Health, Spirituality and Medical Ethics

Words are the appearance of meanings, and meanings are the appearance of facts from the interconnected chain of the mind and external realities. The more credible the words are, the more effective they show the meanings and bring the minds closer to the facts. Today, some people reduce the capacity of words to access more meanings, and of course, they are eager to reduce meanings. They keep the facts out of reach and look at superficial and ineffective facts [1].
In simpler terms, if a word, especially a value phrase, is not used correctly, it will convey the meaning of failure in the reader’s mind, and its scientific and practical mission will be distorted. On the one hand, it may be ignored by the scientific community and put aside in practice. Of course, the danger increases when the word is mixed with religious concepts [2]. Terms such as “Islamic medicine” have sometimes challenged the scientific community due to their incomplete understanding and incorrect use of this word and its confusion with the phrase “medicine of the Imams” or “medicine of the prophet” or “medicine of the period of Islamic civilization” [3, 4]. On the other hand, different medical schools have played a role in human health based on their philosophy. Although the modern medical school is at the forefront of these schools, the dominance of its materialistic view of humans (purely anatomical perspective) has caused its effectiveness to be questioned in some areas [2]. The evidence of this is the change in the definition of health and the increasing tendency towards complementary medicine [5, 6].
In addition, the explicit and covert ex-communication of the adherents and fanatics of each school compared to other medical schools has led to field conflicts, which have seriously challenged the community’s right to access health. In the meantime, finding a clear and logical way is a desirable goal. Therefore, in this article, the approach of the comprehensive school of Islam from the perspective of “religious science” using its two epistemological sources, namely “reason and narrative” is proposed on the concept of “Islamic medicine” to reduce these conflicts [2].
Methods
This research is a review and library study that is purposeful and with specific criteria by searching for good intellectual (interpretive, philosophical, scientific, moral, etc.) and narrative (narrative and Quranic) books. This study includes Tasnim (Interpretation of the Holy Quran), the Status of Reason in the Geometry of Religious Knowledge, Principles of Ethics in the Quran, Allusions, and Punishments, Science of Hadith and the Understanding of Hadith, Nahj al-Balaghah, Behar-al-Anwar Al-Jame’al-Dorar, News of the Imams, Vasael-al-Shiites to Study the Issues of the Sharia, Al-Amali va Al-Majales, the Holy Quran, and other sources of religious publications. Likewise, some domestic and international scientific databases, including SID, Noormags, PubMed, Scopus, Google Scholar, and some software such as Noor software with the keywords: Human, religious science, Islamic medicine, evidence-based medicine, and reason and narration have been done separately and without time limit. Research information was often extracted from relevant books, manually filed, and categorized according to a specific pattern. Finally, the content of the study has been analyzed by re-reading.
Since the research information is mainly extracted manually via these books for easier searching, first in the book list, the titles studied with the mentioned keywords, such as religious science, Islamic medicine, reason and narration, and Islamic anthropology or verses and Hadiths somehow related to these categories of material that helped understand the problem were studied separately. Finally, after determining the content, a suitable title is written and a brief explanation is given. In databases, with the mentioned keywords, especially Islamic medicine, related articles were extracted as much as possible and associated materials were removed from the texts and added to the previous content.
Data have been analyzed in the form of content analysis. The categories of notes are placed together, a theme is extracted from each note, and a collection of these themes that belonged to the notes of a category are placed together to form a new note. Then by summarizing these themes, the topics were identified and extracted by the mentioned method. To increase the study’s validity, professors were consulted, and direct results were obtained from the data obtained from the study samples without opinion analysis. Observance of the principle of fidelity duty in expressing the contents by mentioning the source for all matters, including ethical points, is considered.
Results
The chapters that should be considered in recognizing the concept of Islamic medicine and research in this field to help understand this school are as follows:
1. The basis of scientific differences: To understand the basis of scientific differences, there are three sides in the matter of sciences such as science, known, scholars, and it is the scholars who have problems with each other, otherwise no science is involved with another science and no known with another known. Because the information is all the divine revelations, everyone says the same and says that there is God wherever you look. Science shows the same. In other words, all sciences serve each other or have nothing to do with each other; they provide another subject, predicate, or argument [7].
2. The concept of Islamic science: To understand this concept correctly, first, the criterion of Islamic science is not to be taught in a seminary. Many other humanities and experimental sciences can be considered Islamic sciences; however, the degree of citation of their contents to Islam depends on their scientific degree [8].
