Whereas Islam as the
last religion revealed by Allah, the Omnipotent and Omniscient Creator
of the universe, both visible and invisible beings, is of universal and
comprehensive character to include all fields and aspects of human culture
and civilization throughout the ages.
Whereas science and technology with all its branches and ramifications in general and organ transplantation in particular have therefore also been parts of Islamic teachings, so that it should be an area to be thought and discussed by the followers of Islam especially Muslim doctors and religious scholars.
Whereas the entire universe is governed by Sunnatullah or Natural Laws, Muslim religious scholars and medical experts are expected by means of their cognitive capacity and free will to discover these Laws. Whereas in Islamic teachings the Muslims are required to perform ijtihad before they are allowed to make decisions concerning Islamic Laws, a Seminar has been jointly held in Jakarta by:
THE INDONESIAN FORUM FOR ISLAMIC MEDICAL STUDIES
THE INDONESIAN COUNCIL OF ULAMA
THE FEDERATION OF ISLAMIC MEDICAL ASSOCIATION
with the resolutions presented hereunder:
The Muslim World is badly in need of a clear-cut Islamic opinion and fatwa concerning:
1. Death Certainty 2. Organ Transplantation 3. Donors 4. Having children to be organ resources
1. DEATH CERTAINTY
It has been universally
acknowledged that man is mortal, and this universal fact has been stated
in QS. Al Imran (3): 185: “KULLU NAFSIN DZAIQATUL MAUT” and that the moment
of death has been determined by Allah SWT Himself as stated in QS. An-Nisa(4):78;
death of everything has been determined by Allah.
Notwithstanding this universal fact, the sick and even the dying person, should be medicated on the ground that Islamic Teachings also encourages human beings to cure their diseases because for every disease there is also a medicine. Islam does not allow human beings to remain idle and let alone feel downcast whenever their lives are threatened by death.
They must do their utmost to tackle and overcome the menace. Only after all kinds of medicines have been given to the patient, may the Muslims submit the final decision to Allah SWT and even then a person who seems to have passed away should be medically examined by means of the most possible sophisticated medical instruments. And only upon this examination, the religious scholars and medical experts could be convinced that the dying person is really dead.
This is not only of utmost importance but also the most delicate from the jurist viewpoint because in this regards jurists depend heavily on the opinions of experts on medical science who determine the existence of death to avoid any possible accusations that might be put forward by the family of the dead person against the doctor concerned afterwards.
Up to date the latest technology to determine death is the absent of the function of the brain stem which could be detected by EEG. If EEG shows zero function of the brain stem along with zero function of lung and heart and those condition are irreversible, then we can affirmatively conclude that the man concerned is dead.
Conclusion 1: Brain death accompanied by zero function of the lungs and heart are unanimously agreed by ulama and doctors who attended this seminar, as definitive criteria to determine death, unless new techniques emerge in the future.
2. ORGAN TRANSPLANTATION
In compliance with the
Oath of Muslim Physician, any doctors should try to their utmost to treat
and heal diseases afflicted by a patient. This stand is in line with the
Islamic teaching that one should seek treatment if they get sick, since
the Prophet said:
“There is medicine for each disease and whenever the medicine is correct the disease will be healed, Insha Allah.” (HR. Muslim).
“Allah does not create any disease without its respective medicine.” (HR.Bukhari and Ibn. Majah from Abu Hurairah).
“Allah has not created a disease but also created its medicine to heal it except one i.e. being aged.” (HR.Bulhari).
The mode of treatment is in line with the development of science and technology as fas as it does not contradict the Islamic teaching.
Organ transplantation as admitted by doctors is an alternative mode of treatment which shall be taken if the existing mode of medication fails to cure the disease. The ulamas of various schools have had a consensus that it is a duty of every doctor to save the life of the patient. If organ transplantation is the only option left to be taken to save the life of the patient, then they are allowed to do that.
Conclusion 2: Organ transplantation is agreed by doctors and ulamas who attended this seminar as a mode of treatment to save the life of the patient. This mode of treatment could only be undertaken if there is no other appropriate option left
3. HUMAN DONORS
Doctors are in the same
opinion that the best organs to be transferred are those which belong to
human being, particularly the matched ones which usually come from siblings
or from parent to their children or vice-versa. But since science and technology
can overcome the problems of tissue rejection, sources also open to other
people not related to the patient or the patient's family. Islamic scholars
are facing a very fundamental problem regarding the issue of human organ
to be given to the people in need. The problem is related to the question:
Do human organs belong to human beings themselves or belong to Allah SWT?.
In answering this question the ulamas fall into 3 schools.
First, the school of Milku-ar-raqabah where man owned beyond doubt their whole body including organs of the body. This school regards man as having the right to sell or to give their organ to other people.
