ORGAN DONATION

Raha punya part

Ethical Basis Against Organ Donation

From Islamic Perspectives

The Status of Human Body in Islam

• The body of a human being is treated as sacred in Islam, regardless of the state it is currently in; dead or alive.

• Organ donations are divided into two types; cadaveric organ donation and brainstem-death organ donation.

• Both types of organ donation requires the body of the donor to be opened up and the respective organ being removed to constitute “transplantation”.

• This action is considered as a mutilation and deformation of the human body, hence, is against the basic Islamic principle of prohibiting such act to be conducted upon human being, dead or alive, no matter how grave the need for it; as narrated in Sahih Muslim, 2/82.

Human Body as a Trust

• A good Muslim will understand that everything we see, everything we have or we will ever have does not belong to us, but to Allah SWT. So does our body.

• Our body were put in trust to us, it is a loan to us from Allah SWT. The true ownership lies with Him alone and to Him we shall return. When we borrowed something from someone, we will be sure to return what we have borrowed in the state of when we first have it.

• Thus, it is inappropriate for us to determine, on our own capacity, to donate the organs in our body while it does not even belonged to us.

• Our body is solely Allah’s and it is preferable that one day we return to Him in one piece.

Infliction of Harm

• Donating organs will only inflict harm upon ourselves.• Donating organs will increase the likelihood that we will

not survive a condition should one day, for instance, our only kidney does not function properly as it should. There will be a certain death from kidney failure.

• This act of donating organs contradict the key principle in Islamic law which states that it is unlawful for individuals to inflict harm upon themselves.

ISLAM AND ORGAN DONATION

VIEWS ON ORGAN DONATION

• There are two views with regards to organ donations.

• The human body, whether living or dead, enjoys a special honour and cannot be violated.

• "The saving of life is not absolute, but subject to the amount of cost that has to be borne.

• Fundamentally, Islamic law emphasises the preservation of human life.

• general rule that 'necessities permit the prohibited' (al-darurat tubih al-mahzurat), has been used to support human organ donation with regards to saving life.

• Enhancing a life of another is included with the rule that the benefit outweighs the personal cost that has to be borne.

• There are several verses that support this statement :-

• "Whosoever saves the life of one person it would be as if he saved the life of all mankind”, (Holy Quran, chapter 5 v 32)

• Prophet Muhammed (pbuh)• "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."

ALTERNATIVE VIEW IN ISLAM

• Although the above quotation enjoins the saving of life, it does not come without restrictions.

• A similarly large number of Muslim scholars does not permit organ donation.

• They consider that organ donation compromises the special honour accorded to man and this cannot be allowed despite the cost.

• Scholars, such as the Islamic Fiqh Academy of India, allow live donations only." Mufti Mohammed Zubair Butt, Muslim Council of Britain.

• In a formal decision in 1996, the UK Muslim Law Council issued an Ijtihad (religious ruling) that organ transplantation is entirely in keeping with Islam.

• Muslims in the UK may carry donor cards, and live donation is seen as an act of merit.

• Previously, the Islamic Jurisprudence Assembly Council in Saudi Arabia approved deceased and live donation in a landmark decision in 1988.

• The National Transplant Resource Centre, based at the Kuala Lumpur Hospital, is the coordinator for activities pertaining to organ and tissue procurement:The centre's statistics showed that the number of organ pledgers as at Dec 31 last year was 81,894 about 0.3% of the total population. From this number, there were only 141 actual donors.

• Decrees on such permissibility had been made by the Islamic Fiqh Academy and Islamic scholar Dr Yusof Qardawi.

• In Malaysia, the fatwa on the permissibility of organ donation and transplantation was issued in June 1970.

• The principle of Fiqh, based on the above Qur’anic guidelines, states: “Necessity makes prohibition lawful” (See: Ibn Nujaym, al-Ashbah wa al-Naza’ir, P. 85 ).

• According to Imam Shafi’i (Allah have mercy on him), it is permissible for a person dying out of hunger to consume the meat of another human. (See: Ibn Qudama, al-Mugni, 9/335).

• In cases of need and necessity, impure, unlawful and Haram things become permissible. If and when a person’s life is in danger and he is in dire need for transplantation, he is in such a situation, thus the transplantation of organs will be permissible.

CIRCUMSTANCES FOR ORGAN TRANSPLANT

• The National Fatwa Council which sat on 23rd and 24th June 1970 decided that eye and heart transplant from deceased donors to living recipients are permissible in Islam, under the following considerations.

• A) It is carried out in critical and crucial situations where the life of the recipients depends on the organ transplantation, and the transplantation have a high degree of success.

