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RENAL DATA FROM THE ASIA - AFRICA |
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| Year : 2009 | Volume
: 20
| Issue : 1 | Page : 154-156 |
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| The islamic perspective of organ donation in Pakistan |
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Muhammad Ilyas, Mukhtar Alam, Habib Ahmad
Department of Genetics, Hazara University, Mansehra, NWFP, Pakistan
Click here for correspondence address and email
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How to cite this article:
Ilyas M, Alam M, Ahmad H. The islamic perspective of organ donation in Pakistan. Saudi J Kidney Dis Transpl 2009;20:154-6 |
 Introduction | |  |
The word Islam means "submission", or the total surrender of oneself to God. An adherent of Islam is known as a Muslim, meaning "one who submits (to God)" and recognizes in Muhammad (PBUH) as his last Prophet and Messenger. From its inception Islam was concerned with ethics in all its aspects of social well being of individuals and the community. Social ethics was, and remains, an important component of Islamic religious law, the Sharia. [1] The Qur'an and the exemplary life of the Prophet (PBUH) provides the two major sources for deriving ethical and legal guidelines for Muslims. Part of this social ethics is bioethical prescription to regulate health care based on distributive justice and the total welfare of those needing the health care.
The modern techniques of biology did not exist at the time of advent of Islam. However, there are Ayahs and Ahadiths which expound the fundamentals of Islamic thinking and scholars (Ulama) have examined the modern questions of bioethics in the light of such fundamental principles and have drawn conclusions with respect to cloning, genetics engineering, organ donation, and tissue culture etc.
About 95% of the Pakistani population is Muslim. Sixty-five percent of the country's population is still rural, with a per capita income of $408 per year. [2] The overall literacy rate is estimated to be 41.5% with a much lower percentage in women. Health care sector in Pakistan is also experiencing an increase in high-tech tertiary level medicine such as advanced cardiology, cardiac surgery, major joint replacements, reproductive technology, and organ transplantation. [3]
Long time ago, organ transplantation has transformed from an altruistic act to an illegal trade. [4] A report from Sind Institute of Urology and Transplantation Karachi revealed that 75% of renal transplantation in 1991 was living related in contrast to 80% unrelated renal transplants in 2003 majority performed for foreigners. [5] It is estimated that with "transplant packages" ranging from $13,000 to $ 25,000 the business garners close to $15 million annually for transplant physicians and their hospitals.
Kidney transplantation is the preferred treatment for end-stage renal disease and improved survival has resulted in increase demand for kidney donation. [6] Legislation in different countries restricts the organ donation to living related or cadaveric donation. In the absence of state law supervising the transplant practices in Pakistan, people from across the world benefited from the organ wholesale market, commonly known as Gurda Piri. [7]
An organ transplant bill that had been under study with the senate since 1992 was finally approved on 5 September 2007 as "A Transplantation of Human Organs and Tissues Ordinance 2007" by the Government of Pakistan, and many illegal organ donation and transplantation centers were closed down and many senior doctors involved in the organ trade were arrested and punished.
| Islamic Perspective | | |
In the light of a number of Ahadith, it can be concluded that seeking medical treatment for ailment is obligatory or at least recommended. On the other hand, mutilation and violation of corpses is strictly forbidden in Islam, whether it is a muslim or non-muslim cadaver.
The Permanent Committee for Legal Rulings (Fatawa) in Saudi Arabia conclude the following regarding dissection on dead bodies: [8]
- Dissection to discover if there is a criminal act causing the death is sanctioned.
- Dissection to see if there is a contagious disease and to then conclude how to stop its spread is sanctioned.
- Dissection for educational and training purposes is accepted.
It is also allowable to perform any organ transplant such as the human heart or the eye. [9]
As a consequence of the present development in medical knowledge and skills a number of questions have arisen. These are:
- Is it allowed to remove an organ like the kidney from the body of a living person and transplant it into the body of a sick person whose life depends on it?
- Is it permissible to remove an organ from the body of a dead person to be used to save the life of a living person?
- Is a person allowed to donate his body or part of it to be used after his death in saving the life of another human?
- Does Islam recognize the new definition of death such as brain stem death?
- If it does, is it permissible to remove from brain stem dead persons organs for transplant while there are signs of body functions such as heart beat, temperature and breathing?
