Fasting: Unto Life and Until Death

The month of Ramadan is drawing to a close. During this time, Muslims from every terrain, from the hottest countries, to the most Westernised societies, have been involved in a shared yet equally an exclusive passage of religious rites.

Ramadan is a unique time in the Islamic year. For a period of one month, the spiritual attire of a pious Muslim is found in the exercise of fasting. With the exception of the sick, a Muslim is forbidden to eat or drink during the hours between sunrise and sundown.

The routine is one that involves the highest degrees of self-discipline and control. Through such rituals, there becomes a higher degree and awareness of spirituality. With the removal of a conscious acknowledgement of bodily needs, there is space for reflection and prayer. However, the object of effect is the human body. Awareness of the soul can be attained only through the regulation of the human body. Thus, there is almost a paradoxical relationship between the body and the soul during fasting.

Ramadan also signifies symbolic moments for prayer, whereby the gates to heaven are said to be open and Shaitaan, of hell, is in chains. There are special prayers held during the night, adding an element of sleep deprivation to the state of starvation.

Of course, the human body prevails and exists, and even with the announcement of the soul, there is consequently a vulnerability that creeps in and the fasting Muslim may be subject to medical ailments. These include changes in blood sugar levels, fainting, and dehydration. In addition to food and drink, all oral products are prohibited, including medications.

One of the ways modern medicine has been of aid to fasting Muslims is through the introduction of drugs with half lives, which do not require frequent doses. In addition, skin patches of certain medications, particularly for blood pressure regulation, can be used and negate the need for oral medication.

The views on Ramadan tend to concentrate on the spiritual side of the act of fasting. Yet, the body is still an entity of our being and existence.

The fusion between contemporary medicine and ancient religious practices illustrate the delicate nature of our interpretation of what it means to be human. By minimising the role of the human body, Ramadan serves the purpose of  integrating the Creator into creation in order to expose life in its rawest form.

Yet, the same act that is used to bring forth the experience of life, is also used to bring forth death.

In Jainism, one of the practices is Sallekhana. In direct opposition to the goals of Ramadan, Sallekhana is a process of fasting for the sick who are nearing death.

The procedure is undertaken when a person is facing terminal illness. Sallekhana is a method of fasting, unto death is reached. Thus, it is often described as a religious form of suicide. The Jain religion, however, completely distinguishes Sallekhana from suicide. Sallekhana is considered to be a spiritual enterprise, where the end of our ascetic being is drawn to a close. Suicide, on the other hand, results from anger, despair, and depression.

Sometimes, the reminder of our cultural relativity serves a role that does not have to lead us into the problematic objectivity of reasoning what are the right and wrong-doings of human behaviour. Rather, the extent to which the integration of death fits into our daily lives is a familiarity throughout all societies. Even though the nature of how death is interpreted into life is part of an intricate cosmos of ancient beliefs, bound within the identity of a people’s religion, environment, language, societal hierarchy and traditions, it is still a facet of human kind that we are persons of life, and of death.

Sallekhana is a significant cultural enterprise because of the way it resonates with discourses on euthanasia.

Contemporary medicine, in the “West”, has formed a strange alliance between life and death. On the one hand, medical techniques venture into the human body in an unprecedented way, allowing us to perceive parts of our body and physiological make-up that we could never hope to envision in any other manner, and most definitely not through the naked eye. Contemporary medicine is also able to sustain life beyond previous boundaries that saw life inevitably terminated and becoming death. Yet, on the other hand, contemporary medicine is increasingly becoming challenged about death, or, more specifically, about the nature of our dying.

Medicine is needing to ask of itself how to define death, when life is able to be artificially supported? Moreover, how is contemporary medicine expected to treat the dying patient? If a cure is not possible to a specific disease or illness or form of suffering then is medicine redundant? It seems that the rise of euthanasia support and some legislations in the Netherlands, or Switzerland, to permit the practice of euthanasia, that death is being managed in a certain way.

Sallekhana confronts the inevitably of death but it does not attempt to hasten death. The effect that death is brought about, and could be caused, or at least facilitated, from starvation is a process of preparation from death.

In all of these strands of life and of death; Ramadan, Sallekhana, euthanasia, contemporary medicine, there is a display of the facets of our human nature.

This display contain numerous colours. We experience its art in many forms.

Yet, the foundation, the canvas on which our suffering and our healing is presented, begins first and foremost with our fallibility as human beings.

For medicine to function, its role needs to exist on a fundamental level, in the veins of where the source of being human flows. This is ultimately a body of life and of death. Perhaps, then, medicine’s strength is belied by our vulnerability, which is not to cure death, not to enhance life, but to treat and recognize that our cultural, religious, or aesthetic practices are not individual enterprises but part of the fabric of medicine, which surely is to tend to the human condition.