Q: My question is regarding stem cells and their usage in treatment.
Stem cells are ‘blank’ cells that have the potential to become any cell in the body e.g. heart, brain, muscle, etc.
Primarily, stem cells are taken from two sources:
1. Human embryos that are between 3 to 5 days old. The cells are usually taken from embryos that are fertilized in a lab (not in the womb).
2. Adult tissue. In this case, the stem cells can be taken from bone marrow, fat tissue (e.g. in the buttocks), blood, amniotic fluid (the fluid in the womb around the baby), the umbilical cord and many other parts of the body.
These stem cells can be harvested from the patient himself or from donors.
After the stem cells are harvested, they are ‘grown’ (cultured) in the laboratory where they multiply into more cells (daughter cells) until the number of cells is sufficient for treatment purposes. They are then used for treatment in some of the following ways:
1. The stem cells are manipulated in the lab to become (for example) heart cells. These heart cells are then injected into a damaged heart where they repair the damage to the heart. In a similar manner, the stem cells can be manipulated into brain cells and injected into the brain, spinal cord tissue and injected into the spinal cord, etc. These stem cells then repair whatever damage is found in the organ into which they are injected.
2. In some cases, if (for example) a patient has a damaged organ, the doctors can use stem cells to grow him a new organ in the laboratory. This has already been achieved in 2011 where a woman with a damaged windpipe had a new windpipe grown with stem cells and transplanted into her body to replace her damaged windpipe.
In which cases will stem cell treatment be permissible in Shari’ah?
Similarly, is IVF permissible in the case where the husband and wife do not have children?
اَلْیَوْمَ اَکْمَلْتُ لَکُمْ دِیْنَکُمْ وَاَتْمَمْتُ عَلَیْکُمْ نِعْمَتِیْ وَرَضِیْتُ لَکُمُ الْاِسْلَامَ دِیْنًا
Today I have perfected for you your religion and completed My favour upon you and I am pleased with Islam as your religion.
Being a complete and perfect way of life demands that Islam possess the solutions to all problems and situations, and be able to withstand and endure the tests of all times. However, it is extremely important for one to understand Islam correctly and remain within the parameters and limits set by Allah Ta’ala.
The Position of Man
At the onset, one should understand the position and status of man compared to all the other creations of Allah Ta’ala. Man is the paragon of Allah’s Ta’ala creation and the purpose for which this entire universe has been brought into existence. Allah Ta’ala says:
وَلَقَدْ کَرّمْنَا بَنِیْ اٰدَمَ
We bestowed honour to the children of Nabi Aadam (alayhis salaam)
Every organ in the human body is an amaanah (trust) of Allah Ta’ala. We are only permitted to utilise this trust and derive benefit from it in the manner that Allah Ta’ala has allowed us to do so. When we are not the sole owners of our bodies, we are not allowed to deal in them in the manner we deem appropriate when it violates the command of Allah Ta’ala. Hence, the crucial question that arises is, “What are the commands of Shari’ah in regard to this amaanah?”
What are the commands of Shari’ah in regard to this amaanah?
Shari’ah has commanded that respect be shown to this amaanah and that one refrain from doing anything which amounts to disrespecting it. The actions which amount to respect or disrespect will be understood through referring to the Fuqahaa. The Fuqahaa are those personalities who have understood Deen correctly and sacrificed their entire lives for the cause of preserving Deen and deducing the laws and injunctions of Deen from the Quraan Majeed and Hadith.
The ruling of the Fuqahaa regarding the various parts of the body
The Fuqahaa have ruled that the nails and hair of a person, once removed from the body, should be respectfully disposed of by being buried. It is not permissible for one to sell, donate or gift any of these parts to anyone. This ruling is equal in regard to Muslims and non-Muslims.
The law that applies to the hair and nails also applies to other parts of the human body viz. the heart, eyes, kidneys, ears, and other limbs and organs. Hence, it is not permissible for any person to donate his body limbs during his lifetime, regardless of whether he will suffer ill health or not through donating the limb. Similarly, it is not permissible for one to donate any limb of his body after his demise.
The impermissibility of selling and donating these limbs is on account of the fact that every part of the human body has been granted honour and should hence be respected. Gifting, donating or selling any part of the human body is regarded as showing disrespect to it as one is reducing it to a material commodity that is sold, gifted or disposed of. Therefore, we find that the Fuqahaa have ruled that it is not permissible for one to use human hair as a wig or to donate one’s hair for this purpose. We thus understand that the basis for the impermissibility in all these masaa’il is that we are not the owners of our bodies.
