Transplant for Shah Alam Nov 2008

8/7/2019 Transplant for Shah Alam Nov 2008

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ISUISU--ISU KESIHATAN TERKINIISU KESIHATAN TERKINI

DAN PENYELESAIANNYADAN PENYELESAIANNYAMENURUT ISLAMMENURUT ISLAM

PROF. DR. ABDUL LATIFFPROF. DR. ABDUL LATIFFMOHAMEDMOHAMED

M.D.(Mal.), M.R.C.P.(U.K.), Ph.D.(Cardiology)(Leeds)M.D.(Mal.), M.R.C.P.(U.K.), Ph.D.(Cardiology)(Leeds)

Consultant CardiologistConsultant CardiologistDeputy Dean of Clinical StudiesDeputy Dean of Clinical Studies

Cyberjaya University College of medicalCyberjaya University College of medicalSciencesSciences


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Islamic MedicineIslamic Medicine

Evidence basedEvidence based Based on facts and researchBased on facts and research

Elements of research and proofElements of research and proof Treatments includeTreatments include

DoaDoa

Effort : Physical, spiritual and social

Effort : Physical, spiritual and social

Tawakkal : Belief in Allah as ultimateTawakkal : Belief in Allah as ultimatehealerhealer


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Popular IssuesPopular Issues

1.1. Organ TransplantOrgan Transplant

2.2. Brain Death and Life supportBrain Death and Life support

systemsystem3.3. EuthanasiaEuthanasia

4.4. Post Mortem and CadaverPost Mortem and Cadaver

DissectionDissection5.5. Haram elements in DrugsHaram elements in Drugs

6.6. Use of Botox (botulinum toxin)Use of Botox (botulinum toxin)


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TRANSPLANTTRANSPLANT


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HistoryHistory

Mentioned in ancient Chinese mythologyMentioned in ancient Chinese mythology

Pioneer : Alex CarrelPioneer : Alex Carrel first heart lungfirst heart lung

transplant in dog.transplant in dog. First carried out in human 1967First carried out in human 1967

Christian BarnardChristian Barnard

Only accepted as an established therapyOnly accepted as an established therapyin early 80sin early 80s

1994 : 30 200 performed in 257 centres1994 : 30 200 performed in 257 centres


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Transplantable OrgansTransplantable Organs

Up to 50 lives can be saved or enhanced by a singleUp to 50 lives can be saved or enhanced by a singledonor.donor. Solid organsSolid organs alone can help up to eightalone can help up to eightindividuals, andindividuals, and tissuetissue can help many times thatcan help many times thatnumber.number.

Solid Organs :Solid Organs : HeartHeart KidneysKidneys LiverLiver LungsLungs PancreasPancreas

KidneyKidney--pancreaspancreas IntestineIntestine

Tissues: blood, bone marrow, connective tissue,Tissues: blood, bone marrow, connective tissue,corneas, heart valves, skincorneas, heart valves, skin


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Heart TransplantHeart Transplant


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Lung TransplantLung Transplant


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Other easier transplantsOther easier transplants


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Donors : Causes ofdeathDonors : Causes ofdeath

Cause of deathCause of death No. DonorsNo. Donors

Head TraumaHead Trauma 6868

Gunshot woundGunshot wound 2121Cerebrovasc. AccidentCerebrovasc. Accident 2323

AsphyxiationAsphyxiation 55

Brain TumourBrain Tumour 11Liver failureLiver failure 11

Heart lung receipientHeart lung receipient 11


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ProcedureProcedure


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ProcedureProcedure


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PreventionPrevention

CyclosporineCyclosporine

TacrolimusTacrolimus MethylprednisoloneMethylprednisolone

PrednisolonePrednisolone

AzathioprineAzathioprine


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Transplant TeamTransplant Team


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Transplant Patient (Tee Hui Yee)Transplant Patient (Tee Hui Yee)


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CostCost

Up to RM 400 000Up to RM 400 000

Hospital stay : around 23Hospital stay : around 23 24 days24 days 22 --3 days in ICU3 days in ICU

DonorDonor

ProcedureProcedure

DrugsDrugs


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Survival expectationsSurvival expectations

RehabilitationRehabilitation

1 year survival more than 80 %1 year survival more than 80 %

Marginal decrease in suvival in pts.Marginal decrease in suvival in pts.withwith Longer donor ischaemic timeLonger donor ischaemic time

Older donor ageOlder donor age NonNon--O blood typeO blood type

50 % mortality in 950 % mortality in 9--10 years10 years


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Survival curveSurvival curve


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ProblemsProblems

DONOR !!!DONOR !!!

