The spinal problems (both lumbar and cervical) of Anwar Ibrahim are causing a lot of anguish for our medical fraternity not to mention the untold anxiety of his loved ones. It was our fervent hope that an amicable compromise would be obtained and Anwar would be offered the best, safest and evidence-based surgery currently available for his spinal predicament. But quite clearly there is a stand-off and political doctoring has gained the upper hand and evidenced-based medicine has been sidelined.

The members of our association participate in numerous humanitarian and medical missions worldwide, eg. Bosnia, Kosova, Turkey, Gujarat, Maluku, Mindanao, Iraq, the depths of Pahang and Sarawak etc. and it would seem most irresponsible of me if I did not now address what is fundamentally a humanitarian (and medical) issue vis a vis the medical condition of Anwar.

As a healing and caring profession we are the instruments of Allah's mercy (Ar Rahmah) and I am reminded of the oath of a Muslim physician "To be the instrument of Thy Will and Mercy, and, in all humbleness, to exercise justice, love and compassion for all Thy creation; To extend my hand of service to one and all, to the rich and to the poor, to friend and foe alike, regardless of race religion or colour." (If I may add, the imprisoned or freed.)

Being a fellow Muslim physician I am sure that you subscribe similarly and continually to these noble values and would ensure that they would always prevail. I would appeal to you to put a stop to all the unkind and merciless statements made by various politicians and enable Anwar to undergo the optimal surgery available.

His large central disc herniation and the associated spinal stenosis preclude a conservative dorsal approach due to the increased risk of post-operative morbidities. And it has been agreed by the panel of experts in Kuala Lumpur (three orthopaedic surgeons, three neurosurgeons, two radiologists, one neurologist and one anaesthesiologist) and Dr Hoogland Thomas (orthopaedic surgeon and diplomate of the American Board of Orthopaedic Surgery from Alpha Klinik, Munich) that a transforaminal endoscopic discectomy would be the surgical procedure of choice for decompression of the nerves.

Furthermore, it obviates the need for general anaesthesia and endotracheal intubation considering Anwar's longstanding cervical problems, as the endoscopic procedure can be performed under local and intravenous anaesthesia. Other post-operative sequelae, namely neural damage, back pain and sepsis, are also considerably less.

And it was also emphasised that the surgery should not be delayed beyond four to six weeks to ameliorate any further neurological compromise. This is the art and science of evidence-based medicine in practice and it should not be tarnished by political doctoring from various quarters. I would again appeal to you to enable the medical experts to discharge their duties professionally without any form of interference whatsoever from pseudo doctors.

The excruciating pain and physical suffering of Anwar, the sense of helplessness of his family and friends alike, the diagnostic MRI scans and the consensus of opinions of the medical experts must surely touch the deep recesses of our hearts and human conscience; and more so to the Muslim physician.

And I appeal again to you to make it possible for Anwar to undergo the endoscopic procedure at the earliest possible opportunity, in the best possible medical centre dedicated to spinal surgery. I truly believe that your magnanimity in this painful medical scenario would go a long way towards alleviating the hurt that has much wounded this great nation of ours.

And to Allah, The Omniscient and The Wise Judge do we turn for succour.