ISU-ISU KESIHATAN TERKINI ISU-ISU KESIHATAN TERKINI DAN PENYELESAIANNYA DAN PENYELESAIANNYA

MENURUT ISLAMMENURUT ISLAM

PROF. DR. ABDUL LATIFF PROF. DR. ABDUL LATIFF MOHAMEDMOHAMED

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 medical Cyberjaya University College of medical SciencesSciences

Islamic MedicineIslamic Medicine

““Evidence based”Evidence based”• Based on facts and researchBased on facts and research

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

• Do’aDo’a• Effort : Physical, spiritual and socialEffort : Physical, spiritual and social• Tawakkal : Belief in Allah as ultimate Tawakkal : Belief in Allah as ultimate

healerhealer

Popular IssuesPopular Issues

1.1. Organ TransplantOrgan Transplant

2.2. Brain Death and Life support Brain Death and Life support systemsystem

3.3. EuthanasiaEuthanasia

4.4. Post Mortem and Cadaver Post Mortem and Cadaver Dissection Dissection

5.5. ““Haram elements” in DrugsHaram elements” in Drugs

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

TRANSPLANTTRANSPLANT

HistoryHistory

Mentioned in ancient Chinese mythologyMentioned in ancient Chinese mythology Pioneer : Alex Carrel – first heart lung Pioneer : Alex Carrel – first heart lung

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

Christian BarnardChristian Barnard Only accepted as an established therapy Only accepted as an established therapy

in early 80’sin early 80’s 1994 : 30 200 performed in 257 centres1994 : 30 200 performed in 257 centres

Transplantable OrgansTransplantable OrgansUp to 50 lives can be saved or enhanced by a single Up to 50 lives can be saved or enhanced by a single

donor. donor. Solid organsSolid organs alone can help up to eight alone can help up to eight individuals, and individuals, and tissuetissue can help many times that can help many times that number. number.

Solid Organs :Solid Organs :• HeartHeart • KidneysKidneys • LiverLiver • LungsLungs • PancreasPancreas • Kidney-pancreasKidney-pancreas • IntestineIntestine

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

Heart TransplantHeart Transplant

Lung TransplantLung Transplant

Other “easier” transplantsOther “easier” transplants

Donors : Causes of deathDonors : Causes of death

Cause of deathCause of death No. DonorsNo. Donors

Head TraumaHead Trauma 6868

Gunshot woundGunshot wound 2121

Cerebrovasc. AccidentCerebrovasc. Accident 2323

AsphyxiationAsphyxiation 55

Brain TumourBrain Tumour 11

Liver failureLiver failure 11

Heart lung receipientHeart lung receipient 11

ProcedureProcedure

ProcedureProcedure

Graft Rejection : acute & chronic Graft Rejection : acute & chronic

PreventionPrevention

CyclosporineCyclosporine TacrolimusTacrolimus MethylprednisoloneMethylprednisolone PrednisolonePrednisolone AzathioprineAzathioprine

Transplant TeamTransplant Team

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

CostCost

Up to RM 400 000Up to RM 400 000

• Hospital stay : around 23 – 24 daysHospital stay : around 23 – 24 days• 2 -3 days in ICU2 -3 days in ICU• DonorDonor• ProcedureProcedure• DrugsDrugs

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.

with with • Longer donor ischaemic timeLonger donor ischaemic time• Older donor ageOlder donor age• Non-O blood typeNon-O blood type

50 % mortality in 9-10 years50 % mortality in 9-10 years

Survival curveSurvival curve

ProblemsProblems

DONOR !!!DONOR !!! TechnologyTechnology ““Learning curve”Learning curve” Rejection – matching registryRejection – matching registry CostCost

AlternativesAlternatives

I. Opposing viewpointsI. Opposing viewpoints

Two prominent Muslim scholars who have written Two prominent Muslim scholars who have written against organ transplantation are the late Mufti against organ transplantation are the late Mufti Muhammad Shafi` of Pakistan and Dr `Abd al-Muhammad Shafi` of Pakistan and Dr `Abd al-Salam al-Sukri of Egypt. Salam al-Sukri of Egypt.