TechnologyTechnology

Learning curveLearning curve

RejectionRejection matching registrymatching registry

CostCost


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AlternativesAlternatives


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I. Opposing viewpointsI. Opposing viewpoints

Two prominent Muslim scholars who have writtenTwo prominent Muslim scholars who have writtenagainst organ transplantation are the late Muftiagainst organ transplantation are the late MuftiMuhammad Shafi` of Pakistan and Dr `Abd alMuhammad Shafi` of Pakistan and Dr `Abd al--Salam alSalam al--Sukri ofEgypt.Sukri ofEgypt.

Mufti Shafi` holds organ transplantation as notMufti Shafi` holds organ transplantation as notpermissible on the basis of the followingpermissible on the basis of the followingprinciples:principles:


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A. sacredness ofhumanA. sacredness ofhuman

life/bodylife/body

The human body being an amanahThe human body being an amanah

(trust); and finally that such a(trust); and finally that such aprocedure would be tantamountprocedure would be tantamountto subjecting the human body toto subjecting the human body to

material ends.material ends.


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Do not kill (destroy) yourselves: ForDo not kill (destroy) yourselves: Forverily Allah has been to you Mostverily Allah has been to you MostMerciful (alMerciful (al--Nisa', 4:29).Nisa', 4:29).

Make not your hands contribute toMake not your hands contribute toyour own destruction (alyour own destruction (al--Baqarah,Baqarah,2:195).2:195).


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If anyone slays a human being unless it be in legalIf anyone slays a human being unless it be in legalpunishment for murder or for spreadingpunishment for murder or for spreadingcorruption on earth it shall be as if he had slaincorruption on earth it shall be as if he had slainthe whole of mankind; whereas if anyone saves athe whole of mankind; whereas if anyone saves alife, it shall be as if he had saved the life of alllife, it shall be as if he had saved the life of allmankind (almankind (al--Ma'idah, 5:32).Ma'idah, 5:32).

In the Hadith literature it is recorded that theIn the Hadith literature it is recorded that theProphet Muhammad (PBUH) made the followingProphet Muhammad (PBUH) made the followingdeclaration in his Farewell Sermon (Khutbat aldeclaration in his Farewell Sermon (Khutbat al

Wada`ah)Wada`ah)

Your life and your property and your honour areYour life and your property and your honour aresacred until you meet your Lord."2sacred until you meet your Lord."2


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Hadith:Hadith:

Breaking the bone of a dead person isBreaking the bone of a dead person isequal in sinfulness and aggression toequal in sinfulness and aggression tobreaking it while a person is alive.4breaking it while a person is alive.4


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B.B. The human body as anThe human body as an

AmanahAmanah

The Holy Qur'an (17:70; 21:20) tellsThe Holy Qur'an (17:70; 21:20) tells

us that Allah (SWT) has honouredus that Allah (SWT) has honouredman, made serviceable to himman, made serviceable to himwhatever is in the heavens and onwhatever is in the heavens and onearth as a blessing and mercy.earth as a blessing and mercy.


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C.C. Subjecting the human body toSubjecting the human body to

material endsmaterial endsThe impermissibility of subjecting the human body toThe impermissibility of subjecting the human body to

material ends may be deduced from these twomaterial ends may be deduced from these twoexamples:examples:

Fatawa `Alamgiriyyah : if a person, owing toFatawa `Alamgiriyyah : if a person, owing tohunger, finds himself on the verge of death, and ishunger, finds himself on the verge of death, and isunable to find even the meat of a dead animal inunable to find even the meat of a dead animal inorder to save himself, and at that instant is offeredorder to save himself, and at that instant is offeredhuman flesh, it would not be permissible for him tohuman flesh, it would not be permissible for him topartake of it.partake of it.

