KULIYYAH OF ISLAMIC REVEAL KNOWLEDGE AND CIVILIZATION

ETHICS & FIQH FOR EVERYDAY LIFE

(UNGS 2050)

INDIVIDUAL CHAPTER REVIEW: CHAPTER 12

“CONTEMPORARY BIOMEDICAL ISSUE: AN

ISLAMIC PERSPECTIVE”

NAME MATRIC NO. AFIFAH NABILAH BT MOHAMAD SAFEI 1321976

Lecturer’s Name : Dr. Md. Yousuf Ali

Section : 20

Session : Semester 1, 2015/2016

Submission date : 21 December 2015

Scope of Biomedical Technology

1. Population control (contraceptive devices, sterilization programs and etc)

2. Termination of life (abortion, euthanasia)

3. Prolongation of life (organ transplantation, artificial organs, respirators, cardiac

pacemakers)

4. Gender pre-selection and sex-change operations

5. Improving the quality of life (genetic screening, genetic engineering, artificial

insemination, sperm banks)

6. Coping with fetility problems (test-tube fertilization, surrogate mothers, ova banks)

7. Experiments involving human beings

8. Controlling behavior by physical means (psychosurgery, psychotherapeutic drugs)

Contraception

Meaning: The measure undertaken to frustrate the possibility of the birth of children.

Implies the non-fulfilment of one of the purposes of marriage which is procreation of

human species.

Purpose: To control the timing of births with the intent of distancing the occurances

of pregnancy or to delay it for specific amount of time for different reasons.

Islam encourages married couple to have children (Hadith Abu Dawud)

Celibacy and monasticism are against the principle of Islam (Hadith al-Bukhari)

Children are a blessing from Allah (An-Nahl: verse 72, Al-Kahfi: verse 46)

The contraceptive method used during the time of Prophet PBUH is al-‘azl.

Al-‘azl (coitus interruptus): The process of withdrawal by the man during the time of

emission to prevent inseminaton of the ovum.

Five school of Islamic law: Permissible (mubah) but a blameworthy (makruh)

practice because it deprives the woman the right to experience sexual

fulfilment and to have children.

Imam Al-Ghazali: Practicing ‘azl would be justified if it was done for the sake

of protecting the wife’s life from the risk of child birth or if one fears of

excessive hardship (kathrah al-haraj) because of an excess of children or

genuine financial dificulties.

Shaykh Ahmad al-Sharabassi of Egypt: Contraception is valid under the

following circumstances:

1. To give the woman a chance to rest between pregnancies.

2. If either or both partners have disease, which can be transmitted

3. To safeguard the woman’s health

4. If the husband’s finances are insufficient to support more children

Infanticide: the actual murder of children in existence.

Contraceptive methods:

Withdrawal (‘azl)

Spermicide: A contraceptive agent that kills spermatozoa

Condom: A contraceptive devide consisting of a sheath of thin rubber or latex

that is word over the penis during intercourse.

Diaphragm: A contraceptive device consisting of a thin flexible disk, usually

made of rubber, that is designed to cover the uterine cervix to prevent the entry

of sperm during sexual intercourse.

Vasectomy: Surgical removal of all or part of the vas deferens, resulting in

sterility in men. Vas deferens is the duct that transports the sperm from the

epididymis to the penis.

Tubal Ligation: A method of permanent sterilization for women, inolving the

surgical sealing of the fallopian tubes to prevent the ovum from passing the

ovary to the uterus.

Hysterectomy: Surgical removal of all or part of the uterus.

Hukm:

Not permissible to use any devices that permanently incapacitate a person to

procreate.

Not permissible the use of irreversible methods of sterilizing men and women.

Such methods can only be prescribed by medical doctor if pregnancy would be

hazardous to the woman’s physical or mental health.

Bith Control

The council of the Islamic Fiqh academy:

1. It is not permissible to issue a general law restricting the freedom of a married couple

on the issue of procreation.