Mufti Shafi` holds organ transplantation as not Mufti Shafi` holds organ transplantation as not permissible on the basis of the following permissible on the basis of the following principles: principles:

A. sacredness of human A. sacredness of human life/bodylife/body

The human body being an amanah The human body being an amanah (trust); and finally that such a (trust); and finally that such a procedure would be tantamount procedure would be tantamount to subjecting the human body to to subjecting the human body to material ends. material ends.

Do not kill (destroy) yourselves: For Do not kill (destroy) yourselves: For verily Allah has been to you Most verily Allah has been to you Most Merciful (al-Nisa', 4:29).Merciful (al-Nisa', 4:29).

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

If anyone slays a human being unless it be in legal If anyone slays a human being unless it be in legal punishment for murder or for spreading punishment for murder or for spreading corruption on earth it shall be as if he had slain corruption on earth it shall be as if he had slain the whole of mankind; whereas if anyone saves a the whole of mankind; whereas if anyone saves a life, it shall be as if he had saved the life of all life, it shall be as if he had saved the life of all mankind (al-Ma'idah, 5:32).mankind (al-Ma'idah, 5:32).

In the Hadith literature it is recorded that the In the Hadith literature it is recorded that the Prophet Muhammad (PBUH) made the following Prophet Muhammad (PBUH) made the following declaration in his Farewell Sermon (Khutbat al declaration in his Farewell Sermon (Khutbat al Wada`ah)Wada`ah)

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

Hadith: Hadith:

Breaking the bone of a dead person is Breaking the bone of a dead person is equal in sinfulness and aggression to equal in sinfulness and aggression to breaking it while a person is alive.4 breaking it while a person is alive.4

B.B. The human body as an The human body as an AmanahAmanah

The Holy Qur'an (17:70; 21:20) tells us The Holy Qur'an (17:70; 21:20) tells us that Allah (SWT) has honoured man, that Allah (SWT) has honoured man, made serviceable to him whatever is made serviceable to him whatever is in the heavens and on earth as a in the heavens and on earth as a blessing and mercy. blessing and mercy.

C.C. Subjecting the human body to Subjecting the human body to material endsmaterial ends

The impermissibility of subjecting the human body to The impermissibility of subjecting the human body to material ends may be deduced from these two material ends may be deduced from these two examples:examples:

Fatawa `Alamgiriyyah : if a person, owing to hunger, Fatawa `Alamgiriyyah : if a person, owing to hunger, finds himself on the verge of death, and is unable to finds himself on the verge of death, and is unable to find even the meat of a dead animal in order to save find even the meat of a dead animal in order to save himself, and at that instant is offered human flesh, it himself, and at that instant is offered human flesh, it would not be permissible for him to partake of it.would not be permissible for him to partake of it.

Hadith Literature : the Prophet Muhammad (PBUH) Hadith Literature : the Prophet Muhammad (PBUH) said that Allah (SWT) has denounced or cursed the said that Allah (SWT) has denounced or cursed the one who joins the hair of a woman to that of another one who joins the hair of a woman to that of another so as to make her hair appear long - and He (SWT) so as to make her hair appear long - and He (SWT) has also cursed the woman with whose hair such hair has also cursed the woman with whose hair such hair is joined is joined

D. Prohibition of making use of D. Prohibition of making 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 the cure. For every disease He has cure. For every disease He has provided a cure. So treat yourselves provided a cure. So treat yourselves with medicines, but do not treat with medicines, but do not treat yourselves with prohibited things". yourselves with prohibited things".

