Organ donation in Islam

This is an edited version of a speech given by Mrs Tahmina Aziz

Firstly, a little bit about organ donation, as you most probably know, there are two types of organ donation: live donations, where one living person donates an organ to another, and donations from the bodies of the deceased to living recipients.

Why should we think about this?

With medical advances it is now possible to use transplanted organs and tissues to enhance the life chances of those suffering from a range of terminal conditions such as renal, liver and heart failure.

Despite these advances the official statistics paint a very poor picture for ethnic organ donation. 66% of Black, Asian and some Ethnic Minority (BAME) communities living in the UK refuse to give permission for their loved ones’ organs to be donated compared to 43% of the rest of the population.

Blood and tissue type are among the most important factors when organs, such as kidneys, are allocated to patients and organ matching is likely to be closer when the ethnicity of the donor and recipient are the same.

As a result, on average, BAME communities will wait a year longer for a kidney transplant than a White patient. Many may die while waiting for an organ to become available.

Why don’t Muslims donate?

Most Muslims in Britain are from a South Asian background, so to be able to have donations from this part of the population could potentially save thousands of lives for people with similar backgrounds.

There could be several reasons, why we don’t donate, from being scared to simply not knowing enough about the procedures and risks. Another, perhaps more compelling reason, is that religion can be a barrier to people agreeing to organ donation because they feel their faith doesn’t allow it, particularly amongst black African and Muslim communities.

What does Islam say?

In Islam there are two schools of thought with regards to organ donation. One that condemns it and one that approves it. This is a contemporary issue and there is nothing said directly about it in the classical literature. Therefore, what has resulted is we have ended up with differing views from scholars, with some trying to establish the validity of their views on Sharia and hadiths.

It is worth pointing out that according to the NHS organ donation website, all the major religions of the UK support the principles of organ donation and transplantation.

The argument against

The people who condemn it believe it’s a form of mutilation, it’s disrupting the deceased. In Islam violating the human body, whether living or dead, is forbidden. They consider that organ donation compromises the special honour accorded to man and this cannot be allowed whatever the cost. Various examples from Hadith are used to come to this decision:

Allah’s curse is on a woman who wears false hair (of humans) or arranges it for others. – (Sahih Muslim, no. 2122).

Breaking the bone of a dead person is similar (in sin) to breaking the bone of a living person. –  (Sunan Abu Dawud, Sunan Ibn Majah & Musnad Ahmad).

Harming a believer after his death is similar to harming him in his life. –  (Musannaf of Ibn Abi Shayba)

They also claim this is also supported by the verse of the Qur’an, where Allah Almighty mentions the words of the devil, when he said:

I will mislead them and I will order them to slit the ears of cattle, and to deface the (fair) nature created by Allah –  (4: 119).

They believe that to deface the human body created by Allah, both physically and spiritually, is what the devil likes and orders to practice.

There are many more examples that have used quoting from various sources and extrapolated to mean you cannot donate because you need to honour the human body and to not cut and tamper with the human body.  But are these examples a bit of a stretch?

It could be argued that the Hadith about false hair is more to do with a persons’ vanity, and that breaking the bone of a dead person and harming the dead is to mean treating the dead with respect as you would the living.  There is also precedence here because people do undergo amputation (breaking the bone) to save their lives.

As to the Qur’anic verse, they imply that this is what the devil wants, I don’t personally believe this can be likened to organ donation.  As the act of organ donation is not disrespectful and ultimately has good intentions.

The Muslim burial customs deserve consideration as well: it is traditional for Muslims to be buried within 24 hours, and a lengthy organ retrieval procedure may raise concerns. However as many people can attest to, in the Western World, it can be very difficult to get all the necessary paperwork in place in time to be able to bury a deceased person within 24 hours.

The argument for

And on the other side, we have those who believe very strongly that it is one of the greatest of the commendations given by Islam, for someone to give the most beautiful gift – to save a life.

Altruism is also an important principle of Islam, and saving a life is placed very highly in the Qur’an:

Whosoever saves the life of one person it would be as if he saved the life of all mankind. – (chapter 5:32).

A few other examples are used from the Qur’an regarding human life:

3:185 Every soul will taste of death. And you will be paid your reward fully only on the Resurrection day. Then whoever is removed far from the Fire and is made to enter the Garden, he indeed attains the object. And the life of this world is nothing but a provision of vanities.
6:32 And this world’s life is naught but a play and an idle sport. And certainly the abode of the Hereafter is better for those who keep their duty. Do you not then understand?

The Holy Quran talks a lot about the differences between life here and the hereafter and how this life is a vessel to arrive at the right place in the hereafter.

40:39 O my people, this life of the world is but a (passing) enjoyment, and the Hereafter, that is the abode to settle.

The argument being that if this life, and this body, is merely a vessel to the hereafter then it is perfectly acceptable for this vessel to be used to save many more lives.

Flexibility in Islam

Now Islam gives us rules and guidelines to live our lives by, but much like in early Islam these have flexibility in them.  So for example a starving Muslim will be excused for eating pork, if nothing else were available and the meal would save his life. And it could be argued that you can fall back on this flexibility to suggest that organ donation should be allowed, because you are saving a life, maybe several.

To give you just two medical examples, this principle has been used previously to approve the use of pork based insulin and porcine bone grafts. On the basis of these examples, 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.

And it is not just the Muslim Law council in the UK to produce this ruling, you might be surprised to know that Saudi Arabia, Egypt, Iran and Pakistan have rules in place to say organ donation is allowed.

Even though this is agreed upon in Muslim countries, figures from the Global Observatory on Donation and Transplantation body show that there are fewer organ transplants from deceased people in Muslim-majority countries, compared with the rest of the world.

Death is not always death

But there is also the concept and definition of brain stem death. Does Islam consider Brain stem death as human death? And if it does, is it permissible to remove organs for transplantation from persons who are dead based on brain stem death criteria (e.g. a person who still has a heartbeat, a temperature and is still breathing)?

So, what do we do?

As a Muslim how do you personally answer the question about organ donation? As it is not something specifically mentioned in the Holy Quran, does that mean we can all make a personal, often emotionally charged, decision about organ donation? Or has Islam given us the help we need?

Leave it to the experts

Hadith 2362, as narrated by Rafi b. Khurayj:

The Prophet (peace be upon him) had come to Madînah while they were cross-pollinating their date palms. He asked: “What are these people doing?”

 

They replied: “This is something that has been our practice.”

 

He said: “Maybe if you were not to do so, it would be good.”

 

So they abandoned it and the crop that resulted was impoverished. They mentioned this to him and he said: “I am only a human being. When I command you with something regarding your religion, accept it. When I command you with something from my own opinion, then I am only a human being.”

The Holy Prophet Muhammad (pbuh) here was clear in saying that in his opinion it seemed wrong but he left the decision to the experts. So he deemed right the decision by the farmers do to the best for their yield of dates and if we use this example from the life of the Holy Prophet (pbuh) we can say that we should look to the medical professional when asking whether it is appropriate to harvest organs from a person about to die. If they deem it acceptable then we should accept their opinion on the matter.

In the end we can build multiple levels of complexity into things when trying to argue for and against something, but for me, personally, I think the answer is simple.

If it was you or your child who was sick and a transplanted organ would save you or your child’s life, would you accept it?  and if so, if you can accept one, can you give one?