CHOOSING LIVES: Pandemic Emergency Triage from the Perspective of MaqÄshid
DOI:
https://doi.org/10.19105/islamuna.v8i2.5439Keywords:
Triage; Pandemics; MaqÄá¹£id; Bioethics; Preservation of LifeAbstract
The spike in Covid-19 cases in Indonesia in mid-2021 has led to scarcity of various resources and resulted in a functional crisis of hospitals in accommodating patients. This condition puts health workers and relevant policy makers in difficult situation and ethical dilemma in triaging patients. In this context, there are at least two competing ethical approaches. The utilitarian approach demands maximum benefit in saving lives, whereas the egalitarian approach emphasizes equal rights and opportunities for treatment. This brings up several problems related to giving priority. The problems also include withdrawal of treatment in favour of other patients. This article normatively tries to discuss the issue from the MaqÄshid perspective. This article is qualitative. Literature review of several related recommendations was carried out to explore the basic problems and then putting them in light of the maqÄshid theory. This article argues that MaqÄshid can be an alternative ethical approach in determining priorities. All considerations need to be read in the light of MaqÄshid and its principles with primary focus on scientific and medical considerations.
ABSTRAK
Lonjakan kasus Covid-19 di Indonesia pada pertengahan tahun 2021 menyebabkan kelangkaan berbagai sumber daya dan krisis fungsional rumah sakit dalam menampung pasien. Kondisi ini menempatkan tenaga kesehatan & pengambil kebijakan berada dalam situasi sulit dan dilema etik untuk melakukan triase pasien. Dalam konteks ini, ada dua pendekatan etis yang bersaing yaitu utilitarian yang menuntut manfaat maksimal dalam menyelamatkan nyawa dan pendekatan egaliter menekankan persamaan hak dan kesempatan untuk mendapatkan perlakuan. Hal ini memunculkan beberapa permasalahan terkait pemberian prioritas. Artikel ini secara normatif mencoba membahas masalah tersebut dari perspektif MaqÄshid. Artikel ini bersifat kualitatif. Tinjauan pustaka terhadap beberapa rekomendasi terkait dilakukan untuk menggali permasalahan mendasar dan kemudian meletakkannya dalam tinjauan teori maqÄshid. Artikel ini melihat bahwa MaqÄshid dapat menjadi alternatif pendekatan etis dalam menentukan prioritas triase. Seluruh pertimbangan yang ada perlu dibaca berdasar MaqÄshid dan prinsip-prinsipnya dengan fokus utama pada pertimbangan ilmiah dan medis.
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References
Afandi. “Dilema dr. Corona: Sekarang, Hampir Setiap Hari Saya Memilih Nyawa Pasien.†Cahaya Islam Berkemajuan (blog), June 28, 2021. https://muhammadiyah.or.id/dilema-dr-corona-rintawan-sekarang-hampir-setiap-hari-saya-memilih-nyawa-pasien/.
Al-Bar, Mohammed Ali, and Hassan Chamsi-Pasha. Autonomy. Contemporary Bioethics: Islamic Perspective [Internet]. Springer, 2015. https://doi.org/10.1007/978-3-319-18428-9_6.
Al-Buti, Muhammad Said Ramadhan. DawÄbith Al-Mashlahah. Damaskus: Al-Risalah, 1973.
Alim, Ahmad Muttaqin. “Ketika Dokter Terpaksa Memilih.†detiknews, July 5, 2021. https://news.detik.com/kolom/d-5632004/ketika-dokter-terpaksa-memilih.
Al-Raysuni, Ahmad. NaẓarÄ«yÄt Al-MaqÄshid ‘inda al-ImÄm al-ShÄthibÄ«. Kairo: Dar al-Kalimah, 2014.
Al-ShÄthibÄ«, Abu IshÄq. Al-MuwÄfaqÄt. Edited by Abdullah Darraz. Kairo: Dar Ibn al-Jauzi, 2013.
Auda, Jasser. Al-ManhajÄ«yah al-MaqÄshidÄ«yah. Dar al-Maqasid, 2021.
COVID-19, Website Resmi Penanganan. “Peta Sebaran.†covid19.go.id. Accessed December 2, 2021. https://covid19.go.id/peta-sebaran.
Ehni, Hans-Jörg, Urban Wiesing, and Robert Ranisch. “Saving the Most Lives—A Comparison of European Triage Guidelines in the Context of the COVID-19 Pandemic.†Bioethics 35, no. 2 (2021): 125–34. https://doi.org/10.1111/bioe.12836.
Emanuel, Ezekiel J., Govind Persad, Ross Upshur, Beatriz Thome, Michael Parker, Aaron Glickman, Cathy Zhang, Connor Boyle, Maxwell Smith, and James P. Phillips. “Fair Allocation of Scarce Medical Resources in the Time of Covid-19.†New England Journal of Medicine 382, no. 21 (May 21, 2020): 2049–55. https://doi.org/10.1056/NEJMsb2005114.
Firdaus, Haris. “Krisis Oksigen RSUP Dr Sardjito, Label Hoaks, dan Liputan Kolaborasi.†kompas.id, August 5, 2021. https://www.kompas.id/baca/di-balik-berita/2021/08/05/krisis-oksigen-rsup-dr-sardjito-label-hoaks-dan-liputan-kolaborasi.
Gharib, Othman Muhammed. “Five Essentials Between the Restriction and Addition.†Journal of Arts, Literature, Humanities and Social Sciences 12 (2017): 54–76.
