I am a doctor working in the organ transplant department. I have read the fatwas issues on this matter on your website but want some clarification on some very important issues.
1. Am I correct in understanding that one cannot donate organs on death (as we don’t own our bodies)? If so, then a heart transplant is impossible at all times as that is a vital organ and cannot be donated during one’s life. Is that correct? I find this hard to come to terms to, given that one of our young renal patients who also had a terminal heart problem would have died had he not received a heart transplant from an altruistic soul who was on the organ donor register and donated his heart (which was well-matched) on death. The patient who received the life-saving heart transplant is now alive because of this great act of charity. Is it not enough that one person’s life is saved by this act to make it permissible in these circumstances?
2. I meet many Muslim patients who are happy to receive a kidney (from living or deceased donors) yet do not donate organs (in life or upon death). Many in our department view this as hypocrisy. It has become a problem to the extent that certain influential parties are calling for the stick approach for Muslims/Ethnic minorities. That is, to prioritise those people on the organ transplant waiting list, who have also been registered donors for more than 3 years. This would essentially force Muslims who are on the transplant waiting list to go on to the organ donor register, if they even want to stand a chance of getting an organ in future. Many regard this as merely being fair. For more info on this, please see: http://www.bmj.com/content/347/bmj.f5036?etoc= My question to you is: Is the hypocrisy of receiving but not donating organs justified in Islam?
3. Lastly, I want to ask if kidney transplants are ever halal. This is because you state that a transplant can only ever occur if life is at stake. However, the dialysis machine can always compensate in renal failure and therefore a kidney transplant is never the only option. Muslim patients can always just keep on using the dialysis machine. Obviously the dialysis machine is a far inferior treatment (patients attend for 4 hours sessions 3-4 times a week, and many patients have told me their lives are essentially put on hold for however many years they are on dialysis). However given that it is a valid (albeit inferior) alternative, surely this renders renal transplants haram at all times? Dialysis is not a very effective treatment option – with a 50% chance survival in 5 years time. It is more of a stop-gap
Your answers and clarifications on these issues will be most welcome.
In the Name of Allah, the Most Gracious, the Most Merciful.
As-salāmu ‘alaykum wa-rahmatullāhi wa-barakātuh.
Dr Yassar Mustafa,
We acknowledge your deep sentiments for assisting the medically disadvantaged. This is indeed an expression of your deep human values which is highly commendable.
The issue of organ transplants has been discussed extensively by the Islamic Fiqh Academy of India comprising of hundreds of elite Ulamā, Muftīs and medical experts who obviously have similar sentiments as your good self[1].
There are two core issues in organ transplants:
- Human dignity and honour
- Medical need
While we have to safeguard ourselves from the evils emanating from commercialising human organ parts and organ trafficking to preserve human dignity and honour; we also have to be sensitive to medical needs and demands. As such, where a medical need can be fulfilled without compromising human dignity and honour, it will be considered. A human body is sacred and its sanctity cannot be compromised in any way even for a medical need. If there is any such fear, the Sharia has closed all avenues leading to that.
Accordingly, kidney transplants, being a medical need, can be conducted[2] while upholding the sanctity of the human body with the following conditions:
- The kidney must be a pure donation and not sold[3]
- The health of the donor is not affected
- The donor should be a family member
In upholding these conditions, it is hoped that a medical need will be fulfilled with maintaining the respect and dignity of the human body. In spite of this permissibility, if the human dignity and honour will be compromised in any way or it may lead to that, the ruling can be reversed. This answers points two and three of your query.
We do acknowledge the consequential benefits of donating one`s heart upon one`s demise; however, the fear of disrespect and indignity to the human body cannot be ruled out especially in view of the widespread corruption of commercialising human organs[4].
In brief, all rulings on organ transplants will be governed by the demand of a medical need without compromising and negatively impacting on human dignity and honour. In fact, this is the overwhelming and overarching principle in all other medical demands like, IVF, cloning, stem cells etc.
The above is a broad and general ruling. If one is faced with a specific issue, then that will be analysed and the ruling will be issued accordingly, which may be different from the general ruling of prohibition[5].
And Allah Ta’āla Knows Best
Hanif Yusuf Patel
Student Darul Iftaa
UK
Checked and Approved by,
Mufti Ebrahim Desai.