Second, the school of Milku-al-manfa'ah that regards man only has the right to use their organ and this in turn has the right to lend their organ but they cannot sell it.
Third, the school of Milku al-intifa that regard man has the right to use their organs only for themselves. They don’t have the right to lend not to mention to sell it to other people.
The ulamas who attended this seminar unanimously agrees that they totally support the school of Milku al-intifa. This means that human beings have the right only to use their organs but their bodies belong to Allah SWT. This view is in line with what al Quran says in al Baqarah (2)195 and an Ni'sa' (4);29.
Since human organs do not belong to human beings, then we do not need their permission - while they are still living or dead - to make use of their organ as long as such thing does not endanger their lives. Likewise permission from their families are not legally right simply because permission is necessary if the organs belong to human beings.
QS.al-Baqarah (2): 39 says: “He it is who created for you all that is in the earth..”
This means, that Allah's belongings were created for the sake of human social interest. In this regard, social interest should be represented by the government, who has duty to make stipulations to allow human being to use human organ (of living or dead donor) in conformity with the guidance of medical science and noble character. To avoid misunderstanding among the family of the living or dead donor, the stipulations should include permission of the family concerned. Through stipulations issued the government can also determine the necessity to give compensation to the donor. The stipulation should also be accompanied by strict regulation and heavy sanction for the transgressors.
Conclusion 3: The. ulamas and doctors who attended this seminar are in the same opinion that ownership of organs are in the frame of Milku al-Intifa' that regard man has right to use their organ only for themselves while their body belong to Allah SWT. Man has no right to sell or to lend their organ. To prevent abuse of the organs (of living or dead donor), the government of Muslim countries or relevant Muslim authority in countries where Muslims are minority, to issue stipulations on human donors including compensations, if any. Although the families of the dead donor have no right, as a consequence of adopting the concept of Milku al-Intifa', the stipulation mentioned above should include regulation that prevent the donor's family to file any claim or suing action to the doctor. Beside that stipulation, it is compulsory to get written permission from living donor. For those who intend to donate their organs after they die, it is strongly recommended to make a written will while they are still healthy.
4. ANIMAL DONOR
There are 3 legal status
a. halal animal b. dubious animal c. haram animal.
The use of organ from halal animal for medical interest do not create problems as far as the animal has been slaughtered in line with Islamic law.
Based on the Prophet saying Ikhtilafu ummati rahmah (the disagreement of opinions among ummah is blessing) the ulamas who attended this seminar agree that organ of dubious animal can be used by man for transplantation purposes.
Organ of haram animal creates problems. Traditional interpretation of haram animal is unlawful to consume. But in the process of organ transplantation, man never consume but only use it and this in turn creates khilafiah. The ulamas who attended this seminar are in the opinion that using organ from haram animal is permissible. But haram animal also belong to najis things which creates another khilafiah.
Some ulamas prohibit people to treat with najis things, but other ulamas are in favor to use it for medication: In this regard the ulamas who attended this seminar are in the same opinion that if doctors convince that the najis things are the only medication available to cure a disease than its law is permissible.
Conclusion 4: The ulamas and doctors who attended this seminar unanimously agree that there is no problem taking organ of halal and khilaf animal for transplantation purposes. But for haram animal, if organ transplantation is unanimously convinced by doctors as the only way available to cure a disease then its law is permissible. This opinion is based on that man in organ transplantation never consume but only use it and using haram animal as najis thing for medication is a matter of khilafiah. The ulamas who attended this seminar agree that medication with najis things is permissible .
5. HAVING CHILDREN TO BE ORGAN RESOURCES
Parents who have intention (niyat) to have new baby for organ transplantation purposes is beyond the domain of ibadah. Niyat (intention) is needed when one intend to perform ibadah. Notwistanding that Islamic law does not allow human being to posses human being including their own children. The possession of human beings was only justifiable in slavery which at the moment no longer exist. Based on this, the legal status of children (or fetus) is the same as that of the people.
Conclusion 5: The ulamas and doctors attending this seminar are in the same opinion that niyat (intention) is only needed in the domain of ibadah. Human beings as imposed by Islamic law never possess the children or babies to be born. Organ of the coming babies should be stipulated by the government or Muslim authority in charge and a strict regulation and heavy sanction should be issued for the transgressors.
Jakarta, 30 July 1996.
The Federation of Islamic Medical Association
(FIMA) DR. A. Hegazv Badauy President
The Indonesian Council of Ulama(MUI) Prof. Ibrahim Hosen Chairman, Board of Executive
The Indonesian Forum for Islamic Medical Studies(FOKKI) Dr. Jurnalis Uddin Chairman, Board of Directors
FORUM KAJIAN KEDOKTERAN ISLAM INDONESIA (FOKKI)
INDONESIAN FORUM FOR ISLAMIC MEDICAL STUDIES
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