Understanding Consciousness

Understanding Consciousness
Understanding Consciousness 2

Human Consciousness and Conscience

Human Consciousness and Conscience

In the name of Allah, Most Gracious Most Merciful

     Two of the many great blessings which many would have but would not realise are having consciousness as well as conscience in mind and self. Interesting, the whole issue of consciousness and conscience has aroused many intellectual talks, experiments, debates and research in multiple fields such as philosophy, neuroscience and psychology to try to explain these two inter-twined things human being have. These two values, abilities or whatever we want to call them dictate the significance of self and significance of life for us as human being.

     This writing is not intended to explain exhaustively about what each two really means but more of trying to invite readers to think about the essence of these two, how they are inter-connected, how we view from philosophical, medical and neuro-scientifical perspectives and eventually bringing the issue into the context of how Islam views the issue. Consciousness generally speaking means the state of wakefulness, alertness and awareness. While it can be defined as those, consciousness indeed exists in a continuum rather than discreet. Somebody can be awake but not necessarily sharp in awareness or alertness. Somebody can also shut down to the extent he loses his wakefulness, alertness and awareness. From medical perspective, often we talk about alteration of consciousness that can occur with complex seizures where patient does not necessarily lose his full consciousness but alteration that he loses the understanding, memory of what is going on. In anaesthesia, we also talk about degrees and levels of human consciousness and how deep should we induce the level of unconsciousness in our patients. Many Research enlighten us with the discovery of level of consciousness.

                                                Alert and Oriented

                                                       Fatigue

                                                       Stupor

                                             Locked-In Syndrome

                                            Minimal Conscious State

                                                       Coma

                                             Persistent Vegetative State

                                                    Chronic coma

                                                   Brainstem Death

Decreasing level of consciousness moving down the diagram( with exceptions in some respects)

      The state in each level is very interesting. Locked-in syndrome for instance is a state where a patient is fully awake but lose motor control of the body making it possible to be physically perceived as unconscious. Patient is locked in the body in not being able to walk,talk, move and others but the primary vegetative function such as heart beating and respiratory function. Here is where we can throw in or out a debate to consider whether it is a state of conscious or unconscious. Again, that is why from medical perspective at least, consciousness exists in a spectrum. Glasgow Coma Scale which was initially invented to gauge the extent of traumatic brain injury which was then modified and used as a means to measure conscious level of patients, explains well the existence of consciousness in a spectrum.

    Let us bring this to another step. We know neuro-scientifically, reticular formation via reticular activating system is what controls variety of functions including cardiorespiratory control, pain modulation, sleep and wakeful cycle, somatic motor control and habituation. Reticular formation interacts with various aspects of cerebral cortex to alter our perception of things around and our consciousness as well as interaction with optical circuit to provide body with circadian rhythm. SubhanAllah, cerebral cortex also sends signals down to reticular formation to allow good control of tone, balance, coordinated movements through central pattern generators, etc. These two brain parts interact with the body via spinal cord. This designates beautifully how mind and body actually works and how mind will be affected if body is affected and vice versa.

                                                 Human brain

     We understand biologically the basic about how human gets his consciousness. This is only a foundation to consciousness in the context of human psychology and socio-culture. Consciousness when discussed in other areas means more than just this. Consciousness brings the meaning of being aware of your very self, who you are and many other questions we encounter in philosophy. I believe that consciousness is the essence of philosophy and it is the essence that dictates how we define ourselves, the others, and how we function in our lives. To make it more interesting, when we understand this, we know that we can be biologically conscious but spiritually unconscious. We can be biologically conscious but culturally and socially unconscious. We can indeed be an unconscious being that walks in this world and we can also be consciously unconscious in our dealings everyday.

