Introduction
Conscientious Muslim physicians remain concernedabout
the centrality of a wholesome physician-patient
relationshipin ensuring better health outcomes,while
fulfilling their accountability to Allah swt. An Islamic
conscience facilitates medical interventions aligning
withIslamic and general medical ethics.This
multifacetedrelationship is best understood through the
Islamic concept of trust (al-amānah),which embodies
integrity, trustworthiness1 or honesty2 to uphold justice
and fairness.Amānahrefers to fulfilling trust or
responsibilities toward the one who grants it or depends
on it.Nevertheless, how does this complex concept relate
to a humane physician-patient relationship? Islamic
ethics are derived and inferred from the Qur’ān, the
Sunnah of Prophet Muhammad (saw), scholarly
consensus (ijmā’), and analogy-based reasoning (qiyas)
To understand amānah in this context, we turn to these
sources, using the methodology of differentiation (furuq)
– a rational-linguistic approach that examines a term’s
usage in Qur’ānic and Prophetic contexts
Commonly rendered as ‘trust’in its nominal form, the
Arabic word Amānah(pl: amānāt) appears six times in
the Qur’an: Allah bestowing the trust of obedience to
humankind (Q33:72), warning against betraying mutual
trusts (Q8:27), emphasising the duty to return a trust after
mutual understanding (Q2:283), commanding belongings
to be entrusted to those worthy of them (Q4:58), and
highlighting a defining quality of believers – safeguarding
their trusts (Q23:8, Q70:32).
At the heart of the term amānah is the triliteral Arabic
root (ʾa-m-n) / ن-م-أ, which forms approximately 900
words in the Qur’an. The most common are the verbs “to
believe, have belief” (āmana-yu’minu) appearing 537
times, ‘believer’ (mu’min) and its variants (e.g.,
mu’minūn) appearing 202 times, and “Islamic faith and
belief” (ʾīmān) appearing 45 times. Classical linguist Ibn
Manẓūr defined security (amnun) as the opposite of fear
(khawf), trust (amānah) as the opposite of betrayal
(khiyānah), and faith (ʾīmān) as the opposite of disbelief
(kufr). The shared triliteral root of these words reflects
their deep etymological and conceptual connections,
which we will explore in relation to the physician -patient
context.
Am nah and the Mu’min physician
Faith or belief (ʾīmān)is distinguished from a Muslim’s
submission(islām) sinceas explained by
Gabriel4 (as) to the Prophet (saw):
inwardbeliefs about Allah, His book and the unseen;
Islām as outward religious rituals and
in faith and submission.connotation, as the Qur’ān reprimands5Bedo
claiming “we have believed” (āmannā) whilst they had
merelysubmitted (aslamnā), and had yet to truly believe
(lam tu’minū).Imānis known to have seventy branches,
including testimony of faith, modesty, moderation in
speech, and removing harmful things from paths
direct Qur’anic mentions (Q23:8, Q70:32) of
come as prerequisites of ʾīmānand being a
who possesses true faith, beyond mere submission).These
indicatethe broad and profound nature of
amānah,encompassing multiple aspects of what it means
to be faithful and believing.A key characteristic of
successful believers is fulfilling trust7 (al
a lack of trustworthiness impliesweakness of
faith8.Breaking the trust9 is a sign of
hypocrisy.Allahbestowed amanah on humankind as a
virtue,
“Indeed, we offered the Trust(al-amānah) to the heavens
and the earth and the mountains, and they declined to
bear it and feared it; but man [undertook to] bear it.
Indeed, he was unjust and ignorant.” Q33:72.
Among exegetes (mufaṣṣirūn), Aṭ-Ṭabarī related that this
trustrefers to acknowledging obedience to Allah,
accepting His obligations, and exercising free will in
fulfilling them, consequently opting for reward or
punishment that none agreed to bear and carry out except
for humankind.10Paying attention to the textual context
(siyāq an-naṣ), Ibn Ashūr adds11that the subsequent verse12 (Q33:73)explains why humankind is deemed
unjust and ignorant:except for the believers, many would
turn disobedient unable to render this
the noun believers (al-mu’minūn
“to believe” (āmana-yu’minu
connected to the word amānah.