2. It is strictly forbidden by religion to deprive a man or woman of his or her physical

capacity to procreate (sterilization) except in cases of necessity according to the

criteria set by shariah.

3. It is permissible to control procreation temporarily in view of spacing the pregnancy

periods or to interrupt it for a fixed duration in case of necessity recognized by the

shari’ah (should be done according to mutual agreement between married couple,

provided no prejudice is caused and the method to e used is legal without causing any

harm to an ongoing pregnancy)

Sanctity of Life

Every life has its sanctity. There is no differences between the life of a foetus, a young

person, an aged person and a terminally ill one. (5:32, 17:31)

Life is a gift from Allah SWT. Only Him has the right to take it away. (4:29. 2:195)

Abortion

Meaning: Termination of pregnancy. Maybe spontaneous as a result of physical

injury or internal biomedical disorder or the women. Maybe deliberate through human

intervention.

Spontaneous abortion is known as miscarriage.

When does the life of foetus starts?

Some scholars agree that inviolable life of the foetus starts after the soul is

breathed into him, and that is after 120 days. (Hadith Bukhari and Muslim).

Some others agree that the inviolable life of embryo starts within the forty days

after the fusion of the sperm and the egg. (Hadith reported by ‘Abdullah ibn

Mas’ud)

Some others are in the opinion that inviolable life starts once the embryo

implants itself in the lining of the womb, a few days ater the fusion of the

sperm and the egg.

Some other scholars agree that inviolable life starts once the sperm fuses the

egg and the product of their fuse gets ready to receive life.

Abortion: lawful or unlawful?

Few scholars from four major Islamic juristic schools (madhahib) argue that

abortion can be carried out before 120 days (based on the assumption that no

life exists before 120 days since the soul is breathed only after 120 days).

Some scholars are of the opinion that abortion before 120 days is reprehensible

(disapproved).

Some other scholars stated that abortion after before 40 days is permissible and

after 40 days is haram.

Opinion of the majority scholars stated that abortion after the beginning of

pregnancy is forbidden other than for some justifiable reasons such as

pregnancies are the result of rapes and incests.

The difference between contraception and abortion is that contraception is to

prevent pregnancy where there is no assault or crime against the existent

human being while abortion is a direct assault against the life of an existing

human being.

According to majority scholars,

- if the matter aborted is in the form of human being when the organs

have started to appear or when the specialists confirm that the matter

aborted is an embryo or pre-embryo, the person who aborts has to pay

ghurrah (1/20 of diyyah = 75 dirhams. 1 dirham = 31 gold grams).

- If the matter aborted is still in the form of blood, no need to pay

ghurrah.

- There may be a punishment as imposed by law or a judge for the

assault on the mother.

- According to Imam Malik, a person who aorts is required to pay

ghurrah even if the matter aborted still in the form of blood.

All scholars agree that abortion is forbidden. Deliberate abortion, after the soul

has been breathed into the feotus after 120 days is a crime against a living

human being includes the cases of unlawful sexual intercourse (zina), rapes or

incests.

The punishment of abortion after 120 days:

a) When the feotus is aborted alive with any visible symptoms of life:

The case will be dealt with an act of manslaughter. The person reponsible will

subject to this punishment:

- Religious punishment: Kaffarah (free a slave or fast for 2 consecutive

months)

- Legal responsibility: full blood money (diyyah) in addition to a punishment

imposed by law or the judge if abortion is caused by an assault on the

mother.

b) When the foetus is delivered dead:

- Legal responsibility: Ghurrah should be paid which is equal to 1/20 (50%)

of blood money (diyyah) in addition to a punishment as imposed by law or

the judge if abortion is caused by an assault on the mother.

- Individual responsibility: Everyone is responsible for his own offences and

misconduct and no one will be penalized for the offences and crimes

committed by others including parents. A foetus who is the outcome of

unlawful sexual intercourse will never be held responsible for the crime of

his mother and father. (6:164)

When abortion may be allowed?

If the mother has a health condition that makes the continuation of pregnancy a

danger to her life.

