Islamic bioethical perspective on organ transplantation
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Islamic bioethical perspective on organ transplantation

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  • Islamic ethics: ( would you please revise this paragraph and try to put it in slides as the main examples of philosophy in Islam) 1- The human quality that encompasses the concept of the ideal ethical value in the Quran is summed up by the term (taqwa) : which signifies the ethical conscience which makes human beings aware of their responsibility to god and society . 2- Ethics in redressing injustice in economic and social life: the individuals are urged to spend of their wealth and substance on: family and relatives, orphans, poor, the travelling homeless, the needy, freeing of the enslaved. 3- such acts define a Muslim’s responsibility to develop a social conscience and to share individual and communal resources. the duty of (ZAkat) a term connoting: giving, virtue, increase and purification. 4- at the social level, Quran give concern to the family and especially to ameliorate the status of the women through abolition of pre-islamic practices (female infanticide ) and give he right to inheritance, ownership of property, the right to contract marriage and initiate divorce and maintain one’s own dowry. 5- the main message of the Quran is to teach us to command the right and prevent the wrong.
  • Acceptance by the majority of trusted scholars on a given issue to be permissible Measurement , i.e. to measure a newly introduced issue e.g. assisted reproduction, organ donation, drug-abuse, etc., on previously known agreed on issues; and
  • 1- Taqwa: which signifies the ethical conscience which makes human beings aware of their responsibility to god and society . Zakat: a term connoting: giving, virtue, increase and purification.
  • إضافة حديث ( لا ضرر ولا ضرار )
  • in the absence of a donor card or an expressed wish to donate their organs,
  • (e.g. no living heart donation, or eye donation permissible) or already removed from the donors body as a cure of disease (e.g. corneal donation from a removed eye);
  • who is an adult and in full possession of his/her faculties so that he/she is able to make a sound decision by himself/herself;

Islamic bioethical perspective on organ transplantation Islamic bioethical perspective on organ transplantation Presentation Transcript

