"Ask the people of The Remembrance if you don't know".
[The Qur'an, 16:43]
The issue of organ donation has been discussed since the 1950s by ulama and scholarly councils time and time again in every decade. Due to it being a contemporary issue (as is the case with most contemporary issues), the scholars of Islam disagreed regarding its permissibility. Therefore, it is very much a personal choice for the individual to decide whether to opt-in or opt-out of any organ donation programmes. However, there are many conditions for those who intend to participate and take the opinion of permissibility. The following two answers are taken from Dar-al-Ifta in Egypt (one of the pioneering foundations for Islamic fatwa in the Muslim world established in 1895) and summarise the conclusion of the majority of imams and fiqh councils.
A note should be made that the main area of controversy is regarding the usage of the parts of another human being more so than the donating of parts. According to the Hanafi School of law, a person’s limbs are akin to their wealth and they may be donated if there is a benefit in doing so. The following texts state this clearly:
“There is no liability by agreement like his statement, ‘Cut my hand off’ or ‘my foot’ even if it spreads to himself and dies because limbs are like property, therefore, the command is valid.”
[Al-Durr al-Mukhtar, Chapter of Criminal Offences (Jinayat)]
“It has been mentioned in the Commentary of Al-Tahawi: If he said to another person, ‘Cut my hand off’ then if it is for a medical reason like if gangrene occurred in his hand, then it is OK and if it is not for a medical reason, then it is not permitted. However, if he cuts it off, he is not liable in both scenarios.”
[Radd al-Muhtar, Chapter of Criminal Offences (Jinayat)]
“Abu Hanifah’s evidence is that limbs follow the same rule as for property, therefore, giving freely applies in relation to them.”
[Al-Ikhtiyar, Chapter of Making a Claim (Da’wa)]
In the case of post-mortem donation, explicit permission would be needed from the person before dying by either being mentioned in a will or being on the organ donation register. Likewise, the respect of the deceased must be strictly adhered to when removing any organs as well as rules around exposing nakedness.
“Post-mortem transplantation is permissible as long as it does not involve selling, buying or trading. The procedure must be void of any financial remuneration in exchange for the organ to the donor if he is alive or to his heirs if he is deceased. In all cases, post-mortem transplants must meet the following legal criteria:
1 – It is prohibited to transplant any organ that will lead to lineage confusion. – The donor’s death must be determined by ascertaining that all his body systems have completely and irreversibly ceased to function.
2 – An overwhelming necessity: Post-mortem transplants are permissible when a patient suffers from deteriorating health and it is medically determined that there is no other alternative to the procedure.
3 – The deceased donor must have made an expressive wish during his lifetime and when he was in his full mental capacity to donate a certain body organ to another without any undue influence or pressure. It is impermissible to donate a number of organs such that it leaves the body empty since this contradicts the words of Allah:
And We have certainly honored the children of Adam [Quran 17: 70].
4 – Transplant procedures must be undertaken in a state recognized, licensed, specialized medical institution. There must not be any financial remuneration for any of the parties involved. Guidelines must be set down to regulate equal opportunities for the rich and poor alike. Precedence is based on medical necessity alone and upon which saving a person from certain harm, death or incapacitation is dependent.”
Human beings in Islam
Allah Almighty created man, honored and favored him over the rest of creation and made him His vicegerent upon earth. Allah Almighty says:
And We have certainly honored the children of Adam and carried them on the land and sea and provided for them of the good things and preferred them over much of what We have created, with [definite] preference. [Qur`an 17: 70]
Therefore, Islam seeks to protect man and prevent anything that may harm him in anyway. The Shari’ah [Islamic law] commands man to undertake all measures to protect his body, life and health against harm, commanding him to shun prohibitions and anything that incurs corruption and harm.
The Shari’ah urges man to seek medical treatment through all possible means
Textual evidence from the Qur’an
Allah Almighty says:
And do not throw [yourselves] with your [own] hands into destruction [Qur`an 2: 195].
And do not kill yourselves [or one another]. Indeed, Allah is to you ever Merciful [Qur`an 4: 29].
Usama ibn Shuraik narrated, “A Bedouin came to the Messenger of Allah (peace and blessings be upon him) and said: ‘O Messenger of Allah! Should we seek treatment for our illness?’ The Messenger said: ‘O servants of Allah! Seek treatment because Allah did not make a disease without making a cure for it; some know of it and others do not’ ” [Ahmed].
Organ transplantation in Islam
Organ transplantation, whether from a living donor or one whose death has been established, is among the means of treatment which have proved its efficacy in saving lives by the will of Allah. According to Islamic law, organ transplants from a living donor or a cadaver is permissible under the following conditions:
• The transplant must not involve disrespecting human life which Allah has honored. The human body may not be the subject of commercial transactions.
• Organ transplantation must be for the purpose of cooperating in righteousness, piety and alleviating pain.
• The procedure is permissible in the absence of alternative means of treatment to save a patient’s life. Qualified physicians must determine that organ transplantation achieves a certain benefit, will not harm the donor’s health, and will maintain his functional integrity.
• It must not involve organ trafficking.
• There must not be any compensation, financial or otherwise, to the donor if he is alive or to his heirs if he is dead.
Saving lives is one of the fundamentals of the Shari’ah
• Islam categorizes organ transplantation under the virtue of saving lives. Allah Almighty says:
If any saves a life, it is as if he saves the lives of all mankind [Qur`an 5: 32].
