Organ Transplant
By Dr. Zaki Badawi with a preface
by Shaykh Mohammad Afifi al-Akiti



Preface

"O' servants of Allah, seek treatment for your ailments, for surely He who has created the disease has also given a cure for it. Those who are knowledgeable will be able to discover this cure."
(Related by Bukhari)

Aisha' narrated that the Prophet MHMD said:

"Indeed the Believers would be hardly pressed, and indeed every believer who is to suffer even from a sting or pain, Allah would as a reward, erase one of his sins and increase his rewards a degree."
(Related by Ahmad, Ibn Sa'd, al-Bayhaq & al-Hakim)

The opinion among most Fuqaha (jurists) is that seeking medical treatment is either recommended (Mandub) or obligatory. There are many Ahadith which encourage the Muslims to seek medical treatment. Therefore it is up to the patient to decide whether or not if he or she wants to undergo organ transplant.

In regards to the prohibition of violating and mutilating the dead, it has been narrated that a man was digging a grave and he stumbled on some bones, the Prophet of Allah MHMD said:

"Breaking the bones of the dead is like breaking the bones of the living."
(Related by Ahmad, Abu Dawud & Ibn Majah)

It is a general rule in Fiqh in which it is prohibited to violate, harm or mutilate the dead body whether it is a Muslim or non-Muslim cadaver, as an act of revenge, showing disrespect or doing so without any good reason. There are exceptions to this general rule especially in the light when there is a Necessity (Darurah).

"The Fuqaha of the Maliki and the Hanbal schools state that it is impermissible to dissect a dead pregnant lady in order to retrieve the baby, as it is difficult to determine whether the baby is alive. Because of this uncertainty, it should not be a cause to violate the sanctity of the dead. On the other hand, the Fuqaha of Shafi'i allows this dissection to be carried out. Besides, to dissect a dead body in order to remove valuable goods is allowed according to Jumhur (majority of scholars or the three Madhdhabs as opposed to just one) except the Hanbal school."
(Ad-Durr al-Mukhtar 3/246)

Nowadays, it is possible for medical authorities to determine whether the baby is alive or not when such cases arise. The uncertainty that some Fuqaha had, is thus removed.

In Fiqh al-Islam wa Adillatuh (7/3), the author concludes:

"Based on the rulings which allows dissection on dead bodies in specific cases, therefore any dissection or operation done on the dead body due to a significant necessity is allowable. For example, dissection for the knowledge of medicine and dissection in order to find the cause of death to convict criminals by which there are no other avenues to come to the truth (al-Haqq). These are based on the Shari'ah principle of establishing justice ('Adil) in any ruling given by the court, in order to avoid injustice (Dhalim) from happening to the innocent or to ensure the guilty not to escape from the punishment as a result of his crimes.

Even though such dissections are allowed, it should be done within necessary limits without overdoing it. Besides, the sanctity of the dead body has to be respected and handled properly. After the investigation, bits and pieces should be gathered, the body should be closed by suturing it up and finally shrouding the body.

It is also allowable to perform any organ transplant such as the human heart or the eye. This must be with the condition that the donor is proven to be dead by a specialist in the field. This is because the priority is given to the living. The success of recovering vision for a human is a wonderful gift and is demanded by the Shara'."

In al-Ifta', The Permanent Committee for Legal Rulings (Fatawa) in Saudi Arabia conclude the following regarding dissection on dead bodies:

  1. Dissection to discover if there is a criminal act causing the death is sanctioned.
  2. Dissection to see if there is a contagious disease and to then conclude how to stop its spread is sanctioned.
  3. Dissection for educational and training purposes is accepted.

The following is another legal ruling about organ transplant.

Wabillah al-Tawfiq.

M. Afifi al-Akiti,

Belfast, 18 March 1996.


• • • 


The Council which consists of scholars from all the major Muslim Schools of Law in Great Britain, together with three distinguished lawyers has considered the issue of organ transplant and resolved that:

•  The medical profession is the proper authority to define the signs of death.
•  Current medical knowledge considers brain stem death to be a proper definition of death.
•  The Council accepts brain stem death as constituting the end of life for the purpose of organ transplant.
•  The Council supports organ transplant as a means of alleviating pain or saving life on the basis of the rules of Shari'ah.
•  Muslims may carry donor cards.
•  The next of kin of a dead person, in the absence of a donor card or an expressed wish of the dead person to donate his organs, may give permission to obtain organs from the body to save other people's lives.
•  Organ donation must be given freely without reward. Trading in organs is prohibited.

