On the death of intention and the dehumanisation of medicine: an Islamic ethical reflection

In their response to Shahvisi, Porat-Wojakowski <i>et al</i> challenge what they describe as the 'medicalisation of war', cautioning against judging conflict through the lens of public health. Their argument contributes a provocation to medical ethics by questioning the limits of moral medicine under conditions of political violence. This reflection engages their position through an Islamic ethical framework, where niyyah (intention) functions as the axis of moral agency and the condition for ethical clarity. Within this framework, to heal is both an act of compassion and an epistemic stance that preserves the visibility of human dignity, or karāmah, amid structural violence. When the intention to heal gives way to the intention to justify, medicine risks becoming a moral instrument of power rather than a sanctuary of care. Drawing on Islamic morality, this reflection argues that dehumanisation often emerges from procedural reasoning that makes suffering administratively invisible. Medicine's moral vocation, in this view, lies in sustaining intention as an act of resistance to abstraction. The enduring question is not whether healthcare can adjudicate the ethics of war, but whether societies can preserve the moral consciousness that makes healing possible at all.