Islam & Medicine P5 – Competency of Health Adviser

These various disciplines of medicine are not inherent to any single individual (i.e. they are not born with those skills), rather they require learning of knowledge and skills from someone already competent within that discipline and to learn for a period of time that the one teaching is content that the student has completed all the competencies required for that discipline such that they can practice that form of medicine independently. This is not just generic to medicine but is the same in all walks of life and many different types of skilled occupations. However the danger is when an overtly keen student does not recognise his limitations, causing a false sense of confidence in the absence of certification or qualification of one already acquainted with that field leading to a half medical practitioner. One who on occasions will be correct and on occasions incorrect, but due to what is at stake, i.e. a persons health and life, then the gravity of the matter is serious indeed.

This agrees with the sound reason, so for example, if there was an engine problem with one’s car (and money wasn’t an issue) who would you take it to? A qualified car mechanic? Or someone who knows a bit about cars? Or some one who knows about physics/mechanics (i.e. an understanding of car components)? No doubt it would be to a qualified car mechanic otherwise your at risk of damaging your car further if the two alternatives are used. The sound reason is also in agreement with the Prophetic methodology as is established in the following narration (hadeeth related by Aboo Daawood). The Messenger of Allah sallallaahu‘alaihiwasallam said:

“If anyone carries out medical treatment, yet previously he was not known as a medical man, then he takes the responsibility.”

The Scholar, Ibnul Qayim rahimullah, discusses it in depth in his book Prophetic Medicine (Tibb an-Nabawiy) differentiating between the linguistic, legal and medical aspects.

The words of the Prophet sallallaahu‘alaihiwasallam used were: “Whoever practices medicine (tatabbaba)”, he did not say “whoever is a physician (tabba)”. The expression of the fifth form (tafa‘ala) indicates some constraint in the action, and entering into it with difficulty, and that the one so described is not originally one of its practitioners. Similarly, we find the expressions: to attempt clemency (tahallama), to show courage (tashajja‘a), to adopt patience (tasabbara) and others of this kind. Thus, ‘to force oneself ’ (takallafa) is formed upon this pattern. The poet said: ‘And Qays of ‘Aylaan, and whoever sought to be a Qays (taqayyasa).

The legal (shar‘ee) aspect is that this hadeeth establishes the liability of the ignorant practitioner. For if he assumes the knowledge and practice of medicine, without formerly having any acquaintance with it, by his ignorance he risks causing harm to the lives of people; he practices irresponsibly what he does not know and, thus, deceives the sick person. Therefore he must be held responsible. This is the consensus among all scholars. Al-Khattaabee said: I do not know of any disagreement regarding the fact that when a person carrying out treatment transgresses the limits of his knowledge and expertise and causes harm to the patient he should be held responsible. One who lays claim to knowledge or practice which he does not have is an impostor. When injury is brought about by his action, he is responsible for the blood-money (compensation), and he has no right to retaliation (qawad); for he has no authority without the sick person’s permission. The consequences of the practitioner’s felony – according to the opinion of most jurists – falls upon his clan (‘aaqila).

So what is important is that competency of health practitioners, those that give health related advice on a personal individual level is known and demonstrated and there is a level of trust that the practitioner advises within his competency and doesn’t go into extremes of that delving into fields that he has no knowledge. This issue is even more important if the health advice is on a public level as the number of people it will affect is greater hence having greater consequences.

Inappropriate advice leads to destruction of the body which no one will doubt or disagree, but unqualified advice (i.e. from one who has not demonstrated competency) will inevitably lead to inappropriate advice. This is in agreement with what we witness from the scholars that some of them have given the example of the three destructive people; first, the half physician who destroys the body, second, the half grammarian who destroys the language and third, the half (religious) scholar who destroys the religion. This statement is used to stress the importance of the scholar but using the example of the doctor as that has been known by necessity. However our usage here is the opposite in that we are stressing the importance of the doctor by example of the scholar and grammarian. So just as the half scholar is one who has some knowledge and understanding but the knowledge is not complete but he regards himself as being complete in those issues which he delves into, then on occasions he will be correct and on occasions he will be incorrect, but this incorrectness will damage and destroy the religion, because of the gravity and extent of what the religion necessitates. Then likewise the half doctor being the health practitioner that advises about health, who believes that he is competent because of some knowledge in that field, whereas in reality he is not competent to enter into health, diseases and disease management then on occasions he will be correct and on occasions he will be incorrect but because of the gravity and extent that health necessitates he destroys the body and life with his incorrectness.

One who is even worse than this half trained doctor is the one with no health training at all, rather he has deluded himself by some knowledge in other scientific areas but makes the fundamental error of equating it to health, whereas in reality it is not management of health and disease, not in the estimation of any health practitioner be that in modern medicine, homoeopathy, traditional/folk medicine, nutritional medicine, physiotherapy, herbal medicine, etc. This individual is worse than the ignorant, as absence of knowledge of medicine is not blameworthy. The blameworthy individual is the one ignorant yet claims knowledge, (i.e. arrogantly ignorant), then this one will align himself with the knowledgeable, and Allah’s aid is sought from his destructive evil.

Thus anyone wishing to enter the arena of medical health to advise on medical conditions or treatments but yet has not had any training, nor experience, nor certification then for this one I fear that he is the ‘Impostor’ which the Scholars Ibnul Qayim and Al-Khattaabee rahimahumullah both mentioned and that this impostor is to be held accountable and responsible for his actions for entering into the medical issue without qualification, his legal shari’ah responsibility remains, if the people are led to believe that he is a knowledgeable & proficient medical advisor be that well researched or experienced. If an individual gives advice of tailored information to an individual patient, such that it involves the likes of detail application of treatments, interpretation of medical tests or diagnosis of specific conditions (based upon signs and symptoms) have been alluded to without recourse to a medical practitioner (for that tailored advice) but rather this adviser has given that information from himself, then no doubt this is medical advice irrespective of what it is named be that ‘information sharing’ or otherwise. Likewise if this advice is communicated at a broader public audience, propagating issues related to the efficacy of treatments to prevent harm, whether treatments are associated to harm or whether medical conditions in of themselves are illness and harmful, then all of this is medical advice irrespective of what it is named or any disclaimer given. The implications and consequences of such advice remains, from a shari’ah perspective, with the individual giving it irrespective of whether any disclaimers are given. If the case was otherwise then anybody would be free to speak about any matter be that politics, health or even religion, then simply give a disclaimer after such speech. The fact that common people request medical advice to a website that deals with health, and more so the health of Muslims, then it implies that there is a trust that the Muslim advocating the advice is speaking from within his knowledge, skills, experience and proficiency. If he is being asked questions out side of these worldly skills then it is only because the impression given is that of a health adviser who is qualified to give health advice. If one is asked then it is upon them to point that patient to real health experts.

We have discussed an example of those that opened this door of tribulation from among the Muslims here.

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