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Saturday, February 4, 2023

Ensoulment

From Wikipedia, the free encyclopedia

In religion and philosophy, ensoulment is the moment at which a human or other being gains a soul. Some belief systems maintain that a soul is newly created within a developing child and others, especially in religions that believe in reincarnation, that the soul is pre-existing and added at a particular stage of development.

In the time of Aristotle, it was widely believed that the human soul entered the forming body at 40 days (male embryos) or 90 days (female embryos), and quickening was an indication of the presence of a soul. Other religious views are that ensoulment happens at the moment of conception; or when the child takes the first breath after being born; at the formation of the nervous system and brain; at the first detectable sign of brain activity; or when the fetus is able to survive independently of the uterus (viability).

The concept is closely related to debates on the morality of abortion as well as the morality of contraception. Religious beliefs that human life has an innate sacredness to it have motivated many statements by spiritual leaders of various traditions over the years. However, the three matters are not exactly parallel, given that various figures have argued that some kind of life without a soul, in various contexts, still has a moral worth that must be considered.

Ancient Greeks

Aristotelian Soul

Among Greek scholars, Hippocrates (c.460 – c.370 BC) believed that the embryo was the product of male semen and a female factor. But Aristotle (384 – 322 BC) held that only male semen gave rise to an embryo, while the female only provided a place for the embryo to develop, (a concept he acquired from the preformationist Pythagoras). Aristotle believed a fetus in early gestation has the soul of a vegetable, then of an animal, and only later became "animated" with a human soul by "ensoulment". For him, ensoulment occurred 40 days after conception for male fetuses and 90 days after conception for female fetuses, the stage at which, it was held, movement is first felt within the womb and pregnancy was certain. This is called epigenesis, which is "the theory that the germ is brought into existence (by successive accretions), and not merely developed, in the process of reproduction," in contrast to the theory of preformation, which asserts the "supposed existence of all the parts of an organism in rudimentary form in the egg or the seed;" modern embryology, which finds both that an organism begins with an inherited genetic code and that embryonic stem cells can develop epigenetically into a variety of cell types, may be seen as supporting a balance between the views.

Stoicism maintained that the living animal soul was received only at birth, through contact with the outer air, and was transformed into a rational soul only at fourteen years of age.

Epicureanism saw the origin of the soul (considered to consist of only a small number of atoms even in adults) as simultaneous with conception.

Pythagoreanism also considered ensoulment to occur at conception.

Christianity

Historical development

From the 12th century, when the West first came to know more of Aristotle than his works on logic, medieval declarations by Popes and theologians on ensoulment were based on the Aristotelian hypothesis.

Aristotle's epigenetic view of successive life principles ("souls") in a developing human embryo—first a vegetative and then a sensitive or animal soul, and finally an intellective or human soul, with the higher levels able to carry out the functions also of the lower levels—was the prevailing view among early Christians, including Tertullian, Augustine, and Jerome. Lars Østnor says this view was only "presaged" by Augustine, who belongs to a period later than that of early Christianity. According to David Albert Jones, this distinction appeared among Christian writers only in the late fourth and early fifth century, while the earlier writers made no distinction between formed and unformed, a distinction that Saint Basil of Caesarea explicitly rejected. While the Hebrew text of the Bible only required a fine for the loss of a fœtus, whatever its stage of development, the Greek Septuagint (LXX) translation of the Hebrew text, a pre-Christian translation that the early Christians used, introduced a distinction between a formed and an unformed fœtus and treated destruction of the former as murder. It has been commented that "the LXX could easily have been used to distinguish human from non-human fœtuses and homicidal from non-homicidal abortions, yet the early Christians, until the time of Augustine in the fifth century, did not do so."

The view of early Christians on the moment of ensoulment is also said to have been not the Aristotelian, but the Pythagorean:

As early as the time of Tertullian in the third century, Christianity had absorbed the Pythagorean Greek view that the soul was infused at the moment of conception. Though this view was confirmed by St. Gregory of Nyssa a century later, it would not be long before it would be rejected in favour of the Septuagintal notion that only a formed fœtus possessed a human soul. While Augustine speculated whether "animation" might be present prior to formation, he determined that abortion could only be defined as homicide once formation had occurred. Nevertheless, in common with all early Christian thought, Augustine condemned abortion from conception onward.

Through the Latin translations of Averroes's (1126–1198) work, beginning in the 12th century, the legacy of Aristotle was recovered in the West. Christian philosophers such as Thomas Aquinas (1224–1274) adapted largely to his views and because they believed that the early embryo did not have a human soul, they did not necessarily see early abortion as murder, although they condemned it nonetheless. Aquinas, in his main work, the Summa Theologica, states (Part I, question 118, article 2 ad 2)"…that the intellectual soul is created by God at the end of human generation". Although Jesus may have been exceptional, Aquinas did believe that the embryo first possessed a vegetative soul, later acquired sensitive (animal) soul, and after 40 days of development, God gave humans a rational soul.

In 1588, Pope Sixtus V issued the Bull Effraenatam, which subjected those that carried out abortions at any stage of gestation with automatic excommunication and the punishment by civil authorities applied to murderers. Three years later after finding that the results had not been as positive as was hoped, his successor Pope Gregory XIV limited the excommunication to abortion of a formed fœtus.

In 1679, Pope Innocent XI publicly condemned sixty-five propositions taken chiefly from the writings of Escobar, Suarez and other casuists (mostly Jesuit casuists who had been heavily attacked by Pascal in his Provincial Letters) as propositiones laxorum moralistarum (propositions of lax moralists) as "at least scandalous and in practice dangerous". He forbade anyone to teach them under penalty of excommunication. The condemned propositions included:

34. It is lawful to procure abortion before ensoulment of the fetus lest a girl, detected as pregnant, be killed or defamed.

35. It seems probable that the fetus (as long as it is in the uterus) lacks a rational soul and begins to first have one when it is born and consequently it must be said that no abortion is homicide.

