Organ Transplant Debate: Arguments For and Against

Organ donation is a new issue for Islamic jurisprudence. There are no clear provisions regarding this topic in the Quran or hadiths. However, the religion of Islam, which is universal and offers solutions to all problems that exist until the doomsday, will certainly have a solution in this regard. Therefore, Islamic scholars have made great efforts to clarify the issue, especially by using the analogy method[footnoteRef:1]. Although there are differences of opinion among scholars, this essay will focus more on the view accepting organ donation and some of their evidence. [1: Analogy (qıyas) is the assignment of the ruling (hukm) of an existing case found in the texts of the Qur’ān, Sunnah or ijmaʿ to a new case whose ruling (hukm) is not found in these sources on the basis of a common underlying attribute called the ʿillah (effective cause).]

Organ donation is a subject that brings along the organ transplant debate. Organ transplantation takes place either by an alive person gives an organ that will not endanger his own life, such as the kidney, the eye, to someone else who needs that organ; or by the declaration of deceased before his death or the consent of his heirs after his death. İn both cases, the goal is to save the lives of people who are sick and desperately await death. This is the main issue that scholars who accept organ transplants emphasize; saving a person's life. There is a verse related to this goal; “whoever kills a soul unless for a soul or for corruption [done] in the land - it is as if he had slain mankind entirely. And whoever saves one - it is as if he had saved mankind entirely.” [5,32] Besides, the saving of life is one of the essentials (daruriyyat) accepted by all scholars and it even comes before protection of religion. Therefore, the scholars have prioritized human life and put this at the center point while making a decision regarding organ donation.

Since organ donation and organ transplantation is a new issue in many respects, there is no explicit judgment regarding the Qur'an and sunnah of the Prophet Muhammad (pbuh), which was descended fourteen centuries ago. It is not possible to find a clear statement on the subject in classical fiqh books. Because there was no such treatment method at that time, this was not an issue. Scholars, as with many issues, used the method of analogy in organ donation, while seeking solutions and new judgments for subjects in which there was no clear provision in the Qur'an and the hadith.

The first proof of scholars who accepted organ donation is “It is stated with the following verses that prohibited foods and beverages will be enjoyed in cases of necessity such as hunger and thirst that threaten human life.” The verse is “He has only forbidden to you dead animals, blood, the flesh of swine, and that which has been dedicated to other than Allah. But whoever is forced [by necessity], neither desiring [it] nor transgressing [its limit], there is no sin upon him. Indeed, Allah is Forgiving and Merciful” [2,173]. In this verse, Allah has forbidden some things first, but later, as a manifestation of His own mercy and forgiveness, He allowed those things that were forbidden in the necessary situations to be overcome. As a creator and legislator, Allah prioritizes the protection of human life and introduces an exceptional provision here. Although, in some verses and hadiths, it is said that man is created honorable, he does not possess his own body, and his body is entrusted to him; organ donation can be acceptable according to the above verse. Because, according to this verse, necessities can make forbidden things, halal. Here, even if the human body is dignified and untouchable, it is imperative to save someone else's life by donating organs.

As it is known, in order to apply the analogical provisions on an issue, the effective cause (‘illah) of both issues must be same. Namely, there should be a union of causes between the subject that is clear judgment in the Quran or sunnah and the subject to be compared with it. In the first case, it is the effective cause to rescue from death by eating something that is forbidden. In the second case, it is the effective cause to donate the organ of a dead person to someone who is most likely to die due to organ failure, and to save his life. In both cases, there is certainly an effective cause for saving lives.

The second proof of scholars who accepted organ donation is a fatwa (new judgment) of Kasani in the book of al-Fatawa al Hindiyyah. [Kâsâni, a.g.e., I, 61-62; Fetâvâ el- Hindiyye, Beyrut, tsz, V, 355.] The fatwa is “It is considered permissible to use alcoholic and narcotic drugs, which are forbidden and filthy, if there is certain information or that is highly probable that patients who cannot be treated otherwise can be cured.” İf something that is forbidden can be used for treatment in necessary situations, human organs that are dignified and untouchable can also be used to save a person from death. There is an example in the life of Prophet (pbuh); He had forbidden men to wear silk clothes. However, He allowed some companions to wear silk because it is good for some skin diseases. [Bukhari, book of wear 29]

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The third point is we can say that an evidence of organ donation is to avoid wastefulness. Waste is prohibited in the Qur'an and hadiths. Allah Almighty says in the Quran; “eat and drink, but be not excessive.”[7,31]. Allah Almighty says that in the Qur'an, He is also practicing this in the universe He created. When we look at the earth, we see that nothing is wasted. All beings help each other and prevent waste. For example, the corpses of each dead animal are consumed by other animals and reintroduced into the ecosystem. If we look at organ donation with this view, we will see how much waste will be prevented by organ transplantation. Some people die without donating their organs, all organs will fall into the ground when they die and they will miss the opportunity to find solutions to sick people in need. Otherwise, if people donate their organs, when they die, they will give life to other sick people with their organs. We know that waste is not limited to eating and drinking. Even in the simplest things like eating and drinking, Allah Almighty prohibits waste. It is unthinkable that He allows waste when it comes to human life. Therefore, scholars have said that when a person dies, Allah will not allow the organs to be wasted.

