Introduction
As humanity develops new technologies, their impact upon
the lives of people can also lead to significant challenges for
society. Such has been the case with the huge developments in biology
and medicine towards the latter half of the 20th century. The advent of
cloning technology, transplantation medicine, fertility treatment and
embryonic stem cell research have all posed challenging ethical problems
for humanity leading to major debates and international legislation.
For example, IVF technology has led to several cases where elderly
women have become pregnant. Transplantation medicine and the shortage
of donor organs has led to calls for "presumed consent" as a system of
organ donation by the British government and is already implemented in
Spain. But the most controversial technology is that of cloning which
poses tremendous possibilities for new medical treatments but also
challenges for society with the occurence of "saviour siblings" and the
potential to select "designer" offspring!
For Muslims, the advances in these medical technologies have also raised ethical questions that required Islamic verdicts. This paper discusses some of the current medical technological issues and demonstrates how the Sharia has provided definitive guidance on such matters that Muslims and humanity in general can have a clear view towards the usage of new medical technologies.
Ethics in Islam
Few Islamic books contain chapters entitled Islamic bioethics. This is because it is a relatively new area of research due to the decline of Islamic thought over the preceding four centuries but also due to the fact that the need to compile such a set of rules was not deemed necessary by the traditional scholars of the past as the rules regarding such matters were generally well known to those engaging in the scientific arena. Many of the well known Islamic scientists were also competent jurists in their own right e.g. Ibn Sina, Ibn Rushd.
However, in the 9th century Ishaq bin Ali Rahawi addressed ethical issues in medicine in a book entitled Adab al-Tabib (Conduct of a Physician). In Rahawi's work there are twenty chapters, which include:
* What the physician must avoid and beware of,
* The manners of visitors,
* The care of remedies by the physician,
* The dignity of the medical profession,
* The examination of physicians, and
* The removal of corruption among physicians
Ethics (akhlāq) in Islam represent the Sharia rules relating to personal conduct and how Muslims behave towards others. The sahabi (companion) Abdullah ibn Amr (ra) reported that the Prophet Muhammed (saw) said, "The best amongst you is the one best in morals" This means that Islamic ethics must be derived from the Sharia alone if they are to be considered as Islamic. Similarly, Islamic bioethics should be understood as a branch of the Sharia or the Sharia laws relating to matters arising from biomedical research and development.
Science, technology and Sharia
Islam views science and technology are branches of human knowledge that help us to understand the nature of the universe we live in and to utilize its components to improve our quality of life. Such knowledge is generally not specific to any culture or people but rather common to all civilisations irrespective of their view towards life since it deals primarily with the universal or natural laws and not creedal issues. Islam has allowed Muslims to utilise the proven and validated scientific knowledge and technologies discovered by other civilisations provided that they usage does not conflict with Islam.
The hadith corpus have shown that the Prophet Muhammad (saw) witnessed and approved of the practise to increase the yield of dates by the cross fertilization of date palms. This evidence shows that the Sharia is generally not concerned by issues relating to science, technology and non-creedal areas of human activity such as improving efficiency through administrative and organisational procedures. The second khaleefah, Umar ibn al Khattab (ra), utilised the divan system of army registers that was used by the Persians of his day, indicating that the Sahaba (ra) (companions) adopted administrative techniques from other nations.
Cloning technology and stem cell research
Cloning is the production of a genetically identical copy of a biological organism. This can be plant, animal or potentially human. Since the cloning of Dolly the sheep, by the British group at the Rosalyn Institute in Scotland, the original technology of transferring a donor nucleus into a denucleated recipient egg cell, a process termed "nuclear transfer technology" (NTT) has been expanded by the discovery of other methods. Scientists have developed the capacity to initiate the developmental process in the absence of fertilization from a single egg cell; a process called parthenogenesis or as the press has referred to it as "the immaculate conception."
Sharia's view on cloning
The cloning of plants and animals is aimed at achieving increased productivity and improved quality in addition to the generation of new drugs using transgenic or GM animals as bioreactors. Islam has permitted this (provided that there is no mistreatment of animals in this process) based upon the approval of the Messenger of Allah (saw) of the practise of the cross pollination of date palms by the Arabs which was aimed to improve the yield and quality of their date crops. With regard to medicine, Islam has sanctified human life and encourages medical treatment. This is based upon the hadith reported by Imam Ahmed from Anas (ra) who said that the Messenger of Allah (SAW) said " Allah (SWT) has created the illness and the cure. So seek the cure." Therefore, the use of cloning technology with regard to animal and plants is permitted in Islam.
With regard to human cloning which can potentially be by
a) NTT-the method used to clone Dolly the sheep
b) Parthenogenesis
c) Foetal cloning-akin to IVF and identical twins.
The application of cloning technology must be restricted in a manner defined by the principles laid down in the Sharia. There are three legal principles that cannot be violated when utilizing this technology relating to the initiation of human life;
1. Production of children from a male and a female-The continuation of the human species in a manner that deviates from the reproductive process that Allah (SWT) has created is forbidden. Human reproduction involves the formation of offspring from the combination of parental gametes or sexual cells, that is, the fusion of the male sperm of the father with the female egg or ovum of the mother. Maintenance of this process is obligatory, for Allah says.