Adopting halaal means for medical treatment
As far as a person who has an ailment or disability is concerned, Shari’ah has allowed him to seek treatment for his condition. However, Shari’ah has commanded him to adopt the halaal means in the process of undergoing medical treatment. As long as a halaal alternative is available, he is prohibited from adopting a haraam means.
In the case where a halaal alternative is not available, he is permitted to resort to haraam medication, provided it is under the guidance of an experienced Muslim physician who advises him to adopt the haraam means for his cure. Under such circumstances, it is permissible for him to adopt haraam medication, and this will be likened and compared to a person who is allowed to consume wine, swine or carrion in order to save his life. Based on the same principle, the Fuqahaa have allowed blood transfusion in the case where one is in need of blood. Accordingly, the Fuqahaa have permitted using the breast milk of a woman for medicinal purposes in the case where it is proven to be a means of cure and there is no halaal alternative available.
Apart from the situation of dire need, it is not permissible for one to benefit from the breast milk of any woman – even though it is considered paak – as it has been produced through the human body. Similarly, it is not permissible for one to use blood as a means of cure in the case where there is no dire need, as blood is regarded as najis (impure) in Shari’ah. Hence, apart from blood being produced by the human body (as is the case with breast milk), blood is also considered najis, and hence there are two factors that render it impermissible for one to use. However, despite this, the Fuqahaa have permitted the use of these two substances as a means of medication and cure at the time when there is no halaal alternative found.
Blood transfusion and utilising stem cells for treatment
It should be borne in mind that the permission of Shari’ah for resorting to treatment through such substances is not restricted to a life-threatening situation, but even applies in the case of removing bodily pain and discomfort. Hence, blood transfusion is permissible at the time when one requires blood as a cure for an illness, even though the illness is not life-threatening.
When one examines the situation closely, one finds that stem cells, enzymes or bone marrow that are extracted from the body resemble blood and women’s breast milk in this respect that the body reproduces and replenishes these substances and their removal does not generally endanger one’s life or affect one’s health.
Proof from the fatwa of Hazrat Mufti Abdur Raheem Laajpuri (rahimahullah)
The author of Fataawa Raheemiyah, Hazrat Mufti Abdur Raheem Laajpuri (rahimahullah), was once asked whether it is permissible for a burn-patient to be treated with an ointment which contains cells taken from the amniotic sac (the membrane containing the baby in the womb which is expelled with the after birth) as an ingredient, and whether skin grafts for such a patient is permissible. Hazrat Mufti Laajpuri (rahimahullah) gave the following reply:
In the case in question, if there is a dire need and there is no halaal alternative available then both forms of treatment will be permissible.
If the cells taken from the amniotic sac, which contains the child in the womb and is expelled with the after birth, is used for external medical treatment (i.e. one does not consume it) then it is permissible and there is no harm in using this as a treatment. The amniotic sac, after child birth, is something which is not needed and is worthless, and the ointment which contains cells from the amniotic sac is used and is beneficial in treating burn wounds immediately after they are sustained. This is contrary to skin grafts which are not used as a treatment immediately after the burn wound is sustained but are rather used as a treatment later on.
The Fuqahaa have permitted the usage of a woman’s breast milk, which is produced by the human body, for the purpose of treatment.
ولا بأس بأن يسعط الرجل بلبن المرأة ويشربه للدواء (الفتاوى الهندية 5/355)
From the fatwa above, we see that Hazrat Mufti Laajpuri (rahimahullah) has permitted using the stem cells from the amniotic sac (or placenta, umbilical cord, etc.) which is attached to the mother and child for the purpose of medication or cure at the time of dire need. This is regardless of whether it is used for the benefit of the mother or child, or for the benefit of another person prior to the amniotic sac being buried.
Based on this fatwa, we understand the permissibility of using stem cells, enzymes, bone marrow, etc. in situations where it is proven that they will assist in saving one’s life, repairing a damaged area in the body or improving health.
The reason for the permissibility of using stem cells
The reason for the permission of using the stem cells from fat cells, enzymes or bone marrow is that it is equated to blood transfusion, where one donates blood for the benefit of someone in need. Hence, in the case of the placenta and umbilical cord, the permissibility will be to a greater degree, as the placenta and umbilical cord are not required after childbirth and these are buried.
At this juncture, it should be understood that the permission of donating the stem cell is on account of it not decreasing the limb itself. Rather, it is only a few cells that are removed which are similar to blood taken out of the body. If some person wishes to consume these body parts (placenta, umbilical cord) for some medical cure, it will not be regarded as permissible as one is decreasing and using the actual body part itself which is not permissible.
