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Some principles of Islamic ethics as found in Harrisian philosophy
  1. Sahin Aksoy
  1. Correspondence to Professor Sahin Aksoy, Harran University, Faculty of Medicine, Department of Medical History and Ethics, Dekanlik Binasi, Yenisehir Kampusu 63200 Sanliurfa, Turkey; sahinaksoy{at}yahoo.com

Abstract

John Harris is one of the prominent philosophers and bioethicists of our time. He has published tens of books and hundreds of papers throughout his professional life. This paper aims to take a ‘deep-look’ at Harris' works to argue that it is possible to find some principles of Islamic ethics in Harrisian philosophy, namely in his major works, as well as in his personal life.

This may be surprising, or thought of as a ‘big’ and ‘groundless’ claim, since John Harris has nothing to do with any religion in his intellectual works. The major features of Harrisian philosophy could be defined as consequentialism or utilitarianism with liberal overtones. Despite some significant and fundamental differences in the application of principles (ie, abortion, euthanasia), the similarities between the major principles in Harrisian philosophy and Islamic ethics are greater at some points than the similarities between Islamic ethics and some other religious ethics (ie, Christian, Judaism).

In this study I compare Harrisian teachings with major Islamic principles on ‘Responsibility’, ‘Side-effects and Double-effects’, ‘Equality’, ‘Vicious choice, guilt and innocence’, ‘Organ transplantation and property rights’ and ‘Advance directives’.

  • Philosophical ethicsreligious ethicsmoral and religious aspectscultural pluralism

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Introduction

John Harris is one of the prominent philosophers and bioethicists of our time. He has published tens of books and hundreds of papers throughout his professional life. Everyone, including his opponents, acknowledges his brilliance and authority on ethics. I had the chance to study with him as a PhD student for 5 years.

I have always respected and appreciated Harris because of his brilliance in ethics and relevant social sciences and also for his personality and life philosophy. When I contemplated the actual reason for this respect and appreciation, I found that I had seen in him the signs of moral elements that I had been advised, thought and preached at home, school and in the mosque. Since I had grown up in a Muslim society, and my moral framework was shaped with Turkish and Islamic values, I thought this must be ‘something’ that I should look deeper into. This paper is the result of this ‘deep-look’. With this look, I found that it is possible to find some principles of Islamic ethics in Harrisian philosophy, namely in his major works, as well as in his personal life. It may seem surprising, or thought of as a ‘big’ and ‘groundless’ claim, since John Harris has nothing to do with any religion whatsoever in his intellectual works, but it should be kept in mind that believing in a religion and behaving or thinking like a religious person are separate things. I do not use religion here in the sense that Bertrand Russell uses in his writings1; I do not want to make the mistake of considering only Christianity and Judaism as religions and neglecting an important tradition, namely Islam as one of them.

Religious teachings mainly serve two objectives; one is to govern this world and the other is to shape the hereafter (if there is any). After this point, due to the limitation of my expertise and the space in this article, I will solely concentrate on Islam. The Qur'an (the Holy book of Muslims) comprises stories, which give indirect messages and examples for leading a good life, and direct commands that a believer should obey. Therefore, the Qur'an can be considered as both a book of morals as well as a book of worship. Since Allah (the God in Islam) says in the Qur'an; “We have not sent thee but as a (Messenger) to all mankind, giving them glad tiding, and warning them, but most men know not” (Saba'; 34:28), the words in the Qur'an and Hadith (sayings of Prophet Muhammad) are not only for Muslims or even just for ‘believers’, but for all mankind. The Qur'an says; “This (Qur'an) is, with its evidences, wisdom light for mankind, and a Guidance and a Mercy for people who will have Faith with certainty” (Al-Jathiya; 45:20). The Qur'an never relates as “O you Muslims!” The verses frequently go “O you who believe!” or “O mankind!” Therefore, the verses about worshipping are for Muslims who wish to obey the God, follow his commands, seek for His approval and have a ‘good life’ in this world and hereafter. However, the verses about morals are for mankind looking for a harmonious society with self-respect and respect for others. Is not this what moral philosophy and ethics are all about?