E. Safeguarding the honour of E. Safeguarding the honour of human lifehuman life

Abd al Rahman ibn `Uthman (RA) Abd al Rahman ibn `Uthman (RA) reports that a doctor came to the reports that a doctor came to the Prophet (PBUH) and asked him about Prophet (PBUH) and asked him about the permissibility of making use of the permissibility of making use of frogs in medicines. The Prophet frogs in medicines. The Prophet (PBUH) forbade him from doing that. (PBUH) forbade him from doing that.

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 doubtful matters. and in between them are doubtful matters. So whoever forsakes those doubtful things So whoever forsakes those doubtful things lest he may commit a sin will definitely lest he may commit a sin will definitely avoid what is clearly illegal; and whoever avoid what is clearly illegal; and whoever indulges in these doubtful things boldly, is indulges in these doubtful things boldly, is likely to commit what is clearly illegal. Sins likely to commit what is clearly illegal. Sins are Allah's hima (i.e. private pasture) and are Allah's hima (i.e. private pasture) and whoever pastures (his sheep) near it is whoever pastures (his sheep) near it is likely to trespass in it at any moment. likely to trespass in it at any moment.

II. Favorable viewpoints II. Favorable viewpoints

Muslim scholars who advocate the Muslim scholars who advocate the permissibility of organ trans-permissibility of organ trans-plantation are of the opinion that it plantation are of the opinion that it should be recognized as a form of should be recognized as a form of altruistic service to fellow Muslims. altruistic service to fellow Muslims.

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

(i)(i) Necessity makes the unlawful Necessity makes the unlawful permissible.permissible.

(ii)(ii) When two interests conflict let When two interests conflict let the one which will bring greater the one which will bring greater benefit take precedence.benefit take precedence.

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

ExamplesExamples

Islamic Law would permit the cutting of Islamic Law would permit the cutting of the belly of the dead pregnant woman in the belly of the dead pregnant woman in order to remove the foetus should any order to remove the foetus should any movement be detected. Thus, the right of movement be detected. Thus, the right of the living supercedes consideration over the living supercedes consideration over the dead.the dead.

Likewise, Islamic Law would allow the Likewise, Islamic Law would allow the cutting of the belly of the deceased who cutting of the belly of the deceased who had swallowed a valuable diamond or a had swallowed a valuable diamond or a piece of gold in order that it may be piece of gold in order that it may be returned to its rightful owner. returned to its rightful owner.

organ transplantation should be organ transplantation should be hedged with certain restrictionshedged with certain restrictions

1. That the transplantation is the only form 1. That the transplantation is the only form (means) of treatment.(means) of treatment.

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

3.3.The consent of the owner of the organ or of The consent of the owner of the organ or of his heirs have been obtained.his heirs have been obtained.

4.4. Death must have been fully Death must have been fully established by Muslim doctors of upright established by Muslim doctors of upright character before such a venture is character before such a venture is undertaken.undertaken.

5.5.The recipient has been informed of the The recipient has been informed of the operation and its implications.operation and its implications.

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

Help you one another in righteousness and Help you one another in righteousness and piety (al-Ma'idah, 5:2)piety (al-Ma'idah, 5:2)

and from the Sunnah the following hadith and from the Sunnah the following hadith may be cited:may be cited:

The believers, in their love and sympathy for The believers, in their love and sympathy for one another, are like a whole body; when one another, are like a whole body; when one part of it is affected with pain the one part of it is affected with pain the whole of it responds in terms of whole of it responds in terms of wakefulness and feverwakefulness and fever

Living donor : restrictionsLiving donor : restrictions

1.1. The consent of the donor must The consent of the donor must be obtained.be obtained.

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

3.3. That there is no obvious danger That there is no obvious danger to the life of the donor. to the life of the donor.

4.4. The respective transplantation The respective transplantation has been proven successful in the has been proven successful in the past.past.