[1] [Jadeed Fiqhi Masa`il, 5: 59, Zamzam Publishers]
For a lengthy discussion on organ transplants and blood donation, see: [Ahsan al-Fatawa, 8:270-86, H.M. Saeed Company, Karachi; Jawaahir al-Fiqh, 7:51-64, Maktabah Darul-Uloom Karachi; Jadeed Fiqhi Masaa`il, 5:59, Zamzam Publishers]
[2] يجوز للعليل شرب الدم والبول وأكل الميتة للتداوى إذا أخبره طبيب مسلم أن شفائه فيه، ولم يجد من المباح ما يقوم مقامه
[Al-Fatawa al-Alamgiriyyah, (Al-Karahiyah: at-tadawi wa al-mu`alijat), 5: 355, Maktabah Rashidiyyah; ad-Durr al-Mukhtar ma`a Radd al-Muhtar, (Al-Hazar wa al-Ibahah), 6: 389, H.M. Saeed Company]
يجوز للعليل شرب الدم والبول وأكل الميتة للتداوي إذا أخبره طبيب مسلم أن شفاءه فيه ولم يجد من المباح ما يقوم مقامه وإن قال الطبيب يتعجل
[Al-Fatawa al-Hindiyyah, 5: 355, Maktabah Rashidiyyah]
فإن الإستشفاء بالمحرم إنما لا يجوز إذا لم يعلم أن فيه شفاء، أما إذا علم أن فيه شفاء وليس له دواء آخر غيره يجوز الإستفتاء به
[Al-Muhit al-Burhani, (Al-Karahiyah wa al-Istihsan: at-tadawi wa al-mu`alijat), 8: 82, Idarah al-Qur`an wa al-Uloom al-Islamiyah, Karachi]
مطلب في التداوي بالمحرم ( قوله ورده في البدائع إلخ ) قدمنا في البيع الفاسد عند قوله ولبن امرأة أن صاحب الخانية والنهاية اختارا جوازه إن علم أن فيه شفاء ولم يجد دواء غيره قال في النهاية : وفي التهذيب يجوز للعليل شرب البول والدم والميتة للتداوي إذا أخبره طبيب مسلم أن فيه شفاءه ولم يجد من المباح ما يقوم مقامه ، وإن قال الطبيب يتعجل شفاؤك به فيه وجهان ، وهل يجوز شرب العليل من الخمر للتداوي فيه وجهان ، وكذا ذكره الإمام التمرتاشي وكذا في الذخيرة وما قيل إن الاستشفاء بالحرام حرام غير مجرى على إطلاقه وأن الاستشفاء بالحرام إنما لا يجوز إذا لم يعلم أن فيه شفاء أما إن علم وليس له دواء غيره يجوز ومعنى قول ابن مسعود رضي الله عنه لم يجعل شفاؤكم فيما حرم عليكم يحتمل أن يكون قال ذلك في داء عرف له دواء غير المحرم لأنه حينئذ يستغني بالحلال عن الحرام ويجوز أن يقال تنكشف الحرمة عند الحاجة فلا يكون الشفاء بالحرام وإنما يكون بالحلال ا هـ
[Radd al-Muhtar ala ad-Durr al-Mukhtar, 5: 228, H.M.Saeed Company]
فالضرورة: بلوغه حدا إن لم يتناول الممنوع ،هلك أو قارب، وهذا يبيح تناول الحرام الحاجة: كالجائع الذى لو لم يجد ما يأكله لم يهلك غير أنه يكون فى جهد ومشقة، وهذا لا يبيح الحرام، ويبيح الفطر فى الصوم المنقعة: كالذى يشتهى خبز البر ولحم الغنم والطعام الدسم الزينة: كالمشتهى بحلوى والسكر الفضول: التوسع بأكل الحرام والشبهة
[Sharh al-Hamawi ala al-Ashbah wa al-Naza`ir, 1: 252, Idarah al-Qur`an wa al-Uloom al-Islamiyyah]
[Jadeed Fiqhi Masaa`il, 5:59, Zamzam Publishers; Fiqhi Faslay (Urdu translation) p. 157]
[3] لم يجز بيع الميتة والدم لإنعدام المالية التي هي ركن البيع فإنهما لا يعدّان مالا عند أحد وهو من قسم الباطل
[Al-Bahr ar-Ra`iq, (al-Bay al-fasid), 6: 115, Maktabah Rashidiyyah; Tabyin al-Haqa`iq, 4: 362, Dar al-Kutub al-Ilmiyyah Beirut; Fatawa Haqqaniyyah, 6: 56, Dar al-Uloom Haqqaniyyah; Fatwa Mahmudiyyah, 18: 328-9, Dra al-Ifta Jamiah Faruqiyyah Karachi]
[4] [Fatawa Mahmudiyyah, 18: 336, dar al-Iftaa Jamaiah Faruqiyyah, Karachi]
أحدهما أن يوصي بما هو معصية عندنا وعندهم كالوصية للمغنيات والنائحات فهذا لا يصح إجماعا
[Majma` al-anhur Sharh Multaqa al-Abhur, 4: 451, Makatabh Gaffariyah Kuwaitah; Radd al-muhtar ala ad-Durr al-Mukhtar, 6: 696, H.M. Saeed Company; al-Bahr ar-ra`iq, 9: 303, Maktabah Rashidiyyah]
Reuters, “Selling organs discouraged”, 13 November 2000.
[5] الضرورات تبيح المحظورات
[Al-Ashbah wa an-Naza`ir ma`a Sharh al-Hamwi, 1: 251, Idarah al-Qur`an wa al-Uloom al-Islamiyyah, Karachi]
المشقة تجلب التسير
[Al-Ashbah wa an-Naza`ir ma`a Sharh al-Hamwi, 1: 226, Idarah al-Qur`an wa al-Uloom al-Islamiyyah, Karachi]