In the 1869 Bull Apostolicae Sedis, Pius IX rescinded Gregory XIV's not-yet-animated fetus exception and re-enacted the penalty of excommunication for abortions at any stage of pregnancy, which even before that were never seen as merely venial sin. Since then, canon law makes no distinction as regards excommunication between stages of pregnancy at which abortion is performed.

In spite of the difference in ecclesiastical penalties imposed during the period when the theory of delayed ensoulment was accepted as scientific truth, abortion at any stage is currently claimed to have always been condemned by the Church and continues to be so. However, in its official declarations, the Catholic Church avoids taking a philosophical position on the question of the moment when a human person begins to be:

This Congregation is aware of the current debates concerning the beginning of human life, concerning the individuality of the human being and concerning the identity of the human person. The Congregation recalls the teachings found in the Declaration on Procured Abortion: "From the time that the ovum is fertilized, a new life is begun which is neither that of the father nor of the mother; it is rather the life of a new human being with his own growth. It would never be made human if it were not human already. To this perpetual evidence ... modern genetic science brings valuable confirmation. It has demonstrated that, from the first instant, the programme is fixed as to what this living being will be: a man, this individual-man with his characteristic aspects already well determined. Right from fertilization is begun the adventure of a human life, and each of its great capacities requires time ... to find its place and to be in a position to act". This teaching remains valid and is further confirmed, if confirmation were needed, by recent findings of human biological science which recognize that in the zygote resulting from fertilization the biological identity of a new human individual is already constituted. Certainly no experimental datum can be in itself sufficient to bring us to the recognition of a spiritual soul; nevertheless, the conclusions of science regarding the human embryo provide a valuable indication for discerning by the use of reason a personal presence at the moment of this first appearance of a human life: how could a human individual not be a human person? The Magisterium has not expressly committed itself to an affirmation of a philosophical nature, but it constantly reaffirms the moral condemnation of any kind of procured abortion. This teaching has not been changed and is unchangeable.

Citing the possibly first-century Didache and the Letter of Barnabas of about the same period, the Epistle to Diognetus and Tertullian, the Catholic Church declares that "since the first century the Church has affirmed the moral evil of every procured abortion. This teaching has not changed and remains unchangeable. Direct abortion, that is to say, abortion willed either as an end or a means, is gravely contrary to the moral law."

Even when the prevailing scientific theory considered that early abortion was the killing of what was not yet a human being, the condemnation of abortion at any stage was sometimes expressed in the form of making it equivalent to homicide. Accordingly, the 1907 article on abortion in the Catholic Encyclopedia stated:

The early Christians are the first on record as having pronounced abortion to be the murder of human beings, for their public apologists, Athenagoras, Tertullian, and Minutius Felix (Eschbach, "Disp. Phys.", Disp. iii), to refute the slander that a child was slain, and its flesh eaten, by the guests at the Agapæ, appealed to their laws as forbidding all manner of murder, even that of children in the womb. The Fathers of the Church unanimously maintained the same doctrine. In the fourth century the Council of Eliberis decreed that Holy Communion should be refused all the rest of her life, even on her deathbed, to an adulteress who had procured the abortion of her child. The Sixth Ecumenical Council determined for the whole Church that anyone who procured abortion should bear all the punishments inflicted on murderers. In all these teachings and enactments no distinction is made between the earlier and the later stages of gestation. For, though the opinion of Aristotle, or similar speculations, regarding the time when the rational soul is infused into the embryo, were practically accepted for many centuries still it was always held by the Church that he who destroyed what was to be a man was guilty of destroying a human life.

The Catechism of the Catholic Church states that Human life "must be treated from conception as a person." Thomas P. Rausch states,"Although the church has not determined officially when human life actually begins, it has taken the course of maintaining that human life is present from the moment of conception or fertilization." On the other hand, Carol A. Tauer states,”Such speculations have arisen within the context of an authoritative Church teaching: the Catholic Church, in its official magisterium, asserts that human life must be given equal protection at all stages from fertilization through adulthood.”

Catholicism

On 27 November 2010, Pope Benedict XVI stated

"from the moment of its conception life must be guarded with the greatest care." [...] With regard to the embryo in the mother's womb, science itself highlights its autonomy, its capacity for interaction with the mother, the coordination of biological processes, the continuity of development, the growing complexity of the organism.

It is not an accumulation of biological material but rather of a new living being, dynamic and marvelously ordered, a new individual of the human species. This is what Jesus was in Mary's womb; this is what we all were in our mother's womb.

At the same time, the Catholic teaching has acknowledged that we do not know when the embryo, which is a human "being", becomes a human "person" (called philosophically "ensoulment"). And probabilism may not be used where the life of a human person may be involved, and so the human being must be treated as a person from conception. In relation to elective abortion, Pope John Paul II wrote about ensoulment in his 1995 encyclical letter Evangelium Vitae that:

Throughout Christianity's two thousand year history, this same doctrine of condemning all direct abortions has been constantly taught by the Fathers of the Church and by her Pastors and Doctors. Even scientific and philosophical discussions about the precise moment of the infusion of the spiritual soul have never given rise to any hesitation about the moral condemnation of abortion.

While the Church has always condemned abortion, changing beliefs about the moment the embryo gains a human soul have led their stated reasons for such condemnation and the classification of abortion within canon law codes to change over time.

Baptists

The Southern Baptist Convention teaches that ensoulment occurs at conception. Resolution 7, which was adopted by the Southern Baptist Convention in 1999, declared that "The Bible teaches that human beings are made in the image and likeness of God (Genesis 1:27, 9:6) and protectable human life begins at fertilization."

Eastern Orthodoxy

The Orthodox Church while not having dogmatised either Traducianism or Creationism (of the soul), follows the fathers who, either Traducianist or Creationist, believe that the embryo possess a soul from conception.

