[0:00 – 1:30 — Welcome]
Bismillāh al-Raḥmān al-Raḥīm. Al-ḥamdu lillāhi Rabb al-ʿālamīn, wa ṣallallāhu ʿalā Sayyidinā Muḥammadin wa ālihi al-ṭayyibīn al-ṭāhirīn.
Assalāmu ʿalaykum wa raḥmatullāhi wa barakātuh, and a very warm welcome to all of you.
My name is Alexander Khaleeli, and I have the honour of serving as Head of the International Centre for Advanced Islamic Research — ICAIR. On behalf of ICAIR and our partners in this evening — NASIMCO and IMI Canada — thank you for giving us your Friday evening, and thank you to our hosts here at the Az-Zahra Centre for the dinner and for this beautiful space.
Tonight’s title — Dying an Islamic Death in 2026 — names something that touches every family in this room, and that almost none of us talk about until we are forced to.
[1:30 – 3:30 — The bedside]
Let me begin where this subject actually lives. Not in a lecture hall — in a hospital corridor, at two o’clock in the morning.
A family is gathered outside an intensive care unit. Their father — grandfather — has been ill for a long time, and tonight the doctors have asked them a question: do you want us to continue? Continue the machine that is breathing for him. Continue the treatment that is no longer making him better, only holding him where he is.
And this family — a good family, a believing family — is trying to do two things at once. They are trying to love their father. And they are trying to obey Allah. Someone phones an uncle overseas. Someone searches the internet. Someone calls a shaykh — maybe two shaykhs — and receives two different answers. And in that corridor, at that hour, they carry a fear that perhaps you have carried too: what if, in trying to be merciful, we do something ḥarām? And what if, in trying to be obedient, we prolong his suffering?
That corridor is why we are here tonight.
[3:30 – 6:00 — Why now]
For nearly all of human history, no one asked these questions, because death was something that simply happened to us. The illness took its course. There was nothing to decide.
Modern medicine has changed that. Ventilators, dialysis, resuscitation, artificial feeding, advanced oxygen support. These technologies save lives every single day; many of us are alive, or have parents alive, because of them. But they have also done something unprecedented: they have turned dying into a series of decisions. Decisions about starting treatment, continuing it, stepping it down. Decisions that used to belong to Allah’s decree alone now pass, in part, through human hands — the hands of doctors, and of families.
And so questions arise that our grandparents never had to ask. When is treatment obligatory, and when does it stop being so? Where is the line between allowing a natural death and causing a death? How do we weigh suffering, and the patient’s own wishes, in the scales of the sharīʿah?
And there is a quieter question beneath all of these. Our tradition surrounds the dying person with its own care — the presence of family, remembrance of Allah, preparation of the soul for its return — and we must ask what becomes of that sacred space when death unfolds instead amid machines, monitors, and visiting hours. The danger of our age is not the machines themselves, but the temptation they bring: to treat death as a problem to be solved, rather than a meeting to be prepared for. Dr Zaidi will speak to this directly later this evening.
These questions fall on three groups of people, and all three are represented in this hall tonight: patients facing their final illness; families asked to decide for those they love; and our Muslim doctors and nurses, who face these dilemmas not once in a lifetime but every week, inside institutions whose rules were not written with our fiqh in mind.
In a few minutes, Dr Sabira Kanani and Dr Akber Mithani will walk us through what these decisions actually look like clinically, and what the terms mean — DNR, CPR, withholding, withdrawing. I will leave that ground entirely to them, and I’d encourage you to hold your questions about specific medical scenarios for the panel.
[6:00 – 9:30 — What ICAIR has done: the story]
What I want to give you is the story of what our community has been doing about this — because tonight is not the beginning of a conversation. It is a progress report on one.
In April of last year, ICAIR, together with NASIMCO and IMI Canada, convened the Islamic Futures Symposium in Toronto, at the Jaffari Community Centre. In the biomedical ethics stream, something quietly remarkable happened: our clinicians and our scholars sat in the same room, and the clinicians spoke honestly about the cases that keep them awake at night — and the scholars listened. What emerged was a clear conclusion: our community does not primarily lack rulings. It lacks a bridge between the rulings and the bedside.
So we set out to build that bridge, in three steps.
First, we compiled. Our researchers gathered the relevant rulings of Ayatollah Sayyid ʿAli al-Sistani — from the Tawḍīḥ al-Masāʾil and from his office’s published responsa — translated them, and organised them by theme: the definition of death, life support, end-of-life interventions, medical liability. Word for word, fully sourced, with no paraphrasing and no editorial hand. That baseline now exists, and it did not exist before.
