Memorandum by the Muslim Burial Council
of Leicestershire (MBCOL)
Q1. Please would you describe any particular
aspects of organ donation and transplantation which are considered
ethically problematic within the contact of your organisation's
religious beliefs—as these are perceived:
(a) within the UK; or (b) in the EU Member States?
1. The interference and or the violation
of the human body, whether living or dead, are prohibited in Islam.
This concept has been applied in many differing ways by the Muslim
community with regard to matters that relate to organ donation
and transplantation.
The application of this concept has in some
cases been more rooted in cultural attitudes than strict application
of Islamic (Shariah) Law.
One fundamental aim of Shariah Law is the positive
injunction for believers to save life. Islam places a very high
value on life.
As with some of the prohibitions there is a
balance that needs to be struck. This balance is achieved by the
prohibition being waived in some instances. These are in cases
of necessity; to preserve the life of others and of one self.
This is the Islamic legal maxim of "al-darurat tubih al-mahzurat"
(necessities overrule prohibition). This has great relevance to
organ donation. This can be seen in the Quran when Allah declares:
"Whosoever saves the life of one person
it would be as if he saved the life of all mankind".
Holy Qur'an, chapter 5 vs 32
Many Scholars in Islam have examined this issue
and the points that flow from opinions appear to be as follows:
(a) Medical professionals should be entrusted
in defining "death" by clinical criteria and this is
a question of medical fact rather than one of religious analysis.
(b) We should accept brain stem death as
the proper definition of the end of life.
The ethical questions in transplantation relate
to the source of donor organs eg anencephalic donors, cadaveric
donation which is still controversial in some countries, paid
living donors, donation under coercion or by minors, and by patients
in a persistent vegetative state as well as organs from animals
(xenotransplantation). The other major ethical issue has to do
with equitable distribution of organs.
For these opinion makers the facts point to
the fact that organ donation is permitted.
The issue therefore would also require analysis
of all cultural perspectives in the UK.
Q2. Please would you explain if there is any
significant tendency for individuals from your faith group to
oppose organ donation either for themselves or for a family member
on the basis on the basis of their own interpretation of the religious
teaching of the group, rather than on the basis of that teaching
is more generally interpreted. If so, how, if at all, do you think
this tendency might best be addressed?
2. The tendency for opposition to organ
donation tends to be based on both individual application of what
individuals believe and what some Muslim scholars say about the
human body and parts. The human body is a trust (amanah) that
has been given to us by God as such; it will be impermissible
for one to donate any organs of his body. In view of the above
and other evidences, according to these scholars, it is unlawful
to donate and transplant organs, whether it be of a living person
or a dead body, and whether there is a need or otherwise. In other
words, there is no permissibility whatsoever for the transplantation
or donation of organs.
One way to address this would be for institutions
to engage with the Muslim community in order to clarify the particular
aspects of Sharia (law) relating to this area. It must be understood
that, even in this instance, people will still want to exercise
their own personal right to refuse for their own personal reasons.
This personal choice of course may be true of all people regardless
of their faith.
Q3. To what extent would a change to a system
of presumed consent of organ donation in the UK (under which everyone
would be assumed to have consented to donate their organs after
death unless they explicitly opted-out from the system) be ethically
acceptable for your faith group?
3. We do not believe that a system of "presumed
consent" would be appropriate. The idea of people having
to "opt out" is in our view inappropriate when we look
at the fact that ones organs are being used. Personal and cultural
feelings about ones body are intrinsically very problematic. We
can envisage families raising legal, moral and ethical challenges
against the medical profession when they are opposed to one of
their loved ones bodies being used in this way. We all sensed
that extreme concern and discomfort when we learnt of the Alder
Hays organ retention scandal. It would not be ethically or religiously
acceptable to us.
Q4. If presumed consent were to be introduced
in the UK, what would be your views about the idea that members
of any particular groups should be assumed to be opted out as
a whole without the need for individual opt outs? (An example
of this is in the case in Singapore, where Muslims are assumed
to have opted out unless they expressly opt in).
4. We do not accept that the concept of
"opting in" or "out" would be acceptable.
What we would recommend is that all GP's and Hospital Doctors
should be placed under an obligation to get each of their patients
to declare their decision as to organ donation. There also has
to be a distinction between those donations that are for the purpose
of helping to save a life and organ donations for the purpose
of clinical research only. There should be a clear instruction
as to what part of the body or organ (or part of an organ) is
being donated. The patient should be able to withdraw any such
consent given at any time and this can also be determined in any
testamentary document such as a Will. Lawyers should be encouraged
to advise their clients to draw up Wills and to address this issue
in it. This is creating a system where people are encouraged to
apply their minds to the issue of donating their organs and to
make an informed decision, which is what Islam requires. The intent
of the deed is paramount, rather than the issue being determined
on your behalf by others. It also follows that we firmly believe
that organ donation must be given freely, without reward, and
trading in organs is strictly prohibited.
21 February 2008
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