Third session : Amman, Jordan, on October Third session : Amman, Jordan, on October 16, 1986 the Council of Islamic 16, 1986 the Council of Islamic

Jurisprudence (majma` al-fiqh al-islami) Jurisprudence (majma` al-fiqh al-islami)

The person is considered legally dead, and all the guidelines The person is considered legally dead, and all the guidelines provided by the Shari`a to determine death are applicable provided by the Shari`a to determine death are applicable when following signs are confirmed: when following signs are confirmed: • When complete When complete cessation of the heart or respirationcessation of the heart or respiration occurs, occurs,

and the expert physicians ascertain that the cessation is and the expert physicians ascertain that the cessation is irreversible. irreversible.

• When When complete cessation of all functions of the braincomplete cessation of all functions of the brain occurs, and the expert physicians ascertain that the occurs, and the expert physicians ascertain that the cessation is cessation is irreversible and the brain is in the state of degenerationirreversible and the brain is in the state of degeneration . . In this condition it is permissible to discontinue the life supportive In this condition it is permissible to discontinue the life supportive system from the patient even when some of the patient's organs system from the patient even when some of the patient's organs like the heart are kept functional by artificial means. God knows like the heart are kept functional by artificial means. God knows the best!the best!

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

activity including the brain stem. Before any supportive means is activity including the brain stem. Before any supportive means is discontinued, the family members must be counseled. This should discontinued, the family members must be counseled. This should be documented in the patient's chart.be documented in the patient's chart.

C. Sale of organsC. Sale of organs

HARAMHARAM(i)(i) A person cannot trade in A person cannot trade in

something of which he is not the something 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 one accountable on the Last Day is one who sold a freeman and ate up the who sold a freeman and ate up the proceeds.proceeds.

D. Non-Mulsim organsD. Non-Mulsim organs

The permissibility for Muslims to receive the The permissibility for Muslims to receive the organs of non-Muslims is based on the organs of non-Muslims 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 danger should A Muslim's life would be in danger should the transplantation not be carried out.the transplantation not be carried out.

Fardhu KifayahFardhu Kifayah

In order to circumvent the problem of In order to circumvent the problem of Muslims becoming recipients of non-Muslims becoming recipients of non-Muslim organs, some of the Muslim organs, some of the contemporary Muslim jurists are of contemporary Muslim jurists are of the opinion that a Muslim's gesture the opinion that a Muslim's gesture in donating any of his organs is to be in donating any of his organs is to be categorized as fard kifayah categorized as fard kifayah

The Inclusion of Organ Donation The Inclusion of Organ Donation into one's Willinto one's Will

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

Likewise, the Prophet Muhammad (PBUH) also Likewise, the Prophet Muhammad (PBUH) also emphasized the need to write down one's will. He emphasized the need to write down one's will. He said: said:

"It is not right for any Muslim person, who has "It is not right for any Muslim person, who has anything to bequeath, that he may pass even two anything to bequeath, that he may pass even two nights without having his last will and testament nights without having his last will and testament written and kept ready with him" written and kept ready with him"

(a) al-Ithar (altruism i.e. generosity towards (a) al-Ithar (altruism i.e. generosity towards humankind) A. Al-ithar (altruism)humankind) A. Al-ithar (altruism)

A living person's gesture in willing to donate A living person's gesture in willing to donate his/her cornea, for example, after death his/her cornea, for example, after death has taken place should be viewed as an has taken place should be viewed as an act of altruism. After all, through corneal act of altruism. After all, through corneal transplant the donor would have made a transplant the donor would have made a noble contribution in restoring the sight of noble contribution in restoring the sight of another fellow human being suffering from another fellow human being suffering from corneal blindness.corneal blindness.

(b) Al-darurah (the rule of (b) Al-darurah (the rule of necessity).necessity).

Dr. Tanzil-ur-Rahman, former Chief Justice of Dr. Tanzil-ur-Rahman, former Chief Justice of Pakistan, is of the opinion that the Pakistan, is of the opinion that the inclusion of corneal donation, for example, inclusion of corneal donation, for example, in one's will may be held permissible on in one's will may be held permissible on the basis of the rule of necessity. He the basis of the rule of necessity. He explains that the rule of necessity is based explains that the rule of necessity is based upon the juridical principle of al-Istihsan upon the juridical principle of al-Istihsan (juristic prefrence), that the needs of the (juristic prefrence), that the needs of the living are given preference over those of living are given preference over those of the dead. Thus the inclusion of organ the dead. Thus the inclusion of organ donation in one's will could be a positive donation in one's will could be a positive step in resolving organ donation shortages step in resolving organ donation shortages worldwide.worldwide.