The Fuqahaa have clearly stated that if some part of a person’s body falls off, it is permissible for him to undergo surgery to reattach that part to his body. Accordingly, the Fuqahaa explain that if one’s ear has fallen off, it will be considered najis in regard to other people, however in regard to the person whose ear has fallen off, it will be regarded as paak and it will be permissible to rejoin it to the body through surgery. The same ruling of permissibility applies to the rejoining of a fallen tooth. Hence, from this, we understand that if a portion of the body is burnt, then for one to undergo surgery and graft skin from one’s own body is permissible. Taking skin from the body of another person is not permissible.
Organ transplants or donating one’s organs during one’s life or after death cannot be compared to donating stem cells, enzymes and bone marrow as in the case of organ transplants or organ donations, one is decreasing a part of one’s body and causing harm to oneself for the benefit of improving another person’s health. However, in the case of stem cells, enzymes and bone marrow, the body reproduces and replenishes these substances and their removal does not generally endanger one’s life or affect one’s health. If one is advised by the physicians that his health will be adversely affected, it will not be permissible for such a person.
One is not permitted to donate one’s organs as he is not the owner of the organs, but is rather a trustee of them. The trustee is commanded to deal in the trust in the manner that he is commanded by Allah Ta’ala. Dealing in the trust against the command of Allah Ta’ala will amount to a breach of trust and render him sinful.
Embryonic stem cells
As for embryonic stem cells, they are acquired from embryos which are created when the man’s sperm and woman’s egg are combined for fertilization. Thereafter, the stem cells are removed and used medically. In regard to the Shar’ee ruling of removing the egg from a woman is concerned, it is not permissible for a woman to expose her satar in order for her egg to be removed. However, if the stem cells have already been prepared, the treatment will be permissible.
Acquiring a child through In Vitro Fertilization
In regard to in vitro fertilization, some Ulamaa regard it to be permissible for a husband and wife who are unable to have children to give the sperm and egg to the in vitro lab for the purpose of fertilization of an embryo which will thereafter be inserted into the womb of the woman. However, according to most of our Ulamaa, it is not permissible for the following reasons:
1) Firstly, this method of falling pregnant is an unnatural one wherein there is fear of the sperm and egg of different people getting mixed. The sperm of one man may get mixed with the egg of a woman who is not his wife. Numerous cases of this have been reported.
2) Secondly, the woman is required to expose her private parts for carrying out this medical procedure whereas it is not permissible for a woman to expose her satar – even before other women – unless she is in need of medical treatment to cure an ailment.
3) Thirdly, there is great potential of this leading to things which are against Shari’ah such as cloning, etc. Hence, when there are other alternatives available, there is no need to explore an avenue which is against the Shari’ah.
It is on account of these reasons that many of our senior Ulamaa regard it impermissible for a husband and wife to adopt this medium of falling pregnant.
Among our Ulamaa who regard this to be impermissible are the following:
1. Hazrat Mufti Mahmood Hasan Gangohi (rahimahullah)
2. Hazrat Mufti Rasheed Ahmad Ludhyaanwi (rahimahullah)
3. Hazrat Mufti Abdur Raheem Laajpuri (rahimahullah)
4. Hazrat Mufti Ahmad Khaanpuri (daamat barakaatuhum)
5. Hazrat Mufti Salmaan Mansoorpuri (daamat barakaatuhum)
6. Hazrat Mufti Zainul Islam (daamat barakaatuhum)
And Allah Ta’ala knows best.
