Dear Dr. Abou El Fadl,
I have read a few articles on your website and highly value your expertise and opinion. I am hoping to ask your view on a difficult situation my wife and I are currently facing.
My wife is 6 months into her pregnancy, and we have just found out by prenatal MRI scan that our baby has a [serious condition] that would lead to him being significantly physically and mentally disabled, as well as requiring multiple operations from starting early in life.
We first had an indication at early ultrasound scans, however we were advised that it was likely to not affect his development. We are both educated professionals. We have seen first hand the extreme impact these disabilities have on children and their parents. I have done a lot of research and reading, including your advice at
https://www.searchforbeauty.org/2015/01/04/fatwa-on-the-permissibility-of-abortion/
What I have read seems to indicate that abortion after 120 days is impermissible in Islam - unless it is life threatening to the mother.
We are very conflicted as to what we should do, and this situation has taken a great toll on both of us - my wife has cried about it most days since we found out. To continue the pregnancy and give birth to a baby that is guaranteed to have such a significant illness is very frightening and stressful. We are very concerned about the quality of life our child would have, the multiple operations he would require - and most of all, on what would become of him when we pass away - as he would have significant care needs, and would likely need to live in a care facility/nursing home.
Having passed the window of 120 days, are you aware of any fatwas / hadiths / schools of thought surrounding the permissibility of an abortion in the setting of significant foetal disability?
Thanks and kind regards,
[Name Withheld for Privacy]
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[Additional details were shared with the Shaykh, which were omitted for privacy but do not affect the substance of the fatwa]
Al-salamu alaykum,
I pray that God surrounds you with divine blessings. You and your family have been in my prayers since I received your message. Allah has chosen you and your family for a most difficult and challenging test. I can only wholeheartedly pray that Allah aids and strengthens you and grants you proper guidance and wisdom.
As you set out in your message, your wife is six months pregnant and you have discovered that your child suffers from [name of condition omitted for privacy], which is a most serious medical condition that is bound to cause a formidable challenge to the child and the family. As you stated, the broad consensus of Muslim scholars is that after the first trimester, a fetus may not be aborted unless there is a danger to the mother's life or a risk of serious bodily injury. The jurists who allowed abortions for reasons less than a risk to the mother's life in the first trimester did so on the assumption that the soul enters a fetus in the second trimester. Those jurists usually pointed out circumstantial evidence in support of the thesis that the soul enters the fetus in the second trimester, but as has been pointed out by many scholars, we do not know when precisely a soul becomes united with the physical body, and it is even possible that the soul exists from the moment of fertilization onwards. In all cases, you are correct that the vast majority of scholars oppose aborting a fetus for anything short of the most dire reasons (ie. preservation of the mother's life) after the first 120 days. The reason for this juristic position is the sanctity of life and the absolute importance of honoring and preserving human life. Human life is sacred and cannot be denied except under the most narrow of circumstance.
If you will allow me to elaborate, jurisprudentially we have two principles here. The first principle is the preservation of life. The second principle dictates that human suffering must be avoided and alleviated whenever possible. In early scholarly debates, some jurists argued that if a child will be born suffering from a non-treatable fatal condition or a condition that denies the child the ability to function as a human being, for instance, a child born without vital organs or with a non-treatable condition that would naturally lead to death hours or days after birth, that balancing the two principles together - the principle of preservation of life and alleviation of suffering - under these circumstances, a child may be aborted even if there is no danger to the mother's life.
In the modern age, a scenario very similar to the one that confronts you was the subject of a fatwa by the rector of Al-Azhar, Shaykh Jad al-Haqq, in 1980, in which he basically stated that if a condition is treatable so that the life of the child can be prolonged or even has a slight chance of being preserved, an abortion is not permissible. Since then, the Azhar has grown rather steadily more conservative, especially with the rise of the field of genetic testing, siding with the principle of preservation of life above all else. In other words, since the 1980 fatwa, in various fatawa dealing with the question of genetic defects and pre-birth testing that reveal serious illness, there has been a clear trend among contemporary scholars to see this as a possible slippery slope, and thus to close the door on abortions that might compromise the principle of the sanctity of life.
Personally, I completely understand and support positions that prefer to err on the side of preserving life, especially when there is any chance of treatment regardless of how small. Nevertheless, as I say this, it is my obligation as a scholar and jurist to put myself in the position of those who suffer, meaning not just you but also the child, and ask, is it fair to give birth to a child who will go through one surgery after another, suffering while not understanding the reasons that they suffer, and then to end with a very high chance of ending up seriously impaired or handicapped for the rest of their life? This is especially all the more so in situations where I have seen children unable to see, hear, or even gain minimal mobility, and who are born to suffer grievously for a number of months or years before passing away? I ask my Lord, what is the truly merciful and compassionate course here? Do we honor the principle of preserving life regardless of the amount of suffering? Or do we sometimes recognize very limited and narrow exceptions?
My dear brother, you asked if I knew of a Qur'anic verse or hadith that would give you some relief. The truth is there is no textual source that addresses the type of situation that you are confronted with other than the many Qur'anic verses and hadith that prohibit killing and the equally numerous sources that command human beings to alleviate suffering.
In summary, if you want the scholarly position, it is to accept your fate, not abort, and endure the hardships that you are about to confront with faith, patience and fortitude. If you want my personal advice, turn to Allah for guidance, pray on this again and again and again, until a tranquility and peace besets your heart and you will know the path that is most pleasing to Allah.
As is the case, in so many questions that I have been forced to deal with involving so-called bio-ethics, I have found myself informing people as to what the law is, but then counseling the same people to be satisfied with nothing less than a personal response from Allah. It requires a great deal of worship, humility, honesty and transparency, but it is the only pure and honest course of action when confronted with truly gut-wrenching challenges.
I will steadily pray for you and your family and your child. May Allah bless you, guide you and take your hand to the one and true beautiful path of your Lord. And only Allah knows best. May Allah forgive me my sins and my ignorances.
Wa al-salamu alaykum,
Shaykh Abou El Fadl