"And He (Allah) created the pairs, male and female, from Nutfah (male and female sexual discharge) when it is emitted." [An Najm 45-46]
And He (SWT) has also said
"O humankind ! We have created you from a male and a female." [Al Hujurat 13]
2. Children cannot be produced without a father- It is not permitted in Sharia for children to be created without both biological parents and this means a mother and a father. Even adopted children must be called by the names of their biological parents as mentioned in the verse of the Quran;
" Call them by the names of their fathers, that is more just in the sight of Allah." [Al Ahzab 5]
So a process, such as NTT or parthenogenesis, that could allow the production of a human being without the requirement of a father, is forbidden (haram).
3. This process defines lineage, which must be preserved for Islam has made its preservation sacrosanct. There are several ahadith that confirm the sacred position of lineage within Islam, which prohibit the loss of kinship. Numerous sayings of the Prophet Muhammed (saw) have chastised both parents and offspring that deny their lineage through giving false testimonies. For example, Ibn Majah also narrates that Abi Uthman an-Nahri said that he heard Sa'd and Abu Bakrah (ra) each saying that they heard and understood from Muhammed's (saw) saying
" Anyone who makes a claim for somebody other than his father and he knows that he is not his father, then Paradise is forbidden for him."
Abu Hurayrah (ra) narrated that he heard the Prophet of Allah (saw) saying;
" Any woman who introduced to some people an offspring that does not belong to them, then she has nothing to do with Allah and she will not enter Paradise; and any man who denies his son while looking at him, he will not see Allah and Allah will disgrace him in front of the first and last generations"
These texts clearly demonstrate that Islam has prohibited the breaking of lineage or kinship through giving false testimony and has made lineage among the sacred and obligatory matters. Therefore, the cloning of humans by the application of nuclear transfer technology will definitely result in the loss of lineage and kinship in addition to breaking the natural process by which human reproduction proceeds. Islam has thus prohibited the application of this technology to promote human reproduction. The cloning of humans would be a catastrophic for society. The basis of the family structure, i.e. kinship, would become non-existent and this will lead to many foreseeable and unforeseeable problems.
From the Sharia perspective, human cloning would prevent the application of many of the Sharia rules such as those related to marriage, alimony, inheritance, custody, Maharim and 'Usbat (forbidden consanguinity). For all of these reasons, Islam prohibits human reproductive cloning by the methods of NTT and parthenogenesis.
Feotal Cloning
However, the situation with regards to foetal cloning is different. This process in no way undermines lineage but rather increases the number of legitimate offspring, something that Islam has encouraged. In other words, the application of this type of cloning is analogous to fertility treatment, albeit technically distinct, and is likely to be applied as an aid to facilitate married couples having children. It is not allowed however, to implant such a cloned zygote into the womb of another woman such as the husband's second wife, as this would constitute a mixing of kinship. If carried out according to the Sharia limits foetal cloning is even recommended as Islam has encouraged Muslims to marry and have children as indicated by the hadith in which Anas (ra) reported that the Messenger of Allah (SAW) said "Marry the affectionate that is fertile; I will be boasting about your number to the Prophets on the Day of Judgement.
Stem Cell Research and Therapeutic Cloning
For the humanity, the use of human embryos as a source of tissue for either research or medical application is a highly contentious issue and poses an ethical dilemma.
-One body of opinion says that the use of any embryo for research purposes is unethical and unacceptable on the grounds that an embryo should be accorded full human status from the moment of conception.
-The other body states that the embryo deserves no particular moral attention whatsoever.
-There is huge potential to use stem cells to cure some of humanities most dilapidating diseases
The UK Human Fertilisation and Embryology Act of 1990 regulated the use of embryos in medical research. It allowed for the making and use of embryos, arguing that the embryo is special as a potential human being and has fixed an arbitrary limit of 14 days for research on the embryo. The act asserts that respect is at a minimum when the embryo is in its early stages, hence, it would be suitable for medical research.
In diseases characterized by tissue degeneration, such as diabetes, heart attacks and neurological disorders including Parkinson's and Alzheimer's disease, stem cells offer the potential to regenerate the lost or damaged tissue that underlie such pathological conditions. The tremendous potential for stem cell based therapy to revolutionize medicine is generally accepted by all medical experts and could even result eventually in the production of organs to treat those conditions characterised by end stage organ failure i.e. liver failure, heart failure, renal failure and the like. There are currently thousands of people with such diseases in the UK on waiting lists seeking organ transplants and currently hundreds die each year in the UK alone due to the absence of adequate treatment e.g. 100,000 kidney patient in UK and only 30,000 get dialysis or transplants.