PURPOSES OF THE LAW PURPOSES OF THE LAW (MAQASID SHARIAH)(MAQASID SHARIAH)

AD DHARURIYYATAD DHARURIYYATTHE PRESERVATION OF :THE PRESERVATION OF :

1. Religion1. Religion 2. Life2. Life 3. Mind3. Mind 4. Progeny4. Progeny 5. Property5. Property

Keputusan Lujnah Fatwa Keputusan Lujnah Fatwa Kebangsaan):Kebangsaan):

1)Pemindahan/pendermaan organ adalah 1)Pemindahan/pendermaan organ adalah hukumnya harus dalam keadaan darurat.hukumnya harus dalam keadaan darurat.

2)Orang yang mati otak adalah dihukumkan 2)Orang yang mati otak adalah dihukumkan mati.mati.

Walaubagaimanapun sebelum dibenarkan Walaubagaimanapun sebelum dibenarkan untuk melakukan pemindahan/pendermaan untuk melakukan pemindahan/pendermaan atau melakukan keatas orang yang mati atau melakukan keatas orang yang mati otak, ada beberapa syarat yang perlu otak, ada beberapa syarat yang perlu dipatuhi untuk memelihara kesucian Islam:dipatuhi untuk memelihara kesucian Islam:

1. Transplan organ ada 2 1. Transplan organ ada 2 keadaankeadaan

a)Keadaan penderma masih hidupa)Keadaan penderma masih hidup

- Menjalankan perubatan dengan cara terperinci dan profesional - Menjalankan perubatan dengan cara terperinci dan profesional tentang kebaikan dan keburukan pemindahan ini, kejayaan dan tentang kebaikan dan keburukan pemindahan ini, kejayaan dan kegagalan pemindahan kegagalan pemindahan

- Dengan redha penderma tanpa paksaan- Dengan redha penderma tanpa paksaan

- Sudah dipastikan pemindahan itu berjaya pada kebiasaannya- Sudah dipastikan pemindahan itu berjaya pada kebiasaannya

- Keadaan darurat yang mendesak bagi menyelamatkan nyawa - Keadaan darurat yang mendesak bagi menyelamatkan nyawa orang yang didermakan kepadanya, terutama yang ada hubungan orang yang didermakan kepadanya, terutama yang ada hubungan nasab dan keluarganasab dan keluarga

- Organ yang dipindahkan bukan dijadikan dagangan dan jualbeli, - Organ yang dipindahkan bukan dijadikan dagangan dan jualbeli, dagangan dan jual beli hanya akan mengundang perbuatan dagangan dan jual beli hanya akan mengundang perbuatan khianat yang memberi mudarat kepada penerima, memberi khianat yang memberi mudarat kepada penerima, memberi keuntungan kepada orang tengah dan juga kesempatan kepada keuntungan kepada orang tengah dan juga kesempatan kepada doktor-doktor yang tidak bertanggungjawab mengaut doktor-doktor yang tidak bertanggungjawab mengaut keuntungan.keuntungan.

- Kebenaran bertulis daripada penderma dan penderma - Kebenaran bertulis daripada penderma dan penderma dibolehkan menarik balik pada bila-bila masa.dibolehkan menarik balik pada bila-bila masa.