Hadith Literature : the Prophet Muhammad (PBUH)Hadith Literature : the Prophet Muhammad (PBUH)said that Allah (SWT) has denounced or cursed thesaid that Allah (SWT) has denounced or cursed theone who joins the hair of a woman to that ofone who joins the hair of a woman to that ofanother so as to make her hair appear longanother so as to make her hair appear long -- and Heand He

(SWT) has also cursed the woman with whose hair(SWT) has also cursed the woman with whose hairsuch hair is joinedsuch hair is joined


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D. Prohibition ofmaking use ofD. Prohibition ofmaking use of

forbidden things as medicinesforbidden things as medicines

Hadith of the Prophet (PBUH):Hadith of the Prophet (PBUH):

"Allah created the disease and also the"Allah created the disease and also thecure. For every disease He hascure. For every disease He has

provided a cure. So treat yourselvesprovided a cure. So treat yourselveswith medicines, but do not treatwith medicines, but do not treatyourselves with prohibited things".yourselves with prohibited things".


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E. Safeguarding the honourofE. Safeguarding the honourof

human lifehuman life

Abd al Rahman ibn `Uthman (RA)Abd al Rahman ibn `Uthman (RA)reports that a doctor came to thereports that a doctor came to theProphet (PBUH) and asked him aboutProphet (PBUH) and asked him aboutthe permissibility of making use ofthe permissibility of making use offrogs in medicines. The Prophetfrogs in medicines. The Prophet

(PBUH) forbade him from doing that.(PBUH) forbade him from doing that.


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F. Avoiding the doubtfulF. Avoiding the doubtful

In a hadith, the Prophet (PBUH) said:In a hadith, the Prophet (PBUH) said: Both legal and illegal things are obvious,Both legal and illegal things are obvious,

and in between them are doubtfuland in between them are doubtful

matters. So whoever forsakes thosematters. So whoever forsakes thosedoubtful things lest he may commit a sindoubtful things lest he may commit a sinwill definitely avoid what is clearly illegal;will definitely avoid what is clearly illegal;and whoever indulges in these doubtfuland whoever indulges in these doubtfulthings boldly, is likely to commit what isthings boldly, is likely to commit what isclearly illegal. Sins are Allah's hima (i.e.clearly illegal. Sins are Allah's hima (i.e.private pasture) and whoever pasturesprivate pasture) and whoever pastures(his sheep) near it is likely to trespass in it(his sheep) near it is likely to trespass in itat any moment.at any moment.


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II. Favorable viewpointsII. Favorable viewpoints

Muslim scholars who advocate theMuslim scholars who advocate thepermissibility of organ transpermissibility of organ trans--plantation are of the opinion that itplantation are of the opinion that itshould be recognized as a form ofshould be recognized as a form of

altruistic service to fellow Muslims.altruistic service to fellow Muslims.


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A. AlA. Al--maslahah (public welfare)maslahah (public welfare)

(i)(i) Necessity makes the unlawfulNecessity makes the unlawfulpermissible.permissible.

(ii)(ii) When two interests conflict let theWhen two interests conflict let theone which will bring greater benefitone which will bring greater benefittake precedence.take precedence.

(iii)(iii) If forced to choose, choose theIf forced to choose, choose thelesser of the two evils.lesser of the two evils.


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ExamplesExamples

Islamic Law would permit the cutting ofIslamic Law would permit the cutting ofthe belly of the dead pregnant woman inthe belly of the dead pregnant woman inorder to remove the foetus should anyorder to remove the foetus should any

movement be detected. Thus, the right ofmovement be detected. Thus, the right ofthe living supercedes consideration overthe living supercedes consideration overthe dead.the dead.

Likewise, Islamic Law would allow theLikewise, Islamic Law would allow thecutting of the belly of the deceased whocutting of the belly of the deceased whohad swallowed a valuable diamond or ahad swallowed a valuable diamond or apiece of gold in order that it may bepiece of gold in order that it may bereturned to its rightful owner.returned to its rightful owner.


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B. AlB. Al--Ithar (Altruism)Ithar (Altruism)

Help you one another in righteousness andHelp you one another in righteousness andpiety (alpiety (al--Ma'idah, 5:2)Ma'idah, 5:2)

and from the Sunnah the following hadithand from the Sunnah the following hadithmay be cited:may be cited:

The believers, in their love and sympathyThe believers, in their love and sympathyfor one another, are like a whole body;for one another, are like a whole body;

when one part of it is affected with painwhen one part of it is affected with painthe whole of it responds in terms ofthe whole of it responds in terms ofwakefulness and feverwakefulness and fever


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Living donor : restrictionsLiving donor : restrictions

1.1. The consent of the donor must beThe consent of the donor must beobtained.obtained.

2.2. That the transplantation is theThat the transplantation is theonly form of treatment possible.only form of treatment possible.