Hamad, Muhammad A. “I`tibÄr Al-Ma’ÄlÄt Wa ‘atharuhu FÄ« al-FatÄwÄ al-Mu`ashirah.†Majallat KullÄ«yat Al-‘ Ä€dÄb JÄmi`at al-FayyÅ«m 12, no. 2 (July 1, 2020): 1300–1355. https://doi.org/10.21608/jfafu.2020.41108.1126.
Ibn ’Ashur, Muhammad al-Tahir. Al-Tahrir Wal-Tanwir. 30 vols. Al-Dar al-Tunisiyyah, 1984.
Jöbges, Susanne, Rasita Vinay, Valerie A. Luyckx, and Nikola Biller-Andorno. “Recommendations on COVID-19 Triage: International Comparison and Ethical Analysis.†Bioethics 34, no. 9 (2020): 948–59. https://doi.org/10.1111/bioe.12805.
Kurniawan, Edi. “DISTORSI TERHADAP MAQĀSHID AL-SYARĪʿAH AL-SYĀTHIBĪ DI INDONESIA.†Al-Risalah 18, no. 2 (December 12, 2018): 175. https://doi.org/10.30631/al-risalah.v18i2.301.
Liddell, Kathleen, Jeffrey M. Skopek, Stephanie Palmer, Stevie Martin, Jennifer Anderson, and Andrew Sagar. “Who Gets the Ventilator? Important Legal Rights in a Pandemic.†Journal of Medical Ethics 46, no. 7 (July 1, 2020): 421–26. https://doi.org/10.1136/medethics-2020-106332.
Manan, Jimmy. “Krisis Pandemi COVID 19 di Indonesia Hampir pada Level Katastropi.†VOA Indonesia. Accessed December 2, 2021. https://www.voaindonesia.com/a/krisis-pandemi-covid-19-di-indonesia-hampir-pada-level-katastropi/5936441.html.
Padela, Aasim I, Mansur Ali, and Asim Yusuf. “Aligning Medical and Muslim Morality: An Islamic Bioethical Approach to Applying and Rationing Life Sustaining Ventilators in the COVID-19 Pandemic Era.†Journal of Islamic Ethics 5, no. aop (April 15, 2021): 1–36. https://doi.org/10.1163/24685542-12340061.
Persada, Syailendra. “Krisis Tenaga Perawat Hantui Indonesia.†Tempo, July 9, 2021. https://nasional.tempo.co/read/1481587/krisis-tenaga-perawat-hantui-indonesia.
Sachedina, Abdulaziz. Islamic Biomedical Ethics Principles and Application. Oxford University Press, 2009. https://doi.org/10.1093/acprof:oso/9780195378504.001.0001.
Saleh, Mona, and Mohammed Ghaly. “Islamic Ethical Perspectives on the Allocation of Limited Critical Care Resources During the COVID-19 Pandemic.†CILE - Research Center for Islamic Legislation and Ethics. Accessed November 4, 2021. https://www.cilecenter.org/resources/articles-essays/islamic-ethical-perspectives-allocation-limited-critical-care-resources.
Saubani, Andri. “Pandemi di Indonesia Masuki Fase RS Krisis Oksigen Medis.†Republika Online, July 23, 2021. https://republika.co.id/share/qwp7ey409.
Savulescu, Julian, Ingmar Persson, and Dominic Wilkinson. “Utilitarianism and the Pandemic.†Bioethics 34, no. 6 (July 2020): 620–32. https://doi.org/10.1111/bioe.12771.
Setia, A. “Freeing Maqasid and Maslahah from Surreptitious Utilitarianism.†Islamic Sciences 14 (2016).
Sjamsuhidajat, R., Putri Dianita Ika Meilia, and Itsna Arifatuz Zulfiyah. “Etika Kedokteran dalam Kegiatan Tanggap Darurat Bencana.†Jurnal Etika Kedokteran Indonesia 4, no. 1 (February 25, 2020): 1–8. https://doi.org/10.26880/jeki.v4i1.39.
Supady, Alexander, J Randall Curtis, Darryl Abrams, Roberto Lorusso, Thomas Bein, Joachim Boldt, Crystal E Brown, Daniel Duerschmied, Victoria Metaxa, and Daniel Brodie. “Allocating Scarce Intensive Care Resources during the COVID-19 Pandemic: Practical Challenges to Theoretical Frameworks.†The Lancet Respiratory Medicine 9, no. 4 (April 2021): 430–34. https://doi.org/10.1016/S2213-2600(20)30580-4.
The Zayed Charitable Foundation. Ma’lamat Zayid Li al-QawÄ’id Al-FiqhÄ«yah Wal-UshÅ«lÄ«yah. Abu Dabi, 2013.
Truog, Robert D., Christine Mitchell, and George Q. Daley. “The Toughest Triage — Allocating Ventilators in a Pandemic.†New England Journal of Medicine 382, no. 21 (May 21, 2020): 1973–75. https://doi.org/10.1056/NEJMp2005689.
Wilkinson, Dominic J C. “Ethics and Evidence: Learning Lessons from Pandemic Triage.†The Lancet Respiratory Medicine 9, no. 4 (April 2021): 328–30. https://doi.org/10.1016/S2213-2600(21)00132-6.
WizÄrat al-AuqÄf wal-Shu`Å«n al-IslÄmÄ«yah Al-KuwaytÄ«yah. Al-Mausū’ah al-FiqhÄ«yah. Kuwait, 2007.