For example, they accept the In Trullo Cannon, which contains the canons of St Basil of Cesarea, which states that the canonical punishment for abortion is the one for murder, regardless of the development of the embryo (Canon 2 of St Basil, in the letter to Amphiloque of Iconium, in the Pedalion).

Judaism

Jewish views on ensoulment have varied. Rabbi David Feldman states that the Talmud discusses the time of ensoulment, but considers the question unanswerable and irrelevant to the abortion question. In recounting a purported conversation in which the rabbi Judah the Prince, who said the soul (neshama) comes into the body when the embryo is already formed, was convinced by Antoninus Pius that it must enter the body at conception, and considered the emperor's view to be supported by Job 10:12, the tractate Sanhedrin of the Talmud mentions two views on the question.

In a variant reading the rabbi's first statement was that the soul entered the body only at birth.

Other passages in the Talmud, such as Yevamot 69a and Nidda 30b have been interpreted as implying that ensoulment may occur only after forty days of gestation. The Talmud passages, whether speaking of ensoulment at conception or only after forty days, place the views of the rabbis within Greco-Roman culture, whose ideas the rabbis then linked with texts of Scripture and endowed with theological significance.

The view of ensoulment at conception harmonizes with general lore among rabbis about conscious activity before birth. However, most of them did not apply the word nefesh, meaning soul or person, to a fetus still in the womb. The latter half of the Second Temple period saw increasing acceptance of the idea of the soul as joining the body at birth and leaving it again at death.

One Jewish view put ensoulment even later than birth, saying that it occurs when the child first answers "Amen".

The rabbis in fact formulated no fully developed theory of the timing or nature of ensoulment. It has been suggested that the reason why they were not more concerned about the exact moment of ensoulment is that Judaism does not believe in strict separation of soul and body.

Islam

There are four Sunni Islam schools of thought — Hanafi, Shafi‘i, Hanbali and Maliki — and they have their own views on ensoulment, with differing implications.

Two passages in the Qur'an describe the fetal development process:

We created man from an essence of clay, then We placed him as a drop of fluid (nutfah) in a safe place, then We made that drop into a clinging form (alaqah), and We made that form into a lump of flesh (mudghah), and We made that lump into bones (idhaam), and We clothed those bones with flesh (lahm), and later We made him into other forms—glory be to God, the best of creators! (23:12-14)

...We created you from dust, then from a drop of fluid (nutfah), then a clinging form ('alaqah), then a lump of flesh (mudghah), both shaped and unshaped: We mean to make Our power clear to you. Whatever We choose We cause to remain in the womb for an appointed time, then We bring you forth as infants and then you grow and reach maturity. ... (22:5)

The Maliki madhhab holds "that the fetus is ensouled at the moment of conception" and thus "most Malikis do not permit abortion at any point, seeing God's hand as actively forming the fetus at every stage of development." In this view,

The generally accepted belief is that abortion is forbidden at any stage of a pregnancy on the basis of the following verses from the Qur’an.

“….. And do not kill the soul which God has forbidden except for the requirements of justice……” [Glorious Qur’an, Al- An’am 8: 151].

Thus, the termination of a pregnancy, even at the earliest possible stage, without medical justification is not allowed (even for social or economic reasons), as stated in the Glorious Qur’an:

“… do not Kill your children for fear of want: We shall provide sustenance for them as well as for you. Verily the killing of them is a great sin.” [Glorious Qur’an, Al- Esraa’ 15: 31].

The Hanafi madhab places the point of ensoulment at 120 days after conception and a minority opinion teaches that it occurs at 40 days. In the latter view, abortion after 40 or 120 days is considered to be a greater sin.

“Verily, the creation of one of you is brought together in the mother’s womb for forty days in the form of a drop (nutfah), then he becomes a clot ('alaqah) for a like period, then a lump for a like period, then there is sent an angel who blows the soul into him.”

— Hadith #4, Imam al-Nawawī’s Forty Hadith, Ibn Hajar al-Haytamī, al-Fath al-mubīn bi sharh al-arba'īn

Most schools of thought, traditional and modern, make allowances for circumstances threatening the health or life of the mother. In 2003, Shia scholars in Iran approved therapeutic abortion before 16 weeks of gestation under limited circumstances, including medical conditions related to fetal and maternal health.

Hinduism

Some Hindus believe that personhood begins with the reincarnation that happens at conception. But many scriptural references such as the Charaka Samhita, Ayurveda’s most authoritative treatise on perfect health and longevity, states the soul doesn’t become attached to the body until the 7th month “the occupant doesn’t move into the house until the house is finished”, certainly not in the first trimester. The physical body is a biological growth undergoing constant reflexive testing and trial runs as it grows into a physiology capable of housing human consciousness. But the flexibility of Hinduism allows for destruction of embryos to save a human life, or embryonic stem cell research to benefit humankind using surplus blastocysts from fertility clinics.

Bahá'í Faith

In a letter written on behalf of Shoghi Effendi dated October 9, 1947 (Lights of Guidance # 1699), it is stated: "The soul or spirit of the individual comes into being with the conception of his physical body."

Islam and abortion

From Wikipedia, the free encyclopedia

Muslim views on abortion are shaped by Hadith (the words, actions, and the silent approval of the Islamic prophet Muhammad as transmitted through chains of narrators), as well as by the opinions of legal and religious scholars and commentators. The Quran does not directly address intentional abortion, leaving greater discretion to the laws of individual countries. Although opinions among Islamic scholars differ over when a pregnancy can be terminated, there are no explicit prohibitions on a woman's ability to abort under Islamic law.

Each of the four Sunni Islam schools of thought—Hanafi, Shafi‘i, Hanbali and Maliki— have their own reservations on if and when abortions are permissable in Islam. The Maliki madhhab holds "that the fetus is ensouled at the moment of conception" and thus "most Malikis do not permit abortion at any point, seeing God's hand as actively forming the fetus at every stage of development." On the other hand, some Hanafi scholars believe that abortion before the hundred twenty day period is over is permitted, though some Hanafi scholars teach that an abortion within 120 days is makruh (disapproved, i.e. discouraged). All Islamic schools of thought agree abortion is recommended when the mother's life is in danger, because the mother's life is paramount. Sahih al-Bukhari (book of Hadith) writes that the fetus is believed to become a living soul after 120 days' gestation.

