Electroconvulsive Therapy in Islamic Jurisprudence and Medical Ethics: From the Principle of No Harm to a Therapeutic Decision-Making Matrix
Abstract
Electroconvulsive therapy (ECT) is one of the effective methods for treating certain severe psychiatric disorders. Despite its clinical effectiveness, it has consistently faced jurisprudential, ethical, and legal challenges. The nature of this method—which involves direct intervention in the patient’s body and brain—raises serious questions about its legitimacy from the perspective of Islamic jurisprudence and medical ethics, especially in cases where the patient lacks decision-making capacity or when informed consent cannot be obtained. The aim of the present study is to clarify the jurisprudential ruling of ECT and to provide a coherent framework for therapeutic decision-making based on Islamic jurisprudential principles and medical ethics. This research was conducted using a descriptive–analytical method and by drawing on jurisprudential and exegetical sources as well as works in bioethics. In this context, principles such as the rule of no harm (lā ḍarar), the prohibition of self-harm, necessity (ḍarūra), the principle of permissibility (ibāḥa), and the rule of human authority over one’s own body were examined alongside the four core principles of medical ethics—beneficence, non-maleficence, autonomy, and justice—and comparatively analyzed. The findings indicate that the permissibility of ECT is not absolute and depends on factors such as the patient’s capacity, the necessity and urgency of treatment, the balance between benefit and harm, and the presence or absence of valid consent. Accordingly, in life-threatening emergency situations, performing ECT may be permissible or even obligatory, whereas without consent and necessity it lacks jurisprudential and ethical legitimacy. The results of this study include a jurisprudential–ethical decision-making matrix that can serve as a practical guide for physicians and jurists.