A:SHAR’I PERSPECTIVE TO CORNEAL GRAFT
The cornea is a thin transparent tissue on the front part of the eye that covers the iris, pupil, and anterior chamber, providing most of an eye’s optical power. This is one portion of the human body that contains no blood.
A corneal graft is when this tissue is removed from the eye of a dead person and stitched into the eye of a patient who needs a new cornea.
The Shar’i status of this falls under the issue of organ transplant, since the cornea is a portion of the human body. With regard to organ transplant, there are two distinct views among the Ulama. Former Ulama ruled that organ transplant of any sort is totally Haraam. Today the majority of Ulama maintain the same view. Meanwhile, there are other senior Ulama today who have shifted from this orthodox view and maintain that in view of the wide scale medical needs of people and the increase in injuries and health complications, organ transplant is permissible
We take a look at some of the reasons furnished by those who prohibit this medical procedure, as well as the counter arguments.
A common ground for the prohibition of organ transplant is the fact the human parts are sacred, and removing these parts is tantamount to desecration of human life. For this very reason, Jurists of former times have prohibited intifaa’ (deriving benefit) from human parts. They maintain that due to man’s honour and sanctity, one cannot derive benefit from human life.
In answer to this, pro-organ transplant scholars say that in using the body part of one human in another there is no desecration but preservation of that part. They claim that in former times organ transplant never existed, so the benefit referred to in classical works of Fiqh could never refer to transplanting organs. Instead, what the Fuqahaa and former jurists meant by intifaa’ was the consuming of human parts or utilization of the same for some external purpose. Hence we find in Fataawa Hindiyyah the law that one human is not allowed to consume the flesh of another, even if the former is dying. The reason: Sanctity of human life. Furthermore Fuqahaa mention that any portion of the human body that has been severed must be buried. Again, the reason forwarded here is respect and reverence for the human body. Should that part not be buried, it will rot and decay, or become food for vultures and scavengers. However, in the transplant of a human organ there is no desecration or irreverence. Instead, the organ is preserved with the utmost care and continues its normal function. Should that organ not be serving its normal function, it cannot remain inside that body. Should the recipient of the organ die, he will be buried with the organ. The organ is not removed and then subject to desecration and disrespect. In short, the intifaa’ or benefit spoken of in former books did not refer to utilization of that organ in another human body, since this concept never existed in those days. The benefit spoken of there was that of eating or external usage that entailed desecration and destruction to the organ. Indeed eating the body parts of another is highly disrespectful and ignominious, for then man is relegated to the level of ordinary animals. Furthermore, what is consumed will eventually be expelled from the body in the form of impurity and faeces. This is also highly disrespectful, whereas in organ transplant the human part remains intact; it continues its natural function and is not subject to waste and impurity.
The third reason advanced for prohibition is the issue of mutilation. Removing the organ is mutilation of the body. Ulama have responded to this by stating that mutilation actually means the unceremonious disfiguring and dismemberment of the human body. In organ removal, this is not the case; instead, a careful incision is made and the organ carefully removed. Sure there will be a scar left and there will be cutting and bleeding, but that cannot be likened to the mutilation that Shari’ah prohibits. Again, the example of cutting open the stomach of a dead mother to remove the baby, as well as making incisions in the body for general operations on a live person prove that this much of cutting is allowed provided there is a valid reason to do so.
The fourth objection against organ transplant is that the Hadeeth of Rasulullah (Sallallaahu Alayhi wa Sallam) prohibits a woman from adding human hair to her existing hair in order to enhance her looks or increase the amount of hair on her head. The Ulama say that in this Hadeeth, which is narrated in Bukhaari, Muslim, and several other Hadeeth works, the use of a human body-part has been prohibited. Some Hadeeth mention that even a woman who had lost her hair was prohibited from resorting to this form of treatment. It is thus clear that no matter what the reason may be, utilization of a human part is Haraam.
THE CORNEAL GRAFT
Having gone through some of the main arguments for and against organ transplant in general, we concede that the case in favour of organ transplant does not appear very strong, since the arguments presented in its support do not entirely satisfy the heart nor succeed in fully dispelling the objections against. We, therefore, advocate the route of caution and abstention in this regard. However, a corneal graft is not similar to other forms of organ transplant. When considering the nature of the corneal graft we notice that in this operation some of the above reasons against organ transplant are not found. There is no mutilation of the body, there is no discomfort caused to the body as in cutting and removing, and the tissue that is removed is very small and hardly constitutes an organ. The Fuqahaa have overlooked the pieces of skin and hair that inadvertently fall into food when cooked, despite one being aware of this. Yet they disallow the consumption of food in which a human tooth or bone has been ground and cooked. This can be attributed to the small and negligible amount of human tissue that is involved. The same would apply to the small tissue that is removed from the front of the eye.
It has also been reliably reported that some of our Akaabir, such as Hadhrat Moulana Yusuf Binnori Saheb (RA) and Hadhrat Mufti Wali Hasan Saheb (RA, former Grand Mufti of Pakistan) gave permission for a corneal graft, in spite of the fact that these very same Ulama prohibited organ transplant. The Fiqh Academy of India, comprising hundreds of senior Ulama in India, under the presidency of the late Qaadhi Mujaahidul Islam, held a seminar to discuss this issue. The consensus that emerged from their deliberations was that all forms of organ transplant are permissible, provided this is done for valid medical reasons and not just for cosmetic fancies. However, they prohibited the exchange of money for organs donated.
On the basis of the above, it is the writer’s humble opinion that the ruling on corneal graft should be one of permissibility. Should anyone opt for this ruling, there will be no sin incurred, since this ruling was handed down by renowned and acclaimed Ulama. It will be permissible to act on their fatwa and undergo surgery of this nature.
And Allah knows best.
Mufti Siraj Desai