- Organ yang diperlukan lebih dari satu- Organ yang diperlukan lebih dari satu

b)Keadaan penderma yang telah matib)Keadaan penderma yang telah mati

- Menjalankan pemeriksaan perubatan dengan cara terperinci - Menjalankan pemeriksaan perubatan dengan cara terperinci dan profesional tentang kebaikan dan keburukan pemindahan dan profesional tentang kebaikan dan keburukan pemindahan ini, kejayaan dan kegagalan pemindahan, ia memerlukan ini, kejayaan dan kegagalan pemindahan, ia memerlukan pemeriksaan rapi.pemeriksaan rapi.

- Dengan redha penderma melalui wasiat ataupun waris-waris - Dengan redha penderma melalui wasiat ataupun waris-waris dan perakuan daripada kerajaandan perakuan daripada kerajaan

- Sudah dipastikan pemindahan itu berjaya pada - Sudah dipastikan pemindahan itu berjaya pada kebiasaannya atau dalam ertiakta lain pemindahan itu kebiasaannya atau dalam ertiakta lain pemindahan itu dijamin berjaya.dijamin berjaya.

- Dilakukan pemindahan itu dengan penuh disiplin ilmu, iman - Dilakukan pemindahan itu dengan penuh disiplin ilmu, iman dan taqwa, penghormatan yang sewajarnya kepada si mati dan taqwa, penghormatan yang sewajarnya kepada si mati mengikut hukum syarak serta tiada unsur-unsur penghinaan.mengikut hukum syarak serta tiada unsur-unsur penghinaan.

- Keadaan darurat yang mendesak bagi menyelamatkan - Keadaan darurat yang mendesak bagi menyelamatkan nyawa orang yang didermakan kepadanya, terutama yang nyawa orang yang didermakan kepadanya, terutama yang ada hubungan nasab dan keluarga.ada hubungan nasab dan keluarga.

- Organ yang dipindahkan bukan dijadikan dagangan dan - Organ yang dipindahkan bukan dijadikan dagangan dan jualbeli, dagangan dan jualbeli hanya akan mengundang jualbeli, dagangan dan jualbeli hanya akan mengundang perbuatan jenayah yang memberi mudarat kepada penerima, perbuatan jenayah yang memberi mudarat kepada penerima, memberi keuntungan kepada orang tenh dan juga memberi keuntungan kepada orang tenh dan juga kesempatan kepada doktor-doktor yang tidak kesempatan kepada doktor-doktor yang tidak bertanggungjawab mengaut keuntungan.bertanggungjawab mengaut keuntungan.

ii) mati otakii) mati otak

- menjalankan pemeriksaan perubatan - menjalankan pemeriksaan perubatan dengan cara professional tentang dengan cara professional tentang berlakunya mati otak.berlakunya mati otak.

- Digalakkan mendapat persetujuan dari - Digalakkan mendapat persetujuan dari keluarga terdekat dari suami, anak, ibu, keluarga terdekat dari suami, anak, ibu, bapa.bapa.

- Perakuan tentang berlakunya mati otak - Perakuan tentang berlakunya mati otak hendaklah dilakukan oleh sekurang-hendaklah dilakukan oleh sekurang-kurangnya 3 orang doktor professional kurangnya 3 orang doktor professional (doktor islam diutamakan)(doktor islam diutamakan)

- Sekiranya dengan kecanggihan rawatan - Sekiranya dengan kecanggihan rawatan perubatan (sains dan teknologi) boleh perubatan (sains dan teknologi) boleh mengubat maka suasana ini gugur.mengubat maka suasana ini gugur.

THE ISLAMIC PARADIGMTHE ISLAMIC PARADIGM““No one can challenge or oppose God’s No one can challenge or oppose God’s

will. Hence, if the matter is achieved will. Hence, if the matter is achieved then it is certainly under the will of God. then it is certainly under the will of God. Nothing can be created without God’s Nothing can be created without God’s will creating it. As long as humans will creating it. As long as humans continue to do so, it is the will of God. continue to do so, it is the will of God.

