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Medical Issues - Aids

Adapted from the book : "A Code of Practice for Muslims in the West" in accordance with the edicts of Ayatullah Seestani

AIDS or Acquired Immune Deficiency Syndrome is a disease that has afflicted, based on 1996 data, eight million people worldwide and there are about twenty-two million who carry the AIDS virus. The latest data show that one and a half million people have died of AIDS in the year 1996 only, bringing the total number of those who died of the disease to six million! This was announced by World Health Organization on the International Aids Day on 1 December 1996.

Doctors have identified the following ways in which AIDS is transmitted:

a. Sexual intercourse between members of the same sex or the opposite sex [in which one member is already afflicted]. This represents the most dangerous and widespread method of the spread of AIDS. The chance of transmission through this method is 80%.

b. Through blood vessels: by transfusion; by injection (especially in the case of drug addicts); by open wounds; and organ transplantation, and even through surgery if the instruments are not properly sterilized.

c. The feotus can be afflicted while in the womb or at the time of birth if the mother is already afflicted with AIDS.

The data indicate that this disease has affected all countries and that no nation is immune against it; and that the majority of the victims are male. Diseases that had been eradicated have again started reappearing because of the AIDS epidemic (e.g., pulmonary tuberculosis).

Against this background, we presented the following questions to his eminence, Ayatullah Sistani:

368. Question: What is the rule concerning isolating an AIDS patient? Is it obligatory on him to isolate himself? Is it obligatory on his family to isolate him [from the public]?

Answer: It is not obligatory on him to isolate himself just as it is not obligatory on others to do so. Indeed, it is not permissible to prevent him from frequenting public places like masjid, etc, as long as there is no danger of infecting the others with the virus. It is, however, obligatory for him as well as others to be careful in situations where there exists certainty or probability of infecting others.

369. Question: What is the rule on intentionally infecting others with the AIDS virus?

Answer: This is not allowed. If it leads —even after the passage of time— to the death of the person who has been infected, then the heirs of the deceased have the right of retribution from the person responsible for causing to demand the infecting, provided that the latter was aware that that infection could lead to death; but if he was ignorant of that effect, or unaware of it, at that time, only indemnity (blood money) and penalty would apply.

370. Question: Is it permissible for a person infected with AIDS to marry a person who is free from it?

Answer: Yes; but it is not permissible for him or her to mislead the other party by deliberately presenting himself or herself as free from AIDS at the time of proposing while they are not. Similarly, it is not permissible for him or her to become intimate in a way that would infect the other partner.

However, if there is only a probability of infection and no certainty, then it is not obligatory for him or her to refrain from intimacy, provided that there is agreement on it.

371. Question: What is the ruling on marriage between two people who are carriers of the AIDS virus?

Answer: There is no problem in it. However, if sexual relation between them is bound to worsen the disease to a serious level, it is necessary for them to refrain from it.

372. Question: What is the ruling on the sexual relations of an AIDS patient? Is it permissible for a non-infected person to refuse sexual relation with their spouse because sexual intercourse is one of the main ways of transmitting the virus?

Answer: It is permissible for a non-infected wife not to make herself available to her infected husband for intimacy that could lead to infection by the virus. It is indeed obligatory on her to prevent him from such intimacy.

If it is possible to lessen the chances of infection to a level that is insignificant —for example, 2%— by using condom, etc, it is permissible for her to be intimate with her husband. In such a case, it is, based on precaution, not permissible for her to refuse [intimate relations with her husband].

This clarifies also the case of a husband who is not a carrier of the virus and wife who is: it is not permissible for him to have sexual relations with her in accordance with what sensible people perceive as considerable risk— of being infected by the virus. In such a case, the wife’s right to have sexual relations [at least once] every four months is suspended, except when it becomes possible to adopt methods that would properly prevent infection with the virus.

373. Question: What is the ruling concerning the right of the non-infected spouse in seeking separation?

Answer: If deception was involved in the marriage, in the sense that the husband or the wife concealed the fact that they had AIDS at the time of proposing, engagement, so much that the marriage contract (‘aqd) was recited based on that understanding, the deceived party has the right of annulment.

However, if the wife or her representative did not say anything about the issue of the disease and the husband assumed that she is free from it, the silence does not count as deception and, it therefore, does not yield the right of annulment.

If there was no deception or the disease flared up after the marriage, the non-infected husband has the right to divorcing his infected wife. Does the non-infected wife have the right to ask for divorce from her infected husband on the grounds that she is being deprived of her conjugal rights?

There are two views [on this]; precaution should not be ruled out in this case. Of course, if her husband abandons her completely and she becomes like a suspended woman [neither married nor unmarried], it is permissible for her to take her case to the religious judge1 to force her husband to choose one of two courses: either end the abandonment or divorce her.

374. Question: What is the ruling on the divorce of a woman whose husband is AIDS patient?

Answer: It has already been mentioned above.

375. Question: What is the ruling on abortion for a pregnant woman who is infected with AIDS?

Answer: It is not permissible, more so after the soul has entered the feotus. Of course, if continuation of the pregnancy poses a danger to the mother, it is permissible for her to abort it before the entering of the soul in the feotus, but not after it.

376. Question: What is the ruling on the custody of an infected mother with regard to her non-infected baby and also on breast-feeding?

Answer: She does not lose the right of custody of her baby; but she must adopt sufficient methods to ensure that the virus does not infect the baby. If it is probable —a considerable probability— that the virus may be transmitted through breast-feeding, it is necessary for her to refrain from it.\

377. Question: What is the virus on considering AIDS as terminal illness?

Answer: Since this disease lasts long, what can be classified as terminal is its last stage only which is closer to death that is brought about by the disruption and complete destruction of the immune system or the occurrence of fatal nervous breakdown.

378. Question: When a person is diagnosed as having ADIS, is it permissible for the doctor or is it obligatory on him to inform the patient’s relatives, especially their spouse?

Answer: It is permissible to inform them, if the patient or his guardian gives consent. It is obligatory if the survival —for a longer time span— of the patient depends on it. It is similarly obligatory, if he knows that by not informing them, the virus would infect them for not taking necessary precautions. And Allah knows the best.

379. Question: If a Muslim knows that he contracted AIDS, is it permissible on him to engage in sexual relations with his wife? Is it obligatory for him to inform his wife about it?

Answer: If he knows that the virus can infect her through sexual relations, it is not permissible for him at all. Similarly [it is obligatory on him to refrain from sex] if there exists a considerable level of likelihood [of infection], except in the case where the wife knows about it and agrees to it.

Notes:

1. Translator's Note: "Religious judge" means the mujtahid or someone authorized by him in judicial matters.