Despite the need for such treatments, the application of stem cell research and therapeutic cloning must be based on the Divine rulings relating to these issues. The Sharia legislation relating to the application of such technology depends upon several matters relating to the origin of the stem cells and the context of their usage. Regarding the origin of stem cells, these can be derived from 4 sources:
1. Adult tissue e.g. bone marrow, peripheral and umbilical cord blood
2. Early stage embryos produced in the test-tube by IVF and are unused or left over's of infertility clinics,
3. Early embryos developed by cloning
4. Aborted foetuses.
1. As for adult tissue, this is permitted by Islam
This is because, while alive, the Sharia gives the person legal (Shari) authority over his organs. This is based upon the Sharia principle relating to retaliation, if another person removes a person's hand or eye, then the wounded can take diya (blood-money) compensation. The victim also has the right to choose forgiveness. From the Shari point of view, he has final say over the organs and has the right to make decisions regarding them. Hence, he can donate his organ to somebody who needs it. Allah (swt) has allowed forgiveness or diya. However, for a donor to donate an organ the organ should not be vital for his own life.
The Qur'an clearly explains
"Do not kill yourselves" [TMQ An-Nisa': 29]. Stem cells fulfil this requirement. Deriving cells from dead adult tissue would not be allowed due to the sanctity Islam has given to the dead. Abu Dawood reported that Aisha (ra), the mother of the believers, narrated that the Messenger of Allah (saw) said, "Breaking the bone of a dead person is just like breaking it when he is alive." Islam has made the protection of the dead equivalent to that of the living and had prohibited their violation.
2. The Use of IVF to produce stem cell
This is where stem cells are derived from early embryos, which are no longer needed for infertility treatment (‘spare embryos'). From the Shari point of view, this would be allowed. The nature of the IVF process is that embryos will be formed that will not be needed for placement in the woman's womb. These can be utilised for the purpose of producing stem cells if the owners (parents) of the embryos give their permission.
As regards the status of the embryo, Islam does not attribute human status to it at an early stage of development. Furthermore, these embryos would not be considered as dead since they never had life according to the Sharia. Imam Muslim narrates from Ibn Mas'ud (ra) that he said that he heard the Messenger of Allah (saw) saying, "When 42 nights have passed on the nutfah (mixed male and female discharge of semen), Allah sends an angel to form it. He creates its hearing, vision, skin, flesh, and bones. Then the angel says, O Allah! Male or female?" In another narration "40 nights" was mentioned instead of 42. This view is also supported by legal judgement of the Messenger of Allah (saw) on an aborted foetus. Bukhari and Muslim both narrated from Abu Hurayrah (ra) that "The Messenger of Allah (saw) judged on a foetus for a woman from Bani Lahyan which was aborted, to pay a ghurrah" This is a particular sum of (blood money) compensation (diya) equal to 1/10 of a born human being. This is paid if the foetus shows signs of human organs such as a finger, hand foot etc, that is, indicating that it is definitely developing into a human being.
Attack on a human soul is therefore prohibited and this would apply to a foetus but not a pre 40-day stage embryo. The legal status of this early stage embryo is that it is considered nutfah (male-female sexual discharge), which is a form of impurity (najus). This is because they would be considered najus (impure). The Hukm Shari has allowed for the use of najus in the pursuit of medical treatment.
Qatadah narrated on the authority of Anas (ra) that the people from Uqul and Urena came to the Messenger of Allah (saw) and spoke to him about Islam, and the people of Medina were suffering from gastrointestinal disease, so the Messenger of Allah (saw) ordered them (the people from Uqul and Urena) to protect themselves from this illness. He instructed them to go outside of Medina and to drink from the urine and milk of the Camel (Bukhari, Muslim & Musnad of Ahmad). It is permitted to consume najus in the pursuit of medical treatment. In the above hadith, the Messenger of Allah (saw) ordered some people visiting Madinah to seek preventative treatment in the form of the najus. This establishes its legality from a Shari perspective.
3. Use of cloning to produce stem cells
Although the cloning of embryos for human reproduction is forbidden by Islam, the cloning of embryos as a means of obtaining stem cells for research and therapeutic purposes represents a new and distinct issue that necessitates a separate Ijtihad. This matter is currently being investigated by the mujtahideen (jurists).
4. Use of germ cells /organs of an aborted foetus to produce stem cells
In line with the discussion surrounding the use of embryos from IVF, the use of aborted foetuses to extract stem cells from them would be allowed only if the foetus was less than 42 days old (according to the hadith narrated by ibn Mas'ud).
Conclusion
In summary, the Sharia addresses the problems arising from modern biomedical research because they affect human relationships and the way people live. Although Islam and the Sharia generally encourages science and technological development as neutral disciplines, the issues relating to matters affecting personal and societal relationships must be examined. This limited discussion illustrates how the Islamic texts, which are 14 centuries old, can deliver clear guidance for humanity in the 21st century to issues relating to some of the most difficult ethical medical issues of the day. In particular, the Sharia encourages stem cell research and would allow the use of embryos at a more advanced stage of development than is currently allowed under UK legislation, that has set an arbitary limit of 14 days. Thus, medical researchers would learn with greater speed the mechanisms that govern how stem cells mature into their terminal organs, which qould be of considerable value in the pursuit of new regeneraive medical therapies.
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