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

HUMAN GENETIC & HUMAN GENETIC & REPRODUCTIVE REPRODUCTIVE TECHNOLOGYTECHNOLOGY

INFOTECHNOLOGY - 20th

BIOTECHNOLOGY - 21st

Biotechnology IssuesBiotechnology Issues

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

2. Human Cloning2. Human Cloning

3. Therapeutic Tissue Cloning 3. Therapeutic Tissue Cloning

(Stem Cells)(Stem Cells)

4. Preimplantation Diagnosis4. Preimplantation Diagnosis

5. Sex Selection5. Sex Selection

6. Designer babies6. Designer babies

Dr. E & Dr. S pioneered the fertility technique called IVF

IVF – fertilisation outside the body in a test-tube

1978 – birth of the first test tube baby, L.B.

ART – ISLAMIC PARADIGM I

LAWFUL if it only involves a married couple while the marriage contract is validUNLAWFUL if it involves an alien party, whether in the form of semen, an ovum, an embryo or a womb. If the marriage contract has ended due to divorce or death, the egg/sperm/embryo becomes alien to either party. Surrogate motherhood is not allowed

ART – ISLAMIC PARADIGM II

ART centres accredited by health authorities. Ensure confidentiality, guard against mixing of lineages and commercialism.Credentialing of staff to ensure highest standards of professionalism, trustworthiness, integrity and responsibilityActs of legislation to govern ART practice

2. Cloning2. Cloning

                                                           

         

             

                      

REPRODUCTIVE HUMAN REPRODUCTIVE HUMAN CLONINGCLONING

Cloning technology aimed at producing Cloning technology aimed at producing human clones is not permissiblehuman clones is not permissible

Majority considered it Haram in all its Majority considered it Haram in all its detailsdetails

Few – Haram in order to prevent a cause Few – Haram in order to prevent a cause of harm(la darar wa la dirar – the of harm(la darar wa la dirar – the necessity to refrain from causing harm to necessity to refrain from causing harm to oneself and others)oneself and others)

The use of SCNT technology even The use of SCNT technology even between husband & wife was not between husband & wife was not approvedapproved

3. THERAPEUTIC CLONING3. THERAPEUTIC CLONING

Production of human clonal embryos for Production of human clonal embryos for the harvesting of stem cellsthe harvesting of stem cells

Used for research or possible therapeutic Used for research or possible therapeutic purposespurposes

The end-point would not be a human beingThe end-point would not be a human being Confusion / disgust at the concept of Confusion / disgust at the concept of

creating cloned babies transferred to TCcreating cloned babies transferred to TC ““Burning down the stable to catch a flea”Burning down the stable to catch a flea”

POTENTIAL APPLICATIONS

•Basic research into human development & disorders

•Discovery of novel proteins for tissue regeneration & repair

•Development of human cell model for drug discovery and toxicology

•Development of tissue for transplantation

SOURCE OF STEM SOURCE OF STEM CELLSCELLS

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 Embryos created for research

purposespurposes Embryos from SCNTEmbryos from SCNT

SOURCE OF SOURCE OF CONTROVERSYCONTROVERSY

Is an ovum and sperm a person ?Is an ovum and sperm a person ? When do the products of conception become When do the products of conception become

a person ?a 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 The concept of personhood is neither logical

nor empiricalnor empirical Based on one’s assumptions about the Based on one’s assumptions about the

nature of the worldnature of the world A religious or quasi-religious conceptA religious or quasi-religious concept

WHEN DOES LIFE WHEN DOES LIFE BECOME HUMAN LIFE ?BECOME HUMAN LIFE ?