Let's look at Harris' major writings which are in pursuit of a moral way of conduct for life in general, and in the healthcare domain in particular. First of all, it is worth mentioning that there is no doubt about the major features of Harrisian philosophy. I could define it as consequentialism or utilitarianism with liberal overtones. Despite some significant and fundamental differences in the application of principles (ie, abortion, euthanasia), the similarities between the major principles in Harrisian philosophy and Islamic ethics are greater at points than the similarities between Islamic ethics and some other religious ethics (ie, Christian, Judaism). It is worth mentioning here that Islamic law and Islamic ethics are inseparable, though there are different schools of thought, as well as different interpretations within these schools. As a Hanafi and Sunni person, my interpretations should be taken as they are. Another Muslim scholar might come to different conclusions than I do, and is the richness and flexibility of Islam to fit for everyone's individual needs.

Responsibility

Harris' position is quite firm on his ‘responsibility’ argument. He says; “Where something happens, or a state of affairs obtains because someone did something, I will say that the agent is positively responsible for its occurrence; and where a particular state of affairs obtains or something I will say that the agent is negatively responsible for its occurrence”.2 He uses this argument on many practical issues in The value of life, such as selective treatment (or, to him, selective non-treatment), euthanasia and terminal care.

Harris' responsibility argument is quite similar to how Islam defines responsibility. In Islamic law, a person is obliged to act, if the action is in his capacity. It is a crime (that one can be held responsible for) to do something which is forbidden to do, or not to do something which is commanded.3 If someone dies in a neighbourhood due to hunger or cold, the people of the neighbourhood who are able to take care of him are held responsible and are punished for this ‘inaction’ or ‘non-action’. It is especially important when it is a matter of life and death. In Islamic jurisprudence there are statements encouraging individuals to help save others' lives. For instance, though it is forbidden to interrupt or pause salāt (the prayer) for any reason, Islamic scholars say it is not only commended but commanded to do so if it is a matter of saving another's life. Otherwise the person who fails to do so is held as responsible.4

On another occasion the Prophet criticised a person who did not help someone while it was in his capacity, and said “if a person does not help another when it is in his capacity, Allah will not help him in the Hereafter”.5

Side-effects and double-effects

The principle of double-effect, which appears in Catholic theology, is often cited as explaining an important difference between positive and negative responsibility.6 Harris categorically disagrees with this argument and says: “The distinction between effects and side-effects and, between effects and double-effects, drawn in this way is entirely without moral significance. What matters is how our decisions and actions affect the world, not whether that effect is direct or indirect.” And he adds “The crucial point for anyone who wishes to have a realistic appreciation of what is involved in one choice rather than another is surely not: ‘which description makes the most undesirable consequence a side-effect?’ but ‘am I justified in behaving in a way that has these consequences?’” 2

Similar to Harris' arguments, Prophet Muhammad says; “One who leads to a good-doing is like one who has committed it”.7 Islamic scholars also do not accept the concept of ‘double effect’ or ‘side-effect’. Al-Zuhayli says, “even if one does not perform the act of killing and do not aim to kill an individual, if one's action results with the individuals death, one shall pay diyat (blood money)”.4 He gives a similar analogy to Harris and writes, “if someone kills her friend with a gun shot in the forest by mistake, she cannot claim innocence. She must take the responsibility of killing and shall pay blood money, but can be excused from qisas (retaliation).”

Harris defends a similar argument in his Violence and responsibility8 and strongly criticises the doctrine of double effect and rejects the idea of “death as a first effect of what we do is worse than death as a second effect of what we do”. If we foresee the second effect of an action (or an omission) it is nonsense to deny the responsibility for its consequences. As a very prominent 11th century Muslim scholar, al-Ghazali influenced the direction of the way of thinking in Islamic ethics; an action sometimes has a single motive (ba'ith) behind it and sometimes two. If there are two motives, it is open to three possibilities—each of the motives may be so powerful that by itself it can cause the action to happen, or so weak that it cannot cause the action unless it is joined with the other; or one of them may be such that it alone is capable of bringing about the act, but when the other is combined with it, it is aided by it. The second motive in these three cases may respectively be called a ‘companion’ (rafiq), a ‘partner’ (sharik) and an ‘assistant’ (mu'in) of the first.9 Regarding ‘intention’, Harris says that