When a reliable medical source gives a proof indicating that continued

pregnancy, even after the confirmation of the existance of life, would definitely

lead to the mother’s death.

Infertility

May caused by certain ‘defects’ either in the wife or husband.

1. Male factor: may be due to the abnormality of the sperm in ther sense that there is a

low sperm count and poor sperm movement.

2. Female factor: may be resulted from the absence of or a blockage of the fallopian tube.

May also be associated with the failure to ovulate in which no egg emerges from the

ovary. May also because the female is allergic to the proteins contained in the semen.

Sometimes, the female may be borned without an uterus and fertility in such a case is

virtually impossible.

Overcoming the Infertility through Biomedical Possibilities

1. Artificial Insemination

Involves using the husband’s or a donot’s sperm to impregnate a woman.

Five methods are forbidden and absolutely prohited for the their own sake or due to

ensuing consequences manifested in confusion about parenthood and loss of

motherhood and other shariah matters.

1. Fertilization taking place in vitro between the semen taken from the husband

and the ovum taken from a woman who is not his wife, and the fertilized ovum

is planted in the womb of his wife.

2. Fertilization taking place in vitro between the semen taken from a man who is

not the husband and the ovum taken from the wife of another man, and the

fertilized ovum is planted in the womb of his wife.

3. Fertilization taking place in vitro between the semen and ovum taken from

spouses and the fertilized ovum is then placed in the womb of a surrogate

mother.

4. Fertilization taking place in vitro between the male semen and female ovum

from two strangers and the fertilized ovum is then planted in the womb of

another man’s wife.

5. Fertilization taking place in vitro between the semen and ovum taken from

spouses and the fertilized ovum is then planted in the womb of the husband’s

other spouse.

Two methods which is permissible by the council of the islamic academy:

1. In vitro fertilization of a woman’s ovum by her husband’s semen and

implantation of the fertilized ovum in the womb of the same woman.

2. External insemination by taking the semen of a husband and injecting it in the

appropriate place in the womb or uterus of his wife for in vitro fertilization.

2. In Vitro Fertilization (IVF)

A method of assisting reproduction in which the man’s sperm and the woman’s egg

are taken and then combined in a laboratory dish, where the fertilization occurs. Then,

the resulting pre-embryo is transferred to the womans uterus.

3. Egg Transfer

Involves transferring the egg from a donor woman to an infertile woman’s uterus. The

egg maybe fertilized by the recipient’s husband.

4. Artificial Embryonation

Requires flushing an embryo from a woman who has artificially been inseminated by a

donor’s sperm, and implanting the embryo in the womb of the donor’s wife.

5. Embryo Adoption

Involves both donor sperm and donor egg, but they would be transferred to the womb

of the recipient and she would bring the foetus to birth.

6. Ectogenesis

The nurture of a foetus from fertilization to viability in an artificial placenta or glass

womb.

7. Cloning

May occur in plant and invertebrate animals (worms and insects) and in humans.

Consists of removing the nucleus of an egg, and replacing it with the nucleus of a

donated unfertilized egg or the nucleus of a body cell. The re-nucleated cell is then

implanted and brought to term in the womb. The child has only the genetic material of

the donor of the nucleus.

It is artificial virgin birth - a child with the same DNA as the (one) parent.

The Council of Islamic Fiqh Academy at Jeddah announced that it is prohibited to

clone human beings. However, the Shariah permits the cloning techniques and genetic

engineering in the field of microbiology, botany and zoology within the limits

prescribed by the Shariah in order to benefit the people and to prevent inconvenience.

8. Surrogate Parenting

Involves a woman bearing a child of another woman, one who presumably infertile.

The surrogate mother is artificially impregnated with the contracting husband’s sperm.

From Islamic point of view, if the sperm used is from the legal husband in a

continuing marital life, the artificial insemination will be permitted. Otherwise, it is

prohibited. IVF is also lawful and permitted only when it involves a married couple

with a valid marriage contract to prevent the lineage confusion.