     In Islam, we have this saying that those who do not know themselves shall never know their God. In the holy book Quran, Allah mentioned about people who live in this world but in real fact dead in their inner-selves, nauzubillah. Everything in this life has its trigger. Nothing happens without reasons, and nothing is co-incident in nature. Charles Darwin and the evolutionists might not agree when they adopted the evolution theory basing creation and universe existence as co-incident. This is the basis that differentiates divine religions with agnosticism and atheism. Divine religions exist on the basis that creation and universe were created and nothing occurred as co-incidence. Science over time repeatedly shows that there are process to things. Water is only made when Hydrogen atoms bind with Oxygen molecule. Such a ruling will certainly sound absurd without specific design and rules determination. Co-incidence does not create beauty, haphazard work does not create a beautiful design to this universe. The same goes to consciousness, it is not co-incidental. It has its trigger. It maybe difficulties in life, it maybe after going through decades of wasted life or anything that makes people gain the sense of consciousness in any respect of their lives. This includes the very first question everybody needs to ask themselves, why am I in this world, what is my purpose of life? We also need to remember that to not answer this means to actually have answered it ourselves.

     From Islamic perspective, Allah the Almighty innumerably mentioned in the holy book about people who ponder over, people who think, people who contemplate, people who remember. Islam emphasizes the need for this as the key to everything else. Having the verse that asked the prophet Muhammad saw and the muslims to read links very well with the urge to contemplate. It is by reading and by contemplating that human being in general get the message, the realisation and receive the consciousness. Islam also talks about roles and responsibilities having had the consciousness to deliver the message of Islam and to establish justice and peace between human being.

     Let us talk a bit about conscience. What is conscience? It is also a term discussed from many angles and perspectives, from religion to atheistic, secular and science. In general, it is the realisation and the feeling of what is right and what is wrong. It is what generates guilt when doing “bad”. It is also what generates the feeling of good and integrity when doing “good”. Biologically, I personally think that we don't have a specific lobe or area generating this. I do think that it is an integration of multiple lobes which function to generate this higher level function yet being part of the essence of human quality. This is because the conscience which informs our moral judgment can be influenced by upbringings, religions, cultures, social dynamics and values which all require brain perception, memory, judgment, etcetera to eventually formulate the feeling. People won't feel guilty if they perceive what they are doing as right!

                                                       cartoon picture

     Understanding what conscience is, let me the share how Islam perceives conscience. It is interesting to first analyse the fact that consciousness and conscience are very close and inter-related. With conscience, people feel when they are doing bad or good. Consciousness makes people use their conscience when doing things. Also true is when people have conscience, it inculcates consciousness when they are doing things. In Islam, the centre of change is the heart( qalb). It is the centre that perceives good and bad based on common human values and commandments of Allah the Almighty. Islam values conscience very much and it is the action  having this conscience and inspiration of right and wrong that dictates whether the heart is purified or dirtied. When a believer follows his conscience based on what is commanded, then he is indeed answering to the call of God and bringing himself into God's peace and vice versa. Islam also recognises the two whispers that are all prevailing in human being, one calling for evil and the other calling for good. This is what creates tension in human being, and jihaad as often being misquoted is the very value that help to self-control and defeat the evil and violence in oneself. Conscience in Islam is also related to the concept of asking forgiveness and salvation. Conscience is a value, feeling or attitude, but many times human being go against their conscience out of failure to control and master themselves. Islam opens the door to salvation and forgiveness widely, provided believers realise, asks for forgiveness and have the intention of leaving the mistakes. The salvation in Islam is also about not losing hope in God, and it is for believers to do their best, and leaving what is beyond their control to Allah, the God Al-Mighty.

Let us value our consciousness and conscience, insyaAllah( God Willing)

Abu Asr

27/12/11

My nanny in humanity, taking medical to human perspective

Bismillah..

                It was a quiet day, Coronary Care Unit seemed quite settle, not really busy I supposed due to all beds being occupied impeding transfers from other district hospitals. We finished ward rounds early, getting a pat from behind from Prof of cardiology as I reiterated guideline regarding perioperative diabetic management for one of our patients going for CABG surgery. Hmm, what to do, digging myself back into books and notes, learning and learning the superficial, academician style of medicine. Well, not that it is wrong, but it is probably not the art of practising medicine.