In Shia Islam, abortion is "forbidden after implantation of the fertilised ovum." The leader of the Iranian Islamic Revolution, Ayatollah Khomeini declared that shari'a forbids abortion without any reason "even at the earliest possible stage". a position shared by other Shiite scholars.

American academic Azizah Y. al-Hibri claims that "the majority of Muslim scholars permit abortion, although they differ on the stage of fetal development beyond which it becomes prohibited." According to Sherman Jackson, "while abortion, even during the first trimester, is forbidden according to a minority of jurists, it is not held to be an offense for which there are criminal or even civil sanctions."

In the 47 countries of the world with Muslim-majority populations, access to abortion varies greatly. In all, abortion is allowed when the mother's life is at risk. In 18 of the countries, including Iraq, Egypt and Indonesia, this is the only circumstance where abortion is permitted. In another ten countries it is allowed on request. In still others, abortion is permitted under certain circumstances besides preserving the mother's life, such as preserving her mental health, cases of foetal impairment, incest or rape, and social or economic reasons.

History

A majority of scholars during the medieval age viewed 120 days after conception as a crucial dividing line in the development of the fetus -- the time when the fetus became "ensouled" (becomes a living soul), and thus a live human being. Abortion before this point was permissible, according to Islamic law scholar Abed Awad, but afterwards a termination of life. These views towards abortion are still referenced and used by several modern Islamic theologians and scholars.

According to religious studies scholar Zahra Ayubi, historically Muslim thought was more concerned with the topic of preservation of human life and safeguarding of the mother's life, than determining when life begins. Several contemporary Muslim writers have also stated that premodern Islamic scholars were more tolerant on abortion.

The controversial Hanbali jurist Ibn Taymiyyah stated in his fatwa collection Fatawa Ibn Taymiyyah, "Aborting a fetus has been declared unlawful (haram) with the consensus of all the Muslim scholars. It is similar to burying an infant alive as referred to by Allah Almighty in the verse of the Qur’an: 'And when the female infant, buried alive, will be asked as to what crime she was killed for' (Surah al-Takwir, verse 8)".

Hadith and abortion

There were no medical abortions in the time of Muhammad, the Prophet of Islam, but a number of Hadith deal with situations where a pregnant woman lost an unborn child, often by being struck in the belly.

In at least the Hadith mentioned below (all are "sound" Hadith of Sunni Islam), Muhammad, would declare the proper diya (monetary compensation in Islamic law for bodily harm or property damage) for the woman's loss. In each case the compensation was a slave, thus indicating that the value of an unborn child was another human being.

Relevant excerpts

Allah's Messenger gave a verdict regarding an aborted fetus of a woman from Bani Lihyan that the killer (of the fetus) should give a male or female slave (as a Diya) but the woman who was required to give the slave, died, so Allah's Messenger gave the verdict that her inheritance be given to her children and her husband and the Diya be paid by her 'Asaba.

Hadith—Sahih al-Bukhari Book 87, Hadith 47, Narrated Abu Hurairah


Umar consulted the companions about the case of a woman's abortion (caused by somebody else). Al-Mughira said: The Prophet gave the verdict that a male or female slave should be given (as a Diya). Then Muhammad bin Maslama testified that he had witnessed the Prophet giving such a verdict.

Hadith—Sahih Bukhari Book 87, Hadith 44, Narrated Al-Mughira ibn Shu'ba


Umar consulted the people about the compensation of abortion of woman. Al-Mughirah b. Shu'bah said: I was present with the Messenger of Allah when he gave judgement that a male or female slave should testify you. So he brought Muhammad b. Maslamah to him. Harun added: He then testified him.


Abu Dawud said: I have been informed that Abu 'Ubaid said: It (abortion) is called imlas [i.e. a man striking the belly of his wife] because the woman causes it to slip before the time of delivery. Similarly, anything which slips from the hand or from some other thing is called malasa (slipped).

Hadith— Sunan Abi Dawud Book 41, Hadith 77, Narrated Al-Mughira ibn Shu'ba


Umar asked about the decision of the Prophet about that (i.e. abortion). Haml b. Malik b. al-Nabhigah got up and said: I was between two women. One of them struck another with a rolling-pin killing both her and what was in her womb. So the Messenger of Allah gave judgement that the bloodwit for the unborn child should be a male or a female slave of the best quality and then she should be killed.

Abu Dawud said: Al-Nadr b. Shumail said: Mistah means a rolling-pin.

Abu Dawud said: Abu 'Ubaid said: Mistah means a pole from the tent-poles.

Hadith— Sunan Abi Dawud Book 41, Hadith 79, Narrated Ibn-Abbas

Abortion in various schools of thought

Ensoulment

In Sunni Islam, the period when a fetus becomes ensouled can vary within the same madhab even if consensus exists.

  • 120 days after conception. The Hanafi, Shi'is, Zaydi and some Shafi schools view the fetus as being ensouled at 120 days.
  • 80 days. However, other Shafi schools set the ensoulment stage of a fetus at 80 days.
  • 40 days. In the Maliki and Hanbali school of thought, ensoulment is placed at 40 days.
  • Conception. The Ibadi position states that a fetus becomes ensouled right at the time of conception.

Other factors

Most schools consider abortion permissible if the pregnancy poses a physical or psychological harm to the mother. Socio-economic factors or the presence of fetal anomalies is also viewed as justifiable reasons to abort in many schools. However, Islamic jurists in all schools state that abortion is permissible even after the ensoulment stage of a fetus if the mother's life is in danger.

When abortion is permissible

Among Muslims, the permissibility of abortion depends on factors such as time and extenuating circumstances.