The principles of Islamic Jurisprudence (Usul Fiqh) state that:
- A person has the legal authority over his own body, attested by the fact that he can hire himself for work which might be difficult or exhausting. He may also volunteer for war which may expose him to death.
- A person is forbidden from harming himself or others (It is not legitimate in Islam to inflict harm on others or to suffer harm from them - Hadith).
- In case of Necessity certain prohibitions are waived as when the life of a person is threatened the prohibition on eating carrion or drinking wine is suspended. [10]
"He has only forbidden you what has died by itself, blood and pork, and anything that has been consecrated to something besides God. Yet anyone who may be forced to do so, without craving or going too far, will have no offence held against him; for Allah is Forgiving, Merciful."(2:173)
- Islam made it an obligation upon the sick to seek treatment.
- In the light of the above principles the Council which consists of scholars from all the major Muslim Schools of Law in Great Britain, is of the opinion that:
"It is permissible for a living person to donate part of the body such as the kidneys to save the life of another, provided that the organ donated would not endanger the donor's life and that it might help the recipient."
The Prophet (PBUH) stated,
"Whoever helps a brother in difficulty, God will help him through his difficulties on the Day of Judgment."
One can therefore inference that:
- It is permissible to remove the organ of a dead person to be used to save the life of a sick person.
- It is permissible for a person to donate his body or parts of it to be used after death to treat those who need transplant. So it is permissible for Muslims to carry a donor card.
- In the absence of a donor card carried by the dead person, it is sufficient to obtain the consent of the next of kin.
- The proper authorities will act in lieu of relations if they are not known.
- The opinion is that human organs should be donated, and not sold. It is prohibited to receive a price for an organ. [11]
| Conclusion | | |
In a country with low literacy rate mass education at all levels can only increase the awareness about bioethical issues to formulate a "considered opinion" in enforcing the laws related to organ transplantation.
The religious scholars through the help of transplant physicians and surgeons can also be of immense help in this regard.
These issues should also be openly debated through print and electronic media. Seminars, conferences and workshops should be held to encourage interaction between experts, academicians, researchers, students and policy makers, etc.
Curricula of educational institutions including universities, colleges and schools should include advanced or introductory courses on bioethics.
Ulemas and religious scholars should be consulted for their opinion while formulating laws or rules and regulations concerning bioethical issues.
| References | | |
| 1. | Abdallah SD, Khitamy A. Bioethics for clinicians: 21. Islamic bioethics. Can Med Assoc J 2001;164:1.  |
| 2. | Haqqani H. The Role of Islam in Pakistan's Future. The Washington Quarterly. 2005;28: 85-96. |
| 3. | Moazam F, Jafarey AM. Pakistan and biomedical ethics: Report from a Muslim country. Cambridge Quarterly of Healthcare Ethics 2005;14:249-55. [PUBMED] |
| 4. | Calne RY. Organ transplantation with special emphasis on Cyclosporin A. Surg Today 2006;14(6):435-43. |
| 5. | Moazam F. Battling Kidney Trade in Pakistan: The Struggle Continues. Bioethics Links. The Centre of Biomedical Ethics and Culture, SIUT, Pakistan. 2007; 3:1 pp.2. |
| 6. | Chugh KS, Jha V. Problems and outcomes of living unrelated donor transplants in the developing countries. Kidney Int 2000;57(74) S131-5. |
| 7. | Nosheen MR. Pakistan witnesses a major growth in organ trade. Daily Times Pakistan, 25 February 2007. |
| 8. | Badawi MA. 1988. Life, Death and the Religions - An Islamic View. Published in 'Issues in Bio-Medical Ethics', Macmillan India, 1990. |
| 9. | Kamali MH. Two Approaches to the Study of Usul al-fiqh. Principles of Islamic Jurisprudence. 2003;: 17-9. |
| 10. | Badawi Z. Organ transplant, Islam, Fiqh, Fatwa, Ruling, Shariah - A Juristic ruling regarding organ Transplant. Islamic Voice 1998;12(8): 140. |
| 11. | Badawi, Z. Organ Transplant Fatwa. World Islamic Mission. 1995. |
Correspondence Address:
Mukhtar Alam
Department of Genetics/ Director Research and Planning, Hazara University Mansehra
Pakistan
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 19112239 
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