Second, what has been said from the Quran and Hadiths in medicine are the main lines and generalities from which many sub-details and details branch out. Dealing with the micro-medical issue is beyond the scope of a book (the Quran), the constitution of all scientific and practical aspects of Islamic civilization [9]. In this case, dynamic Ijtihad regains its meaning and finds the best way to compensate for the shortcomings and repair the devastation; the conversion of a naturalist’s opinion will never harm the religious aspect of his science if he has a critical understanding of values and principles. Knowledge of religion should be harmonized because systematic knowledge is the rationality of argument [10, 11].
Thirdly, the truth of the Islamization of sciences means eliminating the defects of the common experimental sciences. It does not make sense to divide it into religious, non-religious, Islamic, and non-Islamic [12]. According to this logic, “Islamic medicine” is a system of thought in providing medical services and education, medical research, and the physician’s relationship with the patient, society, and the environment, influenced by Islamic teachings.
It uses advanced information of today and tomorrow of human beings and directs these teachings in accordance with the Islamic thought system and Islamic teachings and put them at the service of people [4]; in other words, “Islamic medicine means that first, the principles of the subject governing medicine should be taken from the monotheistic philosophy and attitude, then to connect the research of this science with beliefs, the scope and basic frameworks of this science should be determined based on the instructions of the religion of Islam [13].
3. Islamic anthropology: Since it is the subject and axis of medical science, accurate definition and knowledge of human beings are necessary for a better understanding of the concept of Islamic medicine. Because in the Quranic culture (as one of the sources of Islam), God, the Creator of man, has created man by nature as “Hayyehe Motalleh” that is, he (the being) is a living being who thinks divine and his life is summed up in believing in monotheistic teachings, not a talking animal and a living creature; otherwise, God knows many disbelievers as cattle, but worse (Surah Al-Furqan, verse 44).
God introduces the real man as someone who is not in the realm of animal and natural life and does not even limit his humanity to speech or thought but must realize his divine and eternal life and natural God-seeking and continue on his endless journey. Taleh takes steps and follows the stages of human evolution to the position of the caliphate (representation) and the manifestation of the names of divine beauty and creation according to the divine ethics [14, 15]. This precise definition of human beings will lead medical researchers to a more comprehensive definition of “health” - beyond the World Health Organization’s critical definition in this area [5].
4. Spiritual medicine: Spiritual medicine refers to a dimension of health that seeks meaning and purpose in life [16], defined in the medical school of Iranian sages during Islamic civilization as follows: “Completing the soul is also an art that sages. It is called spiritual medicine and its benefit was to protect virtue and eliminate vice” [17]. Therefore, it is vital to address a large part of Islamic medicine to this issue because religious scholars who are physicians of the people’s hearts and teach medicine sometimes have the mission of preventing diseases and treating them. Therefore, the best physician in this field is the one who cures “man” not just the common diseases of man and animal [10, 18].
In this regard, Plato says that the elders’ greatest mistake is trying to heal the body without thinking about healing the sick soul [19]. Imam Baqir also says: “There is no knowledge like health and no health like the health of the heart” [20]. Second, the study of the natural course of the writings of the divine sages and physicians confirms this. Thus, one of the most important writings of Abu Bakr Muhammad Ibn Zakaria Razi (873-935) is “spiritual medicine” (Tib-al-Nofoos), which talks about various topics of human mental states and their treatment [21]. Therefore, the human’s need for spiritual medicine is not less than physical medicine; however, in many stages of life, the human’s need for spiritual medicine is more urgent [13].
5. Scope of evidence-based medicine: By definition, evidence-based medicine is the correct, explicit, and prudent use of the best evidence in each patient care decision, and this means combining individual clinical experiences with the best available clinical evidence obtained from systematic research [22, 23]. However, the scope of this medicine is also limited, and it cannot enter into matters that are not material experiences such as the effect of prayer, almsgiving, mercy, miracles, and dignity in the recovery of the patient - which is specified in religious teachings - and comment on how they work, negatively or positively. However, in the school of Islamic medicine, in addition to including material causes that follow the principles of evidence-based medicine, attention has also been paid to these metamaterial causes that are not in the realm of human experimentation. Of course, information and narration alone have no place in the Islamic school of medicine since religious knowledge is the product of referring to reason and narration and the interaction of both [12, 24].
