Human Dignity in the Islamic Bioethical Discourse on HIV/AIDS by Sheikh Farouq Fareez

 

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[ This paper was presented at CILE 6th Annual International Conference which was held in Doha, Qatar on March 17, 2018]

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Introduction

One of the huge challenges for those who want to work on the question of HIV/AIDS in Islam and with Muslims living with the disease, is the attempt to position within the mainstream Muslim community. This is down to the fact that we are not only dealing with a particular community but what is more challenging is we are dealing with our own text. There are certain answers in the text that we believe in and we cannot run away from it. But there are also other social elements that we clearly witness and have a moral obligation to speak. Take for example an imagined dialogue between a scholar and an activist.

The Quran says to take good care of your parents[1] but in reality, we found that Muslims are abandoning their parents when they get old. Therefore the activist started an old age home for these abandon parents. The scholar admonished her and said that this is against Islam as she is normalizing/encouraging people to abandon their parents.[2]

This incident tells us that the conflict between the ideal and reality requires our Ethics to respond to the issue at hand. The on-going story of abstinence is an important narrative but at some point, somebody else has to deal with the fact that the story is not reaching. Moral narratives in some ways or many has the answer but it is not everything. As Muslims when our “local moral world” is being tested and challenged, very often we find conflicting religious proclivities that aim at exalting the values of Islam to be the ultimate frame of reference.[3]

That being said, there is no disease till now that lends itself to such tension like HIV/AIDS. This is because its complexity lies in one of its primary modes of the transmission; namely sexual contact (in 90% of the infected cases), which touches upon very sensitive social and ethical dimensions such as stigmatization, inequalities and conceptualization of deviance.[4]

A study of the available literature on Islam and HIV/AIDS acquaints us with two main approaches in dealing with the pandemic.[5] The first approach regards HIV/AIDS solely as a lifestyle disease and blames it on immoral sexual lifestyle for the spread of the pandemic. It further holds that HIV/AIDS is a sign of Divine’s wrath and see a “return to Islam” as a solution to prevent Muslims from catching the disease. This approach is also known as the “moralist position” and it was first pioneered by prominent Muslim psychologist, Malik Badri which he addressed in his seminal work The AIDS Crisis: A Natural Product of Modernity’s Sexual Revolution. Advocates of this position suggest an Islamically oriented prevention model that can not only prevent the spread of the pandemic but galvanize Muslims to break the chains of "mental slavery" to Western secular values and forego apologetic defensiveness.

However, this was met with fierce resistance by the other camp that argues against the efficacy of an Islamic prevention model as an idealized "one-size-fits-all solution". Being a Muslim is not sufficient security against HIV/AIDS. Advocates of this position suggest the need to re-examine the social relevance of Islam. By doing this, it takes into account the psychological state of the victims and accordingly develops pedagogical strategies to humanize the vulnerable groups who live at the margins of society (mustad‘afun fi’l-ard). This position is known as the “liberationist approach” that is strongly advocated by the South African Muslim scholar, Farid Esack. I argue that the contention between these two approaches is due to different epistemological frameworks. However, it is not within the scope of this paper to argue the differences in detail.

 

Re-Centring of Human Dignity in the Islamic Ethical Discourse on HIV/AIDS

Nevertheless, there is a need for a cross-epistemic dialogue to establish an equilibrium between both factions through the lens of human dignity in order to formulate a balanced approach towards the HIV/AIDS pandemic.

The scriptural vision of human dignity can be divided into two levels. The first level alludes to a metaphysical-ontological ground of human dignity in terms of certain intellectual and moral endowments that enable man to potentially distinguish between what is morally right and wrong. This makes man a self-conscious being and this nature owes its dignity to his primordial nature (fitrah). Although it is generally agreed that fitrah has divine origins, it is also the responsibility of man to actualize its nature. [6] This brings us to the second level of human dignity; unlike the first, it refers to a dignity that is acquired rather than given. Accordingly, man is entitled to honor provided he behaves in a righteous manner. The Quran says:

"O mankind, indeed We have created you from male and female and made you peoples and tribes that you may know one another. Indeed, the noblest of you in the sight of Allah is the most righteous of you. Indeed, Allah is Knowing and Acquainted."[7]

The above-mentioned verse suggests that dignity and righteousness are conceptually linked.  This moral qualification reifies the idea that one's affiliation is not the marker of one's dignity, instead, it hinges upon how righteously one lives. However, does it mean that the emphasis on this moral qualification sets up a hierarchy of dignity where righteous Muslims are at the top and the unrighteous “other” is at the bottom of the pyramid? Here it is important to emphasize that dignity is not the sole right of a particular community but it is a clarion call to all of mankind to employ their intellectual and moral capacity to act righteously and actualize his ontological being.