In Shia Islam, abortion is "forbidden after implantation of the fertilised ovum." As with other Shiite scholars, Ayatollah Khomeini declared that "Termination of pregnancy even at the earliest possible stage under normal circumstances without any reason is not allowed" and that "The shari'a does not permit the abortion of a fetus."

The four Sunni schools of thought have differing perspectives in which parts of gestation where abortion is permissible. It is important to note that Malikites do not permit abortion in any of the stages of gestation.

Before four months of gestation

Sayyid al-Sabiq, author of Fiqh al-Sunnah, has summarized the views of the classical jurists in this regard in the following words:

Abortion is not allowed after four months have passed since conception because at that time it is akin to taking a life, an act that entails penalty in this world and in the Hereafter. As regards the matter of abortion before this period elapses, it is considered allowed if necessary. However, in the absence of a reasonable excuse it is detestable [a legal category meaning discouraged but not forbidden]. The author of ‘Subul-ul-Maram’ writes: "A woman’s treatment for aborting a pregnancy before the spirit has been blown into it is a matter upon which scholars differed on account of difference of opinion on the matter of ‘Azal (i.e. measures to hinder conception). Those who allow ‘Azal consider abortion as allowable and vice versa." The same ruling should be applicable for women deciding on sterilization. Imam Ghazzali opines: "Induced abortion is a sin after conception". He further says: "The sin incurred thus can be of degrees. When the sperm enters the ovaries, mixes with the ovum and acquires potential of life, its removal would be a sin. Aborting it after it grows into a germ or a leech would be a graver sin and the graveness of the sin increases very much if one does so after the stage when the spirit is blown into the fetus and it acquires human form and faculties."

Stage 1 Nutfa (Sperm)

This is the stage from conception to 40 days since the semen has fertilized the ovum. In this stage, Hanafites permit abortions, the majority of Shafites permit abortions, some Hanbalites permit it, but Malikites do not.

Among contemporary Sunni scholars, Yasir Qadhi states that abortion may be performed within the first 40 days of pregnancy "for a very legitimate reason", but is prohibited after that period, at which point ensoulment occurs.

Stage 2 Alaqa (Blood Clot)

This is the stage 40-80 days after conception when the fertilized egg has become blood clot-like. In this stage, Hanafites permit abortions, while only some Shafites and Hanbalites permit it.

Stage 3 Mudgha (Embryo)

This is the stage 80-120 days after conception where the blood clot has now formed into flesh. In this stage, Hanafites permit abortions, only some Shafites and Hanbalites permit it.

Stage 4 Khalqan Akhar (Spirit)

This is the stage 120 days after conception when based on Islam a soul/spirit has entered the body. In this stage none of the four schools of thought permit abortions.

Threat to the woman's life

On the issue of the life of the woman, Muslims universally agree that her life takes precedence over the life of the fetus. This is because the woman is considered the "original source of life," while the fetus is only "potential" life. Muslim jurists agree that abortion is allowed based on the principle that "the greater evil [the woman's death] should be warded off by the lesser evil [abortion]." In these cases the physician is considered a better judge than the scholar.

According to the Twelvers, there is consensus among ayatollahs that abortion is allowed only when it is medically proven that the life of a mother is in danger. Other than that, before or after 120 days, abortion is always forbidden, no matter the circumstances (such as problems with the fetus or poverty, etc.).

Rape

Some Muslim scholars have held that the child of rape is a legitimate child and thus it would be sinful to kill this fetus. Scholars permit its abortion only if the fetus is less than four months old, or if it endangers the life of its mother.

When the pregnancy is unplanned and therefore unwanted, as in the case of rape, the parents, [have to/should, as adoption is unlawful] abort the fetus and thus prevent the disgrace that awaits both mother and child. Also, a mother should be able to decide by herself (in consideration with her parents) if she wants to keep the child even if it was born of rape or zina, as it ultimately hurts her the most [..] the child born of rape, like one born of adultery (walad zina) is a more lowly member of society with regard of the rights he or she is guaranteed and the social status he or she can attain.

Muslim scholars were urged to make exceptions in the 1990s following the rape of Bosnian and Albanian women by Serb soldiers. In 1991, the Grand Mufti of Palestine, Ekrima Sa'id Sabri took a different position than mainstream Muslim scholars. He ruled that Muslim women raped by their enemies during the Kosovo War could take abortifacient medicine, because otherwise the children born to those women might one day fight against Muslims.

Fetal deformity

Some Sunni Muslim scholars argue that abortion is permitted if the newborn might be sick in some way that would make its care exceptionally difficult for the parents (e.g. deformities, mental handicaps). Widely quoted is a resolution of the Saudi-led jurisprudence council of Mekkah Al Mukaramah (the Muslim World League) passing a fatwa in its 12th session held in February 1990. This allowed abortion if the fetus was grossly malformed with untreatable severe condition proved by medical investigations and decided upon by a committee formed by competent trustworthy physicians, and provided that abortion is requested by the parents and the foetus is less than 120 days computed from moment of conception.

Abortion in Islamic countries

In all, there are 57 members in the Organization of Islamic Conference—an organisation of countries with Muslim majorities or pluralities. Most Muslim countries have restrictive abortion laws that permit abortions only when the life of the mother is threatened. Twelve members of the Organization of Islamic Conference allow unrestricted access to abortion. With the exception of Turkey and Tunisia, they are mainly former Soviet Bloc states. Bahrain, a politically and socially conservative Muslim state, is the 12th among these countries to permit unrestricted access to abortion. Among socially conservative Muslim countries, seven countries permit abortion in the first 4 months of gestation for fetal deformities, four countries in subSaharan Africa (Benin, Burkina Faso, Chad and Guinea) and three in the Middle East (Kuwait, Qatar and, now, Iran).