In the medical domain, Islam highly encourages medical
treatment as a divine blessing as every illness has a cure
with Allah’s permission.13However, medical treatment
requires rigorous training and research, and practising
medicine without proper expertise is Islamically
blameworthy.14Studying medicine is particularly
demanding, requiring intellectual capacity, financial
resources, and physical-emotional endurance, making it a
challenge that not everyone can undertake.
For a Mu’min physician, medical knowledge and
expertise are divinely bestowed
intensive study and training, using divine favours such a
perceptive senses, intellect and physique.
prophetic invocation16 in which beneficial knowledge is
sought alongside good provision and acceptable deeds.
Acquiring beneficial knowledge safeguards both material
sustenance and spiritual fulf
human wellbeing and the upliftment of the
fulfilling many branches of iman
The opposite of this principle is embodied by Qārūn, a
wealthy figure from Moses’ time, whose arrogance led
him to declare, “I was only given th
knowledge.” His downfall serves as a cautionary tale
against attributing success solely to oneself or one’s intellect and accomplishments”17Thus, a
physician recognises intellectual capabilities as a form of
amānah and uses them to acquire beneficial knowledge
another form of amānah – to serve humankind
form of amānah to be discussed later.
Preservation and maintenance
Being a Muslim means refraining from harming others,
while being a Mu’minrequires being widely entrusted
In Islamic finance, al-āmanahrefers to a securitydeposit,
business trust or confidentiality.Moreover, for a trustee,
properly distributing entrusted resources from an owner’s
treasury is akin to giving charity.19
Qur’ān (Q2:283), trust appears in the context of security
deposits20 where people entrusted with something (
aminaba’ḍukum) are urged to faithfullyrender trust.It’s
an innate human disposition, preserved in the heart and
fortified by the Qur’ān and sunnah until its
eschatologically destined depletionleads to rampant
untrustworthinessand lossof faith.21
While mutual trust is encouraged, breaking it is not
permissible irrespective of one party’s distrustful conduct22. Entrustment can be mate
regarding financial deposits, Qur’ān (Q3:75) notes
thatregardless of the amount entrusted, people act as per
their trustworthinesslevels.23
prophet Yaʿqūb (as) admonished his elder sons for
mishandling Prophet Yūsu
reluctant to trust them again (
brother, Binyamīn.24
Based on the above, patients can be viewed as an
entrusted to Muslim physicians
the deontological works Ishāq al
CE), whose Adāb al-Ṭabībis one of the oldest surviving
works covering ethical principles for physicians from
Islamic perspectives25. Al-Ruhawi extensively discusses
how physicianscould cultivate virtues
interaction with patients bec
responsibility. For a Muslim physician,
ethical principles complement
obligations, ensuring adherence to Islamic medical
ethics.27 Medical adābencompasses ethical
aspects and religious obligations of a Muslim, who is
also a physician, “the physician’s virtuous inner
disposition and relationship towards patients” which
reflects “the physician’s morality and relationship with
the divine”.28In this light, a patient is an
entrusted to a Muslim physician, and honouring this trust
reinforcesdivine connections.
Authority and Responsibility
Ibn al-Jawzī and al-Dāmaghānī
(i) obligatory matters (farāʾi
deposits (wadāʾiʿ) – Q4:58, Q23:8 and integrity (ʿiffa) – Q28:26. As for (i) obligatory matters,
Allah says,
O you who have believed, do not betray Allah and the
Messenger or betray your trusts while you know [the
consequence]. Q8:27
Exegete ar-Rāzī relates (from Q8:26-28) tha
were warned not to betray the trust of Allah and His
Messenger, as they had been blessed with Islam after a
period of weakness and oppression, and they must not
allow worldly trials (e.g., material possessions and
children) to divert their attention.30 Former people of the
Scripture were entrusted31 with divine guidance which
they devalued and failed to fulfil obligations.