““methods that fail to respect the dignity and value methods that fail to respect the dignity and value of the person must always be avoided. I am of the person must always be avoided. I am thinking in particular of attempts at human cloning thinking in particular of attempts at human cloning with a view to obtaining organs for transplants: with a view to obtaining organs for transplants: these techniques, in so far as they involve the these techniques, in so far as they involve the manipulation and destruction of human embryos, manipulation and destruction of human embryos, are not morally acceptable, even when their are not morally acceptable, even when their proposed goal is good in itself” Pope John Paul II; proposed goal is good in itself” Pope John Paul II; 29 Aug 2000 29 Aug 2000

The soul enters the body at conception and the The soul enters the body at conception and the fertilised ovum is a human person with full human fertilised ovum is a human person with full human rights rights

THE “SCIENTFIC” THE “SCIENTFIC” POSITIONPOSITION

The pre-embryonic stage is defined The pre-embryonic stage is defined as the period from fertilisation up to as the period from fertilisation up to the determinant of the primitive the determinant of the primitive streak at the age of 14 daysstreak at the age of 14 days

The pre-embryo is unable to feel pain The pre-embryo is unable to feel pain or pleasure and has no moral statusor pleasure and has no moral status

The pre-embryos may be The pre-embryos may be cryopreserved, discarded or used for cryopreserved, discarded or used for researchresearch

THE SCIENTIFIC THE SCIENTIFIC PARADIGMPARADIGM

……to cut off this research (without to cut off this research (without clear understanding of the science of clear understanding of the science of TC and its potential to contribute to TC and its potential to contribute to mankind) would be “an act of mankind) would be “an act of intellectual vandalism comparable to intellectual vandalism comparable to papal censorship of Galileo and papal censorship of Galileo and Copernicus” (Lord May)Copernicus” (Lord May)

EMBRYOLOGY & EMBRYOLOGY & ENSOULMENTENSOULMENT

““Read! In the name of your Lord, who has created. Read! In the name of your Lord, who has created. Has created man from alaqa” 96:1-2Has created man from alaqa” 96:1-2

““And indeed We created man from a quintessence of And indeed We created man from a quintessence of clay. Then we placed him as a small quantity of liquid clay. Then we placed him as a small quantity of liquid (nutfa) in a safe lodging firmly established. Then we (nutfa) in a safe lodging firmly established. Then we have fashioned the nutfa into something which clings have fashioned the nutfa into something which clings (alaqa). Then We made alaqa into a chewed lump of (alaqa). Then We made alaqa into a chewed lump of flesh (mudgha). And We made the mudgha into flesh (mudgha). And We made the mudgha into bones, and clothed the bones with flesh. And then bones, and clothed the bones with flesh. And then We brought it forth as another creation. So blessed We brought it forth as another creation. So blessed be God, the best to create” 23:12-14be God, the best to create” 23:12-14

““and breathe into him of His spirit” 32-9and breathe into him of His spirit” 32-9

JURISPRUDENCE OF JURISPRUDENCE OF MEDICINEMEDICINE

The Islamic mind dismisses the pair of The Islamic mind dismisses the pair of contraries : religious-secular; sacred-contraries : religious-secular; sacred-profane; church-stateprofane; church-state

““The Shariah (Islamic Law) is the epitome The Shariah (Islamic Law) is the epitome of the Islamic spirit, the most typical of the Islamic spirit, the most typical manifestation of the Islamic way of life …”manifestation of the Islamic way of life …”

Bioethics is inseparable from religion. Is Bioethics is inseparable from religion. Is built entirely upon the Shariah and built entirely upon the Shariah and flourishes within her jurisdictionflourishes within her jurisdiction

DESIGNER

BABIESThe ultimate shopping

experienceThe “slippery slope”29/08/2000

Adam Nash HFEA – Dec 200127(14%) ban IGM

Other IssuesOther Issues

1.1. Abortion Abortion

2.2. ContraceptionContraception

1.1. EuthanasiaEuthanasia

2.2. Brain DeathBrain Death

CONCLUSIONSUnique opportunity to fathom the treasures and secrets of God’s creationAlong with it grave and unprecedented risksNevertheless, since we do not will unless God wills, can these breakthroughs be regarded as part of the divine will to afford humanity yet another opportunity for moral training and maturity (TARBIYAH) in our quest for excellence (IHSAN). “Thus we have appointed you a middle nation, that you may be witness against mankind, and that the messenger may be witness against you …” 2:143