                Knowledge is extremely important, and internship year is the year to really put yourself in and out of adrenaline test of thinking, how am I gonna manage this patient bio-psycho-socio-spirituo and behaviourally if I were the doctor. Being a junior in the team, but aiming for the best possible care for patients, it means questioning about what senior doctors do and why they do what they do. I mean that’s probably the best way to learn about patient care being a junior member of the team. It is complex, but made easy by good teachers and good examples. I remember reading an article for junior doctor talking about the real way to learn is to be in the ward, seeing, involving, assisting and questioning what happens, why it happens. Knowledge is the basis and transforming knowledge into practice and into context would be a constant moral, intellectual and spiritual challenge for us in all walks of life. I suppose, managing patient is all about looking it holistically. My professor taught me the mechanism- establishing diagnosis, assessing severity, assessing precipitating factors, recognising underlying cause and reconsidering diagnosis. I feel like adding one more, ensuring patient comfort and support.

                Last night, I came across this advice about how to be a good doctor. As a medical student, it seems obvious, go and clerk your patients. Transition into internship year, that will still probably be the case plus added responsibility of needing to know ins and outs of your patients and their care. In doing so, the dimension can be narrowed to keeping to what is essential about each patient, having hooks so that you can remember each different patient.( Amazing how consultants and registrars were able to remember all their patients without having to look at a piece of paper). I found the following advice as I read further being quite important, “go and visit your patients.” In Islam, we get rewards when we go and visit sick people. It is part of our obligations and what we owe to our brothers/sisters when they are sick. Now, why is that? There are many reasons when we logically think, from seclusion and fall from familiar support structure which leads to hospital/institution delirium to sadness, anxiety and fear dealing with diseases, and daily feared, invasive procedures. Being reasonably free, I went to visit one of my patients awaiting CABG and aortic valve replacement (AVR) surgery which will be this Thursday.

                Mrs B, 80ish lady, presented to ED about 2/52 ago with gradual increase in SOB, NYHA class 2. She initially presented with fatigue, night diaphoresis and murmur. (Night sweats + murmur = bacterial endocarditis unless proven otherwise). She has been having moderate-severe aortic stenosis for quite a while, with still reasonable ejection fraction and only mild dilatation of left atrium. Pulmonary capillary wedge pressure was 24, Right ventricular pressure was 96 mm Hg  which suggested pulmonary artery hypertension thought to be caused by LV failure after ruling out PE and OSA,also portal hypertension 2ndary to schistosomiasis – caused by schistosoma mansoni and other schistosoma species causing pipe-stem fibrosis of liver, rare in NZ but common elsewhere in the world). Trans-oesophageal echo showed no vegetation of aorta or bicuspid valves, hence SBE was ruled out. Coronary angiogram showed triple vessel disease which indicates the need for CABG surgery to improve symptom. The trick in this lady was that we were not sure which could predominantly cause the SOB, because it is a symptom that can be caused by both aortic stenosis and coronary artery disease. Hence, treat both since it can be contributed by both factors. ( if it is chronic stable angina on the background of IHD, how much stenosis does not matter, current evidence shows that treating by optimal medical therapy is as good as CABG or PCI in terms of mortality rate. CABG and PCI in this situation improve symptom but not long-term mortality.

                Surgery was planned for her and her name was on the surgical list already. “The Angel experiment”,  that was the book she held and read attentively as I near the bed and watched her for a while. Mrs B has not got any family members near the city she lives except her only son who had gone blind. She has two adorable cats that she shared the story with me, named PC and Midnight. She exercises her mind by doing puzzles nearly every day, filling her days in this temporary “hotel” while awaiting her big surgery around the corner. She is a lovely  old lady who seems to enjoy her life, being gratitude and missing her grand-daughter and great grand-daughters. One of her great grand-daughters developed multiple sclerosis at the age of 4 years old, a very young age, suggesting diseases and challenges afflict people irrespective of common statistical age. She is now waiting for her grand-daughter who will be reaching Dunedin soon. I spent some time with this nanny, joking and chatting, maintaining professionalism but sharing common human values with her. Alhamdulillah, it is really a privilege to be in this field, because you are able to talk and reflect, checking defects and correcting with good deeds. I felt her like my own nanny in humanity, a sense which can be quite different if I were to only come and pull up curtains during ward rounds, checking obs. , writing consultant/ registrar ward round notes and saying “enjoy your breakfast” at the very best.