6. Basic requirements in the school of Islamic medicine: According to verse 36 of Surah Al-Isra’, “do not say or follow what you do not know” the crucial thing is to have the necessary knowledge and monotheistic view of the phenomena of existence [25] because Islam is a research-based religion and the basis of Muslim life is according to the principles of that science. Whether a leader or a follower, a man should live wisely and even in the branches of religion, he should imitate and investigate this imitation [24].
7. Criteria for Islamization of medicine: Medicine is one of the experimental sciences, and if we want the experimental sciences to become Islamic, we must first remove the title “nature” and replace it with “creation”. Second, the Creator’s title, the actual origin, should be considered. Third, the purpose of creation should be considered as the ultimate origin. For example, if a scientist argues that a certain effect is in a certain mineral or that a certain plant species have such properties and products, he thinks in this way and explains that these phenomena and beings were created in this way. The wise Creator has placed the creation scene in such a way that it has special effects and properties so that the purpose of creation, which is the worship of God and the spread of justice, will be more satisfactorily achieved. Fourth, the focus of the discussion is the valid narrative reason, such as a verse of the Quran or an authentic Hadith. Fifth, relying on narrated confirmations should be considered. Sixth, the claim that reason or narration alone suffices is not acceptable in any case. The seventh is the interpretation of each part of creation according to the interpretation of the other part [12].
8. How to deal with medical narrative propositions: In the face of numerous medical narratives, first, “medicine is an experimental science and therefore, in the analysis of medical propositions, the document ranks last” [26]; that is, regarding the document, which is the Quran or Hadith, the following approach should be taken:
a) According to Imam Ali, the most reliable and understandable Hadith should be used as much as possible, he says: “Tell people the Hadiths so that they can understand. Do you want God and His Messenger to be denied? Do you want that God and His Messenger be lier?” [27]. Of course, it is essential to note that in the news issued by the Ma’soumin, there is firm and similar news, and such news is generally similar [28]. Hazrat Amir also stated in a hadith, “Whenever you hear a hadith from us, and you do not understand it, return it to us and stop talking about it and when the truth becomes clear to you, accept it.” It would help if you were not revealing and hasty” [29]. Of course, in such cases, it is possible to use the “exposure of the Sunnah over the Quran” to assess the validity of the Sunnah, and in such cases, “agreeing with the Quran is not a condition for the validity of the hadith; however, opposing it hinders the validity and authenticity of the hadith”. Therefore, a narration that does not differ from the Holy Quran is within the scope of the Quran and is an argument and can be cited” [30]. Therefore, in dealing with Hadiths and narrations that human intellect and science are incapable of understanding; first, we should realize that: the expression of such news was to test the position of faith and followers of the Imams.
According to the narration of Imam Sadegh: “It is difficult and uneven to understand our words, and it should not be understood except by a close angel, a prophet, or a servant whom God has tested his heart with the light of faith [2]. Hazrat Amir said: “Do not take our words and sayings except trustworthy hearts and tolerant intellects” [31]. Ibn Sina also states, “If you have no reason to reject something, you know it is possible” [32, 33].
b) Methodical or rational scientific Ijtihad should be considered a principle in the branches of medical sciences since the Ma’soumin have said: Expressing the principles (topic) with us but explaining its sub-principles with you, and this issue concerns Ijtihad in all fields of Islamic sciences [10].
c) Listening to the various sayings of medical schools and following the best and most complete of them in practice should be considered a basic approach. Because according to the holy verse of the Quran which says: “Those who listen to the word, then follow, which is the best for those whom God has guided and those who have been guided by him.” (Surat Al-Zumar, verse 18). This is the only way to guide, reason, and evangelize. Imam Baqir also says: “I accept the aspects of opinions according to the custom of the error” [31], which means that one who welcomes different thoughts and opinions will distinguish right from wrong.
9. The pattern of writing subjects in Islamic medicine: However, the pattern of rational or scientific writing of issues is not a problem in the school of Islamic medicine. If the discussion is based on a valid narrated reason such as a verse of the Quran or a correct hadith, and the procedure and order of writing subjects based on three scientific (rational), Hadith, and Quranic (narrative) topics, it will be more researched and completed.
