[:en]Selling and Buying Organs in the Islamic Perspective[:]

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Question : If we look at the coverage in the media, we read and hear that buying and selling human organs is not a new thing in the world. Every year, more than 100.000 patients wait for donors to have kidney, heart or liver transplants. While they are a race against time, donors for organs are extremely limited and strictly regulated. Perhaps because of that, the buying and selling of organs is rife. Why would anyone want to sell their organs? What is the Islamic view on this matter, please explain? thank you very much for the answer.

Azzahra Nafi' Syafarani, Yogyakarta.

Answer:

Humans are the most noble creatures as God's creation. Humans with their minds have various advantages compared to other creatures, especially in developing science and technology. Humans are given orders and responsibilities and are even given the freedom to study natural law (verse qauniyah) and religious law (verse qauliyah) in order to achieve happiness in this world and the hereafter. One of the advances that humans have achieved today is medical technology related to organ transplants so that the supply of "organ spare parts" is sure to become a separate market. Is the organ market or buying and selling of organs permissible according to Islam and how does Islamic ethics guide the application of organ transplantation technology.

According to the mashlahah-based Islamic view as far as technology provides mashlahah to humans, everything is permissible as long as it is not harmful and no religious prohibitions are violated. According to mashlahah-based legal understanding, it means that buying and selling organs is permissible as long as it is profitable and provides benefits to human life, especially to restore bodily functions and avoid death. This does not mean that everyone can sell their organs at a low price or at an appropriate and high price, once again it is not a matter of price but of human value. The analogy is the same as donating blood in that everyone is encouraged to donate blood for the sake of humanity, even though sometimes some people, due to tight circumstances, want to donate blood by asking for a fee. But once again, when someone wants to donate blood, of course they have to go through a series of examinations so that the donor is safe for those who donate it because their condition is indeed fit and everything is normal such as Hb and albumin or safe for those who receive donors, namely free from HIV infection and other infections. Even though in practice it costs money to reward donors in the form of milk drinks and other nutrients as well as fees for blood management services and blood bags, this does not mean that there is a process of buying and selling blood. Moreover, blood is a forbidden item according to Islam. In a situation where the need for blood donors is getting bigger, a business process is needed that serves humanity but the spirit is still not "for profit" even though in practice nothing is completely free. He admits that business development will definitely continue, and in the end some will start to be oriented "for profit" in secret. Especially when you enter the world of capital-intensive industry, full of human resources, full of bureaucratic rules, and full of problems, it is clear that no one wants to lose with this investment. The opinions of the scholars regarding blood donation generally agree that for the benefit of giving the law it is permissible even with conditions that must be met to prevent harm. Except for the Jehova Witnes sect of Christianity, which refuses to donate blood at all because it is considered against God's rules and risks going to hell forever.

Likewise with other organ donors such as eyes, kidneys, skin, and others which will continue to develop and become new breakthroughs in the medical world which of course the scholars have a different attitude to, some are pro and some are against. Quickly, to reject or accept organ donors, we can use the sharia maqosidus (MQS) approach, namely the purpose of Islamic law to be enforced by Allah to humans to protect religion/morality (hifd diin), protect the soul (hifd Nafs), protect the mind (Hifd Aql) protect offspring (hifd Nashl), protect property and self-respect. (Hifd Mal). From the perspective of maqosidus sharia, of course, religious considerations must be prioritized, meaning that organ transplantation technology and organ donor practices must be maintained and maintained and not conflict with religious laws, especially the prohibition laws. In addition, this action must preserve religious laws related to lineage of guardianship so that it is not permissible to donate reproductive organs or sperm and ovum that are not married. The goal of sharia to protect lives must apply to both donors and recipients, but it is not the only consideration for legalizing organ donation. The application of sharia maqosidu must be assisted by qowaaidus shariah (QWS), namely sharia principles/rules such as intention principle that his intentions are noble according to MQS because of Allah. Principle of belief that the action is believed to be done and high success. Loss principle that action is not detrimental and does not harm anyone. Principle of emergency that is, in an emergency, even things that are forbidden are permissible as long as they are in accordance with the needs for the sake of rescue and are not contrived which refer to mashallahah dharuriyat level (primary needs) to save from the threat of death. If the dharuriyat aspect is not fulfilled, then other reasons from the hajiyat aspect (secondary needs) and tahsiniyat (tertiary needs) must be weighed with the first prima facie or maxim approach that appears and the strongest rights and alternatives within the frame of Islamic values. Final customary principles based on the culture of the local community that does not conflict with the Islamic faith. Applications from MQS and QWS will be selective. For organs that are only one and very vital, such as the heart, liver and brain, of course, the donation of these organs is completely prohibited while the donor is still alive. When a donor has died under the pretext of benefit, the success is still unclear and there are no studies on the psychological impact of living with other people's brains and other people's hearts. Transplantation of organs that are outside such as limbs and eyes because it causes harm to the donor to the hajiyat and tahsiniyat levels is also prohibited. Transplantation of a pair of organs such as a kidney that can be taken alone and not life-threatening to the donor must still maintain the donor's quality of life and not cause disturbances at the hajiyat and tahsiniyat levels. The process of organ transplantation through the provision of organs by donors must be based on MQS and QWS so that a study is made of who is the donor, who is the recipient and under what conditions and what organ is to be donated for what reasons (Who, How, What, Why). The Who, How, What and Why aspects must be answered so that they do not conflict with the MQS and QWS as well as the Koran and al hadith. Another aspect that is no less important is whether there are alternatives other than organ donors for organ transplantation to treat medical problems by using prostheses or artificial organs, dialysis machines or dialysis machines for kidney disorders, stem cell technology to replace damaged and damaged tissue. dead, as well as the availability of biobanks (body tissue savings) such as for corneas or other things that comply with sharia principles.