                I suppose being a good doctor really means having therapeutic but also human relationship. Being humble as a doctor, sharp as a clinician will be the key to excellent patient care and well-being. It is recognising your medical obligation in the context of broad human values but also recognising humanity in your narrow medical context. It is caring for a pluralistic society, projecting “litakunu as-syuhada’ alannas” ( so that you can be the witness to human being) as commanded by Allah SWT and being self-critical to yourself. It is a struggle, to combat passivity form of laziness. I believe life is a dimension for constant learning, an opportunity to better one-self, with hope and pro-activity, not down and passivity.

۞ وَقَضَىٰ رَبُّكَ أَلَّا تَعۡبُدُوٓاْ إِلَّآ إِيَّاهُ وَبِٱلۡوَٲلِدَيۡنِ إِحۡسَـٰنًا‌ۚ إِمَّا يَبۡلُغَنَّ عِندَكَ ٱلۡڪِبَرَ أَحَدُهُمَآ أَوۡ كِلَاهُمَا فَلَا تَقُل لَّهُمَآ أُفٍّ۬ وَلَا تَنۡہَرۡهُمَا وَقُل لَّهُمَا قَوۡلاً۬ ڪَرِيمً۬ا (٢٣)

Thy Lord hath decreed that ye worship none but Him, and that ye be kind to parents. Whether one or both of them attain old age in thy life, say not to them a word of contempt, nor repel them, but address them in terms of honour. (23)

Abu Asr- 13/12/11

Question for medical students?

1)      What are symptoms and signs of severe aortic stenosis?

2)      What is the commonest cause of aortic stenosis in young, 20ish Caucasian people?

3)      How can sub-acute bacterial endocarditis complicate  aortic valves?

4)      How do you treat a patient with SBE affecting prosthetic valve?

Islam and Medicine: Munchausen or not – To suspend the judgment and to...

Islam and Medicine: Munchausen or not – To suspend the judgment and to...: Alhamdulillah, all praises be to Allah SWT for His blessings upon us and the time He gives as an opportunity to design the kind of end we...

Munchausen or not – To suspend the judgment and to seek to understand

Alhamdulillah, all praises be to Allah SWT for His blessings upon us and the time He gives as an opportunity to design the kind of end we aspire in this life. Remembrance and praise be to Muhammad saw, our beloved Messenger of Allah, his family and companions, may Allah grants them peace and happiness and may we be among them as well in our dreams, aspirations and our end insyaAllah.

Medicine is really interesting and I find it really eye-opening. In its complexity, there is simplicity, in its simplicity, there is an unread message. It is complex not only because it deals with general biological sciences but also individualised challenges in each individual patient. Hardly is patient like a single textbook. The best way to learn is to learn around patients because it involves bio-psycho-socio-spirituo-culturo and behavioural dynamics. It is complex because it deals with managing human being who has not got any single fixed rules regarding anything. SubhanAllah, while it teaches you to be sharp in mind, supposedly professional and flash in attitude, it also teaches and reminds us everyday about the value of humbleness.

Everyday we are seeing patients. If we are to be asked about the profession that can bring us closest to the reality of human being, it is indeed any profession that resembles this approach or profession, listening, being close, lending ears and humbly negotiate approach and means of how to save human being. In saying that, it is aware that this applies much much more when doctors/ anybody comes from within the society rich dynamics, having difficulties, challenges and hardships they go through in their lives.

It is an answer today, as time will always provide with every uncertainty and hence why the prophet was asked to wait when the unbelievers rejected the message. I have this one interesting patient with unbearable background history of breast ca bilaterally Rx with bilateral mastectomy. She also had Hodgkin lymphoma Rx with mental radiotherapy and chemotherapy. Splenectomy was also done as part of Rx pathway. Twenty years down the track, this woman developed chronic chest pain diagnosed as chronic pain syndrome secondary to radiotherapy effect managed on-goingly with Amitryptyline, Carbamazepine, Gabapentin, Methadone and Fentanyl patch. In short, max management of pain but with unsatisfactory effectiveness.

