Islamic Jurisprudence Permits Withdrawing Futile Care for Anencephalic Infants, Study Finds

Anencephaly, a lethal congenital anomaly in which an infant is born without a fully developed brain and skull, raises some of the most difficult questions in neonatal medicine: whether to sustain biological life when no recovery is possible, what moral status such an infant holds, and how end-of-life decisions should be made. A new study published in BMC Medical Ethics argues that Islamic jurisprudence offers a coherent and clinically sensitive answer to these questions, one that does not require prolonging dying through futile care.

The research, authored by Orhan Onder, Pakeezah Saadat and Tuba Erkoç Baydar, employs a normative and doctrinal analysis of classical Islamic legal texts across the four major Sunni schools of law—Ḥanafī, Mālikī, Shāfiʿī and Ḥanbalī—combined with a comparative evaluation of contemporary secular bioethical frameworks, particularly principlism. The authors analyzed classical legal sources with particular attention to the distinction between definitive and speculative treatment efficacy, interpreting the findings in light of current medical knowledge on anencephaly. The article is an open-access research paper published on 15 October 2026, currently shared as a peer-reviewed, accepted version subject to further editorial edits.

The central finding is that Islamic jurisprudence does not impose an absolute obligation to sustain biological life at all costs. According to the analysis, across all four schools of law, obligations to provide medical treatment are contingent upon the presence of an achievable benefit. When treatment is deemed medically futile—offering no possibility of recovery or meaningful benefit—Islamic legal reasoning permits, and in some cases supports, the withholding or withdrawal of life-sustaining interventions. Crucially, the authors emphasize that this position affirms the inherent dignity of the infant while rejecting the moral necessity of prolonging dying through futile care.

This conclusion challenges a common assumption that religious ethics necessarily oppose non-intervention at the end of life. The comparative analysis reveals substantive convergence between Islamic and secular frameworks in practical conclusions, alongside significant divergence in their normative foundations. In other words, while Islamic and secular bioethicists may reach similar decisions at the bedside, the underlying moral reasoning that leads them there differs substantially—a distinction the authors argue is important for clinicians working with Muslim families.

The study’s authors position Islamic moral reasoning as enriching, rather than merely paralleling, dominant secular approaches to neonatal ethics. They note that Islamic jurisprudence remains underrepresented in comparative neonatal ethics scholarship, even though secular bioethical frameworks dominate clinical guidance. By systematically mapping how classical legal reasoning addresses treatment futility, moral status and end-of-life decision-making for anencephalic infants, the study aims to inform ethically grounded decision-making in culturally and religiously diverse clinical settings and to contribute to pluralistic bioethics more broadly.

As a normative and doctrinal analysis of classical legal texts rather than an empirical study of clinical practice, the research examines how these traditions reason in principle; it does not measure how decisions are actually made in hospitals or how families and clinicians respond in practice. Its findings concern the structure of Islamic legal arguments and their comparison with secular frameworks such as principlism, applied to the specific clinical context of anencephaly, where no possibility of recovery exists. Within those limits, the study offers a documented scholarly basis for a position that many readers may find surprising: that classical Islamic law, far from demanding maximal intervention at any cost, builds the obligation to treat on the presence of achievable benefit—and permits letting go when that benefit is absent.

Subject of Research: Comparative Islamic and secular bioethical analysis of end-of-life care for anencephalic infants

Article Title: End-of-Life Care for Anencephalic Infants: A Comparative Analysis from Islamic and Secular Perspectives

Article References: Onder, O., Saadat, P., & Erkoç Baydar, T. (2026). End-of-Life Care for Anencephalic Infants: A Comparative Analysis from Islamic and Secular Perspectives. BMC Medical Ethics. https://doi.org/10.1186/s12910-026-01636-8

Image Credits: AI Generated

DOI: 10.1186/s12910-026-01636-8

Keywords: anencephaly, neonatal end-of-life care, Islamic jurisprudence, bioethics, medical futility, Sunni schools of law, principlism, treatment withdrawal, neonatal ethics, comparative ethics, End-of-Life, Care