On 3 January, Deputy Menteri Besar Datuk Mohd Amar Nik Abdullah has stated that the Kelantan government will study ways to adopt the Qatar’s implementation of the Islamic penal law, hudud, which includes governance over the punishment of amputating limbs.

“According to experts, surgeons can execute the hand-cutting punishment and it doesn’t have to be by an Algojo (executioner),” he said, while also commented that, with surgeons to carry out the punishment, “any damages to the remaining parts of the limb” can be avoided.

However, this has caused an uproar from the government and the medical community.

The Hippocratic Oath: The basic rule to follow

President of MMA Dr Ravindran R Naidu backed the MOH, saying that the Hippocratic Oath, as well as the statement by the WHO should be followed. Photo credit: Choo Choy May/MalayMail Online
President of MMA Dr Ravindran R Naidu backed the MOH, saying that the Hippocratic Oath, as well as the statement by the WHO should be followed. Photo credit: Choo Choy May/MalayMail Online

The Ministry of Health (MOH) and the Malaysian Medical Association (MMA) have voiced out against the proposal, stating that it violates the Hippocratic Oath of not harming to the human body. They urged that the oath should be taken seriously.

“We are supposed to save people from illnesses and injuries, not harm them, and this is our stance. This should be applicable to all registered doctors in Malaysia,” said President of MMA Dr Ravindran R Naidu, adding that the statement by the World Health Organisation (WHO) should be followed as well.

“We must not violate our professional oath of doing no harm to the human body,” said Health Director-General Dr Noor Hisham Abdullah. “As stated ‘Primum non nocere’ which means ‘first, do no harm’.”

“What we said in 2015 still stands today. Both the health ministry and Malaysian Medical Council (MMC) are clear about this,” Dr Noor Hisham added while referring back to a report in April 2015. “Hudud or otherwise, surgeons and doctors must not be made executioners.”

Datuk Dr Noor Hisham said that both the MOH and MMC will never allow amputations on criminals. Photo credit: MalayMail Online
Datuk Dr Noor Hisham said that both the MOH and MMC will never allow amputations on criminals. Photo credit: MalayMail Online
 

Muslim doctors speak out as well

Director Ahmad Farouk Musa of the Islamic Renaissance Front commented, referring to Datuk Mohd Amar Nik, “He should know that the medical profession is the noblest profession on earth and that it is morally wrong to suggest such a heinous act against another human being in the name of religion.”

Kota Raja MP Siti Mariah Mahmud, a doctor who previously taught medicine at the University Kebangsaan Malaysia (UKM), pointed out that “hudud is criminal law”, and that the people who enforce criminal law should take the matter in hands, not doctors.

“Even in countries that do practice, it’s not doctors who perform these procedures. Doctors can only verify whether a person is fit to undergo the punishment,” she added. More explanations are also needed if there is a need for the hudud law to be enforced.

According to Dr M Bakri Musa, a California-based surgeon and political commentator, said a surgeon’s job is “to help improve lives that have been ravaged by diseases or injuries, not add to their suffering”.

A surgeon’s duty: Saving lives, not carrying out punishments

While the Hippocratic Oath is the basic rule to follow, ethics are equally important as it involves the application of a moral code to the practice of medicine.

To consider a medical practice ethical, these four principles should be respected – autonomy, beneficence, non-maleficence and justice.

In the medical context, it is a requirement for healthcare providers (HCPs) to consult patients for their informed consent before anything can be done to them. HCPs should also take actions that serve the best interests of patients or any individuals, and ensure that the treatments provided do not harm them.

It is also important for doctors to be fair and provide equal treatment to all. Though surgeons have specialised skills, their time is limited. As such, there is a need to prioritise those who require urgent life-saving treatment, rather than spending time on amputating healthy limbs. MIMS

Read more:
Not only the government, community including doctors urged to play a role in improving healthcare system
How cultural sensitivity could help battle social stigma of cancer in women
Hypocrite VS Hippocratic Oath

Sources:
http://www.themalaymailonline.com/malaysia/article/deputy-mb-kelantan-to-model-qatars-hudud-law-including-amputation#ysgEwWKc4v69OZM1.97
http://www.freemalaysiatoday.com/category/nation/2018/01/14/muslim-docs-say-no-to-punitive-amputation/
http://www.freemalaysiatoday.com/category/nation/2018/01/14/no-surgeons-cant-be-executioners-says-health-dg/
http://www.themalaymailonline.com/malaysia/article/amputating-limbs-under-hudud-law-violates-medical-regulations-says-mma#GMFtSjuBeE1o2Uyc.97
http://www.themalaymailonline.com/malaysia/article/do-no-harm-health-dg-says-on-kelantans-hudud-proposal-for-surgical-amputati#HQeqVHX7kBhcIBA7.97
https://www.thestar.com.my/opinion/letters/2018/01/17/medical-ethics-in-punitive-action/
https://patient.info/doctor/medical-ethics