Is organ donation permitted in Islam?
I am frequently asked whether it is permissible to donate organs in Islam.
The opinions of Islamic scholars regarding organ transplantation are ijtihadi in nature, which means that the ijtihad (juristic interpretation) is based on Islamic legal maxims, because they are related to a new development that were not discussed by previous scholars.
Based on authentic fatwas, organ transplantation and donation are permissible in Islam. This is because organ transplantation and donation fulfil the requirement in the preservation of human life, which is one of the five objectives in maqasid al-syar‘iyyah (objectives of the Islamic law).
Protect human life
The Shariah seeks to protect human life and dignity. Therefore we are expected to do whatever we can within permissible limits to preserve life and health, which are an amanah.
Seek medical treatment and cure
When there is need for cure, in the first instance we should seek appropriate medical treatment through all possible means and by consulting specialists. As Allah Almighty stated in the Quran:
And do not kill yourselves [or one another]. Indeed, Allah is to you ever Merciful. (4:29)
The Prophet (peace be upon him) said:
“O’ servants of Allah, seek treatment for your ailments, for surely He who has created the disease has also given a cure for it. Those who are knowledgeable will be able to discover this cure.” (Bukhari)
The opinion among most Fuqaha (jurists) is that seeking medical treatment is either recommended (mandub) or obligatory. There are many hadith which encourage Muslims to seek medical treatment. Therefore it is up to the patient to decide whether or not if he or she wants to undergo organ transplant.
Organ transplants are a matter of choice
Organ donation is a method of saving lives. It is not compulsory, but is a valid choice.
There are different views depending on different schools of thought and fatwas.
According to one very valid, authentic opinion is it is allowed based on the principle in Islam that in situations of necessity, the prohibited becomes permissible.
The Fatwaa of the Islamic Fiqh Council (Majma’ al-Fiqh al-Islami)
The Fatwa of the Islamic Fiqh Council (Majma’ al-Fiqh al-Islami), decision (26), the fourth meeting in Jaddah, 1988:
- The medical profession is the proper authority to define the 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 transplant.
- The Council supports organ transplant as a means of alleviating pain or saving life on the basis of the rules of Shari’ah.
- Muslims may carry donor cards or opt in to a donor register.
- The next of kin of a dead person, in the absence of a donor card or an expressed wish of the dead person to donate his organs, may give permission to obtain organs from the body to save other people’s lives.
- It is permitted to transplant or graft an organ from one part of a person’s body to another, so long as one is careful to ascertain that the benefits of this operation outweigh any harm that may result from it, and on the condition that this is done to replace something that has been lost, or to restore its appearance or regular function, or to correct some fault or disfigurement which is causing physical or psychological distress.
- It is permitted to transplant an organ from one person’s body to another, if it is an organ that can regenerate itself, like skin or blood, on the condition that the donor is mature and understands what he is doing, and that all other pertinent shar’i conditions are met.
- It is permitted to use part of an organ that has been removed because of illness to benefit another person, such as using the cornea of an eye removed because of illness.
- It is haram to take an organ on which life depends, such as taking a heart from a living person to transplant into another person.
- It is haram to take an organ from a living person when doing so could impair an essential vital function, even though his life itself may not be under threat, such as removing the corneas of both eyes. However, removing organs which will lead to only partial impairment is a matter which is still under scholarly discussion.
- It is permitted to transplant an organ from a dead person to a living person whose life depends on receiving that organ, or whose vital functions are otherwise impaired, on the condition that permission is given either by the person before his death or by his heirs, or by the leader of the Muslims in cases where the dead person’s identity is unknown or he has no heirs.
- Care should be taken to ensure that there is proper agreement to the transplant of organs in the cases described above, on the condition that no buying or selling of organs is involved. It is not permitted to trade in human organs under any circumstances. But the question of whether the beneficiary may spend money to obtain an organ he needs, or to show his appreciation, is a matter which is still under scholarly debate.
- Anything other than the scenarios described above is still subject to scholarly debate, and requires further detailed research in the light of medical research and shar’i rulings.
Allah the Almighty said:
He has only forbidden you what has died by itself, blood and pork, and anything that has been consecrated to something besides God. Yet anyone who may be forced to do so, without craving or going too far, will have no offence held against him; for Allah is Forgiving, Merciful. (Al Baqarah: 2:173)
Allah has excluded the situation of dire necessity from the prohibited things. No, doubt that the sick person who needs desperately an organ is in dire necessity because his life is endangered such as kidney failure, damaged liver or heart.
Confronted with two evils a person is permitted to choose the lesser of the two, as in the case of a starving person whose life could be saved by either eating carrion or stealing from another person’s food. He would be permitted to opt for the latter.
In the rulings of Fiqh (Al Qawa`d Al Fiqhiyyah) we have:
- “Necessities override prohibitions.”
- “Choice of the lesser of the two evils if both cannot be avoided.”
Since the saving of life is a necessity that carries more weight than preserving the integrity of the body of donor or deceased and since the injury of the body of the donor is less evil compared with leaving the patient to die, the procedure of organ donation and transplantation is sanctioned.
- The Fatwa Council supports organ transplant as a means of alleviating pain or saving life on the basis of the rules of Shari’ah.
- The Prophet (peace be upon him) said:
“There should be neither harming nor reciprocating harm” [Ibn Majah].
In normal circumstances, it is not permissible in Islam to inflict harm on others or to suffer harm from them.
In case of necessity, certain prohibitions are waived for instance, when the life of a person is threatened, the prohibition on eating carrion or drinking wine is suspended.
By this reasoning, it is permissible for a living person to donate part of the body such as the kidneys to save the life of another, provided that the organ donated would not endanger the donor’s life and that it might help the recipient
If a healthy person, in the light of the opinion of medical experts, is sure that he/she can live with one kidney only, it will be valid for him/her to donate one kidney to an ailing relative, if it be necessary to save his life while no alternative is available, but without charging any price.