3.3. That there is no obvious danger toThat there is no obvious danger to

the life of the donor.the life of the donor.4.4. The respective transplantation hasThe respective transplantation hasbeen proven successful in the past.been proven successful in the past.


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Third session : Amman, Jordan, on OctoberThird session : Amman, Jordan, on October

16, 1986 the Council of Islamic16, 1986 the Council of Islamic

Jurisprudence (majma` alJurisprudence (majma` al--fiqh alfiqh al--islami)islami)The person is considered legally dead, and all the guidelinesThe person is considered legally dead, and all the guidelines

provided by the Shari`a to determine death are applicableprovided by the Shari`a to determine death are applicablewhen following signs are confirmed:when following signs are confirmed: When completeWhen complete cessation oftheheart or respirationcessation oftheheart or respiration occurs,occurs,

and the expert physicians ascertain that the cessation isand the expert physicians ascertain that the cessation is

irreversible.irreversible. WhenWhen completecessation ofall functions ofthe braincompletecessation ofall functions ofthe brain

occurs, and the expert physicians ascertain that theoccurs, and the expert physicians ascertain that the cessationcessationisirreversibleand the brain isin thestate ofisirreversibleand the brain isin thestate ofdegenerationdegeneration. In this condition it is permissible to discontinue. In this condition it is permissible to discontinuethe life supportive system from the patient even when some ofthe life supportive system from the patient even when some ofthe patient's organs like the heart are kept functional bythe patient's organs like the heart are kept functional by

artificial means. God knows the best!artificial means. God knows the best!

The document then proceeds to list the procedure that must beThe document then proceeds to list the procedure that must befollowed as part of the Brain Death Documentation:followed as part of the Brain Death Documentation: Brain death is the irreversible cessation of all spontaneous brainBrain death is the irreversible cessation of all spontaneous brain

activity including the brain stem. Before any supportive meansactivity including the brain stem. Before any supportive meansis discontinued, the family members must be counseled. Thisis discontinued, the family members must be counseled. This

should be documented in the patient's chart.should be documented in the patient's chart.


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C. Sale oforgansC. Sale oforgans

HARAMHARAM

(i)(i) A person cannot trade inA person cannot trade insomething of which he is not thesomething of which he is not the

owner.owner.(ii) A hadith which states that:(ii) A hadith which states that:

`Amongst those who would be held`Amongst those who would be held

accountable on the Last Day is oneaccountable on the Last Day is onewho sold a freeman and ate up thewho sold a freeman and ate up theproceeds.proceeds.


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D. NonD. Non--Mulsim organsMulsim organs

The permissibility for Muslims to receive theThe permissibility for Muslims to receive theorgans of nonorgans of non--Muslims is based on theMuslims is based on the

following two conditions:following two conditions:

1.1. No organs are available from Muslims.No organs are available from Muslims.

2.2. A Muslim's life would be in dangerA Muslim's life would be in dangershould the transplantation not be carriedshould the transplantation not be carriedout.out.


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Fardhu KifayahFardhu Kifayah

In order to circumvent the problem ofIn order to circumvent the problem ofMuslims becoming recipients of nonMuslims becoming recipients of non--Muslim organs, some of theMuslim organs, some of thecontemporary Muslim jurists are ofcontemporary Muslim jurists are ofthe opinion that a Muslim's gesturethe opinion that a Muslim's gesturein donating any of his organs is to bein donating any of his organs is to be

categorized as fard kifayahcategorized as fard kifayah


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The Inclusion ofOrgan DonationThe Inclusion ofOrgan Donation

intoone's Willintoone's Will

O you who believe! When death approaches any ofO you who believe! When death approaches any ofyou, (take) witnesses among yourselves whenyou, (take) witnesses among yourselves whenmaking bequests, two just men of your ownmaking bequests, two just men of your own(kindred) or others from outside (your kindred) if(kindred) or others from outside (your kindred) ifyou are journeying.....(alyou are journeying.....(al--Ma'idah, 5:106)Ma'idah, 5:106)

Likewise, the Prophet Muhammad (PBUH) alsoLikewise, the Prophet Muhammad (PBUH) alsoemphasized the need to write down one's will. Heemphasized the need to write down one's will. Hesaid:said:

"It is not right for any Muslim person, who has"It is not right for any Muslim person, who hasanything to bequeath, that he may pass even twoanything to bequeath, that he may pass even twonights without having his last will and testamentnights without having his last will and testamentwritten and kept ready with him"written and kept ready with him"


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(a) al(a) al--Ithar (altruism i.e. generosity towardsIthar (altruism i.e. generosity towardshumankind) A. Alhumankind) A. Al--ithar (altruism)ithar (altruism)

A living person's gesture in willing to donateA living person's gesture in willing to donatehis/her cornea, for example, after deathhis/her cornea, for example, after deathhas taken place should be viewed as anhas taken place should be viewed as anact of altruism. After all, through cornealact of altruism. After all, through corneal

transplant the donor would have made atransplant the donor would have made anoble contribution in restoring the sight ofnoble contribution in restoring the sight ofanother fellow human being suffering fromanother fellow human being suffering fromcorneal blindness.corneal blindness.


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(b) Al(b) Al--darurah (the rule ofdarurah (the rule of

necessity).necessity).Dr. TanzilDr. Tanzil--urur--Rahman, former Chief JusticeRahman, former Chief Justice

of Pakistan, is of the opinion that theof Pakistan, is of the opinion that theinclusion of corneal donation, for example,inclusion of corneal donation, for example,in one's will may be held permissible onin one's will may be held permissible on

the basis of the rule of necessity. Hethe basis of the rule of necessity. Heexplains that the rule of necessity is basedexplains that the rule of necessity is basedupon the juridical principle of alupon the juridical principle of al--IstihsanIstihsan(juristic prefrence), that the needs of the(juristic prefrence), that the needs of theliving are given preference over those ofliving are given preference over those of

the dead. Thus the inclusion of organthe dead. Thus the inclusion of organdonation in one's will could be a positivedonation in one's will could be a positivestep in resolving organ donation shortagesstep in resolving organ donation shortagesworldwide.worldwide.


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PURPOSES OF THE LAW (MAQASIDPURPOSES OF THE LAW (MAQASID

SHARIAH)SHARIAH)AD DHARURIYYATAD DHARURIYYAT

THE PRESERVATION OF :THE PRESERVATION OF :

1. Religion1. Religion

2. Life2. Life

3. Mind3. Mind4. Progeny4. Progeny

5. Property5. Property


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Keputusan Lujnah FatwaKeputusan Lujnah Fatwa

Kebangsaan):Kebangsaan):

1)Pemindahan/pendermaan organ adalah1)Pemindahan/pendermaan organ adalahhukumnyaharus dalam keadaan darurat.hukumnyaharus dalam keadaan darurat.

2)Orang yang mati otakadalah dihukumkan2)Orang yang mati otakadalah dihukumkanmati.mati.

Walaubagaimanapun sebelum dibenarkanWalaubagaimanapun sebelum dibenarkanuntuk melakukan pemindahan/pendermaanuntuk melakukan pemindahan/pendermaanatau melakukan keatas orang yang matiatau melakukan keatas orang yang matiotak,ada beberapasyarat yangperluotak,ada beberapasyarat yangperludipatuhiuntuk memeliharakesucian Islam:dipatuhiuntuk memeliharakesucian Islam:


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1. Transplan organ ada 21. Transplan organ ada 2

keadaankeadaana)Keadaan penderma masihhidupa)Keadaan penderma masihhidup

-- Menjalankan perubatan dengan caraterperinci dan profesionalMenjalankan perubatan dengan caraterperinci dan profesionaltentangkebaikan dan keburukan pemindahan ini,kejayaan dantentangkebaikan dan keburukan pemindahan ini,kejayaan dankegagalan pemindahankegagalan pemindahan

-- Dengan redhapendermatanpapaksaanDengan redhapendermatanpapaksaan

-- Sudah dipastikan pemindahan itu berjayapadakebiasaannyaSudah dipastikan pemindahan itu berjayapadakebiasaannya

-- Keadaan darurat yang mendesak bagi menyelamatkan nyawaKeadaan darurat yang mendesak bagi menyelamatkan nyawaorang yang didermakan kepadanya,terutama yangadahubunganorang yang didermakan kepadanya,terutama yangadahubungannasab dan keluarganasab dan keluarga

-- Organ yang dipindahkan bukan dijadikan dagangan dan jualbeli,Organ yang dipindahkan bukan dijadikan dagangan dan jualbeli,

dagangan dan jual belihanyaakan mengundangperbuatandagangan dan jual belihanyaakan mengundangperbuatankhianat yang memberi mudaratkepadapenerima, memberikhianat yang memberi mudaratkepadapenerima, memberikeuntungan kepada orangtengah dan jugakesempatan kepadakeuntungan kepada orangtengah dan jugakesempatan kepadadoktordoktor--doktor yangtidak bertanggungjawab mengautkeuntungan.doktor yangtidak bertanggungjawab mengautkeuntungan.