  • I slamic P erspective on O rgan T ransplantation Dr. Azza Hamdy El-Elemi Dr. Ghaiath Hussein
  • Objectives
    • Introduce the basic principles on which Islamic philosophy is based
    • Discuss how these principles affect its approach to organ transplantation issue
    • Case Study
  • Basic Resources of Islamic philosophy & legislation:
    • The Koran: believed by Muslims to be the book whose chapters and verses (Ayat) are from God (Allah), through revelation on His prophet Mohammed
    • The Sunna: term that comprises all the deeds, and sayings that the prophet said, did, or agreed upon
    • Unanimity of scholars on whether the discussed issue is allowed (Halal), or forbidden (Haram)
  • Islamic Ethical values
    • 1- Human Dignity: The human quality that encompasses the concept of the ideal ethical value summed up by the term (taqwa)
    • 2- Economic and social life: distribution of wealth on: family, orphans, poor, the traveling homeless, the needy, freeing of the enslaved.
    • 3- Responsibility to develop a social conscience and to share individual and communal resources. the duty of (Zakat)
  • Islamic Ethical values…
    • 4- Social Value: Quran give concern to the family to ameliorate the status of the women through abolition of pre-Islamic practices (female infanticide)
    • Giving women rights to inherit, ownership of property, the right to contract marriage and initiate divorce and maintain one’s own dowry.
    • 5- A main Islamic ethical message is to command the right and prevent the wrong.
  • Basic principles of Islamic philosophy on LIFE and death
    • Lives and bodies are ultimately owned by their Creator
    • humans are only “vicegerents” so their possession of their bodies is not absolute
    • human life is a gift of God that should be respected and preserved as long as possible
  • From Koran and Sunna
    • “ he who saved one life should be regarded as though he had saved the lives of all mankind.” TMQ [5:32]
    • No harm to oneself, “ … (And) make not your own hands contribute to (your) destruction ” TMQ [2:195]
    • The Hadith: "There is no (harm) injury nor return of (harm) injury." [ Malik's Muwatta, Book 36: 1429 ]
  • Basic principles of Islamic philosophy on Life and death
    • No clear cut “religious” definition of death
    • Contemporary scholars came to adopt the following definition
    •  
    • “ The death of that part of the brain responsible for the primary vital functions, which is called the brain stem, is a reliable indicator of the occurrence of death”
    • (Statement of The Islamic Organization for Medical Sciences About the Medical Definition of Death, 1996)
  • How do these concepts affect position on transplantation?
    • The majority of contemporary Muslim scholars legalized organ donation, with clear conditions as means of preserving life
    • However, other scholars refused even the concept of donation claiming that:
      • - bodies are ultimate possession of God
      • -no one has a right to donate what s/he does not possess
      • - donation of any human tissue is a violation for the rule of being vicegerents.
  • Major rules of transplantation
    • the medical profession is the proper authority to define signs of death
    • current medical knowledge considers brain stem death to be a proper definition of death
    • brain stem death constitutes the end of life for the purpose of organ transplantation
    • organ transplantation is a means of alleviating pain or saving life on the basis of the rules of the Shariah
    • Muslims may carry donor cards
  • Major rules of transplantation… cont.
    • the next of kin of a dead person may give permission to obtain organs from the body
    • organ donation must be given freely without reward
    • trading in organs is prohibited.
  • Interfaith and Organ Transplantation
    • CATHOLICISM
    • Transplants are acceptable to the Vatican and donation is encouraged as an act of charity
    • JEHOVAH’S WITNESSES
    • Donation is a matter of individual conscience with provision that all organs and tissues be completely drained of blood
  • Interfaith and Organ Transplantation … cont’d
    • JUDAISM
    • Jews believe that if it is possible to donate an organ to save a life, it is obligatory to do so. Since restoring sight is considered life saving, this includes cornea organ transplantation
    • BUDDHISM
    • Donation is a matter of conscience
    • HINDUISM
    • Donation of organs is an individual decision
    • Source: http://transplantforlife.org/miracles/religion.html
  • General Conditions to permit organ transplantation
    • The benefit to recipient weighs the potential harm to the donor
    • The life, or a basic life function of the donor doesn’t depend on donated organ
    • The donated organ is renewable or its function is naturally compensated
    • Organ sale is NOT permissible
    Islamic Jurisprudence Council Conference, 1987
  • Conditions associated with a living donor:
    • capable person
    • done on his/her own free will
    • never be the outcome of compulsion, family embarrassment, or financial need
    • The organ must not be a vital organ
    • No transplantation of sexual organs is allowed.
  • Conditions associated with a dead donor:
    • death have been accurately diagnosed
    • Organ donation from a deceased person should only be permitted by the close family members (heirs), or by the authorities if the dead is unidentifiable homeless, or of absolutely no heirs
    • It must be done after having ascertained the free consent of the donor prior to his /her death. It can be through a will to that effect, or signing the donor card, etc.
    • In a case where organ donation consent was not given prior to a donor’s death, the consent may be granted by the deceased’s closest relatives who are in a position to make such decisions on his/her behalf.
  • Conditions associated with a dead donor… cont.
    • It must be an organ or tissue that is medically determined to be able to save the life or maintain the quality of life of another human being
    • The organ must be removed only from the deceased person after the death has been ascertained through reliable medical procedures
    • Organs can also be harvested from the deceased with unidentifiable identities, but it must be done only following the valid decree of the authorities
    • (source: http://www.islamonline.net/ )
  • what does The Islamic code of Medical Ethics say?
    • The individual patient is the collective responsibility of society, that has to ensure his health needs by any means inflicting no harm on others
    • This comprises the donation of body fluids or organs such as blood transfusion to the bleeding or a kidney transplant to the patient with bilateral irreparable renal damage
    • Markets of human organs are proscribed by key Fatwas (legal rulings)
  • More liberal point of view
  • The principles affecting distribution
    • Distributive justice (Equity)
    • Duty
    • Right
    • Virtue
    • justice
    • In Islam: bioethical decision-making is carried out within a framework of values derived from revelation and tradition
  • Challenges facing transplantation
    • Ethical and legal challenges for transplantation:
    • Declaration of death (dead transplantation)
    • Consent to donation
    • Uncertainty in determination of death:
    • When should a person be treated as dead?
    • Who should decide what concept of death is to be used?
  • Challenges facing transplantation… cont’d
    • Teams specialized for recruitment of organs
    • Organ preservation
    • Organ allocation:
        • No resources
        • No clear law
        • No organized program of dead transplantation
  •  
  • Let’s Practice…
    • An 18-year-old Muslim man sustains severe head injuries in a traffic accident while riding his motorcycle.
    • He is declared brain dead
    • The transplant coordinator approaches the grieving mother to obtain consent for organ donation
    • At first the patient’s mother is shocked at this approach
    • She then politely says that she would like to wait for her family to arrive before making a decision
  • Hints…
    • Mutilation, and thus cremation, is strictly prohibited in Islam.
    • Cadaveric organ donation is permitted
    • Death is considered to have occurred when the soul has left the body ( lay people )
    • Responsibility of declaration of death ( physician )
    • One of the Muslim requirement is to bury the body on the same day
  • References and suggested readings
    • http://www.islamset.com/bioethics/death/index.html
    • Bioethics for clinicians: 21. Islamic bioethics. Abdallah S. Daar and A. Khitamy ( http://www.cmaj.ca/cgi/content/full/164/1/60#T127 )
    • ISLAMIC MEDICINE ( http://www.islam-usa.com/im1.html )