If someone, knowing that they were infected with the pulmonary plague mimicking HIV, were to enter a crowded bus they might not intend in some narrow sense to infect the other occupants, but they would share the same responsibility for subsequent deaths that would fall to the person who entered such a bus firing randomly a machine gun without taking aim at any particular individual or caring whether anyone or no-one was actually hit.10

Equality

As a real egalitarian, Harris believes that any group should not be systematically and unfairly disadvantaged since everybody is equal to each other. It is also the case that the Qur'an considers all men equal, and reads: “We created you from a male and female, made you into nations and tribes, that you may know one other. Verily, the most honourable of you in the sight of Allah is he who is the most righteous and pious. Verily, Allah is All-Knowing and All-Aware.” (Al-Hujurat; 49:13) While explaining his perspective on ‘non-vicious choice’, Harris re-states that any kind of discrimination based on race, gender, religion or else. He says: “We must recognise that although all persons' lives will differ in length, happiness and success, in short in the degree to which their fundamental interests are satisfied, they all, each and every one, matter morally despite these differences not because of their race gender and age.”11 Prophet Muhammad also emphasis the absolute equality between men by saying; “All humans are equal to each other like the teeth of a comb”.12

Non-vicious choice, guilt and innocence

In terms of ‘non-vicious choice’, Harris argues that, we can see in some special cases that a doctor ought to save as many lives as she can, even at the expense of her children, but she should not be blamed if she saves her children,2 and equates this with Derek Parfit's ‘blameless wrongdoing’, and quotes from him: “When I save my child[ren] rather than strangers I am acting on a set of motives that it would have been wrong for me to cause myself to lose. This is enough to justify my claim that, when I act in this way, this is a case of blameless wrongdoing.”13 In Islam, preferring or giving priority to the relatives and next of kin in certain circumstances is also encouraged. Charity, donation and life saving are among these circumstances. Giving religious advice and inviting people to practice Islam is one of the most crucial duties (and also a favour to the individual) upon Muslims. Allah commands people to give priority to their relatives on this duty in the Qur'an. (Ash-Shu'ara; 26:214; Al-Baqarah; 2:177) Therefore, it is also a blameless, even an encouraged act in Islamic ethics to favour your child(ren), family member or a next of kin.

Harrisian philosophy has a clear and firm position on killing, guilt and innocence; if one can only protect oneself from being tortured by killing an innocent person then one may well not be justified in resisting at such a cost (although it could be understood and perhaps forgiven if one does) but neither justice, nor any other moral principle, requires one to protect, at the cost of terrible injury to oneself, those who would inflict such injuries upon him.2 This approach fully matches what a Muslim ethicist would say on this issue. Islam is not a pacifist doctrine; however no one is permitted to kill an innocent unjustly. Allah says in the Qur'an “And do not take life—which Allah has made sacred—except for a just cause. And if anyone is slain wrongfully, We have given his heir the authority (to demand qisas [law of equality in punishment] or to forgive, or to take diyat [blood money]; but let him not exceed limits in the matter of taking life (ie, he should not kill except the killer only). Verily, he is helped (by the Law).” (Al-Isra'; 17:33)

In Islamic Law, if one kills a burglar or an attacker to protect his property, his honour, his family or to take the stolen property back, he shall not be punished.14 Al-Zuhayli says in his Islamic Jurisprudence Encyclopedia, if someone attacks for another individual's life, property or honour, this individual has the right to defend them by all means, and it is legitimate for outsiders to help such a defence.4

Organ transplantation and property rights

On the issue of organ transplantation, Harris has a quite radical view which was widely criticised and discussed when it was first spelled out. Harris believes that a person cannot be wronged or harmed by the transplant of their organs ‘against their will’ for they have no will—they are not there to be harmed. And argues that, if the State has the power to order a post mortem examination to the dead on the slightest of suspicions as to the cause of death, how much more important and useful it would be to be able to order post mortem transplantation!2 Parallel to Harris' controversial suggestion on making cadaver organs available for ‘public benefit’,15 as cited in Ghanem's book, Ibn Qudâma allowed, six centuries ago, the re-use of the organs of the deceased.16 Although the prior consent of the deceased for organ removal is ideal in Islamic ethics, that I believe Harris would also agree, if the life of an individual depends on this organ, this principle can be neglected since it contradicts with one of the most frequently employed maxims among Islamic legal scholars: ‘al-darûrât tubîh al-mahdzûrât’ (necessities render the prohibited permitted).17 That maxim means that when there is no other way to save a life, forbidden means become permitted; this includes the removal of organs from a cadaver.