The verse Q4:58 was revealed during the Day of Victory
(yawm al-fatḥ), when the Prophet (saw) opened the gate
of the Kaʿbah, recited this verse, and handed the keys to
ʿUthmān bin AbīṬalḥa (ra) as an entrustment
explicit command to render trust:
“Indeed, Allah commands you to render trust to whom
they are due and when you judge between people to
judge with justice. Excellent is that which Allah instructs
you. Indeed, Allah is ever Hearing and Seeing.” Q4:58
Ibn Kathīr clarified that these rulings are general
(faḥakamuhumā ‘āmmun), applying not just to the
historical context but to all trust-related matters between
Allah and humankind, as well as mutual trust between
people33.Al-Qurṭubī further elaborated, referencing
several companions (ṣahabah) and the plural form
(amānāt) to indicate that this concept extends to
everything (al-amānatufīkulli shay), including fulfilling
religious obligations, i.e., prayer and fasting, even
business transactions.34Although the verse is categorised
under the deposit-related theme, it is immediately
followed by Q4:59,which instructs to obey those in
authority.35This is why aṭ-Ṭabarī interpret
referring to those in positions of authority entrusted to fulfil their trust.36. Thus, amānah
Q4:58 is central to authority and responsibility.
In Greek (yunānī) medicine, physicians are termed the
“wise one” (ḥakīm), a term that also signifies “he who
delivers the ruling (ḥukm)”. Physicians’ health
recommendations are to be closely followed by patients,
who place their trust in them. Therefore, Muslim
physicians with specialised knowledge hold a significant
amānah and are entrusted to carry out their
obligations.AbūʿUbayda ibn al
commander and one of the ten companions promised
Paradise, was known for his trustworthiness. His
reputation for authority and sincerity made him the ideal
candidate for important missions, such as teaching Islam
to a Christian delegation from Najrān after the Battle of
Tabūk.37On asking the Prophet about governing position,
a companion was reminded to consider these a type of
amānah,which could lead to difficulties on th
Resurrection if unmeted.38Habitually entrusting power to
the undeserving breaches the
approaching of the Hour.39From this perspective, Muslim
physicians carry a dual responsibility
in their field and trustees of amānah
and Islamic ethics, which further strengthens the
physician-patient relationship.
Trustworthiness and Confidentiality
Prophet Muhammad (saw) was universally
acknowledged as the most reliableand honest
person,which led to his
trustworthy”(al-Amīn), a quality endorsed even by his
enemies and non-Muslims. It is derived from the same
triliteral root (‘a-m-n / ن-م trustworthy” (amuna) implying both the process of
becoming trustworthy and acquiring this as a permanent
characteristic. The Prophet’s entrepreneurial career,
spanning 40 years, reflected his traits and professional
conduct, before the commencement of his 23
mission.40
The Qur’ān hails archangel Gabriel (as) as “trustwort
spirit” (al-rūḥ al-amīn) due to their unfaltering obedience
and for conveying revelations.Noble human beings like
prophets were divinely guided towardsembodying
trustworthiness, serving as exemplary figures for their
followers and humankind. Prophet Hūd
himself as a trustworthy advisor (nāṣihunamīn
prophets Nūḥ, Ṣāliḥ, Lūṭ, and Shu’ayb (as) implored
people for recognition as trustworthy messengers
(rasūlunamīn).41Prophet Musa (as), before prophethood,
impressed prophet Shu’ayb’s (as) daughters with his
integrity and unblemished character, leading one of them
to recommend him for employment as a strong and
trustworthy man (al-qawī al-amīn).42After prophethood,
Mūsā (as) asserted his trustworthiness to Pharaohin
delivering the Children of Israel43.Prophet Yusuf (as)was
appointed an advisorby an Egyptian king, noting his
exclusive establishment and trustworthiness
(makīnunamīn).44Al-amīn is also associated with non
human entities – a powerful djinn (‘ifrīt
Sulaymān’ (as)army claimed to be powerful and
trustworthy45 (qawīyunamīn) to fetch Queen of Sheba’s
throne in an eyeblink. Thus, the Prophet’s honorific is
historically significant as angelicor a reflection of the
inherent trustworthiness of prophets.This was validated
by the Arabs, who were very well-versed in literary
excellence, alluding that the prophet upheld all aspects of
amānah.
In the medical domain, physicians gain patients’ trust for
their knowledge and expertise, positioning them in a
guardianship role – directly addressing many Qur’ānicrenditions of the term. Persian physician Abū
Bakr al-Rāzī (d. circa 925 AD / 313 AH) argued that a
patient’s treatment outcome is tied to relying on a single
trustworthy physician.46Due to the high level of trust,
patients often confide their deepest issues, relying on
physicians to maintain confidentiality
discussed across medical ethics
consent, protecting confidentiality and privacy concerns
are the building blocks of a physician
relating to trust49. Keeping a secret as
generic understanding of amānah
saying defining it as such.50The most significant form of
trust is not violating the secrecy of marital intimacy.
