A new academic study provides the most comprehensive Islamic legal assessment of euthanasia requests arising from depression, trauma, and other mental disorders — and its conclusions challenge both Western bioethics and popular assumptions.
In May 2022, a 23-year-old Belgian woman named Shanti De Corte died by euthanasia. She had been exposed to the Brussels Airport bombing five years earlier. Although she suffered no physical injuries, the trauma led to severe depression, panic attacks, and multiple suicide attempts. Two psychiatrists approved her request. Her death was legal under Belgian law.
In March 2026, 25-year-old Noelia Castillo Ramos died by euthanasia in Spain. She had experienced severe childhood trauma, including sexual abuse while in state care. After a suicide attempt left her paraplegic, she requested euthanasia. Her father fought the decision in court for 601 days. Ultimately, he lost.
These cases represent a growing trend: euthanasia for psychological suffering, not terminal physical illness. And they raise profound questions that extend far beyond Europe. For the world’s 1.8 billion Muslims, and for Muslim patients in Western healthcare systems, a different moral universe applies — one where life is not a possession but a trust, where suffering carries spiritual meaning, and where the “right to die” does not exist.
A study published in the journal Religions offers the most systematic Islamic legal assessment of this issue to date. Conducted by researchers from Ibn Haldun University and Erzurum Technical University in Turkey, the study bridges clinical psychology, Islamic theology, and classical jurisprudence. Its findings are both compassionate and uncompromising.
The Clinical Reality: When Psychological Pain Becomes Unbearable
The study begins by taking psychological suffering seriously. It identifies several determinants that drive euthanasia requests among people with mental disorders:
Hopelessness is the most powerful predictor. When patients lose faith in the treatability of their condition, the desire for death intensifies. Depression is the mental disorder most frequently associated with euthanasia requests. Research shows that 44% of cancer patients with depression express a desire for euthanasia.
Emotional dysregulation — particularly in borderline personality disorder — compromises an individual’s ability to cope with stress. Suicidal behavior occurs at significantly higher rates in this population.
Social isolation amplifies vulnerability. Many psychiatric patients who request euthanasia are unmarried or socially isolated. The absence of protective relationships creates an environment where suicidal ideation flourishes.
Trauma history can engender enduring cognitive distortions: beliefs of worthlessness, unlovability, and the world as fundamentally unsafe. Trauma is increasingly understood as an “existential injury” that confronts individuals with foundational questions about life’s meaning.
Functional deterioration — family conflict, impaired social functioning, difficulties at work or school — cumulatively reduces life satisfaction and may contribute to euthanasia requests.
The study acknowledges that in Belgium, the Netherlands, and Luxembourg, euthanasia for mental disorders is already legal, albeit under stringent conditions. Between 2011 and 2014, Belgium received 100 psychiatric euthanasia requests. Forty-eight were approved. Thirty-five were performed.
But the study then poses a more fundamental question: even if psychological suffering is real, even if it is severe, even if it is chronic — does it constitute a legitimate justification for euthanasia within an Islamic legal framework?
The Islamic Framework: Life as Divine Trust, Not Personal Possession
To answer this question, the study turns to classical Islamic jurisprudence (fiqh). The researchers examine canonical texts across the four Sunni legal schools (Hanafi, Maliki, Shafi’i, Hanbali), as well as works of Qur’anic exegesis (tafsir) and theology (kalam).
The foundational concept is amānah — divine trust or stewardship. Derived from Qur’an 33:72, this concept holds that human life is not owned by the human being. It is lent by God, held in trust, and must be preserved. The human being is a steward, not an absolute proprietor.
From this flows a radical conclusion: the individual does not possess a “right to die.” In Islamic law, the term ḥaqq (right) refers to a power or entitlement conferred by law. But a review of classical sources reveals that the scope of ḥaqq does not extend to authorizing death. One cannot claim a right to terminate something one does not own.
