With doctors in South Africa facing an uphill battle to find life-saving organ donations, there remains a tremendous amount of uncertainty amongst Muslims on the Islamic perspective on this controversial issue. According to one scholar, it is permissible to be an organ donor on the condition that the person can remain alive without undue hardships. Maulana Abdul Fattah Carr of the Muslim Judicial Council’s Fatwa Department says most mainstream scholars have no issue with living donations, for example, donating a kidney to a family member that is in need. This however, may only be undertaken if the donor will not suffer, in medical terms, as a result of the donation.

“It should be ascertained before-hand that the donor will not have undue hardships if the donation is completed,” Carr stated.

Thus, as a Muslim you can be a living donor, which means that you can donate a kidney, bone marrow and blood. However, you should seek no financial gain from this donation and it should only be done if you will be able to aid in the well-being of the recipient, he explained further.

“There should be no remuneration to the donor. It should just be a simple organ donation from the donor to the patient,” Carr added.

However, the donating of organs when the donor has passed is a more complex matter.  While many scholars from certain schools of thought have stated that organ transplantation is not permissable, others believe it to be persmissable under certain conditions.

“The person [deceased] must have stated in their Wasiya (last will and testament) that an organ can be donated,” Carr stated.

While organs can be donated after death, the main point of contention is that some scholars do not view brain death as actual death. According to Carr, all the signs of death should be prevalent in order for a person to be declared dead.

The MJC Fatwa department has addressed a delegation from Groote Schuur hospital with regards to organ donation and whilst both parties have agreed that organ donation is an act of charity, the question of death remains a sticking point.

Death defined

Historically, death was defined as the cessation of the heartbeat and of breathing but with the advancement of modern technology, machines are able to keep the heart beating.

For doctors, death can be defined as the cessation of all vital functions and most importantly the brain and brain stem. If that ceases to function, then in medical terms you would be declared dead.

“The view of the MJC Fatwa Department with regards to this is different as we do not consider brain death as death,” Carr said.

“All the signs of death must be prevalent for the person to be considered death, such as the blood not flowing, the heart ceasing to beat amongst other things.”

The MJC acknowledged that whilst other ulema have ruled in favour of brain death as an indication of death, the MJC has not.

“After death has been ascertained and permission has been given for the organs to be donated then organs may be donated.”

In order for a deceased donation to occur, one must be declared dead after the heart stops beating. If a patient is declared brain dead, in the MJC’s terms, the person will not be able to donate their heart as their heart is still beating, even though it is beating with the help of a machine. Furthermore any compensation received for the donations of organs would be forbidden.

The MJC has a fatwa on organ donation however the fatwa was not made available at the time of publication of this article.

Two sides of the debate

International scholar Shaykh Sadullah Khan acknowledged that there is a differing of opinions with regards to organ donation and that modern technology has a huge impact on the rulings of scholars nowadays. He presented two sides of the argument in a paper at a conference on organ donation at Masjidul Quds two years ago.

In the paper, Khan suggests that those who view organ donation as not permissible have quoted passages that refer to the human body as sacred and one may not take benefit from it.

And verily we have honoured the children of Adam (Qur’an 17:70)

He states that those who are against it believe it unlawful to inflict harm upon oneself and on those around you. In this way it can be interpreted that if you were to be an organ donor, you would inflict unnecessary harm upon yourself.

Khan elaborates further in his article that as far as the permissibility of blood transfusion goes, it does not necessitate that cutting of human parts nor does it involve surgical procedures. This is therefore permissible.

To conclude the summation that organ donation might not be permissible, Khan writes that the human body is not in our ownership, but is a trust given to us by the Almighty (God) and should be honoured. Thus, it will be unlawful to tamper with it as it will dishonour the body.

Those who state that organ donation is permissible argue that with the advancement of medical technology, organs may be transplanted to save the life of those in need.

“The human body, whether living or dead, enjoys a special honour and Islamic law emphasises the preservation of human life,” Khan stated.

Thus in the view of those in support of organ donation, it can be argued that if a person is in dire need of organ transplantation and you being alive would be able to save his/her life and not cause damage to your own, then you are able to be an organ donor.

Supporting Fatwa

The international Islamic Fiqh Academy (Majma’ al-Fiqh al-Islami) which consists of a number of major scholars from around the globe researched this issue in February 1988, and after extensive research, issued the following verdicts:
Islamic Fiqh Academy Fatwa:

“Organs from the deceased can be transplanted to a patient, where the life of the recipient depends on the transplant, or if the continuation of the basic bodily functions of the recipient depends on the transplant. This is however, dependent on the deceased’s consent, or that of his next-of-kin after his death, or by the decision of the leaders of the Muslim community, should the deceased be unidentified, or does not have any next-of-kin.”

[The Organisation of Islamic Cooperation /OIC is an international organisation consisting of 57 member states. The OIC has a permanent delegation to the United Nations, and is the largest international organisation outside the United Nations. The Islamic Fiqh Academy is a subsidiary organ of the Organization of the Islamic Conference.]

Their resolution states:
1- It is permissible to transplant an organ from one place in a person’s body to another place in the same body, but attention must be paid to ensuring that the expected benefits outweigh any possible harm; that is subject to the condition that this is done to replace a lost organ or body part, or to restore its regular shape or function, or to correct a fault or remove a deformity that is causing the person psychological or physical harm.
2- It is permissible to transplant an organ from the body of one person to another if it is an organ that renews itself automatically, such as blood and skin. But attention must be paid to the condition that the donor be fully qualified and fulfil the shar’i conditions.
3- It is permissible to make use of organs that have been taken from the body of another person due to sickness, such as taking the cornea from the eye of a person whose eye has been removed due to sickness.
4- It is haram to transplant an organ on which life depends, such as transplanting the heart from a living person to another person.
5- It is haram to transplant an organ from a living person when its removal may cause an essential function to cease, even though his life does not depend on it, such as taking the corneas of both eyes. But if he will still have partial function after removing it, then the matter is subject to further discussion.
6- It is permissible to transplant an organ from a dead person to a living person whose life or basic essential functions depend on that organ, subject to the condition that permission be given by the deceased before his death, or by his heirs after his death, or by the authorities in charge of the Muslims if the identity of the deceased is unknown or he has no heirs.
7- It should be noted that the agreement on the permissibility of organ transplants explained above is subject to the condition that this is not done by selling the organs, because it is not permissible to subject human organs to sale under any circumstances.
As for the beneficiary spending money in order to obtain the required organ where necessary or offering compensation or honouring the donor, this is subject to ijtihaad and further discussion.
8-All cases having to do with this topic are subject to further research and discussion, and they should be studied and discussed in a future session in the light of medical data and shar’i rulings.

In 1995, the UK based Muslim Law (Shari’ah) Council resolved that the Council which consists of scholars from all the major Muslim schools of law in Great Britain, together with three distinguished lawyers has considered the issue of organ transplant and resolved that:
•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
•The Council accepts brain stem death as constituting the end of life for the purpose of organ transplantation
•The Council supports organ transplantation as a means of alleviating pain or saving life on the basis of the rules of the Shari’ah
•Muslims may carry donor cards
•The next of kin of a dead person, in the absence of a donor card or an expressed wish to donate their organs, may give permission to obtain organs from the body to save other people’s lives
•Organ donation must be given freely without reward, trading in organs is prohibited. VOC (Umarah Hartley)