M A Zaki Badawi

Chairman


Organ Transplant Ruling

List of the Ulama' and Scholars who participated during the consultation and then approved the statement on Organ Transplant:

  1. Dr M A Zaki Badawi Principal, The Muslim College, London Chairman, The Muslim Law (Shari'ah) Council UK.
  2. Dr Jamal Sulayman, Professor of Shari'ah, The Muslim College, London.
  3. Dr A A Hamid, Professor of Hadith, The Muslim College, London.
  4. Dr Fazel Milani, Professor at The International College of Islamic Sciences London.
  5. Dr S M A Shahristani, Principal, The International College of Islamic Sciences London.
  6. Moulana Abdul Hadi Umri, General Secretary, Jamia-te-Ahl-e-Hadith (UK).
  7. Moulana Qamaruzzaman Azami, Chief Imam, North Manchester Central Mosque & General Secretary, The World Islamic Mission.
  8. Mufti Mohammed Yunus President, The World Islamic Mission & Imam, Woking Mosque.
  9. Mufti Mohammed Muniruzzaman, Imam, Munir-ul-Islam Mosque, Rochdale.
  10. Dr Abdul Halim, Senior Imam, The Islamic Cultural Centre and London Central Mosque, Regent's Park London.
  11. Mufti Alauddin, Head Imam, Brick Lane Central Mosque, London.
  12. Moulana Hafiz M Khalid, Head Imam, Sparkbrook Islamic Centre, Birmingham.
  13. Moulana Mumtaz Ahmed, Imam of Bradford.
  14. A A Bashiri Esq. Barrister-at-Law.
  15. R Abdullah Esq. Barrister-at-Law.
  16. Dr Safia Safwat, Barrister-at-Law.
  17. Moulana M Shahid Raza, Director, Islamic Centre Leicester & Secretary, The Muslim Law (Shari'ah) Council UK.
  18. Mr S G Syedain, General Secretary, Imams & Mosques Council UK.
  19. Dr. Manazir Ahsan, Director of the Islamic Foundation

Islam holds that Man consists of two essential elements, one material which is the body, the other spiritual which is the soul. Life exists in the human body as long as the soul is joined to it, and it ceases when the soul departs from the body.

{ Who made all things good, which He created, and He began the creation of man from clay then He made his seed from a draught of despised fluid. Then He fashioned him and breathed into him of His Spirit, and He appointed for you hearing and sight and hearts. Yet small thanks do you give for it! } (32:7-9)

Thus the cessation of life means the departure of the soul from the body:

{ Allah recalls souls at the time of their death, and those who have not died, during their sleep. He holds on to anyone whom death has been decided for, and sends the others back for a specific period. } (39:42)

The soul is a mysterious thing and nobody has been able to discover its nature. Its presence in the body results in life which is observed by the movement and the other conventional signs of life. The departure of the soul from the body results in death, which is associated with certain physical signs arrived at as a result of medical observations and knowledge.

The signs of death which the ancient medical doctors have listed are: lack of consciousness, loss of body temperature, cessation of pulse and breathing, glazing of the eyes, parting of the lips, sagging of the nose, and slackening in the muscles of the hands and feet. The heart used to be considered as the centre of life in the body. When it stopped completely it was assumed that death occurred. But if it regained its functions through first aid practices life is assumed to have returned.

The last five decades have witnessed a big leap in medical science bringing great benefits and skills which were unthinkable before. It is now possible to transplant organs from one body into another, which would help the recipient to continue to live.

The significance of the heart has also changed as it is no longer considered the most important organ with regard to life and death. Medical opinion now considers the brain to be the central and crucial part which controls the entire body and its functions.

When it is damaged partially or totally the body will suffer either partial or total deterioration. As a consequence of the present development in medical knowledge and skills a number of questions have arisen. These are:

•  Is it allowed to remove an organ like the kidney from the body of a living person and transplant it into the body of a sick person whose life depends on it?
•  Is it permissible to remove an organ from the body of a dead person to be used to save the life of a living person?
•  Is a person allowed to donate his body or part of it to be used after his death in saving the life of other people?
•  Does Islam recognise the new definition of death that is brain stem death?
•  If it does is it permissible to remove from brain stem dead persons organs for transplant while there are signs of body functions like heart beat temperature and breathing?