Second, we went to the source. In January of this year, a delegation travelled to Najaf and Karbala: Dr Iqbal Jaffer, a cardiac surgeon; Dr Sabira Kanani, a palliative care physician; accompanied by Shaykh Jafar Farishta. And I am delighted that two of those three delegates are sitting with us tonight and will be on our panel. They met with senior scholars — most substantively with Sayyid Muhammad Bāqir al-Sistani, of the office of the Grand Ayatollah — and they did something that is rarer than it should be: they put real clinical cases on the table. Not abstractions. The actual dilemmas of the ICU and the hospice.
Third, we wrote it down. The result is a research white paper — Islamic Biomedical Ethics: End-of-Life Care — which maps, question by question, where the jurisprudence is clear and where clarification is still being sought.
[9:30 – 11:30 — What is emerging, and what remains open]
Let me share, in plain language, a taste of what that engagement has clarified — and let me be precise about its status, because precision here is a religious duty.
We came away with principles, not verdicts. Among them: that treatments are not obligatory in and of themselves — their obligation follows the benefit they give the patient. That the duty of rescue involves a rational weighing of expected benefit against the harm and hardship an intervention inflicts. That when genuine doubt exists in that balance, the informed wishes of the patient carry real weight. And that through all of this, one line remains absolutely firm: it is never permissible to act to bring about a death. The sanctity of life is the fixed star; everything else is navigation.
Now, three honest caveats. First: these principles are our team’s understanding from scholarly discussion — they are not new fatwās, and nothing tonight is issued in the name of any marjaʿ’s office. Second: the white paper is a working draft. Important questions remain genuinely open — how to measure “significant benefit” at the bedside, how modern technologies that didn’t exist when classical categories were formed should be classified, what a believing clinician does when hospital policy and religious obligation pull apart. We are continuing to seek clarification from Najaf on exactly these points; the engagement is live and iterative. And third: tonight is an evening of education, not of personal rulings. If you are facing a decision like this in your own family, our hope is that what we share tonight helps you navigate it with greater clarity and confidence.
I will say this plainly: we could have waited until every question was answered before standing before you. We chose not to — because families are in that hospital corridor tonight, and because a community that only hears about this subject when everything is settled never learns how to think about it.
[11:30 – 13:30 — Where this is going, and why we need you]
Where is this headed? Once sufficient clarity is reached, ICAIR will produce a comprehensive guidebook on end-of-life care in the Shīʿī framework — written for three audiences at once: healthcare professionals, patients and families, and the community leaders who get the phone call at two in the morning. Around it: decision frameworks and flowcharts for common scenarios, worked examples, resources for advance care planning that align with our fiqh, and training for ʿulamāʾ and clinicians alike.
And beyond this project lies a bigger vision: a method — compile faithfully, engage the scholars with real cases, integrate the medicine, build practical tools — that can be turned, next, to other frontiers of Islamic biomedical ethics.
But tonight has a specific purpose in that journey, and it is not for you to listen to us. It is for us to listen to you. This is a community forum. If you are a physician or a nurse: we need your cases. If you have walked this road with a parent or a spouse: your experience is data of the most precious kind. What you raise in the open forum tonight will directly shape the questions we take back to Najaf and the guidance we write. That is not a courtesy; it is the methodology.
[13:30 – 15:00 — The evening, and handover]
So, the road map for the evening. In a moment I’ll invite Abbas Bandali, President of NASIMCO, and then Dr Akber Mithani, President of IMI Canada, for their opening remarks — and I thank both organisations for a partnership that has carried this work from its first day. Then two brief presentations: Dr Sabira Kanani and Dr Akber Mithani will set the clinical context and the key terms; Dr Syed Nasir Zaidi will speak on spiritual healthcare at the end of life — because this subject was never only about machines. And then the heart of the evening: our panel and open forum, where the presenters are joined by Dr Iqbal Jaffer and Sister Sabiha Bandali, and the microphone belongs to you. We will close in time for congregational prayers — maghrib is at 9:43.
Our tradition does not treat death as a defeat. It treats it as a return — and the Qurʾān calls the soul at that threshold al-nafs al-muṭmaʾinnah, the soul at peace. The work we present tonight has one aim: that no family in our community should have to stand in that hospital corridor confused and afraid — that they should stand there, even in grief, muṭmaʾinn: at peace with their Lord, at peace with their decision.
Wa mā tawfīqī illā billāh. Please join me in welcoming Abbas Bandali.