Royal address by Sultan Nazrin Muizzuddin Shah at the book launch of 'Islam and Biomedicine'

1. It gives me great pleasure to be here with you all today to celebrate the launch of Islam and Biomedicine, edited by Malaysia’s own Oxford Muslim theologian, Dato’ Dr Afifi al-Akiti, in collaboration with physician, Dr A.I. Padela, from the University of Chicago. This remarkable collection of thirteen essays in the world-famous Philosophy and Medicine series is a masterclass in interdisciplinary scholarship. Bringing together the discourses of science, medicine, theology and philosophy, these essays demonstrate the richness and the new perspectives that can be achieved by placing these diverse disciplines and world-renowned scholars in conversation.

2. This book is the result of a major scholarly project supported by the Templeton Religion Trust, an organization renowned for its support of the world’s greatest minds, with over USD1.8 billion of funding given since 1984. Its founder, the contrarian investor John Templeton (d. 2008), believed in advancing humanity’s understanding of the profound questions in life. This particular project brings together some of the world’s top Muslim theologians, medics, and intellectual historians. It represents a serious and original attempt to integrate religious, moral and epistemic frameworks, and provides a holistic approach to the bridging of two very different bodies of knowledge: namely, Islam – an ancient religion – and biomedicine – a modern science.

3. The titles of the book’s three sections are indicative of its impressive breadth and erudition. We begin with a historical perspective, looking at early Islamic contributions to medical knowledge in the first section, “From Greek to Islamic Conceptions of Health and Biomedicine”. In its middle section, “The Meaning of Life and Death”, the collection brings Islamic and medical understandings together in a wide-ranging, existential exploration. And in its final section, “Interfacing Biomedical Knowledge and Islamic Theology”, the book focuses on the intersection between Islamic law and modern science, illuminating areas of convergence and divergence.

4. Across these three sections, it is no exaggeration to say that Islam and Biomedicine explores some of the most fundamental questions facing humankind. What does it mean to be human? When does life begin and end? What roles are played by choice, compassion and faith within the modern sphere of biomedicine? These are questions which matter to all of us, but which we often push to the back of our minds  either because they are too large, too philosophical or difficult to grapple with, or because we are simply too preoccupied with more immediate concerns. I would like to commend Dato’ Dr Afifi for his vision in pursuing these deep and important issues, and want to congratulate every one of his collaborators for their deft, sensitive and illuminating handling of their subject matter.

5. In their introduction to the volume, the editors write that their aim is to “draw sustained attention to the intersection of Islam and biomedicine”, to seek ways in which these two seemingly opposite sources of knowledge – rationality versus revelation – can, and indeed, must work in harmony for the good of humankind. The collection seeks and finds areas of complementarity, ways in which the two discourses – science and religion – can contribute to and learn from one another. This unusual endeavour of bringing ethics, Islamic theology, medicine and science into the same conversation feels extraordinarily timely, for a number of reasons.

6. Though the Covid-19 pandemic began over three years ago, and is no longer a global health emergency, its medical, emotional and societal repercussions continue to be felt the world over. It was a crisis of unprecedented scale – and one for which biomedical scientists, health professionals and governments, initially at least, appeared ill-equipped. The world did mobilize, of course, with lockdowns and travel restrictions imposed to limit the spread of the disease, and vaccines developed at record speed. Indeed, we are very fortunate that Professor Tess Lambe, who helped design the Astra-Zeneca Covid-19 vaccine, has travelled from Oxford to be with us this morning to celebrate the launch of this book.

7. But the need to react so rapidly in the face of crisis left little space to consider the deeper psychological and ethical implications of such an event. Such as, for instance, how to balance an immediate medical threat to one vulnerable group, with the potential longer-term mental health impact on another? Or to consider what room is left for individual agency when mass collective action is necessary to overcome a major health emergency? Or how to make decisions in circumstances where the more compassionate course of action may also be the one that potentially promotes the spread of a deadly disease?

8. So while we might now be better prepared, in logistical terms, for future health emergencies, I do not believe our global community is yet fully capable of addressing fundamental ethical questions like these. And it is in areas such as this that the work and thinking presented in Islam and Biomedicine can make such an important contribution. Here, we find essays on the tension between medical determinism and Islam’s conception of the human as a free moral agent. We have explorations of holistic and atomistic approaches to human health, and the different perspectives offered by each. And we have, throughout, a sustained interrogation of the question of what human life is, and why it matters. These essays, in other words, model for us a way of thinking through difficult moral questions, to which medicine, faith and compassion may all give differing answers. The world needs much more of this thoughtful, collaborative, and ethical exploration if it is to prepare itself effectively for the global health challenges of the future.

9. In its consideration of such fundamental questions about the nature of human life, Islam and Biomedicine also intersect in significant ways with an even more recent – and no less seismic – development on the world stage. I am talking, of course, about the impressive advances made in generative Artificial Intelligence technology with the launch late last year of ChatGPT, along with similar highly advanced AI models. AI has rarely been out of the headlines since, with momentous advances it enables being welcomed and celebrated, especially in the medical field. In recent weeks alone, we have heard how AI can help match patients with more tailored and therefore effective treatments; how it can cut radiotherapy treatment times; and how it can speed up the discovery of new antibiotics for tackling superbugs. There is even talk of an AI-powered medical revolution, with rapid, life-saving advances in diagnosis and treatment.

