Health as an Amanah
Islam asserts the position of human beings as God’s vicegerent. According to this understanding, God had exclusively rendered his trust to human kind to administer this world well and make it a peaceful and safe place to live.
As ‘trustee’, every single individual is rendered with the trust (amanah) within his own autonomy. Everything in the universe belongs to God and everything was created for the service of man, who may use anything in the world for a positive purpose, but he is not supposed to abuse anything.
The healthcare professional may have the greater knowledge of vaccine-preventable diseases, of possibilities, risks, treatment, outcomes and the options of prevention with immunisations.
Nonetheless, the principle of autonomy respects and values the individual (or the parents or legal guardians) as the one who makes the self-defining choices upon which he then acts and for which he is accountable. One is responsible for himself and those under his custody, and will be questioned before Allah the Almighty during the Judgement Day based on this ‘amanah’ paradigm.
The principle of individual autonomy however needs to be considered within the context of the wider public interest and benefits.
Thus the principal Islamic legal maxim (al-Qawa’id al-Fiqhiyyah) which stipulates: “individual rights may have to be sacrificed in order to protect public interest.” It is in this vein that medical interventions, such as global immunisation programmes that have been proven to protect the general health and well being of the public, have priority over the considerations of individual interest.
One important moral consideration is to ensure that one’s individual choices do not harm others. Those who do not immunise against vaccine-preventable diseases are at increased risk of being infected, therefore they might pass on the infection to others, who may then be harmed!
“individual rights may have to be sacrificed in order to protect public interest.”
The vast majority of those infected with measles in Disneyland in 2015 were unvaccinated against the disease. It has since infected children in many other states in the US and has moved further to Canada and Mexico. Due to the decreased uptake of the MMR vaccine in Malaysia, there was an outbreak of measles which occurred mainly amongst those not vaccinated.
The omission to vaccinate has obviously impacted negatively on the well being of the public, which is enough argument for policy makers to impose an obligation to act. The recent Australian “no jab, no pay” policy, plans to withdraw childcare and welfare benefits from Australian parents who refuse to vaccinate their kids.
If sufficient numbers of people in a community are immunised, usually in excess of 80%, the protection against vaccine-preventable diseases is conferred to virtually all persons in the community. This is known as herd immunity.
This community immunity offers protection to vulnerable segments of the community who cannot be immunised due to various reasons eg too young, have cancer, have HIV/AIDS, are on chemotherapy or radiotherapy.
“If sufficient numbers of people in a community are immunised, usually in excess of 80%, the protection against vaccine-preventable diseases is conferred to virtually all persons in the community.”
The common good of the community is served which extends beyond the individual. In addition, the community benefits from the economic savings and improved security as a result of the immunisation programmes.