Security and safety
Amānahis complemented by an
amn/amān (security), which extends to non
entities due to the divine oath by the “secured city” (
balad al-amīn).52The Meccans were enjoined to worship
Allah, the owner of the Meccan Ka’bah beca
them safe and secure53 from hunger and fear. This relates
to Prophet Ibrāhīm’s (as) supplication: “Make this a
secure city” (ijʿalhādhābaladanāminan
those who believe (man āmanaminhum
etymological connection between security and faith.
verb āmana (to make someone secure from something) is
transitive, requiring two objects. A derivative of this verb
is one of Allah’s attributes, al
faith and security55. Interestingly, the words believer
(muʾmin) and faith (īmān) originate from the same root,
where āmana often means “to believe” in its most
common Qur’ānic usage.
Renowned Islamic jurist ʿIzz al-Dīn ibn
(d. 660H/1243 CE) summarised the aim of medicine in
his Qawāʿid al-Aḥkām as securing patient’s benefit
(maṣlaḥa) by ensuring safety, preserving and restoring
health, reducing ailments, and protecting against harm.
This principle strongly resonates with
also presents security (āminīn) as a state of being
three distinct contexts, all involving groups of people
feeling safe and secure.In Surat al-Ḥijr (Q15:46, 15:83),
the righteous are invited to enter Paradise in peace and
security (udkhulūhābisalāmināminīn), contrasting with
the false sense of security felt by the Thamūd in their
mountain-carved homes (buyūtanāminīn
term appears in four instances reassuring protection from
fear or insecurity:Allah made travel between the ancient
Yemeni cities of Sabaʾ safe (Q34:18).Prophet M
upon seeing a writhing snake, was reassured
(Q28:31).The Prophet’s (saw) peaceful entry into Mecca
after the conquest (Q48:27).Prophet Yūsuf (as)
welcoming his parents into Egypt safely (Q12:99).The
term also appears as both a warning and an assurance
Prophet Ṣāliḥ (as) warned the Thamūd (Q26:146). In
contrast, people of Paradise are reassured of their eternal
safety (Q44:55). Hence, amnis deeply intertwined with
emphasising that human trustworthiness is complemented
by divine protection. Drawing from Qu
the term reflects the profound connection between faith
and protection, underscoring the ethical responsibility to
safeguard and preserve well-being, whether in medicine
or society.
Tranquility and Assurance
In contrast to amānah (ةنامأ), a closeterm
denotes tranquillity and calmness57
Qur’ānicusages. During the battles of Badr (Q8:11) and
‘Uhud (Q3:154), Allah sent down amanah
relieve believers’ hearts from drowsiness, confusion,
distress, and satanic suggestions. This divine calmness
was so comforting that everyone, except the Prophet, fell
asleep.58 Ibn Masʿūd (ra) noted that sleeping during battle signifies calmness from Allah, while sleeping during
prayer is from Satan.59Ar-
reflected trust in Allah; otherwise, none could sleep on a
battlefield.60
Assurance is also evident in the dialogue
and Prophet Ibrāhīm (as) regarding how the dead are
given life. Ibrāhīm sought this demonstration so his heart
“may be satisfied” (liya
strengthening his faith. Similarly, the disciples of Prophet
ʿĪsā (as) requested a banquet, stating it would reassure
their hearts (wataṭma’innaqulūbunā
satisfy or have tranquillity” (
quadriliteral root (ṭ-ʾa-m-n /
with the triliteral root (ʾa-m
conceptually linked, centring on the human heart.
Qur’ān frequently references the reassurance of the heart
with faith and security,
connection between these concepts.
An unnamed village (qaryah
and security (āminatanmuṭma’innatan
stripped of its blessings due to disbelief and denial of
favours.65 This narrative i
disbelief—the opposites of faith and belief
loss of safety and security. It underscores that faith and
security are not only linguistically but also conceptually
connected in a causal relationship. As seen in Prophet
Ibrāhīm’s prayer for Mecca’s safety and provision, Allah threatened to punish those who disbelieved
in the case of the disciples of ʿĪsā, the sent
came with a warning against disbelief.67
demonstrate that safety and security, ensured through
divine provisions, are subtle examples of trust meant to
be preserved with sincere faith.