In the case of the two main approaches that we have briefly discussed earlier, both agree on the first level of dignity, which is something inborn and makes man unique over other creations. However, where they differ is how they see the acquisition of dignity.

The moralists hold that dignity should be acquired according to dictums drawn from moral narratives within the Texts. This requires one to strictly adhere to the religious ruling  (al-ahkam al-shari’yya) in particular, those with relevance to sexual norms. Whereas for the liberationists, they hold that dignity is an expression of fraternity where it is not sufficient to be individually dignified as it is equally important to create the condition for the dignity of others, in particular, those on the edge of society to flourish. This entails re-examining the social relevance of Islam that takes into account social-justice to humanize the marginalized, which in this case is People Living with HIV (PLHIV).

In this paper, I argue that the premises of both camps hold value and it is not wise to select one over the other or to approach these two positions as mutually exclusive. That being said, the paper attempts to synthesize both approaches and develop three different steps to dignify PLHIV.[8]

 

1) Prevention

At the first level, it aims to control the spread of the pandemic through preventive means and this should be grounded in the principle of "avoiding harm" (darar) that is central to Islamic legal tradition. Kamali (2009) argues that darar should be addressed in light of the five essential values (al-daruriyyat al-khamsah): religion, life, intellect, property and lineage. In relation to HIV/AIDS, it entails the protection of at least two essential values (life and lineage).Furthermore,  due to the damaging effects of the disease, Kamali holds that it becomes a Shari’ah ordained responsibility of every Muslim who values the sanctity of human dignity to join hands and play a role in combating the disease through education and prevention campaigns.

The prevention aspect regards the on-going story of abstinence as an important narrative. This goes back to the point raised earlier that dignity is interlinked with righteousness. That being said, acting righteously entails forbidding harm, also known as the principle of ‘amr bil ma’ruf wa nahy ‘an al-munkar(enjoining good and forbidding wrong) which is an Islamic dictum incumbent upon every Muslim.[9] By the same token, Muslim scholars and activists should first ground their efforts in the principle of “avoiding harm” but it should not in any way cease there. However, alluding to this principle brings about two main issues. Firstly, an appeal to the principle should not be an authoritarian attempt to justify an action that is based on an ossified version of the Islamic tradition that is devoid of its ethical values. This includes both ends of the spectrum that goes against the ethical teachings of Islam such as homophobia and homonormativity that is visible in both moralist and liberationist position.

Secondly, at times the conditions of reality sometimes make the "voiding of harm" difficult to apply.  This happens when the abstinence narrative is not comprehended. It brings us to the second point wherein seeking to prevent harm it entails collaborating even with those you disagree with.[10]

 

2) Collaboration

This aspect holds that the sole dependence on preventive measures based on abstinence is limited. Due to the prevalence and damaging effects of the pandemic, it thus becomes a necessity (darurah) for Muslim societies to resort to Harm Reduction Programmes (HRP) like the distribution of condoms and needle exchange programs that are mostly initiated by human rights organizations such as UNAIDS.[11] Here it is important to clarify the difference between advocating and condoning.  For example, it is categorically forbidden in Islam to have illicit sexual relations as it goes against the ethos of Islam. However, providing condoms and clean needles does not mean that we are condoning the behavior as the objective (maqsad) of the act is to minimize real damage. In the case of HIV/AIDS, the stigma against condoms in some societies have fuelled the spread of the pandemic.[12] However, according to WHO, it has been proven that condoms are an important form of protection from HIV/AIDS and thus deem necessary in controlling the spread of the pandemic.[13] In this context,  it requires us to work with individuals whose actions we disapprove even on matters of morality to help minimize and mitigate a greater harm. Nonetheless, this collaboration should where possible set the ground for longer-term improvements that requires moving from preventive and palliative means in assisting PLHIV to attempts to end the pandemic entirely. This entails the functioning of long-term transformative strategies that are able to bring profound change and eradicate the disease.[14]

 