She presented to the hospital 10 days ago complaining of worsening chest pain, with what described as anginic picture. Series of investigations showed impossibility of Acute Coronary Syndrome, making us wonder could this be secondary to limited microvascular reserve giving syndrome X-like pattern but on the background of re-stented coronary artery because of occluded artery previously. Tachyphylaxis and limited tolerance from chronic pain syndrome would then possibly amplify patient's intolerance and hence why she is suffering in pain nearly each hour.

9 days passed with the team exhausted all the means to control her pain, subhanAllah, this really amplifies the fact that medicine is limited and what amplifies and expands it is by the grace of Allah, teaching human being through their thoughts, discussions, research to find answers to problems they face. It also sends the message clearly that without His help, you can load all possible medications but the pain is not gonna ease itself.

Anyway, throughout the 9 days, due to severe pain and escalating fentanyl IV dose( reaching 100 mcg PRN given every hourly), we started to think is this really a true pain or is this acutally attention-seeking behaviour. Munchausen's syndrome, a term I still remember since my second year in the college, reading a book, The Art of Healing, written by one American MD doctor, talking in one chapter about kind of patients who pretended sick in a really excellent manner to seek attention. They would damage themselves, pretending sick and even harming themselves to seek attention. This came across my mind and the reason being the fact that she really looked like wanting attention especially from the registrar. It is very hard when you don't know someone enough but to formulate what could be the possibility.

Anyway, cutting the story short. Repeat angiogram today showed re-stenosed stent artery. This patient had mental radiotherapy on the chest which causes radiotherapy-induced coronary artery disease over time. It is easy to formulate a judgment and to judge people without first trying to understand patient's perspective. It is also easy to take subsequent actions based on presumptive idea. Not that the team does not know this possibility, but the index of suspicion that it could be re-stenosis this time after several other visits has been really low. To keep an open mind and to first seek to understand before being understood would really be an important element in maintaining human and therapeutic relationship.

-gambar hiasan-

In our daily lives, the same applies. It can be easy to label others and to lose intellectual humility, understanding others' backgrounds. When spiritual therapeutical relationship fails, then people will build barrier against the message, not really because of the message itself, but it can just be because the people who carry the message fail this rapport and reading others very dogmatically. Quran gives an extreme example how the art of advising towards Allah should be done. Musa as and his cousin Harun as were asked to go to Fir'aun and advised him in a very respectful and full of wisdom. This was despite the fact that Fir'aun claimed himself as God.

May Allah SWT enlighten us with things that we are dealing with daily insyaAllah.

Question for medical students : How is Munchausen syndrome differs from Hypochondriasis?

Inspirational Video - Buat Para Doktor dan bakal doktor

Muqaddimah

Muqaddimah

Segala puji bagi Allah SWT, Rabb sekalian alam, yang mentadbir alam yang besar dan tersergam ini. Tiadalah yang layak diagung, disembah dan diletakkan pengharapan melainkan Dia yang Satu. Selawat dan salam ke atas junjungan besar Nabi Muhammad saw, para keluarga dan sahabat baginda yang memperjuangkan keseluruhan kehidupan mereka untuk memberi maksud kepada tujuan insan hidup di dunia ini.

Indahnya sirah Nabi kita Muhammad saw, setiap kali membaca, mendengar sirah baginda, ia sangat jauh sekali daripada apa yang dipamerkan dan diwar-warkan media yang mempersembah kehidupan Muslim. Malah, dalam banyak hal, ia mungkin jauh sekali daripada praktis yang diamalkan oleh majoriti Muslim, bukan dari sudut struktur dan aspek luaran, tetapi dari sudut nilai dan inti kepada setiap perbuatan, perancangan dan kata-kata baginda. Di manakah ingin kita cari insan yang bernama Muhammad saw, insan yang berakhlak dengan khuluquhul Quran, tidak pernah menampar kanak-kanak, memuliakan sahabat, tidak pernah mengutamakan diri, tajam minda dan sangat mulia hati, tetapi juga paling banyak beristighfar kepada Allah Jalla Waala. Dia adalah insan yang terpilih daripada keluarga dan kabilah yang terpilih. Baginda adalah yang terbaik daripada kalangan yang paling baik.