As I have argued elsewhere,18 Harris' argument on making organs public property in certain circumstances can easily be seen as compatible with Islamic ethics. At the First International Conference on Islamic Medicine, it was agreed that the donation of body parts is a social obligation, of the kind classified in Islamic law as fard al-kifâya (a collective duty that must be fulfilled by a sufficient number of community members, though not necessarily by all: the commonest example is making proper funeral arrangements for Muslims and doing the funeral prayer). This means the community is under a collective obligation to find the right organs for transplantation in order to preserve the lives and health of its sick members. If a sick person dies while awaiting a transplant, the society as a whole carries some responsibility for that. In this situation, the medical staff in charge of the transplant procedure represents the community as a whole. Once an organ for transplant has been obtained, the community regards itself exempt from seeking further cure for the recipient of the organ.19

Advance directives

Harris, as a philosopher who believes in the value of life, objects to the default position that under circumstances of irreversible loss of competence, life-sustaining treatment be withheld from all patients in the absence of advance directives to the contrary. He believes that if advance directives are to be taken seriously it is implicit that the principle of autonomy of persons overrides any absolutist view of the sanctity of life.20 This sensible view is also very much in line with Islamic teachings. As the Qur'an clearly states; “Verily, Allah! With Him (alone) is the knowledge of the ‘hour’… No person knows in what land he will die. Verily, Allah is all-Knower, all-Aware (of things).” (Luqmân; 31:34), the appointed time for a person to die is uncertain in Islamic understanding and it cannot be taken as one minute before or one minute after. Thus, it is not appropriate to judge that this person will not be competent again and that he would wish not to live in a particular condition. As Harris says; “instituting a general policy of non-treatment of the incompetent would likely cause anxiety among the competent (that, eg, on the approach of loss of competence they would be used as ‘organ banks’) as to distort the doctor–patient relationship and to undermine confidence in the impartiality of medicine and of society”.20 It is also wrong to assume that people would not wish to sustain a life with low quality or dependent on others. It is more so for Muslim patients, since it is believed by every Muslim that every minute of life is given by Allah and man is tested in every moment of his life. Therefore, even if there is not a living will, doctors are wrong to withheld treatment.

Conclusions

Throughout this paper I have tried to review John Harris' major works and define a ‘Harrisian philosophy’ by identifying his position on various fundamental issues in bioethics. I have also presented the approach of Islamic ethics on the very same issues. It was obvious to me that the similarities between Harrisian philosophy and Islamic ethics were greater than the differences. I have limited my study to issues of bioethics rather than practical applications. When we look at the practical issues (ie, abortion, euthanasia; brain death; organ transplantation) it is possible to find some significant and fundamental differences between Harrisian philosophy and Islamic ethical principles. It is not a surprise since we are talking about religious thought with a heavenly revelation, prophetic sayings, scholarly interpretation on one side and a materialist, rationalist, utilitarian (maybe atheist) 20th century philosopher.

From my point of view, the greatest similarity between Harrisian philosophy and Islamic ethics is acknowledging everyone in his or her own position. This has been the most significant characteristic of John Harris as a philosopher, as a teacher and as a friend. He has always told me as a teacher; ‘Be firm in your position. I do not agree with you, but I fully support you to walk in this way,’ similar to Qur'anic expression in the chapter The disbelievers; ‘To you be your way (your religion), and to me mine (my religion).’ (Al-Kāfirūn 109:6)

Acknowledgments

I am grateful to Dr Adem Akinci of the Faculty of Theology at Harran University, Sanliurfa, Turkey for reviewing the chapter from Islamic perspective and saving me from making vital mistakes. Their help is beyond any appreciation. At last, but not least, I am thankful to my wife Prof Nurten Aksoy for helping and encouraging me to better understand “Harrisian philosophy” since the beginning of my PhD studies in 1994.

References

Footnotes

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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