AIDS as terminal illness

1. Medical opinion: Once diagnosed as HIV positive, the patient could live up to ten years or more. It is true to say that, based on available medical evidence to date, death is inevitable, but like cancer victims, AIDS sufferers can live for several years.

Accordingly, we believe that AIDS sufferers should not, until the very last stage of the disease, be treated as terminally ill patients.

AIDS patients can go through stages of neuropathy, the most common of which are those affecting the brain, leading to changes of behaviour accompanied with symptoms of senility. This occurs in about one-third of AIDS cases during the later advanced stages of the disease.

2. Islamic opinion:

Muslim jurists define a terminal illness as that threatening death even if it proves, eventually, not to be the direct cause of it. Two conditions must apply:

First, the illness threatens death or has been known to lead to death in the majority of cases. It is not necessary that the illness is a crippling or disabling one, or that it should cause the patient to become bed-ridden.

Drought in the Sahel. Natural disasters have played a part in the spread of AIDS by breaking apart community life and disrupting stable relationships.

Second, competent trustworthy medical experts must be consulted in order to decide whether the illness is terminal or not.

Jurists have stipulated these two conditions in view of the state of mind a terminally ill patient is in, which could impair his sense of judgement and cause him to take drastic decisions affecting the rights of creditors and/or inheritors. Islamic law recognises that adverse long-term consequences could ensue if the behaviour and actions of such patients are not properly regulated and monitored.

Dealing with terminally ill patients:

Over a period of just two years, this man watched seven members of his family, including a small grandchild, die in the epidemic. The moths of hopeless nursing haunt his memory and he has given up the will to live though he himself does not have AIDS

The Hanafi school of Islamic law holds the view that terminal illness af- fects competence and restricts the behaviour of the victim without affecting the rights of others around him. The patient's obligations towards God and society remain in effect.

In considering the rights of creditors and inheritors, a terminally ill patient must be restricted in giving his wealth away to such a degree that adversely affect these rights.

AIDS is a syndrome which goes through a number of stages. The incu- bation stage starts when the virus enters the body and continues until the disease's distinctive symptoms begin to appear. This could extend to several years during which the carrier would lead a normal life. In about 30% of cases, however, behaviour changes occur during the later stages of the disease, with patients showing signs of senility and/or mental deterioration.

In view of the above, AIDS sufferers cannot be considered as terminally ill until the full symptoms of the disease are apparent and the patient begins to display signs of senility, or becomes totally disabled that he is no longer able to lead a reasonably normal life, until it cluminates in death.