Is a Medically Induced Coma Permissible as an Alternative to Medical Assistance in Dying (MAID)?
Question
As-salamu alaykum warahmatullahi wabarakatuh,
Medical assistance in dying (MAID) is haram in Islam, whether receiving it or aiding in it as doctors, nurses, or pharmacists. Is it permissible for someone to be placed into a medically induced coma instead of participating in MAID, where the person remains alive and passes naturally, but is no longer aware of what is happening?
Answer
Alhamdulillah, wassalatu wassalamu ala rasulillah, wa ala alihi wa sahbihi ajmain.
This question requires a careful distinction between actively causing death, which is prohibited, and palliative medical care, which aims to relieve suffering without intending death.
1. The Shar‘i Context
Islam strictly prohibits intentionally ending human life.
Allah says:
“And do not kill the soul which Allah has forbidden, except by right.”
Surat al Isra 17:33
Medical assistance in dying involves intentional termination of life, which is why it is unequivocally haram to receive or assist in it.
At the same time, Islam recognizes pain relief and medical treatment as legitimate, even in end-of-life situations, so long as death is not the intended outcome.
2. What Is a Medically Induced Coma in This Context
A medically induced coma, often referred to as palliative sedation, is used when:
- A patient is experiencing severe, otherwise unmanageable pain or distress
- Standard pain management is ineffective
- The intent is to relieve suffering, not to cause death
In this situation:
- Life is not terminated
- The heart and vital functions continue naturally
- Death, when it occurs, happens by natural causes, not by medical action
3. The Critical Difference Between MAID and Palliative Sedation
The key legal distinction in Sharia is intention and causation.
- MAID:
- Intends death
- Causes death directly
- Death is the objective
- Medically induced coma for palliation:
- Intends pain relief
- Does not aim to cause death
- Death is neither intended nor directly caused
Islam judges actions by their intent and effect, not by outward similarity.
4. Conditions for Permissibility
A medically induced coma is permissible under strict conditions, including:
- The primary intention is relief of suffering, not hastening death
- It is recommended by trustworthy medical professionals
- The dosage and method are medically appropriate, not lethal
- Nutrition, hydration, and basic care are maintained where medically indicated
- There is no deliberate withdrawal of life-sustaining care with the intent to cause death
If these conditions are met, this falls under lawful medical treatment, not euthanasia.
5. Relevant Usul Principles
الأمور بمقاصدها
Actions are judged by their intentions.
الضرورات تبيح المحظورات بقدرها
Necessities permit what is otherwise prohibited, but only to the extent required.
Pain relief is permitted to the extent necessary, without crossing into intentional killing.
Final Ruling
Medical assistance in dying is haram in Islam and may not be received or assisted in.
However, placing a patient into a medically induced coma for palliative purposes is permissible, provided the intention is to relieve unbearable suffering and not to cause or hasten death, and that death occurs naturally.
This is a valid and Islamically acceptable alternative to MAID when conducted within proper medical and ethical boundaries.
May Allah grant relief to the suffering, patience to families, and wisdom to those making these difficult decisions.
And Allah knows best.