Continuing our series on religion and organ donation, we present here a compilation of views on Islam and organ donation. Islam strongly believes in the principle of saving human lives. According to A. Sachedina in his Transplantation Proceeding a=ticle, Islamic Views on Organ Transplantation, “The majority of Muslim scholars belonging to various schools of Islamic law have invoked the principle of priority of saving human life and have permitted the organ transplant as a necessity to procure that noble end.” Violating the human body, whether living or dead, is normally forbidden in Islam. The Shariah, however, waives this prohibition in a number of instances: firstly in cases of necessity; and secondly in saving another person’s life. It is this Islamic legal maxim al-darurat tubih al-mahzurat (necessities overrule prohibition) that has great relevance to organ donation.

“Whosoever saves the life of one person it would be as if he saved the life of all mankind.” Holy Qur’an, chapter 5 vs. 32

“If you happened to be ill and in need of a transplant, you certainly would wish that someone would help you by providing the needed organ.”

Sheikh Dr MA Zaki Badawi, Principal, Muslim College, London

Each country has its own “mufti” – a Islamic religious leader who is an interpreter  of issuing a fatwa. A fatwa is a legal statement in Islam, issued by a mufti or a fatwa committee, on a specific issue. A Fatwa committee is chaired by a Mufti and includes prominent religious leaders, lawyers, doctors and other members of the public.

The Muslim Law (Sharia) Council of Great Britain resolved in its life-saving fatwa that:

􀁺 the medical profession is the proper authority to define 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 transplantation 􀁺 the council supports organ transplantation as a means of alleviating pain or saving life on the basis of the rules of the Sharia

􀁺 Muslims may carry donor cards

􀁺 the next of kin of a dead person, in the absence of a donor card or an expressed wish to donate their 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.

“Whosoever helps another will be granted help from Allah.” Prophet Muhammed (pbuh)

Muslim scholars of the most prestigious academies are unanimous in declaring that organ donation is an act of merit and in certain circumstances can be an obligation. These institutes all call upon Muslims to donate organs for transplantation:

􀁺 the Sharia Academy of the Organisation of Islamic Conference (representing all Muslim countries)

􀁺 the Grand Ulama Council of Saudi Arabia.

􀁺 the Iranian Religious Authority

􀁺 the Al-Azhar Academy of Egypt

Dr. Muzammil Siddiqi, former president of the Islamic Society of North America, states the following: ”This question is very much debated by the jurists in past two decades. The Supreme Council of ‘Ulama in Riyadh (in their resolution no. 99 dated 6 Dhul Qi’dah 1402) has allowed both organ donation and organ transplantation in the case of necessity. The organ can be taken from the body of a living person with his/her consent and approval and also from the body of a dead person. In the case of a living person, the jurists have stipulated that this donation should not deprive him/her of vital organs. It should also not cause risk to his/her normal life.

The Fiqh Academy of the Muslim World League, Makkah also allowed organ donation and transplantation in its 8th session held between 28 Rabi’ul Thani- 7 Jumadal Ula, 1405.

The Fiqh Academy of the Organization of the Islamic Conference in Jeddah, during the year 1408, and the Mufti of Egypt Dr. Sayyed At-Tantawi also allowed the use of the body organs of a person who has died in an accident, if the necessity requires the use of any organ to cure a patient, provided that a competent and trustworthy Muslim physician makes this decision. It is important to note that most of the jurists have only allowed the donation of the organs. They do not allow the sale of human organs. Their position is that the sale of human organs violates the rules of the dignity and honor of the human being, and so it would be haram in that case. Some jurists suggest that because people have become too materialistic and it may not be possible to find a free organ, under necessity one can purchase the organs, but a Muslim should never sell his/her organs. ”Sheikh Ahmad Kutty, a senior lecturer and an Islamic scholar at the Islamic Institute of Toronto, Ontario, Canada, issues the following Fatwa: “Organ donation is permitted in Islam if it is done within the permissible limits prescribed by the Shari`ah. The following are the conditions scholars have stipulated for donation:

Conditions associated with a living donor:

1. He/she must be a person who is in full possession of his/her faculties so that he/she is able to make a sound decision by himself/herself;

2. He/she must be an adult and, preferably, at least twenty-one year old;

3. It should be done on his/her own freewill without any external pressure exerted on him/ her;

4. The organ he/she is donating must not be a vital organ on which his/her survival or sound health is dependent upon;

5. No transplantation of sexual organs is allowed.

Conditions associated with deceased donors:

1. It must be done after having ascertained the free consent of the donor prior to his /her death. It can be through a will to that effect, or signing the donor card, etc.

2. In a case where organ donationconsent was not given prior to a donor’s death, the consent may be granted by the deceased’s closest relatives who are in a position to make such decisions on his/her behalf.

3. It must be an organ or tissue that is medically determined to be able to save the life or maintain the quality of life of another human being.

4. The organ must be removed only from the deceased person after the death has been ascertained through reliable medical procedures.

5. Organs can also be harvested from the victims of traffic accidents if their identities are unknown, but it must be done only following the valid decree of a judge.

Islam in the Asia Pacific Region

Islam is predominant in Pakistan, Bangladesh, Malaysia, Brunei and Indonesia, it is less dominant in China, India and Singapore

Fatwas on organ donation - Fatwas have been declared in several countries in this region.

- Saudi Arabia, 1985 – permit both living related and cadaveric organ donation.

- Pakistan, Bangladesh, Malaysia, Indonesia – organ donation permitted.

“Fatwa on bone, skin and amnion”

- Introduced in Malaysia on 4 Sep 1995 by Malaysia Islamic Centre permitting procurement from living and deceased donors.

- First fatwa specific for tissue banking passed in the region.

- Introduced in Indonesia on 29 June 1997 permitting tissue procurement from deceased donors.

- Second fatwa specific for tissue banking passed in the region.

- Attempts to introduce a similar fatwa by Majilis Ugama Islam Singapore (MUIS) unsuccessful.

- Fatwa for cornea passed in 1999, first fatwa for tissues in Singapore.

However, fatwas alone will not work. More public education is needed to change cultural beliefs and practices although Islam does not forbid organ donation per se.