Contrasting Worldviews – Liberal Bioethics vs. Islamic Legal Framework
| Dimension | Liberal Bioethics | Islamic Legal Framework |
|---|---|---|
| Source of life | Not specified / secular | Divine trust (amānah) from God |
| Human role | Owner / autonomous individual | Steward / morally responsible agent |
| Basis of dignity | Individual autonomy | Divine creation + moral accountability |
| Suffering meaning | Problem to be eliminated | Test (balā’), purification (tazkiyah), expiation |
| Right to die | Yes (under certain conditions) | No (life belongs to God) |
| Response to suffering | Technical/medical solution | Patience (ṣabr) + lawful treatment |
| Suicide | Tragic but sometimes justified | Categorically prohibited (major sin) |
Three Legal Pillars: Prohibition of Suicide, Invalidity of Consent, and the Limits of Autonomy
The study identifies three specific legal principles that together foreclose any justification for euthanasia in Islamic law.
First: Suicide is categorically prohibited.
The Qur’an explicitly commands: “Do not kill yourselves; indeed, Allah is ever merciful to you” (Qur’an 4:29). Another verse states: “Do not throw yourselves into destruction with your own hands” (Qur’an 2:195). The Prophet Muhammad (peace be upon him) declared that a man who took his own life during the Battle of Khaybar, unable to endure his wounds, was among the people of Hell.
Classical jurists unanimously classify suicide as one of the major sins (kabā’ir). This prohibition applies regardless of motivation — whether physical pain, psychological suffering, or any other rationale. The 10th-century Hanafi jurist Al-Jaṣṣāṣ states that a person who refrains from lawful nourishment and thereby causes his own death “has rebelled against God’s decree.”
Second: Consent does not legalize killing.
The study examines a striking classical discussion. What if a condemned prisoner, ordered to extend his neck for beheading, complies voluntarily? Does his consent make the executioner’s act permissible? The Hanafi jurist Imām Muḥammad ibn al-Ḥasan al-Shaybānī (d. 189/805) raised this very question. His conclusion: even the prisoner’s compliance carries profound moral weight.
More directly: if a person says “kill me,” the killer remains criminally liable. In the Hanafi school, the killer must pay blood money (diyya) despite the victim’s consent. As the jurist Al-Sarakhsī (d. 483/1090) explains, one cannot authorize another to perform an act that one is not permitted to do oneself. Since no one has the right to take their own life, they cannot transfer that non-existent right to another.
This principle directly addresses assisted euthanasia. Even if a patient explicitly and voluntarily requests death, Islamic law does not recognize that request as legally valid. The act of killing remains prohibited.
Third: Suffering does not create a right to die.
The study acknowledges that suffering — whether physical or psychological — is real and can be severe. But within Islamic thought, suffering is not an unqualified evil. The Qur’an repeatedly teaches that trials serve as tests, opportunities for spiritual growth, and expiation of sins.
“We will certainly test you with fear, hunger, and loss of wealth, lives, and fruits; but give glad tidings to those who are patient” (Qur’an 2:155).
The Prophet taught that “no fatigue, illness, sorrow, pain, anxiety, or even a thorn that pricks a Muslim” occurs except that God expiates some of their sins through it.
This does not mean Islam is indifferent to pain. The obligation to seek medical treatment is well-established across all classical schools. The relief of pain through lawful means is consistently endorsed. But suffering is not reduced to a technical problem requiring a technical solution (euthanasia). It carries moral and spiritual significance that must be respected.
The study makes a crucial logical move: if Islamic law withholds permission to hasten death even in situations of certain death (e.g., a burning ship with no escape), it follows with compelling force that it cannot sanction euthanasia in response to psychological suffering — whose trajectory remains, by medical standards, genuinely open.
The Meaning of Suffering: Test, Purification, and Patience
The study dedicates significant attention to the Islamic theology of suffering — a dimension largely absent from Western bioethics. Drawing on classical scholars like Al-Māturīdī (d. 333/944), Al-Ghazālī (d. 505/1111), and Al-Zamakhsharī (d. 538/1144), the study outlines several functions of suffering:
- Divine trial (ibtilā’): Suffering tests the believer’s patience, sincerity, and faith.
- Spiritual purification (tazkiyah): Afflictions cleanse sins and elevate spiritual rank.
- Reminder: Suffering reminds humans of their dependency on God and the temporary nature of worldly life.
- Expiations: As the Prophet taught, every hardship serves as atonement for sins — a mercy that allows believers to “pay” for their errors in this world rather than the next.