-- Kebenaran bertulis daripadapenderma dan penderma dibolehkanKebenaran bertulis daripadapenderma dan penderma dibolehkanmenarik balikpada bilamenarik balikpada bila--bila masa.bila masa.

-- Organ yang diperlukan lebih darisatuOrgan yang diperlukan lebih darisatu


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b)Keadaan penderma yangtelah matib)Keadaan penderma yangtelah mati

-- Menjalankan pemeriksaan perubatan dengan caraMenjalankan pemeriksaan perubatan dengan caraterperinci dan profesionaltentangkebaikan danterperinci dan profesionaltentangkebaikan dankeburukan pemindahan ini,kejayaan dan kegagalankeburukan pemindahan ini,kejayaan dan kegagalanpemindahan,ia memerlukan pemeriksaan rapi.pemindahan,ia memerlukan pemeriksaan rapi.

-- Dengan redhapenderma melaluiwasiatataupun warisDengan redhapenderma melaluiwasiatataupun waris--waris dan perakuan daripadakerajaanwaris dan perakuan daripadakerajaan

-- Sudah dipastikan pemindahan itu berjayapadaSudah dipastikan pemindahan itu berjayapadakebiasaannyaatau dalam ertiaktalain pemindahan itukebiasaannyaatau dalam ertiaktalain pemindahan itu

dijamin berjaya.dijamin berjaya.-- Dilakukan pemindahan itu dengan penuh disiplin ilmu,Dilakukan pemindahan itu dengan penuh disiplin ilmu,iman dan taqwa,penghormatan yangsewajarnyakepadaiman dan taqwa,penghormatan yangsewajarnyakepadasi mati mengikuthukum syaraksertatiadaunsursi mati mengikuthukum syaraksertatiadaunsur--unsurunsurpenghinaan.penghinaan.

-- Keadaan darurat yang mendesak bagi menyelamatkanKeadaan darurat yang mendesak bagi menyelamatkan

nyawa orang yang didermakan kepadanya,terutama yangnyawa orang yang didermakan kepadanya,terutama yangadahubungan nasab dan keluarga.adahubungan nasab dan keluarga.

-- Organ yang dipindahkan bukan dijadikan dagangan danOrgan yang dipindahkan bukan dijadikan dagangan danjualbeli, dagangan dan jualbelihanyaakan mengundangjualbeli, dagangan dan jualbelihanyaakan mengundangperbuatan jenayah yang memberi mudaratkepadaperbuatan jenayah yang memberi mudaratkepadapenerima, memberikeuntungan kepada orangtenh danpenerima, memberikeuntungan kepada orangtenh danjugakesempatan kepada doktorjugakesempatan kepada doktor--doktor yangtidakdoktor yangtidakbertanggungjawab mengautkeuntungan.bertanggungjawab mengautkeuntungan.


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ii) mati otakii) mati otak

-- menjalankan pemeriksaan perubatanmenjalankan pemeriksaan perubatan

dengan caraprofessionaltentangdengan caraprofessionaltentangberlakunya mati otak.berlakunya mati otak.

-- Digalakkan mendapatpersetujuan dariDigalakkan mendapatpersetujuan darikeluargaterdekat darisuami,anak,ibu,keluargaterdekat darisuami,anak,ibu,

bapa.bapa.

-- Perakuan tentang berlakunya mati otakPerakuan tentang berlakunya mati otakhendaklah dilakukan olehsekuranghendaklah dilakukan olehsekurang--kurangnya 3 orang doktor professionalkurangnya 3 orang doktor professional

(doktor islam diutamakan)(doktor islam diutamakan)

-- Sekiranya dengan kecanggihan rawatanSekiranya dengan kecanggihan rawatanperubatan (sains dan teknologi) bolehperubatan (sains dan teknologi) bolehmengubat makasuasanainigugur.mengubat makasuasanainigugur.


