By Babatunde Jose
The recent travails of a Nigerian Senator embroiled in organ harvesting case in the United Kingdom has brought into focus the concept of organ harvesting and organ donation, especially the Islamic perspective as demanded by some of our readers.
Discussions of transplantation are not new. They predate Islam. The Sushruta Samhita, an ancient Indian text written around 700 BC described the process of skin grafting which was adopted by the 16th Century Italian surgeon Gaspare Tagliacozzi.
Tooth transplantation was practiced by pre-Columbian North and South Americans and refined by Arab surgeons over a thousand years ago.
Albar M. in, Organ Transplantation: A Sunni Islamic Perspective, Saudi Journal of Kidney Disease Transplantation 2012, suggests that a precedent dates back to the era of the Prophet himself as the eye of his Companion, Qatada ibn Nu’man was replaced at the Battle of Badr and that the arm of Muawath bin Arafa and the hand of Habib bin Yasaf’ were also replaced. He points out that procedure of porcine bone grafts and other xenografts were discussed by the 13th Century jurist and judge Zakaria al-Qazwini.
Blood transfusions were sanctioned by Muslim jurists in the 20th century, even though blood is considered to be impure, showing that scholars were able to discuss medical advances in the light of traditional scholarship and within the strict confines of Islam’s primary sources, the Quran and the Sunnah.
Despite this historic legacy, it is during the latter part of the twentieth century that the debate about transplantation intensified and as the century progressed, the focus shifted towards the definition of death.
The concept of brain death emerged in 1959 from the studies of Mollaret and Goulon in their description of patients with irreversible coma. Their research led to the use of terms ‘cerebral death syndrome’ and ‘electrocerebral silence’ and in 1968 Harvard Medical School defined irreversible coma as brain death, stating that ‘an organ, brain or other, that no longer functions and has no possibility of functioning again is for all practical purposes dead.’
Rashid,R. Islamic Response to the Debate on Organ Transplant: Bodily Dignity, Neurological Death and the Dead Donor Rule, London: Al-Balagh Academy Publication Papers, 2020 citing al-Bar and others, suggests, ‘There are more positive Islamic opinions on brain death now which equate brain death with cardiac death.’
One of the earliest Muslim scholarly edicts to directly address organ donation was issued in 1959 when Shaykh Hassan Mamoon sanctioned corneal transplants from cadavers of unidentified persons and from those who agreed to donate upon their death.
The late Ayatollah al-Khu’i had different verdicts on “major organs” and “minor organs”. He had allowed donation of minor organs but disallowed donation of major organs.
A criterion of defining “minor organ” is its ability to regenerate by itself. So donating blood, skin grafting and bone-marrow transplants would be considered as donation of minor organs and would therefore be permissible. But the kidney would be classified as a major organ and, therefore would not be permissible for donation. This is also the view of Ayatollah Jawad Tabrizi.
Ayatollah Sistani, however, does not differentiate between the minor and major organs. As long as the donor would not be seriously handicapped, there is no problem in donating one’s organ, minor or major. Therefore, donating a kidney also would be permissible provided the donor has another healthy kidney. Ayatollahs Nasir Makarim and Khamanie would concur with this view.
In 1964, Ayatollah Khomeini decreed organ donation to be permissible and during the 1960s and 1970s there were several scholarly and legal decrees sanctioning the use of organs extracted after death. However, these did not explicitly discuss the developing concept of brain death.
The practice of organ retrieval from people who had suffered brain death in car accidents, and their subsequent organ transplantation progressed during this period.
The relationship between scholars and medical practitioners following this resolution appears to be one where they worked in collaboration identifying issues related to the main topic. These included topics such as transplantation from nerve tissue for treating Parkinson’s and other ailments and from embryos aborted spontaneously, medically or electively.
Religious communities have had to rethink their approach to the definition of death as science and medicine have advanced. There is no ‘right’ kind of death. When meeting at a final common endpoint, death, the order in which heart, lung and brain cease to function do not define different deaths. There are, however, different forms of death.