Before answering these questions it is important to note the following principles of Islamic Jurisprudence (Usul-Fiqh):

•  A person has the legal authority over his own body, attested by the fact that he can hire himself for work which might be difficult or exhausting. He may also volunteer for war which may expose him to death.
•  A person is forbidden from harming himself or others (It is not legitimate in Islam to inflict harm on others or to suffer harm from them - Hadith).
•  In case of Necessity certain prohibitions are waived as when the life of a person is threatened the prohibition on eating carrion or drinking wine is suspended.

{ He has only forbidden you what has died by itself, blood and pork, and anything that has been consecrated to something besides God. Yet anyone who may be forced to do so, without craving or going too far, will have no offence held against him; for Allah is Forgiving, Merciful. } (2:173)

•  Confronted with two evils a person is permitted to choose the lesser of the two, as in the case of a starving person whose life could be saved by either eating carrion or stealing from another person's food. He would be permitted to opt for the latter.
•  Islam made it an obligation upon the sick to seek treatment.

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In the light of the above principles the Council is of the opinion that:



1. It is permissible for a living person to donate part of the body such as the kidneys to save the life of another, provided that the organ donated would not endanger the donor's life and that it might help the recipient.

The Prophet MHMD said:

"Whoever helps a brother in difficulty, God will help him through his difficulties on the Day of Judgement."

2. It is permissible to remove the organ of a dead person to be used to save the life of a sick person.

3. It is permissible for a person to donate his body or parts of it to be used after death to treat those who need transplants. So it is permissible for Muslims to carry a donor card.

4. In the absence of a donor card carried by the dead person it is sufficient to obtain the consent of the next of kin.

5. The proper authorities will act in lieu of relations if they are not known.

Brain Stem Death

Regarding brain stem death, the Council, having discussed the matter over a number of meetings with doctors and specialists, and having studied the safeguards instituted by the Ministry of Health in Great Britain, went further and examined the research done by trustworthy Muslim doctors and noted the following:

- If the heart stops beating then lack of consciousness and the cessation of breathing will follow immediately.

- If however the person is helped by massage of the heart (CPR) or through the use of electric shock (defibrillation) within four or five minutes the heart may restart.

- If the flow of the blood to the brain ceased for more than a few seconds damage may occur, although some of the cells will remain alive for four or five minutes. On the other hand if the brain stem ceases to function it cannot be made to restart.

After the brain stem is dead it is possible to preserve some organs functioning for a period from six hours to two weeks. The presence of pulse or movement after the death of the brain stem is not a sign of life. We know that a hanged or beheaded person continues to have pulse and movement for a brief period. But they are not considered to be alive and it would not be possible to bring them back to life.

Based on the above the medical profession concludes that life ceases as a result of brain stem death.

The Council is of the opinion that trustworthy doctors are the proper and authentic authority when it comes to defining the signs of death.

After a thorough consideration regarding medical opinion and several edicts issued by different religious bodies, the Council arrived at the following conclusions:

After trustworthy doctors certify that the brain stem has died organs needed to save others' lives might be taken from the body, and then the life support machine may be switched off.

While the Council recognises the need for benefiting from the advances of medical science in alleviating the suffering of the sick and saving lives, it wishes to remind everyone especially doctors of the following points:

Human beings are the most honoured creature on earth. Their dignity in life and death must be maintained.

{ We have dignified the Children of Adam and transported them around on land and at sea. We have provided them with wholesome things and favoured them especially over many of those whom We have created. } (17:70)

Human life is sacred. To terminate the life of one person is equivalent to the termination of the life of all humanity. Conversely the saving of one life is regarded as the saving of all humanity.

{ Whosoever kills any person without another soul being involved or for causing corruption in the earth, it shall be as if he had killed all mankind and whosoever saves the life of one it shall be as if he had saved the life of all mankind. } 5:32)

The Council is of the opinion that human organs should be donated, and not sold. It is prohibited to receive a price for an organ.




from: www.iol.ie


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