Dr. Adel H.

Ali , MRCP(UK) Assistant consultant A-ICU KFSH-Dammam

And surely We have honored the children of Adam, and We carry them in the land and the sea, and We have given them of the good things, and We have made them to excel by an appropriate excellence over most of those whom We have created.

Introduction Definitions and Clarification The Consensus Where is the problem!

Take Home Message.

Saving the life of another human being is a noble act that is much encouraged by Islam. In fact, the preservation and protection of life is one of the purposes of Islamic jurisprudence (maqassid shariah). The reward for saving other people's lives is also significant in the eyes of Islam. This is stated in Surah al-Maidah where God says to the effect: "If anyone saved a life, it would be as if he saved the life of the whole people."

Islam gives great importance to health, cleanliness, beauty and brightness of the body. In Islam, medicine is the second most important science after basic Islamic sciences as the islam treat the soul and the medicine treats the body habitat of this soul. O servants of Allah, seek treatment for your ailments, for surely He has created the disease, has also given a cure for it. Those who are knowledgeable will be able to discover this cure. (Related by Bukhari). Today, organ transplantation is a viable option to cure many diseases and illnesses that may have maintain a lot of lives in the past.

Islam
Life Death
Organ
Transplantation

The religion of Islam is the acceptance of and obedience to the teachings of God which He revealed to His last prophet, Muhammad peace be upon him. Islam is the middle of the road between extremes . It is the light that shines to show us the right details in our life and guides us to the safety side.

In fact , Islam is the ruler of Muslim life, or in short Islam is our life.

Say. Surely my prayer and my sacrifice and my life and my death are (all) for Allah, the Lord of the worlds; (162) No associate has He; and this am I commanded, and I am the first of those who submit. (163)

So that the Islamic rulings ( Shariah) has to consider , discuss and conclude about every single event in Muslim life and give Fatwa by jurists (Fuqaha) specially the new raised issues. That is to say , it is not merely a rituals or tradions to worship So what is

Shariah Fatwa Feqh

Shari'ah

Divine knowledge which is primarily obtained from the Quran and Sunnah. Fixed and unchangeable General principles (). To understand the Shari'ah Detailed rules and is a probable perception

fiqh., faqiha,

Fatwa

Specific answer to specific person , place and circumstances.

Supplementary sources: Primary sources: (judgment based on juristic analogy The Quran (juristic preference) The Sunnah ( presumption of Ijma (scholarly continuity) consensus of opinion that is authentic, ijma as ( extended analogy) ( blocking the means) saheeh). ( opinion of a Companion ( previous scriptures.

THE OBJECTIVES OF ISLAMIC LAW ( SHARIAH) ARE:

Examples of General principles

1- Harm is removed. 2- Public harm or loss is averted by the private assumption of loss. 3- The greater of two harms is averted by assumption of the lesser. 4- Averting harm is to be preferred over procuring benefits. 5- Cases of necessity make permissible what is normally forbidden or restricted. 6- Necessity is determined by the particular circumstances. 7- Hardship secures lenience. 8- It is not permissible to do what will harm ones self.

Preservation of Faith. Preservation of Life. Preservation of Reason. Preservation of Wealth. Preservation of Lineage.

Why life is important in Islam because it is the gift of Almighty Allah for children of Adam to fulfill the main purpose of their existence which is worship him. And big part of Islamic rulings and revelation about creation and maintenance of life. Muslims believe that all life is sacred and must be protected. The respect for life in Islam is common for all humans, irrespective of gender, age, race, color, faith, ethnic origin, financial status or productive stage of life.

Death is the return of the soul to its Creator, God, and the inevitability of death and the Hereafter is never far from Muslim consciousness.

Every person (nafs) shall taste of death; and We try you with evil and good for a testing, then unto Us you shall be returned. ( Prophets 35-6). Death is not always frightful .

For the faithful believers Allah says in the Quran: " Those who have said Our Lord is Allah, and then have become upright, the angels will descend upon them saying Do not fear nor be sad, but receive good news of the paradise which you have been promised. We are your protectors in this life and in the hereafter: therein you shall have all that you desire; therein you shall have all that you ask for "(Quran 41:30-31)

The departure of the soul. We dont know a word after that. Cardiac death.

The heart used to be considered as the centre of life in the body.