In the first topic, the issue is carefully examined and discussed from a scientific point of view. In the second part related to the subject, authentic Hadiths (if any) should be mentioned as a supplement to the discussion. Finally, during the Quranic debate, while combining the verses of the Quran with the issues raised and the possibility of facilitating the presentation of narrations to the verses of the Quran (as much as possible), try to increase the strength of the content and the richness of the content to pave the way for further research [2]. Expressing the principles (topic) with us but explaining its sub-principles with you [34], and this issue concerns Ijtihad in all fields of Islamic sciences [10]. The author has written several books on this subject [35].
Discussion
In this article, the main components that can help recognize the concept of Islamic medicine including identifying the roots of scientific differences, the concept of Islamic science, Islamic anthropology, spiritual medicine, the scope of evidence-based medicine, the basic requirements, and criteria for the Islamization of medicine and the way of dealing with medical narrative propositions have been calculated and examined innovatively and systematically.
However, articles in Islamic medicine have been written in electronic information sources. However, most of these articles have not analyzed this concept in detail and have only mentioned it briefly and nominally, and have not tried its components so that the reader’s mind can reach a proper understanding of the term.
For example, Ibrahim-ben-Murad, in his article “Fi al-Teb-al-Islami” (In Islamic Medicine), without defining this word, only deals with the history of “Islamic medicine” and combines it with the Galenus medicine, Hippocrates, and medicine of the period of Islamic civilization. Therefore, it is not possible to have a correct understanding of the concept of Islamic medicine [36].
Shahbazi et al., without considering the exact concept of Islamic medicine and providing a precise definition of it, examined the issue of human health from the perspective of “traditional and Islamic medicine” and only using some verses and narrations (narrative sources) and listed seven methods of physical medicine, including nutrition therapy, herbal medicine, cupping therapy, sedation therapy, stone therapy, aromatherapy, and color therapy under the heading of “comprehensive Islamic medicine” without considering the rational source of Islam [37].
In the article entitled “Islamic medicine and its place among the great systems of traditional medicine”, Farahnia only refers to the schools and sources on which it is based without defining them. These medicines include the Jundishapur school of medicine, Greek medicine (Galenus Medicine), Syriac medicine, Indian medicine, Egyptian Alexandrian medicine, which was in Coptic, and Teb-al-Nabi (Prophetic medicine), the contents of which have been collected via hadiths and the Prophetic tradition and from the book Al-Sahih Al-Bukhari.
This word still seems to be combined with “medicine of the Islamic civilization” [38]. While introducing the most brilliant periods of Islamic medicine and its lasting impact on European medicine, Najmabadi considers it unique to the 9th to 12th centuries. It seems that this word is still combined with the medicine of the Islamic civilization period [39].
Shir Khoda, in his study entitled “identification and complication of opportunities and threats (external factors) for the development of Islamic medicine”, without defining Islamic medicine and only quoting a narration from Imam Baqir that “if you go to the east and west of the world, you will never find the right knowledge unless it is rooted in our knowledge of the Ahl-al-Bayt” enlisted the difference between Islamic medicine and other medical fields, such as modern medicine, traditional medicine, Chinese medicine, Indian medicine, herbal medicine, etc., in its specific features and methodology, while considered the products of Islamic medicine to be completely limited to herbal and natural medicines [40].
Although Sadeghi et al. have studied the issue by proposing the views of the proponents and the opponents on Islamic medicine and the superiority of the opinions of the proponents and the opponents, and thus helped to understand the problem. As a result, only the lack of a single definition and the existence of different interpretations of Islamic medicine is an obstacle to the development and institutionalization of Islamic medicine, and finally, the acceptance of a single description among experts is a prerequisite for achieving a comprehensive theory of Islamic medicine [41].
In the meantime, Nour Mohammadi’s study entitled “an attitude towards the concept of Islamic medicine” has dealt with this issue more than other studies; however, the limitations have not been clearly explained, and marginalization has added to its ambiguity, a common understanding of the term is still impossible.
Perhaps some of the issues that the study has in common with this study are the discussion of the importance of Islam in acquiring knowledge, the difference between the concept of Islamic medicine and medicine in Islamic civilization and traditional medicine, paying attention to anthropology, eliminating the Western culture that governs world medicine, paying attention to the narrated propositions (verses of the Quran and the Hadiths from Ma’soumin) and Islamic teachings concerning medical sciences, and finally paying attention to the role of religious and spiritual beliefs in the health of individuals, which is worth considering [42].