ومن قتل نفسه بشيء في الدنيا عذب به يوم القيامة… ويؤخذ منه أن جناية الإنسان على نفسه كجنايته على غيره في الإثم لأن نفسه ليست ملكا له مطلقا بل هي لله تعالى فلا يتصرف فيها إلا بما أذن له فيه (فتح الباري 11/539)
عن ابن عمر رضي الله عنهما قال قال رسول الله صلى الله عليه وسلم ادفنوا الأظفار والشعر والدم (السنن الكبرى للبيهقي، الرقم: 76)
فإذا قلم أظفاره أو جز شعره ينبغي أن يدفن ذلك الظفر والشعر المجزوز فإن رمى به فلا بأس وإن ألقاه في الكنيف أو في المغتسل يكره ذلك لأن ذلك يورث داء كذا في فتاوى قاضي خان يدفن أربعة الظفر والشعر وخرقة الحيض والدم كذا في الفتاوى العتابية (الفتاوى الهندية 5/358)
الآدمي مكرم بجميع أجزائه فلا يبتذل بالبيع وسيأتي باقيه… والآدمي مكرم شرعا وإن كان كافرا فإيراد العقد عليه وإبداله به وإلحاقه بالجمادات إذلال له (فتح القدير 6/425)
والآدمي محترم بعد موته على ما كان عليه في حياته فكما يحرم التداوي بشيء من الآدمي الحي إكراما له فكذلك لا يجوز التداوي بعظم الميت قال صلى الله عليه وسلم كسر عظم الميت ككسر عظم الحي (شرح السير الكبير 1/92)
(ولا يجوز بيع شعور الإنسان ولا الانتفاع بها) لأن الآدمي مكرم لا مبتذل فلا يجوز أن يكون شيء من أجزائه مهانا ومبتذلا وقد قال عليه الصلاة والسلام لعن الله الواصلة والمستوصلة وإنما يرخص فيما يتخذ من الوبر فيزيد في قرون النساء وذوائبهن (الهداية 3/46)
مضطر لم يجد ميتة وخاف الهلاك فقال له رجل اقطع يدي وكلها أو قال اقطع مني قطعة فكلها لا يسعه أن يفعل ذلك ولا يصح أمره به كما لا يسع للمضطر أن يقطع قطعة من لحم نفسه فيأكل (فتاوى قاضي خان 3/247)
ومن خاف على نفسه الهلاك من العطش ولم يجد إلا خمرا فله أن يشرب منها ما يأمن به من الموت ثم يكف لأن الله تعالى أباح للمضطر أكل الميتة والدم ولحم الخنزير والخمر مثلها في التحريم فتكون مثلها في الإباحة عند الاضطرار فإذا أمن على نفسه زالت الضرورة وهو خوف الهلاك عاد التحريم (الاختيار 4/102)
ولا بأس بأن يسعط الرجل بلبن المرأة ويشربه للدواء (الفتاوى الهندية 5/355)
(قوله ولبن امرأة) بالجر أي لم يجز بيع لبن المرأة لأنه جزء الآدمي وهو بجميع أجزائه مكرم مصون عن الابتذال بالبيع أطلقه فشمل لبن الحرة والأمة وهو ظاهر الرواية (البحر الرائق 6/87)
ولا بأس بأن يستعطي الرجل بلبن المرأة ويشربه للدواء لأنه موضع الحاجة والضرورة ولو أصاب ثوبا لم ينجسه لأن الآدمي طاهر في الأصل فما تولد منه يكون طاهرا إلا ما قام الدليل الشرعي على نجاسته (المبسوط للسرخسي 15/126)
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 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 اهـ (رد المحتار 6/389)
فالضرورة بلوغه حدا إن لم يتناول الممنوع هلك أو قارب وهذا يبيح تناول (شرح الحموي على الأشباه 1/252)
(ولا يشد سنه) المتحرك (بذهب بل بفضة) وجوزهما محمد (الدر المختار 6/362)
قال العلامة ابن عابدين رحمه الله (قوله المتحرك) قيد به لما قال الكرخي إذا سقطت ثنية رجل فإن أبا حنيفة يكره أن يعيدها ويشدها بفضة أو ذهب ويقول هي كسن ميتة ولكن يأخذ سن شاة ذكية يشد مكانها وخالفه أبو يوسف فقال لا بأس به ولا يشبه سنه سن ميتة استحسن ذلك وبينهما فرق عندي وإن لم يحضرني اهـ إتقاني زاد في التتارخانية قال بشر قال أبو يوسف سألت أبا حنيفة عن ذلك في مجلس آخر فلم ير بإعادتها بأسا (رد المحتار 6/362)
(وشعر الإنسان) غير المنتوف (وعظمه) وسنه مطلقا على المذهب واختلف في أذنه ففي البدائع نجسة وفي الخانية لا وفي الأشباه المنفصل من الحي كميتته إلا في حق صاحبه فطاهر وإن كثر… (ودم سمك طاهر) (الدر المختار 1/207)
وشعر الإنسان وعظمه طاهر وقال الشافعي نجس لأنه لا ينتفع به ولا يجوز بيعه ولنا أن عدم الانتفاع والبيع لكرامته فلا يدل على نجاسته والله أعلم (الهداية 1/23)
فتاوی محمودیه 27/340-351
احسن الفتاوی 8/214-215
فتاوی رحیمیه 179 – 10/177
محمود الفتاوی 4/722-723
کتاب النوازل 16/207
چند اهم عصری مسائل 2/296-300
Mufti Zakaria Makada
Checked & Approved:
Mufti Ebrahim Salejee (Isipingo Beach)