• It also considers organ transplantation among the virtues of sacrifice and altruism that Allah urges Muslims to maintain. He says:
They give [them] preference over themselves, even though they are in privation [Qur`an 59: 9].
The interest of a living person takes precedence over that of the deceased
Just as it is permissible to transplant an organ from a living person to another to save him from certain harm at present or in the future, it is permissible to transplant an organ from a deceased person with the same objective or to achieve a necessary benefit.
Allah honored man, alive or dead, and prohibited violating his dignity in any way. He says:
“And We have certainly honored the children of Adam” [Qur`an 17: 70].
The Prophet (peace and blessings be upon him) said, “Breaking the bones of a dead person is tantamount to breaking the bones of a living person” [Ibn Majah]. Therefore, this honor awarded by Allah is not to be violated upon removing any organ from a deceased to save the life of a living person because the interest of a living person takes precedence over that of a deceased. A living person continues his mission as Allah’s vicegerent on earth by worshipping Him and observing His laws and religion.
Evidence from Fiqh [Jurisprudence]
It is established in fiqh that when the lives of an expectant mother and her fetus are in danger, the mother’s life takes precedence. This is because the life of the mother is certain while it is not certain whether the fetus will be alive upon delivery; therefore, certainty takes priority over uncertainty. Based on this, it is with greater reason to give precedence to a living person over one whose death has been established.
The reward for post-mortem transplants
Taking organs from cadavers is not considered a violation of their sanctity; rather, it is considered an ongoing charity because the deceased will continue to receive its reward for as long as the recipient benefits from the organ. Like transplants from living donors, post-mortem transplants are performed by surgery which preserves the honor of the human body and does not involve any form of abuse.
Conditions for transplants from living donors
1. An overwhelming necessity: Organ transplants from living donors are permissible when a patient suffers health deterioration and qualified physicians determine that transplanting a healthy organ is the only means of saving him from certain harm. The donor must be an adult, sane and able to make a sound decision without undue influence or pressure.
2. A benefit to the recipient: From the medical point of view, there must be a perceived and certain benefit to the recipient. The procedure should prevent certain harm which may occur if the damaged organ is not replaced, and when there is no alternative means to saving the recipient from harm or saving his life.
3. The donor’s health: It must be medically determined that the transplant will not at any time harm the donor in any way or harm his functional integrity. This is because, in Islamic law, the interest of the recipient does not take precedence over the donor’s and because of the legal axioms which state: ‘Harm is not removed by harm’ and ‘Do not harm nor reciprocate harm’. In the absence of any harm to the donor, the preponderant interest of the recipient is to be taken into consideration. There is no objection to performing an organ transplant in the following situations:
– In the face of the possibility of minor harm
– The donor is informed of the harm involved beforehand
– It is possible for him to bear the procedure physically, psychologically and materially based on the opinion of qualified physicians
4. The procedure must be free of any compensation, financial or otherwise.
5. A specialized medical committee comprising of not less than three trustworthy physicians, who do not stand to gain from the procedure, must issue a written document of the above stipulations and give it to both parties before the transplant.
6. The transplanted organ must not in any way lead to confusion regarding one’s lineage.
Conditions for post-mortem transplants
1. Physicians differed on whether brain death can be considered true death. However, the majority agree that it is true death and the Egyptian Islamic Research Assembly adopted this opinion in 2009.
2. An overwhelming necessity: Post-mortem transplants are permissible when a patient suffers from deteriorating health and it is medically determined that there is no other alternative to the procedure.
3. The deceased donor must have made an expressive wish during his lifetime and when he was in his full mental capacity, to donate his organs without any undue influence or pressure. It is impermissible to donate a number of organs such that it leaves the body empty since this contradicts the words of Allah:
And We have certainly honored the children of Adam [Qur`an 17: 70].
4. It is prohibited to transplant any organ, such as the reproductive organs, that will lead to lineage confusion.
5. Transplant procedures must be undertaken in state’s recognized specialized medical institutions. They must not involve any financial remuneration. Guidelines must be set down to regulate equal opportunities for the rich and poor alike. Precedence is based on medical necessity alone and upon which saving a person from certain harm, death or incapacitation is dependent.”
• Previous Grand Muftis of Egypt who have approved organ transplantation based on the above regulations include:
• His Excellency the late Sheikh Hassan Ma`mun. His fatwa on this issue was published in Islamic Fatawa. Vol. 7: 2552. Dar al-Ifta al-Misiriyyah, 1959.
• His Excellency the late Sheikh Ahmed Haridi. His fatwa on this issue was published in Islamic Fatawa. Vol. 6: 2278. Dar al-Ifta al-Misiriyyah, 1966.
• His Excellency the late Sheikh Gad al-Haq Ali Gad al-Haq. His fatwa was issued in Islamic Fatawa. Vol. 10: 3702. Dar al-Ifta al-Misiriyyah, 1979.
• His Excellency the late Sheikh Mohammed Sayed Tantawi. His fatwa was published in his book Fatawa Shar’iyya. p. 43 (1989).
Islamic Fatawa. Vol. 21: 7950.
• Dr. Nasr Fareed Wasil.
• Dr. Ahmed al-Tayb.
•The Fatwa Committee of al-Azhar issued a fatwa on this issue in 1981.
• Other fatawa on this topic and which are too numerous to cite here, have been issued by great scholars and Fiqh assemblies in some Islamic countries.
• Finally, the Islamic Research Assembly maintained the same opinion in its 8th session, round (33) held on 17th Dhul Hijja 1417A.H./ April 24 1997.