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THE ISLAMIC PARADIGMTHE ISLAMIC PARADIGM

No one can challenge or oppose Gods will.No one can challenge or oppose Gods will.Hence, if the matter is achieved then it isHence, if the matter is achieved then it iscertainly under the will of God. Nothing cancertainly under the will of God. Nothing can

be created without Gods will creating it. Asbe created without Gods will creating it. Aslong as humans continue to do so, it is thelong as humans continue to do so, it is thewill of God.will of God.

We do not search for the question whether it isWe do not search for the question whether it isin accord with the will of God. Our search isin accord with the will of God. Our search iswhether the matter is licit or not (Qardawi)whether the matter is licit or not (Qardawi)


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HUMAN GENETIC &HUMAN GENETIC &

REPRODUCTIVE TECHNOLOGYREPRODUCTIVE TECHNOLOGY


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INFOTECHNOLOGY - 20th

BIOTECHNOLOGY - 21st


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Biotechnology IssuesBiotechnology Issues

1. In Vitro Fertilisation (ART)1. In Vitro Fertilisation (ART)

2. Human Cloning2. Human Cloning

3. Therapeutic Tissue Cloning3. Therapeutic Tissue Cloning

(Stem Cells)(Stem Cells)

4. Preimplantation Diagnosis4. Preimplantation Diagnosis

5. Sex Selection5. Sex Selection

6. Designer babies6. Designer babies


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Dr. E & Dr. Spioneered the

fertility technique called IVF

IVF fertilisation outside thebody in a test-tube

1978 birth of the first test

tube baby, L.B.


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ART ISLAMIC PARADIGM I

LAWFUL if it only involves a married couple whilethe marriage contract is valid

UNLAWFUL if it involves an alien party, whetherin the form of semen, an ovum, an embryo or awomb.

If the marriage contract has ended due todivorce or death, the egg/sperm/embryobecomes alien to either party.

Surrogate motherhood is not allowed


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ART ISLAMIC PARADIGM II

ART centres accredited by healthauthorities. Ensure confidentiality, guard

against mixing of lineages andcommercialism.

Credentialing of staff to ensure highest

standards of professionalism,

trustworthiness, integrity andresponsibility

Acts of legislation to govern ART practice


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2. Cloning2. Cloning


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REPRODUCTIVE HUMAN CLONINGREPRODUCTIVE HUMAN CLONING

Cloning technology aimed at producing humanCloning technology aimed at producing humanclones is not permissibleclones is not permissible

Majority considered it Haram in all its detailsMajority considered it Haram in all its details

FewFew Haram in order to prevent a cause ofHaram in order to prevent a cause ofharm(la darar wa la dirarharm(la darar wa la dirar the necessity tothe necessity torefrain from causing harm to oneself andrefrain from causing harm to oneself andothers)others)

The use of SCNT technology even betweenThe use of SCNT technology even betweenhusband & wife was not approvedhusband & wife was not approved


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POTENTIAL APPLICATIONS

Basic research into humandevelopment & disorders

Discovery of novel proteins fortissue regeneration & repair

Development of human cell

model for drug discovery andtoxicology

Development of tissue fortransplantation


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SOURCE OF STEM CELLSSOURCE OF STEM CELLS

Adult stem cellsAdult stem cells Embryonic stem cells (ESC)Embryonic stem cells (ESC)

Surplus embryos from IVF proceduresSurplus embryos from IVF procedures

Embryos created for research purposesEmbryos created for research purposes Embryos from SCNTEmbryos from SCNT


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SOURCE OF CONTROVERSYSOURCE OF CONTROVERSY

Is an ovum and sperm a person ?Is an ovum and sperm a person ?

When do the products of conception become aWhen do the products of conception become a

person ?person ? Does a zygote have a full set of human rights ?Does a zygote have a full set of human rights ?

Does the foetus have a soul ?Does the foetus have a soul ?

