An important debate has begun among Islamic scholars over the implications of the UAE's new organ transplant programme. Sharia experts, along with specialist doctors, were consulted before the formulation of the legal instrument allowing organs to be taken from deceased donors, which was released this week.
Nevertheless, one of the biggest challenges in getting the transplant programme off the ground will be convincing potential donors who are Muslim that their faith permits them to donate. The programme offers hope to thousands of potential recipients, but doctors say the main issue will be encouraging everyone to accept that a patient is dead even if the heart is still beating with the help of a ventilation machine.
Although this type of transplant is allowed in other Muslim countries, there are conflicting views among Islamic scholars over the definition of death. Dr Faisal Badri, the deputy head of the National Organ Transplant Committee and head of general surgery at Rashid Hospital in Dubai, said basic Islamic principles supported organ donation. "The most important part of this was getting the definition of brain death," he said. "Without this, nothing would move on. The critical point is whether the religion will accept it or not."
He said it was important to consider sadaqa, the principle of voluntarily giving a charitable gift, which would include an organ. This applies, he said, even after death. Dr Atul Mehta, the chief medical officer and lung transplant specialist at Sheikh Khalifa Medical City in Abu Dhabi, has been involved in the hospital's live donor programme since 2008. He advised Muslims here to look at other countries in the region.
"There is already a precedent for this type of donation in Muslim countries such as Saudi Arabia," he said. "We can see the benefits." He said making the programme a success would be an uphill battle, but was confident it eventually would be. Dr Ahmad al Qubaissy, the head of Islamic studies at UAE University and Baghdad University, said the different views were understandable but that the medics' version should take precedence.
"There is no doubt that donating organs is for the benefit of humanity and it is the greatest type of donation," he said. "This is elite humanitarianism, because the body will decompose anyway." He refer, however, to some Islamic sources that say a person is only considered dead when he no longer "has a breath in him" and is ready to be buried. Despite this, he agrees the issue of organ transplants is a medical one.
"This is a medical issue, they are the experts to assess the situation, so if they agree that the person is dead, then the mufti has nothing to do with it." In 2008, the General Authority for Islamic Affairs and Charitable Activities articulated its stance on organ donation in a fatwa published on its website. "Organ donation is something of the utmost humanity," the authority said. "But there must be regulations so it does not lead to corruption in the ummah and society."
It endorsed the conclusions of a conference on Islamic jurisprudence held in Saudi Arabia in 1988. There, scholars ruled that the transfer of organs from the deceased should be permitted. More contentious are live organ donations, which the authority also says are permitted if they do not interfere with vital bodily functions. The authority said God "endowed Islamic jurisprudence with the flexibility that allows time and place to conform with it. There no new incident that [Islamic] jurisprudence is not quick to judge on."
It is explicitly forbidden for an organ that is necessary to sustain life - such as the heart - to be given up by a living person to another. Dr Ahmed al Haddad, Dubai's Grand Mufti, agreed that donation should be legal, so long as it is necessary, there is consent, and the organ is not being sold. For justification, he quoted the Prophet: "Whoever can benefit his brother, let him do so." According to the National Health Service Blood and Transplant (NHSBT) organisation in the UK, the Muslim Law Council of Great Britain has approved the use of organs from brain-dead patients.
The council accepts brain death as constituting the end of life for the purpose or transplantation, and supports transplants as "a means of alleviating pain or saving life on the basis of the rules of the Shariah", the NHSBT website states. Khaled Abdul Alim, a prominent Islamic cleric based in Dubai, said there must be co-operation between health and Islamic jurisprudence. "Fatwas sometimes depend on doctors and they cannot be passed unless a doctor is consulted," he said. He added that he supports the law as it would be beneficial to Muslims and society.
munderwood@thenational.ae * With additional reporting by Haneen Dajani