This framework does not glorify suffering. But it refuses to define suffering as an absolute evil that justifies any means of elimination, including the termination of life. The contemporary euthanasia discourse, the study argues, risks reducing the human condition to its cognitive and volitional dimensions, “thereby overlooking the existential, spiritual, and affective aspects of suffering.”
Three Illustrative Cases: Clinical, Spiritual, and Legal Complexity
The study presents three real-world cases to illustrate the practical stakes of its analysis.
Comparison of Euthanasia Cases Involving Psychological Suffering
| Case | Age | Primary Condition | Outcome | Islamic Legal Assessment |
|---|---|---|---|---|
| Shanti De Corte (Belgium, 2022) | 23 | PTSD, depression from Brussels bombing | Euthanasia approved & performed | Not justified: trajectory of condition was open; age of patient; psychological suffering not a legal ground for death |
| Noelia Castillo Ramos (Spain, 2026) | 25 | Childhood trauma, paraplegia from suicide attempt | Euthanasia approved after legal challenge | Not justified: systemic failures in care do not create right to die; physical disability not a ground for termination |
| Geneviève Lhermitte (Belgium, 2023) | Not specified | Guilt/remorse after killing her five children | Euthanasia granted for “irreversible psychological suffering” | Most problematic: moral guilt and legal punishment cannot be medicalized; suffering bound to accountability may be terrain for repentance, not elimination |
The case of Geneviève Lhermitte is particularly troubling from an Islamic perspective. A Belgian woman convicted of killing her five children, she was granted euthanasia on grounds of “irreversible psychological suffering” stemming from guilt and remorse. The study notes that Islamic thought distinguishes between suffering that calls for healing and suffering bound up with moral accountability before God. Guilt-induced suffering may constitute the very terrain on which repentance (tawbah) and spiritual restoration become possible. To eliminate such suffering through death is to foreclose that possibility.
Practical Implications for Muslim Chaplains and Healthcare Professionals
The study concludes with concrete recommendations for Muslim chaplains working in European hospitals where euthanasia is legal. These professionals act as “cultural–theological mediators” between Muslim patients and secular healthcare systems.
Three practical domains require attention:
- Spiritual care and ritual resources: Prayer, Qur’an recitation, dhikr (remembrance of God), and shared silence can cultivate hope and meaning-making. Chaplains should reframe illness as spiritual purification or jihad al-nafs (inner striving).
- Education and training: Healthcare professionals need training in crisis communication, ethical reasoning, and the religious–existential dimensions of suffering. Muslim chaplains need up-to-date knowledge of mental disorders and euthanasia legislation.
- Interdisciplinary clinical cooperation: Psychology, spiritual care, medical ethics, Islamic law, and social sciences must coordinate. Families should be involved. Autonomy must be understood relationally, not individualistically.
The study emphasizes that even in jurisdictions where euthanasia is legal, Muslim chaplains have a professional and religious obligation to advocate for lawful alternatives: aggressive symptom management, psychiatric treatment, spiritual support, and the mobilization of community and family resources.
Conclusion: Compassion Without Capitulation
This study makes a distinctive contribution to both Islamic bioethics and the broader euthanasia debate. It takes psychological suffering seriously — clinically, existentially, spiritually. It does not dismiss the pain of depression, trauma, or personality disorders. It acknowledges that for some patients, the desire for death is overwhelming and real.
But compassion, the study argues, does not mean capitulation. True compassion for the suffering Muslim patient means alleviating pain through lawful means — medication, therapy, spiritual care, community support — while preserving the divine trust of life. It means sitting with the suffering person, not terminating them. It means offering hope when hope has been lost, not validating despair as a rational choice.
The study’s final message is both clear and challenging: within Islamic law, psychological suffering — however severe, however chronic, however unbearable — does not constitute a legitimate justification for euthanasia. Life belongs to God. Humans are stewards, not owners. And the steward does not have the right to destroy what they have been entrusted to preserve.
For the millions of Muslims navigating mental health crises, for their families, for the chaplains and clinicians who care for them, this framework offers not a simplistic prohibition but a rich, compassionate, and theologically grounded alternative to the dominant bioethics of autonomous self-destruction.
Reference: here
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