Alhamdulillah, sudah terlalu lama tidak menulis, membuatkan hati terasa sangat rindu dan sayu apabila menulis ini, melihat jauhnya perjalanan, berlikunya kehidupan. Ketika menulis ini, merasa sedar bahawa dah tahun 6 perubatan rupanya diri ini. Juga telah 4 tahun 6 bulan berada di negara orang. Mungkin bukanlah terlalu lama, tetapi bukan juga masa yang singkat mengharungi kepelbagaian yang pada mulanya asing, namun akhirnya sedikit sebanyak dapat menyesuaikan diri. Selalu juga memikirkan, wahai diri, adakah engkau ini semakin maju ke hadapan atau makin hari makin mundur ke belakang. Persoalan ini amatlah penting, kalaulah ukuran adalah pencapaian lahiriah semata-mata, maka mungkin itu adalah percaturan dan perkiraan yang terlalu mudahdan dangkal. Namun maju dan mundur sangat berkait dengan hubungan dengan Allah SWT. Kesibukan dalam urusan kehidupan tanpa peningkatan dzatiyyah serta peningkatan ilmu berkait soal mengenal Allah dan melaksanakan tuntutan ilmu itu sendiri mampu sahaja menghanyutkan diri dalam arus dunia ini.

Islam dan Cabaran Perubatan “Barat”

Teringat penulis tentang cerita yang diungkapkan dalam sebuah talk mencuplik kisah dalam sebuah novel bertajuk Al-Chemist, karangan Paul Coelho. Kadangkala, untuk memahami Islam di dalam sesebuah tempat asing adalah untuk memahami konteks tempat itu dan kembali semula kepada negara asal dan kemudian kembali semula ke tempat tersebut. Sangat ajaib dan benar, penulis buku ini menceritakan seorang yang datang ke negara Spain dan kemudian merasakan dia menjumpai Islam tetapi dalam konteks dan perspektif yang berbeza. Maka, kembali semula pengembara ini ke Mesir, untuk memahami makna Islam dan kefahaman Islam dan dia kembali ke Spain dan dapat menyesuaikan Islam dalam konteks negara Spain. Begitulah juga apa yang dilihat di dalam sirah Muhammad saw. Islam tidak hadir untuk memadam sejarah dan usul keturunan manusia. Juga ia tidak hadir untuk menyempitkan dinamik kehidupan manusia dengan kepelbagaian bangsa, bahasa, cara hidup dan budaya, malahan Quran menekankan aspek lita'arafuu – supaya kamu saling kenal -mengenal. Rupanya di dalam kepelbagaian kehidupan ini, terdapat rahsia untuk insan faham dan kenal, dan menggunakan wahyu dan ad-deen untuk membangunkan nilai-nilai hidup dalam konteks budaya sesuatu masyarakat yang tidak menyanggahi “ universal call and values” yang digariskan oleh Allah SWT.

Perkara yang bersifat generik ini sangat berkait dengan diri sendiri tetapi juga kesemua para pembaca yang bergaul, berinteraksi dan terlibat langsung dalam kehidupan di negara Barat. Masyarakat barat pada hari ini adalah masyarakat yang sedang menelusuri arus pasca-modenisasi. Asas pada tindakan berkait dengan soal fakta dan ilmu, dan beralih kepada persoalan hak insan dan kemahuan insan. Tiada siapa boleh mengatakan kehendak dan kemahuan seseorang itu adalah salah dan model sistem Barat menampung kemahuan seseorang atau sesebuah kumpulan. Contoh yang paling mudah adalah isu homoseksualiti, ibu tumpang, dan kebebasan mutlak seseorang. Sebagai seorang Muslim dengan asas kehidupan yang sangat berbeza, menelusuri sistem pembelajaran berpaksikan nilai humanisasi tentu sekali sesuatu yang menimbulkan keserabutan pada awalnya, penyesuaian pada pertengahannya dan kebiasaan pada akhirnya. Kita mungkin berakhir dengan bentuk pemikiran yang sama dan selari dengan aliran yang dicorakkan Barat. Perkara yang boleh kita katakan sebagai the clash of civilisation ini memerlukan penelitian yang dalam bagi kita sebagai Muslim supaya nilai agama itu terpancar dalam konteks kehidupan yang berbeza. Seringkali apabila perkataan Barat digunakan, maka konotasinya adalah negatif daripada aspek penglihatan seorang Muslim. Maka Islam dan Barat kelihatannya seperti berlawan arus. Persoalannya adalah adakah Islam dan Barat itu yang berlawan arus ataupun praktis manusia di negara majoriti Islam dan negara majoriti bukan Muslim itu yang berlawan arus. Tiada jalan dan tiada jambatan yang mampu menselarikan pertentangan dua magnet yang berlainan ini melainkan dengan cara bagi seorang Muslim untuk kembali mengkaji Islam dan memahami intipati Islam itu sendiri.