Sajedi et al., while stating the five solutions to producing Islamic medical sciences, such as changes in the principles and presuppositions of medical sciences, the absolutism of religious teachings, revival of Islamic medicine (or) prevention and treatment inspired by books and traditions, establishing a health system based on Islamic teachings, jurisprudence and ethics, and dressing medicine from the symbols of Western culture in the context of Iranian-Islamic culture, has proposed the term “Islamic teachings on health” instead of Islamic medicine, which is thought-provoking in its kind [43].
However, Isfahani, by differentiating between the two terms “Islamic medicine” and “Medicine of the period of Islamic” civilization or traditional medicine or Iranian-Islamic medicine, considers Islamic medicine as a system and introduces it as “Islamic medicine thinks of a system of providing medical services in the dimensions of education, research, health care, and health promotion services in its broad sense. Not only is there nothing in opposition to Islamic jurisprudence and guidelines but the presence and inspiration of Islamic guidelines are fully felt in its processes.
In this way, Islamic medicine is a system that can provide the required medical services to anyone anywhere at any time, in a clean and acceptable form of Islam, without weaknesses and shortcomings and with appropriate quality. He also considered Islamic medicine in its specific sense to be directly or indirectly originated from Islamic teachings, human thought, and experimental achievements. Its emphasized and special features are based on categories such as prevention and modification of lifestyle, mental and psychological therapy, health measures, food therapy, and the use of words, such as God instead of nature or biopsychosocial spirit instead of biopsychosocial, while thought-provoking, generally agrees with the view and results of the present study [44].
Finally, in the article “religious science from the perspective of Ayatollah Javadi Amoli”, the preacher did not directly refer to the definition of Islamic medicine but he implicitly explained the issue of Islamization of science and provided this view and the possibility for the reader to understand the concept of “religious science” as the concept of “Islamic medicine” which can be cited to confirm the findings of this article [45].
He quotes Professor Djavadi Amoli as saying: “In the field of Islamization of sciences and universities, any excesses should be avoided, and one should not think that Islamic science, i.e., Islamic physics and chemistry, is separate from the ordinary natural sciences. The origin of such suspicion is that we consider the relation of religious science to everyday science as the ratio of hand-made carpets to machine-made carpets and imagine that religious science provides an entirely different content from conventional science. Because we see that different physics and chemistry cannot be obtained from the heart of religious science, we thought that we fundamentally deny the possibility of Islamizing science.
The idea of Islamizing science is due to reconciling science with religion and removing the neglect of the place of reason in the geometry of religious knowledge and eliminating the alienation and the gap that has been wrongly established between science and religion, not abandoning the experimental method and proposes a completely new and innovative mechanism for the natural sciences. The truth is that the Islamization of science means to eliminate the defects of the common experimental sciences and that we see the natural sciences in harmony with other epistemological sources, rather than destroying the basis of current sciences and expecting entirely new content in different branches of science. If science is not a pure illusion, it will never become anti-Islamic. The science that turns the pages of the book of Divine Creation and reveals its secrets and mysteries is inevitably Islamic and religious. It does not make sense to divide it into religious, non-religious, Islamic, and non-Islamic. Accordingly, the science of physics (and other experimental sciences such as medicine) is certainly Islamic in a situation that it is bound to certainty or rational certainty. It is not on the border of hypothesis and delusion, even if the physicist (or naturalist and physician) is an atheist or a skeptic" [12].
Conclusion
Given the prominent position of reason in the school of Islam, the true meaning of “Islamic medicine” is far beyond what is now mistakenly used instead of titles, such as “medicine of the imams or medicine of the prophet” or “medicine of the period of Islamic civilization”. The minimum scope of the concept of Islamic medicine encompasses all common medical schools today, whether classical or conventional, complementary or alternative, and traditional and anything from the medical sciences based on reason and evidence-based manners and with a monotheistic view in the direction of human physical and mental health. In addition, many valid narrative propositions accompany this medical school, which can be considered a great advantage and privilege for this medical school [2].
Ethical Considerations
Compliance with ethical guidelines
This article is a review with no human or animal sample.
Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors.
Conflict of interest
The author declared no conflict of interest.
Acknowledgments
The author is grateful to the editorial board and respected referees of the Health, Spirituality and Medical Ethics Journal of Qom University of Medical Sciences.