Conditions for organ donation
Organ transplantation, whether from a living donor or one whose death has been established, is at times the only effective form of treatment for certain medical conditions. According to Islamic law, organ transplants from a living donor or a cadaver are permissible under the following conditions:
First, there should be a real necessity and no alternative means to preserve a patient’s life or save them from harm..
Second, there should not be any risk to the life of the donor or recipient during any stage of the operation.
Third, there should be an authentic medical report stating that this transplantation is likely to be successful.
There should be no harm to the donor
Another fiqh maxim is:
‘Harm is not removed by harm’
‘Do not harm nor reciprocate harm’.
This means that while the donor may endure minor harm, as long as they are informed beforehand of the risks and are prepared to bear the physical and psychological impact of the procedure, and the transplant has been approved by medical experts.
Conditions associated with a living donor:
1. He/she must be a person who is in full possession of his/her faculties so that he/she is able to make a sound decision by himself/herself;
2. He/she must be an adult and, preferably, at least twenty-one years old;
3. It should be done on his/her own free will without any external pressure exerted on him/ her;
4. The organ he/she is donating must not be a vital organ on which his/her survival or sound health is dependent upon;
5. No transplantation of sexual organs is allowed.
If the organ is taken from a dead person, all the five proceeding conditions should be met along with the consent of the dead before his death or the consent of his next-of-kin or the consent of the Muslim ruler if the dead person’s identity is unknown.
Honour of the living and sanctity of the deceased
Allah Almighty created man and honoured him, therefore we have a duty to do what we can to protect life. At the same time we have to preserve the sanctity of the deceased.
And We have certainly honoured 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. [17:70]
To remove organs from cadavers is not considered a violation of their sanctity when the surgery carried out is similar to the surgery carried out on living donors. As the Prophet (peace be upon him) said:
“Breaking the bones of a dead person is tantamount to breaking the bones of a living person” [Ibn Majah].
The living take precedence over the deceased
As established in fiqh [Jurisprudence], the living take precedence over the deceased. We know this from the rule that a pregnant mother’s life takes precedence over her unborn foetus.
The opt out camp
- Those who oppose organ donation do so on the basis that:
- When the organ is transplanted from one living person to another, the donor and recipient do not lead a normal life after the operation.
- The body and the soul are for Allah so we do not have the right to donate the body.
- “As the infant takes its characteristics from the mother’s womb, if it grows in a womb donated by a stranger, he/she will carry some of the stranger’s genealogical characteristic. Then the question has to be raised as to who the child’s mother is.
- The decision forbidding the transplant of sexual organs has its basis on other fatwas concerning organ donation. These rulings say that donating single organs like the heart, liver and pancreas are also not permissible.
Reward for saving life
Saving lives is a key aim of the Shariah and carries huge reward for the deceased as it is sadaqah jariah from them, for as long as the recipient benefits from the organ. It is also a demonstration of altruism (eethar), which is rewarded by Allah Almighty.
If any saves a life, it is as if he saves the lives of all mankind. [5:32]
They give [them] preference over themselves, even though they are in privation. [59: 9]
The Prophet (peace be upon him) says,
Whoever helps a brother in difficulty, Allah will help him through his difficulties on the Day of Judgment. (Muslim)
Do as you would be done by
One should also bear in mind, that if you are prepared to receive transplanted organs, it is only fair that you are prepared to donate your organs.
The Sheikh of Al Azhar joined the ranks of those scholars who urge people to become organ donors.
Transplants from animals
As for transferring an organ from an animal to a person its rule depends on the rule of the animal itself whether it is pure or impure.
If the animal is pure such as legally slaughtered camels goats and sheep – there is no doubt about the lawfulness of using any of its parts in medication (transplantation or others) as it is lawful to seek remedy in any lawful thing. The Prophet said: “Seek remedy as Allah has not sent down any sickness without sending a cure for it” (Abu Dawood and Tirmidhi).
The Scholars are agreed that this is lawful.
Al Nawawi said: “If a person gets one of his bones broken, he could put a pure bone instead of it” (Al Majmone 3-138).
In the book of “Indian Fatwas” it is stated: “There is no harm in being treated with a bone from a goat, a cow, a camel or a horse or any other animal save the pig”.
But if the animal is impure such as dead without being slaughtered or of other impurities, the initial rule is that it is forbidden because putting impurities in the body invalidates prayer and all other forms of worship which require purification.
So, initially it is forbidden to transplant any organ from an impure animal into a human body. But if there is a real necessity the rule can be changed.
Al Nawawi said: “If his bone gets broken, he could change with a pure bone. In the Shafi school, it is said: “It is unlawful for him to put an impure bone as long as he could get a pure one; otherwise he is excused.
But if the pure is not found, the impure can be used under two conditions:
1. There should be a dire necessity for it.
2. There should not be any pure thing available and that could be used as substitute.
If one of the two conditions is not met, it is forbidden to transplant an organ from an impure animal into a human being.
If one of the two conditions is not met, it is forbidden to transplant an organ from an impure animal into a human being.
The opt out system in England
Due to the shortage of organ donations, England changed to an opt out system in 2020.
All adults are deemed to have agreed to be an organ donor when they die unless they have recorded a decision not to donate or are in one of the excluded groups.
When you register as an organ donor on the NHS Organ Donor Register, you can now state on the registration whether or not you would like the NHS to speak to your family, and anyone else appropriate, about how organ donation can go ahead in line with your faith or belief system.
About the organ donation system in England
Register to opt in or out
Shaykh Haytham Tamim – From a course on Organ Donation delivered in 2005 to medical students at UCL
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