3) Transformation

Using Islam as a ‘discursive’ tradition that looks at the future (how the point of a practice can be secured both short and long-term and study why it should be modified or disregarded) through a present (how it is linked to other practices, institutions, and social conditions)[15]; this facet is the culmination of the previous two that  envisions egalitarian socio-economic relationships in the world.[16] In order to actualize this, it is imperative to go beyond pity and seriously take into account socio-economic justice that touches on the systemic roots of the disease. Therefore HIV/AIDS is not just seen as a by-product of ‘sexual immorality’ but it is caused by socio-economic marginalization.[17] For example, in many cases, prostitution is not seen as a choice but it is fuelled by poverty and lack of access to education, [18] This means that socio-economic inequality is not just seen as a factor but in itself is violent and oppressive. This is because poverty has the capacity to compel moral transgressions just like how it compels a thief to steal and a sex worker to fornicate in order to survive. However, the alleviation of poverty would provide alternatives out of these moral transgressions. What is greatly needed is the struggle for justice to make resources for a global healthcare system that is committed to human rights in which the same treatment is available to all, an economic system that puts human needs first before profit; a moral economy[19] that is committed to goodness, fairness and justice.[20]The context of our struggle as Muslims then is to actualize our primordial nature (fitrah) and create the same conditions for others to be dignified(irtifaq) to be in close proximity with God (iqtirab).[21]

A viable response to HIV/AIDS should not remain in the realm of “moralizing” but it is a moral commitment to be empathetic and take into account the lived experience of PLHIV through social collaboration and disintegrate the power structures that have prevented them from living a meaningful life.[22]

 

Conclusion

Idealism is often viewed in a negative light where critics dismiss it as the province of starry-eyed romantics and moral absolutists who are dismissed for being both rigid and impractical as they are disconnected from reality. Nevertheless, a persuasive vision of how things should function is necessary for building a better world. A world in which people reject deviant acts out of strong moral commitment is worth striving for, as the on-going story of abstinence is an important narrative. However, at some point, somebody else has to deal with the fact that the narrative does not reach everyone. [23] A viable Islamic response to HIV/AIDS requires fundamental shifts in both thinking and behavior and we have argued using Islam as a ‘discursive tradition’ to balance long-term transformation and short-term palliation when the moral narrative is beyond reach. There is a place for idealism that is not deliberately blind to reality, but that refuses to have its vision hindered by injustices.

The on-going struggle between ideal and reality tells us that it is imperative to not only develop a good theology, but equally important is living and developing a good living both individually and collectively. This can be possible through an Islamic approach to human development and well-being.[24] It acquaints us of the symbiotic relationship between duties and rights towards the poor and vulnerable and in this case PLHIV. If we are able to identify the critical dimensions of well-being as spiritual(moral narrative) and life-sustaining based on the dignity of people; we are able to provide better alternatives for a mother to not sell her body on the street in order feed her starving children back home. In sum, our understanding of Islam should have the transformative capacity to bring humanity out of darkness to light both physically and spiritually. 

 

 

Sheikh Farouq Fareez

He completed his Master’s degree in Islamic Thought and Applied Ethics at Hamad Bin Khalifa University, Doha, Qatar. He has received a B.A Honors in Comparative Religion and Usuluddin from the International Islamic University of Malaysia.  Farouq is also actively involved in community engagement programs in Singapore through his stints at the Singapore Islamic Scholars and Religious Teachers Association (Pergas) and the Religious Rehabilitation Group (RRG) as a Community Development Executive. He is currently a member of the CILE Alumni Network (CAN), a global platform for members to address contemporary ethical challenges by reflection, research and dialogue. His area of interest involves issues concerning Islam, Human Rights and Ethics.

 

 


 

 

[1] Quran 17:23/24

[2] Esack, F. (2010). Farid Esack at Summit of Religious Leaders on the response to HIV - Part 1. Retrieved from https://www.youtube.com/watch?v=eLa89XpbuSg

[3] Kleinman, A. (2006). What really matters. Oxford: Oxford University Press.

[4] Ghaly, M. (2013) Collective Religio-Scientific Discussions on Islam and HIV/AIDS: I. Biomedical Scientists, Zygon: Journal of Science and Religion, vol. 48, no.3, pp.678.

[5] Please refer to Ghaly (2013) to understand in detail the significance of Badri and Esack works in shaping collective religio-scientific discussions on Islam and HIV/AIDS in Fiqh councils such as IOMS. The contention between Muslim Scholars and Biomedical Scientists is attributed both explicitly and implicitly to the ideas of Badri and Esack mainly on Islamic versus human rights discourse. It also explains how this contention affected the drafting of religious rulings such as the (dis)continuity of marriage and whether to allow PLHIV to travel for Hajj.