Alcohol intoxication

From Wikipedia, the free encyclopedia

Alcohol intoxication
Other namesDrunkenness, ethanol intoxication
Michelangelo drunken Noah.jpg
The Drunkenness of Noah by Michelangelo, 1509
SpecialtyToxicology, psychiatry
SymptomsMild: Mild sedation, decreased coordination
Moderate: Slurred speech, trouble walking, vomiting
Severe: Decreased effort to breathe, coma
ComplicationsSeizures, aspiration pneumonia, injuries, low blood sugar
Usual onsetOver minutes to hours
DurationSeveral hours
CausesEthanol (alcohol)
Risk factorsSocial environment, impulsivity, alcoholism
Diagnostic methodTypically based on history of events and physical examination
Differential diagnosisHepatic encephalopathy, Wernicke encephalopathy, methanol toxicity, meningitis, traumatic brain injury
TreatmentSupportive care
FrequencyVery common (especially in the Western world)
Deathsc. 2,200 per year (U.S.)

Alcohol intoxication, also known as alcohol poisoning, commonly described as drunkenness or inebriation, is the negative behavior and physical effects caused by a recent consumption of alcohol. In addition to the toxicity of ethanol, the main psychoactive component of alcoholic beverages, other physiological symptoms may arise from the activity of acetaldehyde, a metabolite of alcohol. These effects may not arise until hours after ingestion and may contribute to the condition colloquially known as a hangover.

Symptoms of intoxication at lower doses may include mild sedation and poor coordination. At higher doses, there may be slurred speech, trouble walking, and vomiting. Extreme doses may result in a respiratory depression, coma, or death. Complications may include seizures, aspiration pneumonia, injuries including suicide, and low blood sugar. Alcohol intoxication can lead to alcohol-related crime with perpetrators more likely to be intoxicated than victims.

Alcohol intoxication typically begins after two or more alcoholic drinks. Risk factors include a social situation where heavy drinking is common and a person having an impulsive personality. Diagnosis is usually based on the history of events and physical examination. Verification of events by witnesses may be useful. Legally, alcohol intoxication is often defined as a blood alcohol concentration (BAC) of greater than 5.4–17.4 mmol/L (25–80 mg/dL or 0.025–0.080%). This can be measured by blood or breath testing. Alcohol is broken down in the human body at a rate of about 3.3 mmol/L (15 mg/dL) per hour, depending on an individual's metabolic rate (metabolism).

Management of alcohol intoxication involves supportive care. Typically this includes putting the person in the recovery position, keeping the person warm, and making sure breathing is sufficient. Gastric lavage and activated charcoal have not been found to be useful. Repeated assessments may be required to rule out other potential causes of a person's symptoms.

Acute intoxication has been documented throughout history, and alcohol remains one of the world's most widespread recreational drugs. Some religions consider alcohol intoxication to be a sin.

Symptoms

Wine is a Mocker by Jan Steen c. 1663

Alcohol intoxication leads to negative health effects due to the recent drinking of ethanol (alcohol). When severe it may become a medical emergency. Some effects of alcohol intoxication, such as euphoria and lowered social inhibition, are central to alcohol's desirability.

Pathophysiology

Stage Three of the Five stages of inebriation, c. 1863–1868, by Charles Percy Pickering

Alcohol is metabolized by a normal liver at the rate of about 8 grams of pure ethanol per hour. 8 grams or 10 mL (0.34 US fl oz) is one British standard unit. An "abnormal" liver with conditions such as hepatitis, cirrhosis, gall bladder disease, and cancer is likely to result in a slower rate of metabolism.

Ethanol is metabolised to acetaldehyde by alcohol dehydrogenase (ADH), which is found in many tissues, including the gastric mucosa. Acetaldehyde is metabolised to acetate by acetaldehyde dehydrogenase (ALDH), which is found predominantly in liver mitochondria. Acetate is used by the muscle cells to produce acetyl-CoA using the enzyme acetyl-CoA synthetase, and the acetyl-CoA is then used in the citric acid cycle.

As drinking increases, people become sleepy or fall into a stupor. After a very high level of consumption, the respiratory system becomes depressed and the person will stop breathing. Comatose patients may aspirate their vomit (resulting in vomitus in the lungs, which may cause "drowning" and later pneumonia if survived). CNS depression and impaired motor coordination along with poor judgment increase the likelihood of accidental injury occurring. It is estimated that about one-third of alcohol-related deaths are due to accidents and another 14% are from intentional injury.

In addition to respiratory failure and accidents caused by its effects on the central nervous system, alcohol causes significant metabolic derangements. Hypoglycaemia occurs due to ethanol's inhibition of gluconeogenesis, especially in children, and may cause lactic acidosis, ketoacidosis, and acute kidney injury. Metabolic acidosis is compounded by respiratory failure. Patients may also present with hypothermia.

Mechanism

In the past, alcohol was believed to be a non-specific pharmacological agent affecting many neurotransmitter systems in the brain. However, molecular pharmacology studies have shown that alcohol has only a few primary targets. In some systems, these effects are facilitatory, and in others inhibitory.

Among the neurotransmitter systems with enhanced functions are: GABAA, 5-HT3 receptor agonism (responsible for GABAergic (GABAA receptor PAM), glycinergic, and cholinergic effects), nicotinic acetylcholine receptors.

Among those that are inhibited are: NMDA, dihydropyridine-sensitive L-type Ca2+ channels and G-protein-activated inwardly rectifying K+ channels.

Alcohol is also converted into phosphatidylethanol (a lipid metabolite) by phospholipase D2, and this metabolite has been shown to directly bind to and regulate ion channels. The result of these direct effects is a wave of further indirect effects involving a variety of other neurotransmitter and neuropeptide systems, leading finally to the behavioural or symptomatic effects of alcohol intoxication.

The order in which different types of alcoholic beverages are consumed ("Grape or grain but never the twain" and "Beer before wine and you'll feel fine; wine before beer and you'll feel queer") does not have any effect.