• B) In heart transplant, the death of the donor must first be ascertained.

• C) Necessary actions must be taken so that no human killing and organ trading are involved.

• D) Permission must be obtained from the donors prior to transplantation(in cases of normal death) or from the family members (in cases of death resulting from accidents).

CONDITIONS ON PERMISSIBILITY

• Living donors are not inflicted with harm such as death or disabilities (loss of hearing, sight and mobility).

• Transplantation is performed with the permission from the donors.

• The permission is obtained from donors who are legally able to do so. Permission cannot be given by children, mentally-incompetent people or individuals who are confused, under pressure or coerced to donate.

• Not conducted in ways that could violate human dignity such as organ trading. It should be done for altruistic reasons.

• Doctors involved in the transplantation have sufficient knowledge to assess the donors’ and recipients’ conditions based on the principles of maslahah (benefits) and mafsadah (harms) according to Islamic Law.

Organ Transplantation: Ethical Dilemmas

and Policy Choices

• The shortage of organs for transplantation has led to greater use of organs from living donors. It has also led to unhealthy and unethical practices such as the use of organs from executed prisoners and rampant commercialization in transplantation.

• The human body (dead or alive) has not been reduced to mere property, and yet the desperation and need or the organ transplantation had pushed people to exploit another human being.

• The current organ policy laid down by Ministry of Health Malaysia, National Organ, Tissue and Cell Transplantation Policy, was shaped from revising various guidelines from local and foreign sources alike. This Policy serves to:

1. Guide the practice of organ, tissue and cell transplantation in Malaysia.

2. It also ensures that the organ, tissue and cell transplantation is carried out to the highest ethical and professional standards while ensuring that the rights and welfare of living donors are looked after.

Consent

• Who has the right to make decisions about their bodies before and after death? Are there legitimate moral reasons not to be an organ donor or not to allow the organs of a deceased loved one to be taken? Do siblings or parents, while alive, have a moral obligation to donate organs to siblings or children who would otherwise die?

1. Competent adult living persons can donate organ and/or tissue but they shall preferably be related to the recipients and donor consent must be given freely and altruistically without coercion or any commercial inducement.

2. They shall be counseled by donor advocates regarding the risks, benefits and possible consequences.

3. Donor advocates shall be independent of the organ procurement and transplantation team.

4. No organ and/or tissue shall be removed from the body of a living minor for the purpose of transplantation except in the case of regenerative tissues.

5. At each identified hospital there shall be a Tissue Organ Procurement (TOP) Team consisting of trained personnel who shall be responsible for the identification and management of the potential donor including getting consent from the next of kin, evaluation for donation, organizing the procurement, storage and transport of the organs and tissues and speedy return of the donor’s remains to the next of kin.

Physical Exploitation

If possible saving ones’ life must be made by inflicting the least harm to the donors. Society cannot simply take all available organs, and treat dead bodies as a public resource. It is our responsibility to ensure there is no physical exploitation inflicted to the donors.

For examples:1. All clinicians involved in the procurement and transplantation process

shall ensure the highest standards of safety and quality.2. Organ, tissue and cell transplantations shall only be performed in

accredited centres which meet the standards established by the Ministry of Health.

3. Transplantation centres shall maintain high standards of practice. This can be achieved by the regular monitoring of patient and graft survivals and other indices of quality care using internationally accepted criteria.

Financial Exploitation

• The occurrence of black market had promoted the activity that William F. May described as "selling-and-buying" organ or transplantation. For example, in Chennai, India where one of the largest black markets for organs is known to exist, studies have placed the average sale price at little over $1000.

• However this encumbrance can be overcome by:1. Criminalizing “organ’s black market” 2. Implementing policy to prohibit any activity of commercialization of organ,

tissue and cell transplantation and any act that may indirectly promote or lead to commercial transaction.

3. Instead, all of organ, tissue and cell transplantation recipients shall receive appropriate assistance from the Government

4. The cost incurred by the family of a cadaveric donor related to the organ and/or tissue procurement process shall be reimbursable by an authorized body or organization recognized by the Ministry of Health.

REFERENCES

• National Organ, Tissue and Cell Transplantation Policy

• https://bioethicsarchive.georgetown.edu/pcbe/background/org_transplant.html

• http://www.medscape.com/viewarticle/741267_3• http://

www.organdonation.nhs.uk/how_to_become_a_donor/religious_perspectives/leaflets/islam_and_organ_donation.asp

• http://www.themodernreligion.com/misc/hh/organ-transplant.html