Pada hari ini, kita lihat Islam adalah agama yang paling pantas peningkatan jumlah penganutnya di negara barat. Sesuatu yang menghairankan, bagaimanakah ini berlaku sedang kedua-dua negara dengan daya magnet melawan arus ini seperti tidak mempunyai perkara yang boleh disepakati. Benarlah “al-hikmah dallatul muslim”, hikmah itu adalah barangan hilang kepunyaan Muslim, di mana sahaja dia menjumpainya dia paling berhak mendapatkannya. Jawapan kepada pertentangan ini adalah untuk kembali menilai bukan agama, tetapi kefahaman dan sifat kritikal dalam memahami Islam. Apa buktinya? Nabi saw menyatakan bahawa bagi setiap 100 tahun, akan ada mujaddid yang melakukan tajdid bagi agama ini. Tajdid dengan erti kata membaharui bukan agama tetapi tafsiran kepada agama agar tafsiran itu tulen seperti mana yang difahami Nabi saw dan para sahabat rahimahullah. Kita banyak menilai Barat salah. Ya memang salah, tetapi kesalahan itu mungkin sahaja datang dari kehilangan contoh daripada mereka yang digalaskan tanggungjawab “litakunu as-syuhada' alannas”. Kita kehilangan suara,kajian,akhlak dan pancaran Islam untuk kita katakan ini adalah jalan keluar dan ini adalah maksud yang membawa insan kepada kejayaan.

Apa kaitan ini semua dengan bidang perubatan? Sebagai seorang yang belajar perubatan, impak dan kesan perbezaan nilai Western Medical Ethics dan Islamic Ethics in Medicine sebenarnya bukanlah perbezaan yang besar. Ia adalah selari apabila ia memperkatakan persoalan “ human dignity” dan menegakkan keadilan bagi insan. Nilai “justice”, “truthfulness” dan nilai-nilai yang lain adalah nilai yang Islam. Cuma persoalan sejauh mana kita memberi nilai autonomi kepada seorang insan sangat berkait dengan nilai autonomi kita sebagai hamba kepada empunya autonomi ke atas kita. Ia juga adalah panggilan untuk melaksanakan nilai sejagat ini secara serius, bukan sekadar menulis dalam bentuk tulisan atau kertas peperiksaan, juga bukan sebagai omokan seorang pelajar perubatan apabila bosan memperkatakan tentang ethics. Ia adalah “means” dan “goals” untuk kita mencapai sifat professionalisme dalam memberi khidmat kepada manusia, dan ibadah dan ubudiyyah kepada Allah Jalla waala.

Moga Allah memberi kita kekuatan untuk meningkatkan kefahaman kita tentang islam dan interaksi dengan realiti dunia hari ini supaya perjalanan kita adalah syariah(something yang kita ceduk dari sumber asli (Quran dan Sunnah)  utk  kehidupan ini) bagi kita dalam konteks perjalanan di NZ dan negara barat yang lain.

Wallahu a'lam

Abu Asr

Curhat- Mengasah bakat untuk menulis dengan kekuatan pena hati

3/12/11 – Dunedin, NZ