9. Surrogate Motherhood

Occurs in many forms:

1. The sperm and the egg are taken respectively from a legitimate husband and

wife. The egg is fertilized and then implanted in the womb of another woman

who is not the wife of the man.

2. The sperm is taken from the legitimate husband but the egg is taken from from

another woman who is not his legal wife. The egg is fertilized and implanted in

the wom of his legal wife.

3. The sperm is taken from the legitimate husband but the egg is taken from

another woman who is not his legal wife. The egg is fertilized and implanted in

the womb of the same woman from whom the egg was taken.

4. The sperm is taken from the legitimate husband but the egg is taken from

another woman who is nothis legal wife. The egg is fertilized and implanted in

the womb of a third woman (not his wife and not the person who owns the

ovum).

5. The sperm is taken from a husband who has more than one wife. The egg is

taken from one wife. After fertilizing the egg, the pre-embryo is implanted in

the womb of the second wife.

The first four methods is haram because each case involves the third party which is not

the legitimate wife of the husband. For the last method, most of Muslim scholars

believe it is also unlawful because even though the sperm is not a stranger to the

womb of the wife, the ovum is still a stranger since it was taken from another woman.

10. Surrogate Fatherhood

The sperm is taken from a man who is not the legitimate husband of the woman.

This is forbidden because it involves a person who is not tied to that woman with a

legitimate marital relationship.

Foetal Gender Selection

A process to choose the desired gender of a child before the sperm fuses with the egg.

This process is followed for different reasons which are to avoid gender-linked genetic

diseases, to fulfil one’s desire for a specific gender of children.

It is done through selecting the X (girl) bearing or Y (boy) bearing specimens. Then,

the woman is artificially inseminated with the sperm or the egg is fertilized outside of

the womb and then implanted into the womb.

The Islamic Organization for Medical Sciences stated in its seminar on Reproduction

in islam that foetal gender selection is unlawful when it is practiced at a national level.

When it practiced at the individual level, the participants’ opinions differed.

Some are in the opinion that there is nothing legally wrong with an attempt to

fulfil the wishes of a married couple to have a boy or a girl.

Some believe that it is unlawful for fear that it may lead to one gender

outnumbering the other.

Milk Bank

A place for the collection and storage of human milk for dispensing to those who

require it, such as infants who are allergic to cow milk and whose mothers’ milk is

unavailable.

Milk banks receive milk from lactating mothers who have been carefully screened for

health behaviors and communicable diseases, a process similar to the way blood banks

screen donor.

In Islam, breast feeding creates a bond similar to a lineage bond, and forbids according

to Muslim jurists, exactly the same which is foridden due to actual lineage

relationship.

The establishment of milk banks should be prohibited in the Islamic world and it is

prohibited to feed a Muslim child with milk from these banks.

Plastic Surgery

The surgical speciality concerned with the treatment of structural deformity and

disfigurement. It is also involved with the enhancement of the appearance of a person

(beauty).

Two types of plastic surgery:

Cosmetic Surgery

Performed to reshape normal structures of the body to improve the person’s

appearance life faselifts, attempts to reverse the signs of aging and surgery

of breasts.

This kind of surgery is not allowed by Islam because it is a kinf of

deception and its aim is to change and temper with the creation of Allah for

reasons of human vanity.

Reconstructive Surgery

Performed on abnormal structures of the body caused by congenital

defects, development abnormalities, injuries, infection, tumours or

diseases.

Congenital faults include abnormally turned-out lips, split lips, twisted

fingers or toes. Faults that result from illness include scars left by leprosy

or other skin diseases or scars caused by accidents and burns.

This type of surgery is permitted because these faults and scars usually

cause physical and psychological pain to the person inflicted with them.

Moreover, operating on them is not considered as changing the creation of

Allah.

Euthanasia (Mercy Killing)

Meaning:

a) A quiet, painless death

b) The intentional putting to death by artificial means of persons with incurable or

painless diseases.

c) The act of killing someone painlessly, especially to relieve suffering from an

incurable illness.