The concept of personhood is neither logical norThe concept of personhood is neither logical nor

empiricalempirical

Based on ones assumptions about the nature ofBased on ones assumptions about the nature ofthe worldthe world

A religious or quasiA religious or quasi--religious conceptreligious concept


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WHEN DOES LIFE BECOMEWHEN DOES LIFE BECOME

HUMAN LIFE ?HUMAN LIFE ?

methods that fail to respect the dignity and value of themethods that fail to respect the dignity and value of theperson must always be avoided. I am thinking in particularperson must always be avoided. I am thinking in particular

of attempts at human cloning with a view to obtainingof attempts at human cloning with a view to obtainingorgans for transplants: these techniques, in so far as theyorgans for transplants: these techniques, in so far as theyinvolve the manipulation and destruction of humaninvolve the manipulation and destruction of humanembryos, are not morally acceptable, even when theirembryos, are not morally acceptable, even when theirproposed goal is good in itself Pope John Paul II; 29 Augproposed goal is good in itself Pope John Paul II; 29 Aug

20002000 The soul enters the body at conception and the fertilisedThe soul enters the body at conception and the fertilised

ovum is a human person with full human rightsovum is a human person with full human rights


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THE SCIENTFIC POSITIONTHE SCIENTFIC POSITION

The preThe pre--embryonic stage is defined as theembryonic stage is defined as theperiod from fertilisation up to theperiod from fertilisation up to thedeterminant of the primitive streak at thedeterminant of the primitive streak at theage of 14 daysage of 14 days

The preThe pre--embryo is unable to feel pain orembryo is unable to feel pain or

pleasure and has no moral statuspleasure and has no moral status The preThe pre--embryos may be cryopreserved,embryos may be cryopreserved,

discarded or used for researchdiscarded or used for research


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THE SCIENTIFIC PARADIGMTHE SCIENTIFIC PARADIGM

to cut off this research (without clearto cut off this research (without clear

understanding of the science of TC and itsunderstanding of the science of TC and itspotential to contribute to mankind) would bepotential to contribute to mankind) would be

an act of intellectual vandalism comparablean act of intellectual vandalism comparable

to papal censorship of Galileo andto papal censorship of Galileo and

Copernicus (Lord May)Copernicus (Lord May)


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EMBRYOLOGY & ENSOULMENTEMBRYOLOGY & ENSOULMENT

Read! In the name of your Lord, who has created. HasRead! In the name of your Lord, who has created. Hascreated man from alaqa 96:1created man from alaqa 96:1--22

And indeed We created man from a quintessence of clay.And indeed We created man from a quintessence of clay.Then we placed him as a small quantity of liquid (nutfa) in aThen we placed him as a small quantity of liquid (nutfa) in asafe lodging firmly established. Then we have fashioned thesafe lodging firmly established. Then we have fashioned thenutfa into something which clings (alaqa). Then We madenutfa into something which clings (alaqa). Then We madealaqa into a chewed lump of flesh (mudgha). And We madealaqa into a chewed lump of flesh (mudgha). And We made

the mudgha into bones, and clothed the bones with flesh.the mudgha into bones, and clothed the bones with flesh.And then We brought it forth as another creation. SoAnd then We brought it forth as another creation. Soblessed be God, the best to create 23:12blessed be God, the best to create 23:12--1414

and breathe into him of His spirit 32and breathe into him of His spirit 32--99


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JURISPRUDENCE OF MEDICINEJURISPRUDENCE OF MEDICINE

The Islamic mind dismisses the pair of contraries :The Islamic mind dismisses the pair of contraries :

religiousreligious--secular; sacredsecular; sacred--profane; churchprofane; church--statestate

The Shariah (Islamic Law) is the epitome of theThe Shariah (Islamic Law) is the epitome of the

Islamic spirit, the most typical manifestation of theIslamic spirit, the most typical manifestation of the

Islamic way of life Islamic way of life

Bioethics is inseparable from religion. Is builtBioethics is inseparable from religion. Is builtentirely upon the Shariah and flourishes within herentirely upon the Shariah and flourishes within her

jurisdictionjurisdiction


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DESI

ERIES

The ultimate shopping

experience

The slippery slope

29/08/2000

dam ash

HFEA Dec 2001

27(14%) ban I M


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Other IssuesOther Issues

1.1. AbortionAbortion

2.2. ContraceptionContraception

1.1. EuthanasiaEuthanasia

2.2. Brain DeathBrain Death

CONCL SIONS


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CONCL SIONS

Unique opportunity to fathom the treasures and secrets ofGods creation

Along with it grave and unprecedented risks

Nevertheless, since we do not will unless God wills, canthese breakthroughs be regarded as part of the divine willto afford humanity yet another opportunity for moraltraining and maturity (TARBIYAH) in our quest forexcellence (IHSAN).

Thus we have appointed you a middle nation, that youmay be witness against mankind, and that the messengermay be witness against you 2:143

Documents

Transplant for Shah Alam Nov 2008