The Prophet offers a description of the signs of death but neither of the two sources of Islam clearly define the moment of death. Khan FA, in ‘The definition of death in Islam: Journal of Islamic Medical Association 18(1):p18-21, 1986’, after examining the various explanations of death from an Islamic perspective, conclude ‘there is neither a precise definition of death nor a precise description of how to recognize the departure of the spirit from the corpse in either the Qu’ran or the Sunnah’.
The choices facing Muslims is a personal one with all three positions supported by scholarly opinion. Muslims may choose to: 1. Donate their organs after neurological death 2. Donate their organs only after circulatory death 3. Not donate their organs.
According to the late Ayatollah al-Khu’i, donating some of the organs (whether minor or major) after the death is permissible provided you have expressed your intention clearly in your will. Ayatollah Nasir Makarim also holds the same opinion.
Ayatollah Khamenei allows this provided the body does not look like a mutilated body — so donating internal organs would be permissible but cutting off the external organs would amount to mutilation of the corpse which is not permissible.
The recipient of your organ does not necessarily have to be a Muslim; you can donate your organs, wherever permissible, even to a non-Muslim.
There is no problem in transplanting a non-Muslim’s organ to your body. As for the issue of ritual impurity: if it is an internal organ (heart or kidney), then there is no issue of impurity at all.
If the transplanted organ is external, then for the first few days after the transplantation, that area of your body will obviously remain impure because of the surgery done on you and you will have to do ritual ablution in the tayammum or jabira form. (“Jabira” means the ablution done over a bandage).
But after the area has healed, there should be no problem at all because the former organ of the donor has become, after transplantation, your organ and, as such, it will be considered ritually pure.
The same would apply if an animal’s organ (e.g., a baboon’s heart or a pig’s organ) was transplanted to your body.
According to the views of the Ayatollahs Khu’i and Sistani, no parent has a right to donate his or her child’s organ or body to anyone. However, Ayatollahs Nasir Makarim and Khamenei recognize the consent of the heir as sufficient for extracting an organ from the deceased.
Keeping in mind the belief in resurrection and life after death, it is asked, what will happen to an organ which has been transplanted to another person, probably a non-Muslim? Will one be responsible if the organ was used for a crime or a sin?
First of all, after transplantation onto someone else’s body, your former organ will no longer be considered legally yours so there is no need to worry about being held accountable for crimes or sins committed through it!
Secondly, the God who created us from nothing will absolutely have no problem in putting us together on the day of resurrection. See the following verses from surah Ya Sin:
And he (i.e., man) gives us an example and forgets his own creation; he says, “Who will give life to the bones when they are rotten?”
Say: “The same God will give life to them Who brought them into existence the first time, and He is Aware of all creations…Is not He who created the heavens and the earth capable of creating the like of them? Sure! And He is the Creator, the Knower.
“His command, when He intends anything, is only to say to it, `Be,’ and it comes to existence. Therefore, glory be to Him in whose hand is the kingdom of all things, and to Him you shall be brought back.” (Quran 36: 78-83)
Medical science is gradually moving towards therapeutic cloning which will reduce the need for organ donation.
Most scholars hold the opinion that organ donation is permissible given the following conditions;
1. The donor is not harmed by the donation.
2. The recipient requires the organ in order to live or in order to perform an essential function.
3. The donor’s body, whether living or dead, is respected and treated with dignity.
4. The donor gives his or her organs freely.
5. The organs are not bought or sold.
These are based on the verdict of the International Islamic Fiqh Academy, Saudi Arabia, February 1988
I am pleased to announce that my very own brother, Ahmad Olayinka Jose is a happy and appreciative recipient of a successful heart transplant and has continued to enjoy the new lease of life, thanks to the donor. There is nothing religious about it. A life was saved.
Barka Juma’at and Happy Eid.
PRAYER FOR THE NATION AT EID EL KABIR: Yah Allah, You were the God of yesterday, You are the God of today and You will still be the God of tomorrow. You are the God who answered Prophet Ibrahim’s prayer and turned a desert to a blessed land. Please save us in Nigeria. Turn Nigeria to a peaceful Nation. Make Nigeria a country everyone from all walks of life will be dreaming to visit. Turn our fatherland into a blessed land: A land that will once again flow with milk and honey! Aameen.
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