not being able to fulfill family or work expectations.

Men sometimes show depression through anger, and many female clients have told me how difficult it is to live with constant irritability, hostility, and angry outbursts. The spouse of a depressed person may take on additional responsibilities in the family and finances, which leads to resentment and burnout.

I have had a number of clients who, because of a depressed spouse, have had to take on family responsibilities in addition to already-demanding jobs, while feeling powerless to make changes.

Addictions are also often associated with a lack of personal responsibility, and they frequently propel the other spouse into over-responsibility. A person with an active addiction has a hard time being intimate, as their priority becomes fulfilling the addictive desire. Another behavior associated with addicted people is the tendency to blame the world and other people for their problems; this does not make for a healthy marriage.

Every day, those who experience mental health illnesses or disorders and their spouses deal with insecurity, fear, shame and blame.

Renowned relationship expert John Gottman has convincingly argued that criticism, contempt, defensiveness, and stonewalling are the "four horsemen of the apocalypse" regarding relationships and lead to divorce. In marriages where one or both partners is living with a mental health issue, the four horsemen appear considerably more frequently.

When considering a divorce with mental illness as a factor, it's important to ask yourself the following questions:

1) Is the mental health condition treatable, and is the individual willing to receive treatment?

2) How much harm is each family member experiencing?

3) Are you willing to remain in the relationship even if nothing changed?

4) Is the condition stable, or is it likely to get worse over time?

5) What kind of support network is available?

6) What are your values when it comes to divorce?

From my experience, there is no one-size-fits-all approach to divorce decision-making when you include mental illness.

Most people have a long list of conflicting "should" that they have inherited from friends, family, and their community, and this complicates the decision. In order to deal with the added stress of divorcing when either person has a mental illness, the decision maker has to make sure that the decision is truly their own.

 

SECTION 5: ISLAMIC: THE REWARD OF TAKING CARE OF ONE WHO IS SICK

One of the greatest of deeds before Allah, may He be exalted, one of the dearest to the Most Merciful, one of the highest in honour and greatest in chivalry, is showing kindness to the weak and the sick, taking care of them and looking after them.

It was narrated from Ibn ‘Umar (may Allah be pleased with him) that the Messenger of Allah (blessings and peace of Allah be upon him) said: “The Muslim is the brother of his fellow Muslim; he does not wrong him or let him down. The one who meets the needs of his brother, Allah will meet his needs. Whoever relieves a Muslim of distress, Allah will relieve him of distress on the Day of Resurrection.” Narrated by al-Bukhaari (2442) and Muslim (2580).

It was narrated that Abu Hurayrah (may Allah be pleased with him) said: The Messenger of Allah (blessings and peace of Allah be upon him) said: “Whoever removes a worldly hardship from a believer, Allaah will remove one of the hardships of the Day of Resurrection from him. Whoever grants respite to (a debtor) who is in difficulty, Allaah will grant him relief in this world and in the Hereafter. Whoever conceals (the fault of) a Muslim in this world, Allaah will conceal him (his faults) in this world and in the Hereafter. Allaah will help a person so long as he is helping his brother.”Narrated by Muslim (2699).

The one who stays with the one who is sick, and takes care of him and looks after him has done good by serving him and caring for him, and Allah, may He be glorified and exalted, says (interpretation of the meaning): “and do good. Truly, Allah loves Al-Muhsinoon (the good-doers)” [Holy Quran Chapter al-Baqarah 2:195].

Helping the one who is sick and serving him is an act of charity. The Prophet (blessings and peace of Allah be upon him) said: “Helping a man onto his mount or lifting up his luggage onto it is a charity.” Narrated by Muslim (1009).

The same applies to helping the person himself, carrying him or helping him to walk or sleep, or treating him.

It was narrated from Ibn ‘Umar (may Allah be pleased with him) that a man came to the Prophet (blessings and peace of Allah be upon him) and said: O Messenger of Allah, which of the people is dearest to Allah? And which deeds are dearest to Allah? The Messenger of Allah (blessings and peace of Allah be upon him) said: “The dearest of people to Allah, may He be exalted, is the one who does most benefit to people, and the dearest of deeds to Allah, may He be exalted, is joy that you bring to a Muslim, or relieving him of distress, or paying off debt for him, or dispelling his hunger. And to walk with a brother to meet his needs is dearer to me than observing i‘tikaaf in this mosque – meaning the mosque of Madinah – for a month.”Narrated by at-Tabaraani (12/453); classed as saheeh by al-Albaani in Saheeh at-Targheeb (955).

When the daughter of the Messenger of Allah (blessings and peace of Allah be upon him) fell sick, the Prophet (blessings and peace of Allah be upon him) instructed her husband, ‘Uthmaan ibn ‘Affaan (may Allah be pleased with him), to stay with her and nurse her, and to stay behind from the battle of Badr. The Prophet (blessings and peace of Allah be upon him) said to him: “You will have a reward and share (of the booty) of a man who was present at Badr.” Narrated by al-Bukhaari, 4066

The one who takes care of one who is sick must have the characteristic of patience because of what he will encounter of difficulty in staying up at night, and watching and tending to the one who is sick. Allah, may He be exalted, says (interpretation of the meaning): “Only those who are patient shall receive their rewards in full, without reckoning” [Holy Quran Chapter az-Zumar 39:10].

It is also essential that he be compassionate. The Prophet (blessings and peace of Allah be upon him) said: “Those who show mercy will be shown mercy by the Most Merciful. Show mercy to those who are on earth and the One Who is in heaven will show mercy to you.” Narrated by Abu Dawood (4941) and at-Tirmidhi (1924); classed as saheeh by al-Albaani in Saheeh Abi Dawood.

Ibn Abi’d-Dunya narrated in Qada’ al-Hawaa’ij that al-Hasan al-Basri said: To meet the need of a Muslim is dearer to me than praying a thousand rak‘ahs. Ibn Rajab said in Lataa’if al-Ma‘aarif (232):

Many of the salaf (early generations of Islam) used to stipulate to their travelling companions that they should serve them, seeking to acquire reward thereby. Among them were ‘Aamir ibn ‘Abd Qays and ‘Amr ibn ‘Utbah ibn Farqad. This was in addition to their striving hard in worship by themselves. Similarly, Ibraaheem ibn Adham used to stipulate to his travelling companions that he should serve them and give the adhaan. One of the righteous would accompany his brothers on journeys for the purpose of jihad and otherwise, and would stipulate to them that he should serve them. If he saw a man who wanted to wash his garment, he would say to him: This is part of what I stipulated, then he would wash it. And if he saw a man who wanted to wash his head, he would say: This is part of what I stipulated, then he would wash it. When he died, they looked at his hand and saw written on it the words, “One of the people of Paradise.” They looked more closely and saw that it was written between the skin and the flesh. End quote.

Congratulations to the one whom Allah enables to extend a helping hand to the weak, sick and needy; congratulations to the one who spends his life and his time doing acts of kindness. We hope that Allah will bestow upon him mercy and pardon, and be pleased with him.

And Allah knows best.

SOURCES AND REFERENCES

http://www.mayoclinic.org/healthy-lifestyle/end-of-life/in-depth/grief/art-20047491

http://www.zaufishan.co.uk/2011/07/16-things-to-do-when-person-is-dying.html

http://www.yourtango.com/2013191101/when-mental-illness-leads-divorce-what-you-should-know

Islam Q&A, https://islamqa.info/en/105343