Islamic Bioethics of Family Planning and Contraception: A Narrative Review of Classical Jurisprudence and Contemporary Medical Practice

Abstract

Background: Family planning and contraceptive services are acknowledged as critical aspects of reproductive and sexual health services that support maternal and child health, and the prevention of unwanted pregnancies and better family life. Although there are health benefits attached to contraception, misunderstandings still remain about the acceptability of contraception in Islam. Such misunderstandings can have an impact on contraceptive acceptance and utilization among Muslims. To balance religious values with evidence-based reproductive health, an understanding of the Islamic teachings, classical jurisprudence, and modern-day bioethical views is necessary.

The objective of this review is to analyze the Islamic text i.e. the Qur'an, Sunnah, classical Islamic jurisprudence, modern Islamic bioethics and the latest medical research relating to contraception and family planning, according to the Islamic viewpoint. It also examines the ethical and legal decisions that were made on temporary and permanent contraceptives, emergency contraceptives, medical indications for family planning, and the strategy and implementation of family planning programmes in Muslim-majority countries.

Methodology: Narrative literature review was used, which involved articles from peers, international guidelines and authoritative Islamic sources. Relevant literature was retrieved from PubMed, Scopus, Google Scholar, Web of Science and publications by the World Health Organization (WHO) and the United Nations Population Fund (UNFPA). The primary Islamic sources were the Qur'an, Sahih al-Bukhari, Sahih Muslim and classical jurisprudence including Al-Mabsut by Al-Sarakhshi, Al-Mudawwanah al-Kubra by Sahnun, Al-Majmuʾ by Al-Nawawi and Al-Mughni by Ibn Qudamah. The modern fatwas and decisions of the reputable Islamic religious courts were examined. The literature was reviewed thematically to determine the principles and what was generally agreed upon in the literature as well as current ethical problems.

Results: The review showed that contraception is not strictly forbidden in Islam. On the contrary, the permissibility of family planning is determined based on the goals of Islamic law (Maqasid al-Shari'ah), namely the preservation of life (Hifz al-Nafs) and lineage (Hifz al-Nasl). In both the Qur'an and authentic Hadith, there is support for the permissibility of reversible contraceptive methods used for proper purposes, including for the protection of the health of the mother, for spacing births and for child welfare. The view that they are permissible in accordance with the opinions of the four schools of Sunni jurisprudence is supported by evidence. Generally, permanent contraceptions are not permissible, unless the proper use of these procedures is clearly medically necessary, and emergency contraception is permissible if the procedure prevents the actual act of fertilization, but not the established pregnancy. Experience in multiple Muslim majority countries suggests that combining evidence-based reproductive health service delivery with culturally and religiously appropriate counseling is more successful for family planning.

Conclusion: The goals of Islamic bioethics and modern reproductive medicine are the same in that they are geared towards achieving the best health for both mothers and children, ensuring responsible parenthood, and preventing harm. The study results indicate that family planning implemented within the ethical framework of the Qur'an, Sunnah and Islamic jurisprudence are in harmony with Islam and are helpful in achieving public health objectives. Greater interaction between healthcare workers, policy makers, and Islamic scholars can help enhance reproductive health education and increase understanding, while helping to provide culturally competent family planning services within Muslim populations.