GABAA receptors

Ethanol binding to GABAA receptor

Many of the effects of activating GABAA receptors have the same effects as that of ethanol consumption. Some of these effects include anxiolytic, anticonvulsant, sedative, and hypnotic effects, cognitive impairment, and motor incoordination. This correlation between activating GABAA receptors and the effects of ethanol consumption have led to the study of ethanol and its effects on GABAA receptors. It has been shown that ethanol does in fact exhibit positive allosteric binding properties to GABAA receptors. However, its effects are limited to pentamers containing the δ-subunit rather than the γ-subunit. GABAA receptors containing the δ-subunit have been shown to be located exterior to the synapse and are involved with tonic inhibition rather than its γ-subunit counterpart, which is involved in phasic inhibition. The δ-subunit has been shown to be able to form the allosteric binding site which makes GABAA receptors containing the δ-subunit more sensitive to ethanol concentrations, even to moderate social ethanol consumption levels (30mM). While it has been shown by Santhakumar et al. that GABAA receptors containing the δ-subunit are sensitive to ethanol modulation, depending on subunit combinations receptors could be more or less sensitive to ethanol. It has been shown that GABAA receptors that contain both δ and β3-subunits display increased sensitivity to ethanol. One such receptor that exhibits ethanol insensitivity is α3-β6-δ GABAA. It has also been shown that subunit combination is not the only thing that contributes to ethanol sensitivity. Location of GABAA receptors within the synapse may also contribute to ethanol sensitivity.

Diagnosis

Alcohol intoxication is described as a mental and behavioural disorder by the International Classification of Diseases. (ICD-10). Definitive diagnosis relies on a blood test for alcohol, usually performed as part of a toxicology screen. Law enforcement officers in the United States and other countries often use breathalyzer units and field sobriety tests as more convenient and rapid alternatives to blood tests. There are also various models of breathalyzer units that are available for consumer use. Because these may have varying reliability and may produce different results than the tests used for law-enforcement purposes, the results from such devices should be conservatively interpreted.

Many informal intoxication tests exist, which, in general, are unreliable and not recommended as deterrents to excessive intoxication or as indicators of the safety of activities such as motor vehicle driving, heavy equipment operation, machine tool use, etc.

For determining whether someone is intoxicated by alcohol by some means other than a blood-alcohol test, it is necessary to rule out other conditions such as hypoglycemia, stroke, usage of other intoxicants, mental health issues, and so on. It is best if their behavior has been observed while the subject is sober to establish a baseline. Several well-known criteria can be used to establish a probable diagnosis. For a physician in the acute-treatment setting, acute alcohol intoxication can mimic other acute neurological disorders or is frequently combined with other recreational drugs that complicate diagnosis and treatment.

Management

Acute alcohol poisoning is a medical emergency due to the risk of death from respiratory depression or aspiration of vomit if vomiting occurs while the person is unresponsive. Emergency treatment strives to stabilize and maintain an open airway and sufficient breathing while waiting for the alcohol to metabolize. This can be done by removal of any vomit or, if the person is unconscious or has impaired gag reflex, intubation of the trachea.

Other measures may include

  • Administer the vitamin thiamine to prevent Wernicke–Korsakoff syndrome, which can cause a seizure (more usually a treatment for chronic alcoholism, but in the acute context usually co-administered to ensure maximal benefit).
  • Hemodialysis if the blood concentration is very high at >130  mmol/L (>600 mg/dL)
  • Provide oxygen therapy as needed via nasal cannula or non-rebreather mask.
  • Treat low blood sugar, with intravenous sugar solutions as ethanol-induced low blood sugar unresponsive to glucagon.
  • While the medication metadoxine may speed the breakdown of alcohol, use in alcohol intoxication requires further study as of 2017. It is approved in a number of countries in Europe, as well as India and Brazil.

Additional medication may be indicated for treatment of nausea, tremor, and anxiety.

Clinical findings

Hospital admissions

Alcohol intoxication was found to be prevalent in clinical populations within the United States involving people treated for trauma and in the age group of people aged within their 18th - 24th years (in a study of a group for the years 1999 - 2004). In the United States during the years 2010 - 2012, acute intoxication was found to be the direct cause of an average of 2,221 deaths, in the sample group of those aged within their 15th year or older. The same mortality route is thought to cause indirectly more than 30,000 deaths per year.

Prognosis

A normal liver detoxifies the blood of alcohol over a period of time that depends on the initial level and the patient's overall physical condition. An abnormal liver will take longer but still succeeds, provided the alcohol does not cause liver failure.

People having drunk heavily for several days or weeks may have withdrawal symptoms after the acute intoxication has subsided.

A person consuming a dangerous amount of alcohol persistently can develop memory blackouts and idiosyncratic intoxication or pathological drunkenness symptoms.

Long-term persistent consumption of excessive amounts of alcohol can cause liver damage and have other deleterious health effects.

Society and culture

A 1936 anti-drinking poster by Aart van Dobbenburgh

Alcohol intoxication is a risk factor in some cases of catastrophic injury, in particular for unsupervised recreational activity. A study in the province of Ontario based on epidemiological data from 1986, 1989, 1992, and 1995 states that 79.2% of the 2,154 catastrophic injuries recorded for the study were preventable, of which 346 (17%) involved alcohol consumption. The activities most commonly associated with alcohol-related catastrophic injury were snowmobiling (124), fishing (41), diving (40), boating (31) and canoeing (7), swimming (31), riding an all-terrain vehicle (24), and cycling (23).[48] These events are often associated with unsupervised young males, often inexperienced in the activity, and may result in drowning. Alcohol use is also associated with unsafe sex.

Legal issues

A drunk-driving simulator in Montreal

Laws on drunkenness vary. In the United States, it is a criminal offense for a person to be drunk while driving a motorized vehicle, except in Wisconsin, where it is only a fine for the first offense. It is also a criminal offense to fly an aircraft or (in some American states) to assemble or operate an amusement park ride while drunk. Similar laws also exist in the United Kingdom and most other countries.