Ar-Ruhāwī stressed building relationships to understand
patients’ distress and being receptive to their responses.
In the physician-patient relationship, empathy is crucial
for emotional responsiveness, effective communication,
allowing time, and attentively hearing complaints.
approach brings assurance and tranquillity to patients’
hearts, reinforcing their trust in physicians
culmination of faith (īmān), trust (amānah
of security (amn) in human hearts.
Conclusion: Implications for a secular healthcare system
The physician-patient relationship in Islamic medical
ethics is fundamentally rooted in the concept of
(trust) and its relevant terms, which encompasses
multiple layers and is intrinsically linked to faith.This
trust mandates that physicians exhibit transparency,
integrity, and honesty in both intention and conduct.
Amānah manifests in two primary forms: as
endowment from Allah to humanity, and as a mutual
responsibility between individuals concerning specific
duties or obligations. Neglecting this trust can
compromise one’s faith and incur accountability on the
Day of Judgement. The five themes explored converge to
highlight that Muslim physicians working in secular
contexts may reprise the Qur’anic understanding and the
lost Sunnah of amānah and its related terms into their
medical practice and ethics by embracing a holistic
approach. This approach integrates faith
accountability, cultural humility, and a commitment to
ethical integrity, thereby fostering a healthcare environment that is both spiritually and morally
congruent with Islamic teachings.
For Muslim physicians, a profound comprehens
amānah necessitates70 the integration of Islamic cultural
awareness into patient care
practices align with Islamic ethical principles. Scholars
have observed a decline in compassionate patient care,
attributing it to the commercialisation and privatisation of
healthcare72, as well as the marginalisation of religious
values in medical practice
notes: within Islamic medical philosophy, Allah is
regarded as the ultimate healer, with physicians serving
as instruments of His will. This perspective fosters a
stronger physician-patient bond, grounded in the
physician’s accountability to Allah, contrasting with
relationships influenced by materialistic or secular
ideologies that may erode trust.
critiques Western materialistic cultures, the influence of
profit-driven medical care is evident globally, including
in developing nations where disadvantaged patients often
rely on privatised healthcare systems managed by
affluent doctors.75 Physicians deser
fair compensation for their dedication; however, pursuing
medicine primarily for wealth, social status hierarchy, or
authority and entrepreneurial motivescan be a concern.
In certain regions, remnants of colonial legacies persist,
where titles like “doctor sahib
dynamics reminiscent of colonial times.
well-regulated healthcare systems in developed countries,
where these colonial legacies are now extinct, privatised
healthcare in underdeveloped areas can exacerbate power
imbalances, leaving impoverished patients vulnerable
and with limited options beyond placing implicit trust in
their physicians. To mitigate this vulnerability, many
families in developing countries strive to have at least
one doctor among them, ensuring trustworthy medical care during times of illness.Altruism is often ci
motivation for entering the medical profession; however,
this noble pursuit attains true altruism only when
underpinned by a robust ethical framework, including
religious principles and a sense of accountability to
Allah. In the context of Muslim physician
interactions, the adāb(etiquette) component of Islamic
medical ethics safeguards the amānah between physician
and patient, thereby upholding the covenant between the
Muslim physician and Allah.
Incorporating the Qur’anic concept of amānah
medical practice requires Muslim physicians to embody
transparency, integrity, and honesty, recognising their
accountability to Allah and their patients. This trust is
foundational to the physician-patient relation
deeply intertwined with faith. By understanding
as both a divine trust and a social responsibility,
physicians can navigate the challenges posed by
commercialised and secular healthcare systems, ensuring
that their practice aligns with Islamic medical ethics. This
alignment recognises the ability and authority to provide
care as an amānah itself, fosters a compassionate,
empathetic approach to patient care, enhances the quality
of care, strengthens patient trust, and fulfils their
religious and moral obligations.For Muslim physicians,
restoring this integrity aligns with key objectives of
Islamic law (maqāṣid al-sharīʿa), specifically the
preservation of religion and morality (ḥif
preservation of life and health (ḥif
articulated by the exegete al-Qurṭubī.78
