Studying and exposing human body

[Dr Anum]

As salam o alikum . I want to ask a question from you.. I am a doctor by profession and as a doctor I have to study and examine every part of human body including the genitals, without discrimination of gender. So I want to ask u that is it permissible in islam that for study, learning and treatment purpose we can see and examine every human body part whether male or female? And I want to pursue my career en surgery field so in my training and practice I have to do multiple operations which will include exposing whole body so I want to ask is it permissible for me as a female to operate male patient ?

[Ridwaan Ravat]

There are two issues of concern here:

1. Awra’ (exposing parts of the body which are not permissible to a non-mahram)

2. Khalwa’ (seclusion with a non-mahram)

Both of the above are not permitted in shariah.
However, exceptions are made in cases such as medical need or necessity. Most of the fuqaha are agreed upon this but with
conditions:

CONDITIONS

1. Real Need
al-dharurat tubih al-mahzurat (necessity permits the impermissible)
There must be a ‘real need’.

Real need would fall within the scope that examination of a certain anatomy of a person is required to ascertain information that is likely to:

• support a diagnosis or therapy. (this can include a broad system examination for ? cancer, surgical treatment, a process of
investigation i.e transvaginal U/S)

• Prevent medical liability- as this would be threatening to one’s career and would be a
requirement by the medical regulatory bodies and medical law.

• For educational reasons- i.e. learning how to examine a system or taking an exam
Note- One must bear in mind if any of the above can be avoided without medico-legal risk then this would be a better option. Example- If
it is obvious there is a small uncomplicated boil around the groin from the history and there is no evidence of red flags, then it would be
better just to provide antibiotics rather than
examine the groin etc.

2. Availability of appropriate gender health professional
If the patient is of opposite gender then all effort must be made to refer the patient to a
health professional who is of the same gender as the patient. This will depend on availability. Ideally for a female patient the order of
preference is a Muslim female, a non-Muslim
female, a practicing Muslim male and finally a non-Muslim Male. For a male patient a Muslim male, then a non-Muslim female, a Muslim
female and finally a non-Muslim female. Non-
availability will only be justified for the following
reasons:

• The other health professional is not willing to
see or examine the patient

• There is no available health professional, who fulfils the required experience or skill level.
(i.e. A male consultant gynaecologist would be
considered permissible even if a female Muslim gynaecologist is available but does not have the required expertise)

• There is no obligation to undergo hardship to
the extent that it could be detrimental to one’s
career, in seeking an appropriate gender health
professional of sufficient expertise. (i.e. if patients have been placed on one’s named clinic list, it would be considered serious hardship to see only the same gender patients even if an appropriate gender health
professional is available as this could be detrimental to one’s career and reputation) al- mashaqqatu tajlub al-taysir (hardship begets
facility)

• If there is an emergency and the first health professional available is not of the same
gender. al-dharar al-ashadd yuzal bi’l-darar al- akhaff (a greater harm is eliminated by
[tolerating] a lesser harm)
Note- Circumstances where there is a need to examine the genital/anal areas of males and females, or breasts of females would require one to exert some element of hardship in
seeking a health professional of appropriate gender, as these are considered areas of
shahwa (sexual organs or areas of modesty- even to health professionals). It is therefore discouraged for males to specialise in areas of obstretics and gynaecology or females to
specialise in urology where the focus of that speciality are those systems.

3. Not to exceed limits of khalwa’ and exposure
of awra’ al-darar yudfa’u bi-qadr al imkan (harm is to be
eliminated within reasonable limits)


Awra’:

• If any part of the awra’ must be uncovered
then all effort must be made to expose only the minimum required, and to cover as soon as possible.

• If any part of the anatomy is to be palpated or touched then one must ensure that the minimum of touching is done to ascertain what
is required and for the least reasonable period.

Khalwa’:

• The ethical and legal right of privacy competes with the obligation of khalwa’ as
there may be times where one needs to see a patient alone so as not to breach
confidentiality of an embarrassing medical
issue, even before the husband or wife. For this
reason, because of medico-legal requirements, a medical professional would not be liable under shariah if he/she consulted with the opposite gender alone for the same conditions as “Availability of appropriate gender health
professional” above.

• When discussing about, or examining the areas of shahwa’ one should make every effort to do this in the company of the patient’s
spouse. This should be done to the extent the above point allows. Examining patients awra’ in direct view of the patients mahram other than
the spouse is not permissible, if this is considered awra’ for the mahram also. If the
patient insists then there is no shari’ liability on the health professional.

• Examining the areas of shahwa’ should only
be done in direct view of a chaperone of the same gender as the patient. (i.e when a female doctor is obligated to examine a male patient, a male chaperone is advised if possible- this
situation should be avoided by all reasonable means).

Final Note- One must uphold professionalism (aadaab) in one’s conduct always. This is a requirement in both shariah as well as a medico-legal obligation.