Shaykh Arif co-presents paper with AMI graduate Mahdiyya Hussain on ‘Shi’i persepective on Organ Donation’ at the ‘Children, Organ Donation and Islam’ Seminar held by the Great Ormond Street Hospital in conjunction with NHS Blood and Transplant on the 27th November 2017.
Summary of Paper:
The increasing demand for a limited supply of organs is most keenly felt by the UK’s Muslim population who are susceptible to developing end-stage renal failure requiring organ transplantation. To decrease the chances of the body rejecting the transplanted organ it is vital to obtain organs from a donor who shares the same ethnicity as the recipient. However, official statistics show that religious and ethnic minorities are reluctant to donate organs although they are more likely to require a transplant, with surveys on the attitudes of British Muslims identifying religion as an influential factor. With the government now considering transitioning towards an ‘opt out’ system, discussions regarding the permissibility of organ donation are pertinent. Whilst rulings pertaining to living organ donation are generally permissive, certain aspects of cadaveric organ donation, including the changing definition of death, the sanctity of the deceased and donating organs to non-Muslims, are contentious amongst Shi’i scholars.
Organs can be procured after circulatory death and after brain-stem death, where the brain ceases to function, but the heart and lungs continue to function artificially. Brain dead donors are the principal source of deceased donors because they have multiple organs that are suitable for transplantation and, at present, are the only viable source of heart transplants. Nonetheless, it is necessary to ensure that brain death corresponds with the notion of death in Islam. The Quran and tradition speak of death as a metaphysical occurrence of the departure of the spirit from the physical body, which is not subject to empirical verification. Although there are narrations that inform of the physical signs of death, including the whitening of the skin and the slackening of muscles, they do not provide a definition for death. The majority of Shi’i jurists do not consider brain death to satisfy the criterion for death in Islam. However, a growing number accept brain death as the appropriate criterion and allow the procurement of organs at this point reasoning that medical experts are best placed to provide a definition of death. The late Ayatollah Khomeini is recognised as the first amongst Muslim scholars to allow the retrieval of organs from brain dead people.
Even if brain death is not accepted as the appropriate definition of death, cadaveric organ donation may still be allowed after circulatory death. There are numerous traditions informing of the sanctity of the deceased and prohibiting the mutilation off the cadaver. Although it is arguable that these narrations referred to prevalent practices of decapitating bodies on the battlefield as a means of humiliation in pre-Islamic Arabia, the predominant interpretation is in accordance with the apparent meaning of the narrations. The unqualified nature of the narrations means that procuring organs is considered to be an instance of mutilation. Nonetheless, organ donation has been permitted because the obligation to save the life of a Muslim outweighs the obligation to respect the sanctity of the dead body. The majority opinion amongst Shi’i jurists is that cadaveric organ donation is only acceptable when the recipient is a Muslim.
Rulings that differentiate on the basis of religion are both ethically and practically problematic for Muslims residing in the UK. Doctors are not permitted to accept organs donated conditionally, and therefore, since it is not possible to ascertain the religion of the recipient, in practice this precludes Muslims from becoming organ donors. Despite being contentious, no justification is offered for this differential treatment. It is probable that discriminatory rulings were based on an outdated paradigm where the world was divided into Muslim and non-Muslim lands and protection was afforded in accordance with the place of residence. Not only do such edicts create a negative perception of Islam but they also offend basic moral principles that are intuitively known. They ought to be revised in accordance with the ethos of the Quran, which endows human beings with equal dignity and informs of the importance of preserving life without making any distinction based on religion.