Finally we can add that Islam is a religion of convenience. Both people who are sick due to organ failure and their families have difficulties. Many people die while waiting in line for transplantation. This situation also causes an organization called “organ mafia” that darken the lives of many people. It is possible to overcome those difficulties by allowing organ donation. The Prophet (pbuh) had said “'Make things easy and do not make them difficult”.[ Bukhari 69, Book 3, Hadith 11] Therefore, it is the way that is suitable for the sunnah, not to bother people with the hard one while there is an easy one. When people donate their organs, people waiting for organs will recover with new organs and malicious people will not be given the opportunity. Furthermore, there is a principle in the civil law that prepared in the time of the Ottomans called “majallah” ; “the essential thing in the objects is exemption”. Namely, permissibility to benefit from the things or continuity of permissibility to act in a way where there is no evidence against them. Therefore, we can say that there is no explicit judgment for organ transplantation that prohibits it. Since the scholars could not find clear provisions in the Qur'an and sunnah, they concluded that organ transplantation is permissible with the method of analogy.

There are some conditions for organ transplantation.[tdv islam Encyclopedia] 1- There should be a necessity for organ donation; The necessity of organ transplantation is related to its being a last resort. Firstly, all treatment methods should be applied, but if the patient has not recovered, an organ transplant can be applied. This will also encourage scientists to research and find new solutions for organ failure. If they find new treatments, there will be no need for organ transplants. 2- A strong opinion in the experts of the subject that the patient will recover with this treatment; There should be a definitive or close decision by the experts about the patient's recovery. If the patient will not recover with organ donation, there is no need for an organ transplant. 3- The approval of donor before his death or approval of donor’s heirs after his death; The donor must be willing to donate his organs. If he does not have any explanation about this, heirs must be consent after his death. There are also different opinions here. For example, there is no need to obtain their permission, because heirs are not entitled to the organs of the deceased. 4- The definitive of medical and legal death; It is necessary for specialist doctors to decide at what stage someone dies completely. In cases such as brain death or vegetative life, the decisions of doctors should be taken into consideration. 5- The organs are not given for a fee and benefit; Allah Almighty says in the Quran “And We have certainly honored the children of Adam” [17,70]. Allah Almighty has given body of human as a trust. For this reason, people cannot sell their fleshes or any other organs for a fee. 6- The consent of person who will take organ; It says who takes organs should approve to take organ. But there must be an opposite view here. Because, if a person is life-threatening, there is no need to obtain permission from him to save his life. Scholars have said that organ transplantation can be done when these conditions are met. Although scholars determine these conditions, as we have seen, it is necessary to get the opinions of specialist doctors on many issues about organ donation. This makes the cooperation of fiqh scholars and specialist doctors inevitable.

On the other hand, some Islamic scholars say that organ donation is not permissible. They bring evidence the verse that is mentioned above; “And We have certainly honored the children of Adam” [17,70]. Therefore, human body is honored and untouchable even after they died. Likewise, there is a hadith that they use in this case; “It is like breaking the bone of the deceased while it is alive'[Abu Davud, Janaiz, 60]. Furthermore, according to their approachs, the right of the using on one's organs ends with death, and the intervention in the body of the deceased for organ harvesting violates the right of Allah, not the right of human. Therefore, the testament of person is not valid in this regard. Additionally, these scholars said that the moment of death cannot be clearly determined. Brain death and subsequent removal of organs have affected the wiev of these scholars about organ transplantation. Because this will facilitate organ harvesting from a person not yet dead and maybe it will cause abuse organ transplantation.

After all these writings, we can say that; As Muslims, we believe that Islam offers a solution to all current and future problems. Thousands of people die every year due to organ failure. This is a serious problem worldwide and it is unthinkable that Islam does not offer a solution. However, when we look at the research, we see that the organ donation rate in Muslim countries is lower than that of non-Muslim countries. The fact that organ donation is permissible encourages Muslims to donate and it can be a solution to the problem. Right here, there is a great responsibility for Islamic scholars. They should enlighten and encourage Muslims and contribute to the solution of this problem.

İn conclusion, On the one hand, there are people who are desperately waiting for death because they are sick and unable to find suitable organs, and on the other, there are people who die and decay organs in the soil. Considering this, many scholars of Islamic jurisprudence have prioritized human life and said that organ transplantation is permissible. While making these judgment, they mostly used the method of analogy and consider the benefit of humanity. Although this topic is very new, they have worked hard and made positive provisions for the protection and survival of human life. According to verse whoever saves one - it is as if he had saved mankind entirely. Therefore they want to save lıves of people.