Some guidelines in the Qur'an and al-Hadith that must be kept in mind when deciding whether to accept blood donation or not are;

Word of Allah Ta'ala: “Indeed, Allah has only forbidden you carrion, blood, pork and animals (which when slaughtered) are called (names) other than Allah. But whoever is forced to (eat it) while he does not want it and does not (also) exceed the limit, then there is no sin for him. (QS. 2:173).

 

In another verse Allah says: "So whoever is forced by hunger without knowingly sinning, verily Allah is Forgiving, Most Merciful". (QS. 5:3).

 

In another verse Allah also says: "And indeed it has been explained to you what is unlawful for you except what you are forced to eat." (QS. 6:119)

Allahswt said,
"..and whoever saves one life, it is as if he has saved all mankind." (Al-Maidah 5: 32)

 

Hadith of the Prophet SAW: "It is not permissible to do something that endangers the soul and it is also not permissible to harm other people."

As a consequence, if you violate the above principles as the way of the believer, Allah says in QS An-nisa 115;

“And whoever opposes the way of the Prophet after the truth is clear to him and follows a path that is not the way of a believer. We leave him in the error he has committed and will enter him into the Hellfire and that is the worst place to return to."

The good intentions of family relations because considerations for saving his sibling from death alone are not enough to legalize organ transplants because of the high cost aspects of surgery and the suitability of the recipient of the organs because there are genetic similarities are also a consideration. Living donors for paired organs such as kidneys and eyes as well as hands and feet must be reviewed from 2 other principles of Islamic law, namely eliminating mudlorot (danger) and mudlorot cannot be removed by the emergence of a larger mudlorot.

Scholars such as Yusuf Qordhowi and Wahbah Zuhaili tend to allow organ donations if there is approval from the deceased's heirs. If the donor is still alive, only organs can grow again such as blood, what can be donated is not the only vital organ, and there is an advance directive or will in front of the mayar who will donate his organs when he dies. Problems arise when the organs are willing to be removed whether the family agrees or not. Apart from that, there is the problem that organ storage costs money and who should pay for it. If it is offered to the party who will receive the financing, does that include buying and selling organs? Irregularities in the sale and purchase of organs usually occur in donors who are still alive because they are squeezed by the economy and are not strong enough to be poor and because of the stupidity of many poor people, such as in Nepal and Vietnam, who have become victims of brokers and the mafia of buying and selling kidney organs. It is a black market or black market that is against human rights and the principles of Islamic bioethics based on MQS and QWS. The judgment of a competent doctor must also be used by both Muslim and non-Muslim doctors so that the act of organ donation is not in vain and does not endanger both parties. Another ethical issue arises if the donor is a Muslim and the recipient is an infidel whether the perception of MQS hifd diin will be shifted in favor of hifn nafs. As a result, the primacy of Muslims over non-Muslims is sacrificed for the sake of the hifd nafs of people of different religions.

And the scholars who absolutely forbid the issue of organ donation, include Sheikh Abdul Aziz bin Baz and Sheikh Muhammad Al-Utsaimin.

According to these two scholars, Allah ta'ala created a series of organs in the human body with wisdom and faidah, namely to work together in a job. If one is missing, of course there is an influence on the body and its functions.

1. Organ donors are not necessarily successful, while donors must feel pain or discomfort.
2. Rasulullah shallallahu 'alaihi wa sallam said:

"Breaking the bones of a dead person is like breaking the bones while still alive" (Narrated by Abu Dawud and Ibn Majah)

And taking vital organs such as the heart, liver, kidneys is bigger and more painful, of course, than just breaking bones.

Another view that rejects organ donation from cadavers is that a corpse no longer has property rights over itself and it must be buried as it is as God's property which must return to God. Moreover, buying and selling for the organ business clearly violates God's mandate to humans who have been given complete organs by God to worship them, not to sell and sell the gift of the body.[:]