10. But, for every article celebrating the potential of AI to benefit humankind, there are others decrying its dangers. AI, it is feared, will displace huge numbers of jobs, sending shockwaves through the economy of a kind not seen since the First Industrial Revolution in the nineteenth century. Its extraordinary ability to generate text and images almost instantaneously poses a threat to creativity and how it is defined, raising challenging questions about intellectual property rights and the value of the human imagination. Many of the much-heralded medical breakthroughs I just mentioned are also not without their ethical complications, including again those concerning rights over data. And what happens when an AI gets it wrong, as we have seen play out in various sci-fi movies, such as the sentient supercomputer HAL in Stanley Kubrick’s classic film, 2001: A Space Odyssey, or even the hostile AI Skynet in James Cameron’s box-office hit, The Terminator?

11. At the heart of all these fears around AI is a fundamental question about what is unique, what is valuable, and what is sacred, about human consciousness. Across its thirteen chapters, Islam and Biomedicine considers this question again and again, from a range of perspectives. And even beyond that, the book itself is the epitome of everything that AI cannot do. AI can do many things  it can diagnose, prescribe, generate content, collate knowledge  all at superhuman speeds according to the datasets and models on which it is trained. But it cannot reflect. It cannot, as our brilliant human medics and scientists do, look at the data, and then make holistic judgments about the best course of action, taking into account a patient’s physical, mental and emotional wellbeing. Neither can it follow in the footsteps of our wise philosophers, our theologians, our ulama, whose work must often venture far beyond the realms of data.

12. AI machines are not moral beings, able to comprehend ethical nuances and apply compassion to complex situations and decision-making. Only humans can do that. The Qur’an famously declares, as we heard from the beautiful recitation earlier, that even the mountains, the heavens and the earth refused such a burden of trust. No wonder, then, that the Qur’an describes that indescribable uniqueness and mysterious quality of the human consciousness in this memorable passage: ‘They ask you about the human soul (the ruh). Say: “The soul is part of my Lord’s secret. You have only been given a little knowledge”.

13. I see Islam and Biomedicine, then, as a strong testament to humanity, and to the unique contribution humans can and must still make, even as AI expands and accelerates in the years to come. Yet the book is also, I believe, a testament to something else – to something that involves looking not forward, but rather backwards, at the long, symbiotic history that exists between Islam and medicine. For while this book is a model for how science and ethics can intersect in general, it is also, more specifically, a distillation of the way in which Islam and medicine can illuminate and work with one another.

14. After all, Islam and medicine share a long and fruitfully intertwined history. Many of the core foundations upon which scientific and medical practices are still based originated with Muslim scientists, as this book reminds us. Medieval Islamic scholars introduced the concept of control groups in medical experiments, for example, building on the knowledge of their Greek counterparts. In the ninth century, the great Islamic physician al-Razi (d. 925) published treatises that contributed to humanity’s understanding of the then deadly diseases, smallpox and measles. Islamic scientists were the first to observe the efficacy of alcohol as an antiseptic and, in the 13th century, the Muslim physician who was also a famous Islamic theologian, Ibn al-Nafis (d. 1288), described pulmonary circulation  more than 300 years before William Harvey (d. 1657) although it is the English Renaissance anatomist who is generally credited with its discovery.

15. Perhaps most significantly, it was the work of medieval Muslim doctors and scientists that led to the development of hospitals as we recognise them today. In the ninth century, the first Islamic hospitals began admitting patients from all economic backgrounds –irrespective of sex, religion or ethnicity – organizing inpatients into wards by gender and diagnosis.8 This core concept and structure underlies hospital systems around the world to this day. 16. While Islam and Biomedicine is interested in differences of opinion and working through contradictory ideas, therefore, its foundation is very much one of harmony. Islam and medicine, in so many ways, go and always have gone hand-in-hand. Those early medieval Islamic hospitals were funded through waqf, the charitable endowment given by the rich; and zakat, the charitable contribution for the poor and needy that is one of the Five Pillars of Islam. The duty of care for one’s fellow human is enshrined in the religion of Islam, just as it is enshrined in medical practice. For the well-known Hadith tells us that the Prophet sallallahu ‘alayhi wasslam said, “God has not created an illness without also creating a cure for it”; and the Quran categorially states that “if anyone saves a life it is as if he saves the lives of all mankind”. The directive to care and to cure: this is at the heart of, amazingly, both Islam and medicine.

17. I would like to commend all those involved in Islam and Biomedicine once again, therefore, for contributing to a collection which is, at once, a brilliant and timely intervention in our modern world, and the continuation of a long intellectual tradition. I am, moreover, proud to celebrate this project initiated by Dato’ Dr Afifi, a world-renowned scholar in his own right who has contributed so much to contemporary Islamic thought and scholarship, yet always grounded in his Malay Islamic roots. The world needs more collaborative and interdisciplinary efforts like this, and I hope this important book paves the way for future joint projects between the ulama, the religious scholars of Islam, and the modern scientists and medics. Indeed, I am very pleased to see that almost all of Malaysia’s Deans and Heads of medical schools are gathered in this magnificent hall, particularly as this morning’s book launch opens the one-day International Symposium on Islam and Biomedicine – the first of its kind to be held in this country.