In some countries, it is also an offense to serve alcohol to an already-intoxicated person, and, often, alcohol can be sold only by persons qualified to serve responsibly through alcohol server training.

The blood alcohol content (BAC) for legal operation of a vehicle is typically measured as a percentage of a unit volume of blood. This percentage ranges from 0.00% in Romania and the United Arab Emirates; to 0.05% in Australia, South Africa, Germany, Scotland, and New Zealand (0.00% for underage individuals); to 0.08% in England and Wales, the United States and Canada.

The United States Federal Aviation Administration prohibits crew members from performing their duties within eight hours of consuming an alcoholic beverage, while under the influence of alcohol, or with a BAC greater than 0.04%.

In the United States, the United Kingdom, and Australia, public intoxication is a crime (also known as "being drunk and disorderly" or "being drunk and incapable").

In some countries, there are special facilities, sometimes known as "drunk tanks", for the temporary detention of persons found to be drunk.

Religious views

Christianity

Some religious groups permit the consumption of alcohol; some permit consumption but prohibit intoxication; others prohibit any amount of alcohol consumption altogether. Many denominations of Christianity, such as Catholicism, Orthodoxy and Lutheranism, use wine as a part of the Eucharist and permit its consumption, but consider it sinful to become intoxicated.

In the Bible, the Book of Proverbs contains several chapters related to the negative effects of drunkenness and warns to stay away from intoxicating beverages. The Book of Genesis refers to the use of wine by Lot's daughters to rape him. The Book of Leviticus tells the story of Nadab and Abihu, the eldest sons of Aaron, who were killed for serving in the Temple in Jerusalem after drinking wine, presumably while intoxicated. It continues to discuss monasticism, in which drinking wine is prohibited. The story of Samson in the Book of Judges tells of a monk from the Israelite tribe of Dan who is prohibited from cutting his hair and drinking wine. Romans 13:13–14, 1 Corinthians 6:9–11, Galatians 5:19–21 and Ephesians 5:18 are among a number of other Bible passages that speak against intoxication. While Proverbs 31:4 warns against kings and other rulers drinking wine and similar alcoholic beverages, Proverbs 31:6–7 promotes giving such beverages to the perishing and wine to those whose lives are bitter as a coping mechanism against the likes of poverty and other troubles.

Some Protestant Christian denominations prohibit the consumption of alcohol based upon biblical passages that condemn drunkenness, but others allow a moderate rate of consumption.

In the Church of Jesus Christ of Latter-day Saints, alcohol consumption is forbidden, and teetotalism has become a distinguishing feature of its members. Jehovah's Witnesses allow moderate alcohol consumption among its members.

Islam

In the Quran, there is a prohibition on the consumption of grape-based alcoholic beverages, and intoxication is considered an abomination in the hadith of Muhammad. The schools of thought of Islamic jurisprudence have interpreted this as a strict prohibition of the consumption of all types of alcohol and declared it to be haram (lit.'forbidden [in Islam]'), although other uses may be permitted.

Buddhism

In Buddhism, in general, the consumption of intoxicants is discouraged for both monastics and lay followers. Many Buddhists observe a basic code of ethics known as the five precepts, of which the fifth precept is an undertaking to refrain from the consumption of intoxicating substances (except for medical reasons). In the bodhisattva vows of the Brahmajala Sutra, observed by Mahayana Buddhist communities, distribution of intoxicants is likewise discouraged, as well as consumption.

Hinduism

In the Gaudiya Vaishnavism branch of Hinduism, one of the four regulative principles forbids the taking of intoxicants, including alcohol.

Judaism

Drunken Lot and his daughters, from an illustrated Torah

In Judaism, in accordance with the biblical stance against drinking, wine drinking is not permitted for priests and monks. The biblical command to sanctify the Sabbath and other holidays has been interpreted as having three ceremonial meals with wine or grape juice, known as Kiddush. A number of Jewish marriage ceremonies end with the bride and groom drinking a shared cup of wine after reciting seven blessings; this occurs after a fasting day in some Ashkenazi traditions. It has been customary and in many cases even mandated to drink moderately so as to stay sober, and only after the prayers are over.

During the Seder on Passover, there is an obligation to drink four ceremonial cups of wine while reciting the Haggadah. It has been assumed as the source of the wine-drinking ritual at communion in some Christian groups. During Purim, there is an obligation to become intoxicated; however, as with many other decrees, this has been avoided in many communities by allowing sleep during the day as a replacement.

During the U.S. Prohibition era in the 1920s, a rabbi from the Reform Judaism movement proposed using grape juice for the ritual instead of wine. Although refuted at first, the practice became widely accepted by orthodox Jews as well.

Other animals

In the movie Animals are Beautiful People, an entire section was dedicated to showing many different animals including monkeys, elephants, hogs, giraffes, and ostriches, eating over-ripe marula tree fruit causing them to sway and lose their footing in a manner similar to human drunkenness. Birds may become intoxicated with fermented berries and some die colliding with hard objects when flying under the influence.

In elephant warfare, practiced by the Greeks during the Maccabean revolt and by Hannibal during the Punic wars, it has been recorded that the elephants would be given wine before the attack, and only then would they charge forward after being agitated by their driver.

It is a regular practice to give small amounts of beer to race horses in Ireland. Ruminant farm animals have natural fermentation occurring in their stomach, and adding alcoholic beverages in small amounts to their drink will generally do them no harm, and will not cause them to become drunk.

Alcoholic beverages are extremely harmful to dogs, and often for reasons of additives such as xylitol, an artificial sweetener in some mixers. Dogs can absorb ethyl alcohol in dangerous amounts through their skin as well as through drinking the liquid or consuming it in foods. Even fermenting bread dough can be dangerous to dogs. In 1999, one of the royal footmen for Britain's Queen Elizabeth II was demoted from Buckingham Palace due to his "party trick" of spiking the meals and drinks of the Queen's pet corgi dogs with alcohol which in turn would lead the dogs to run around drunk.

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