Brain Death

the medical profession concludes that life ceases as a result of brain death Whole Brain Brain Stem

The need to diagnose Death :

other religious rites. Bathing , shrouding ,prayer and burial . For Laws of Inheritance. For Wills and Testaments (Wasaayaa) For the widows rulings. Technically to continue or discontinue the medical support. For organ Transplantation.
For

It is an expanding field of medicine and as part of treatment option for some diseases actually it may be the curative option or may be the only option to treat the patient. In fact , because it is part of our religion to negotiate any treatment options particularly if fundamental and critical, like Organ Transplantation.

There was a debate about organ transplantation among Muslim jurists ( Ulama = Foqaha). BUT it is obviously ends with the Consensus of most of the national and international institutes , committees and authorities and also well known jurists in favor of transplantation. For Organ transplantation we have to consider 4 areas
Dissection of the dead body Discontinue the life support care

Death and brain death

Transplants

They asked

,Studied
,Consulted
Trustworthy doctors

If cardiac arrest happens so death will occur over next few minutes starting with brain cells

If CPR done early and well circulation will return and possible life back

Due to any cause heart start to beat but no return of brain function despite post CPR care= no way to bring back brain .

So it is acceptable to consider brain death as death despite heart beating .e.g. hanged or deheahded still move + pulse.

The Permanent Committee for Legal Rulings (Fatawa) in Saudi Arabia conclude the following regarding dissection on dead bodies:

1. To discover if there is a criminal act . 2. To see if there is a contagious disease and to conclude how to stop it .

3. For educational and training purposes .

Islamic Jurisprudence Council in Makkah Al Mukkarammah 10th Session (Oct. 17-21, 1987), Resolution No. 2 The life supporting Equipment could be lifted from the patient whose brain functions have completely and irreversibly stopped, and has been decided by three Specialist Physicians, even though the heart and respiration are still functioning (with the help of machines). However such a person will not be considered legally dead until his respiration and circulation stops irreversibly after lifting the life support machines.

The purport of the council of senior scholars in Saudi Arabia No. 99 Dated 06-11-1402 H (25-08-1982 G) The board unanimously resolved the permissibility to remove an organ, or a part from a Muslim or Thimmi (non-Muslim) living person and graft it onto him, provided the need arise, no risk in the removal and the transplantation seems likely successful. Auto-transplant. The board also resolved by the majority the following:

a) The permissibility to remove an organ or a part from a dead person for the benefit of a Muslim, provided the need arise and cause no dissatisfaction and should the transplantation seem likely successful. b) The permissibility for the living person to donate one of his organs or part for the benefit of a Muslim in need.

 99 :
. .

The agreement of majority of Fuqaha, including the opinion of minority objections. So lets summarize the most important and comprehensive fatwa beside what mentioned before.

Amman 1986. eqated brain and cardaic death

Jeddah 1988. prohibited commercialism and organ trafficking

1990. transplant from embryos, IVF and anencephalics were discussed

1952 1959 1966

Sheikh Makhloof Grand Mufti Egypt Corneal transplants. Sheikh Maamoon Grand Mufti Egypt Corneal and Blood Sheik Hureidi Grand Mufti Egypt Organ Transplants

 International Conference Malaysia 1969 Organ transplants Supreme Islamic council Algeria 1972 Organ transplant

Sheik Khater Grand Mufti Egypt 1973 Harvesting skin

 Supreme council for fatwa Jordan 1977 Organ transplants Saudi Grand Ulama 1978 Corneal transplant

Sheik Gad AlhaqGrand Mufti Egypt 1979 Live and Cadaveric donation

 Ministry of Endowment Kuwait 1979 Organ transplants

Saudi Grand Ulama 1982 Organ transplant Islamic World League Fatwa 1985 Organ transplant

It is clear that the overall consensus of Islamic rulings all over the world is agreement for organ transplantation and related issues with clear and safe conditions. So where is the problem. Why there is lack of Donors?!

It is clearly not the Islam..

fear of unknown!!!

Is it right decision? What after death ? How are procedures and the care of my body?

A matter of trust !!!

The physicians ( May be wrong diagnosis and may wake up again) The law and process of donation to ( avoid commercialism).

Lack of Values!!! Culture and social issues!!! What is The way out . Ask, Study, Read

Organ transplant is a new procedure in medicine and Islam has a clear opinion about it.

Life and death are sacred in Islam .

Most of Rulings Bodies of different schools allow and encourage organ donation. Organ donation must be given freely. Trading in organs is prohibited if one does ijtihad and makes a mistake he will have one reward and if he does it correctly he will get double reward. "None of you truly believes until he wishes for his brother what he wishes for himself.

References

Prof . Albar. MD www.alifta.net Saudi journal of kidney diseases and transplantation ,1996 Islamic Voice, Vol 12-08 No:140 ,AUGUST 1998