Type of Euthanasia:

a) Active Euthanasia

Usually taken to be an action performed within a medical setting which is

done with the intention of terminating a human life.

An active intervention by a doctor to end life.

b) Passive Euthanasia

The withdrawal or withholding of some necessary treatment for the

maintenance of human life

A decision not to prolong life or a non-treatment decision

Examples:

- Letting a person die by taking no action to maintain his life like

stopping to give medications to one whose life is dependent on it.

- Withholding medical or surgical procedures and lide support

systems.

Other type of Euthanasia:

Voluntary Euthanasia: A death brought about by an agent at the request of the

person who wishes to die

Involuntary Euthanasia: The killing of someone who could consent but does

not.

Non-voluntary Euthanasia: The killing of an individual who has no capacity to

understand what is involved, out of kindness or a consideration of the patient’s

best interests.

People who involve with euthanasia are:

Patients in a persistent vegetative state who are awake but not aware of

themselve or the environment. The patient has no higher brain functions and is

kept alive on artificial life support (respirators, heart-lung machines, intra-

venous nutrition).

Patient in terminal illness who may or may not be subject to life-support

machine.

People who suffer from great pain.

All religion oppose to euthanasia and regard it as an act of murder. There is no

differences between killing a healthy person and terminally ill patient. The prohibition

of euthanasia in islam is based on Surah Al-Isra verse 33.

Organ Transplantation.

An operation where the tissues of an organ are tranferred from one body or body part

to another. It includes the transplanting an organ from a living persong, dead peron or

from a foetus.

The views of Muslim scholars:

The Opposing View

- It is regard as unpermissible based on the following arguments:

1. The impurity of mutilated human organs, being forbidden.

2. The human beings are not the owners of their own selves.

3. The human body is an amanah from Allah given in one’s possession, such

procedure would be like subjecting human body to material ends and

avoiding the doubtful.

The Supporting View

- Advocates the permissibility of organ transplantation arguing that it is a

form of alruistic service to fellow Muslims.

- Should be hedged with certain restrictions as follow:

1. The transplant of organs is the only means of treatment.

2. The expected degree of success of this procedure is relatively high.

3. The consent of the owner of the organ or of his heirs has been obtained.

4. Death must have been fully established by Muslim doctors of upright

character before such a venture is undertaken.

5. The recipient patient has been informed of the operation and its

implications.

- The restriction for a living donors to donate his organs are:

1. The consent of the donor must be obtained.

2. The transplant is the only form of possible treatment.

3. There is no imminent danger to the life of the donor.

4. The respective transplant has been proven successful in the past.

- A vital organ such as heart cannot be donated as this would result in the

death of the donor. If the donor gives permission, this will be considered as

suicide.

Transplant of Genital Organs

Since the testicles and ovaries continue to bear and discharge hereditary attributes to

the donor, even after it is transplanted in a new recipient, their transplant is prohibited

by the Shariah.

Sale of Organs

It is unlawful based on the following reasons:

A person cannot trade in something of which he or she is not the owner - The body

of a person (living or dead) belongs to Allah alone.

Such practice would be exposed to abuse in the sense that it could result in a

person’s organs being sold in the market like other commodity.

Transsexualism

A transsexual is someone who experiences a deep and long-lasting discomfort with

their anatomical (genital) sex, and wishes to change their physical characteristics,

including genitals, to the opposite of those usually associated with their anatomical

sex, and to live permanently in the gender role opposite to that normally associated

with their anatomical sex.

Allah has created two sexes which are male and female and they are both highly

respected in Islam in which the religion forbids gender discrimination. In Islam, men

and women are equal in the sight of Allah. There is no justifiable reason for what is

called sex change operations.

Hermaphrodite: One who has both male and female sexual organs. In this case, a

medical treatment can be sought to unify one gender. It is considered as a correction.

Not a change in the creation of Allah SWT.

The gender change is not an option that is permissible in Islam and doing so will be

tantamount to tampering with Allah’s creation.