[6] Sachedina, A. (2009). Islam and the challenge of human rights. Oxford University Press, pp.  93-95.

[7] Sahih international. Quran 49:13

[8] Ali, K. (2009). Afterword: Ideals, Realities, and Islam: Thoughts on the AIDS Pandemic. In F. Esack & S. Chiddy, Islam and AIDS: Between Scorn, Pity and Justice (pp. 228-236). Oxford: Oxford Publications.

[9] Cook, M. (2003). Forbidding wrong in Islam: An Introduction. Cambridge [etc.]: Cambridge University Press.

[10] Ali, K. (2009). Afterword: Ideals, Realities, and Islam: Thoughts on the AIDS Pandemic. In F. Esack & S. Chiddy, Islam and AIDS: Between Scorn, Pity and Justice (pp. 228-236).

[11] Collaboration should address various forms of stigma attached to the pandemic.

[12] Prinsloo, T. (2015). Stigmatization of Condom Use amongst Educated Medical Staff: A Practical Theological Approach (Masters). Stellenbosch University.

[13] WHO. (2009). Condoms for HIV prevention. Retrieved from http://www.who.int/hiv/topics/condoms/en/.

[14] Ali, K. (2009). Afterword: Ideals, Realities, and Islam: Thoughts on the AIDS Pandemic. In F. Esack & S. Chiddy, Islam and AIDS: Between Scorn, Pity and Justice (pp. 228-236).

[15] Asad, T. (2009). The Idea of an Anthropology of Islam. Qui Parle17(2), 1-30. doi: 10.5250/quiparle.17.2.1.

[16] Should recognize certain “discursive constraints”: The Islamic tradition is based on a set of foundational texts (Qur'an and the Prophetic traditions) and an established history of its own scholarship by Muslims in the past based on these texts. Therefore, it is imperative to acknowledge past Muslims's discursive relationship and discourses to the foundational texts even if aiming to argue against them. (Anjum, 1997, pp. 662-666).

[17] Bavikatte, K. (2009). Muslims, AIDS, and Justice: Beyond Personal Indictment. In F. Esack & S. Chiddy, Islam and AIDS: Between Scorn, Pity and Justice (pp. 186-196). Oxford: Oneworld Publications.

[18] Monroe, J. (2005). Women in Street Prostitution: The Result of Poverty and the Brunt of Inequity. Journal Of Poverty9(3), 69-88. doi: 10.1300/j134v09n03_04.

[19] "Moral economy might be defined as a kind of inquiry focussing on how economic activities of all kinds are influenced and structured by moral dispositions, values and norms, and how in turn these are reinforced, shaped, compromised or overridden by economic pressures"

[20] Esack, F., & Chiddy, S. (2009). Islam and AIDS: Between Scorn, Pity and Justice (pp. 6-7).

[21]The social philosophy of the erudite eighteenth-century Indian scholar Shāh Walī Allāh Dehlawi(d. 1762).  Based on his observation of the social phenomenon during his time, he holds that all cultured societies since the advent of mankind have adhered to the basic principles of irtifāq (social development). He further contends that these principles are common among all human societies as it stems from the urges rooted in human nature and are(principles) ultimately directed to actualize humanity's common objectives. Accordingly, Shāh Walī Allāh identifies these urges as zarāfah (aesthetic urge) and al-ra’y al-kullì (universality of purpose) that are inborn in man that makes him distinct from other creations. He further highlights that these urges are supplemented by man’s rational and intuitional faculties that consequently engender moral consciousness, which becomes the linchpin of his social and cultural strivings.  Therefore, all endeavors undertaken by man are a response to these urges that are deeply rooted in his natural constitution (fitrah). In this way, it leads to the accomplishments of human society such as the development of civilizations, economic order and political stability. When this irtifāq is successfully achieved, it drives man to be in close proximity with the Divine in which Shah Wali Allah calls it iqtirāb. (Ghazali, 2001, pp. 80-81)

[22] Ali, K. (2009). Afterword: Ideals, Realities, and Islam: Thoughts on the AIDS Pandemic. In F. Esack & S. Chiddy, Islam and AIDS: Between Scorn, Pity and Justice (pp. 228-236).

[23] Ibid.

[24] Refer to Islamic Relief (2014), An Islamic Perspective On Human Development.

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