Many Muslims incorrectly assumed that Islam categorically prohibits organ donation. In fact, organ donation is permitted and encouraged by many Muslim scholars. Organ donation is legal in the majority of Muslim countries, including Saudi Arabia, Turkey, and Iraq. In 2018, the Fiqh Council of North America issued a ruling that permits and encourages Muslim Americans to sign up as organ donors.
The following set of answers related to Islamic permissibility of donation and transplantation are adapted from the FNCA ruling from December 2018.
Is organ donation permissible in Islam?
Yes, as long as certain conditions are met, including:
- First-person authorization (i.e., the person whose organs are being donated was that one that originally indicated that this was to be his or her wish)
- No material benefits or gifts were received in exchange for the donation (i.e., you cannot sell your organs)
- Any living donation (i.e., donating an organ while the donor is still alive) cannot lead to the death of the donor
- Any other donation must be made after the determination of cardiopulmonary cessation (note: there is some difference in the medical community as to what technically constitutes death vs. end stages of the dying process, see more below)
- Any harm to the donor must be minimized, the donor cannot intentionally kill him/herself, and the body cannot be disfigured
- Reproductive organs cannot be donated
The conditions above are meant to be a high-level summary. For further discussion and reasoning, please refer to the original FCNA ruling.
Is there a difference of opinion on the permissibility of organ donation in Islam?
The majority of Muslim scholars in America today permit organ donations as long as certain conditions are met (e.g., the donor had given consent, no mutilation, no reproductive organs)
With that said, generally speaking, views on permissibility can fall into 3 groups:
- Categorically not permitted
- Generally not permitted, with some exceptions
- Generally permitted, with conditions
Why does this difference in opinion even exist?
It is driven by the ethical-legal plurality of Islam, and since it is not unequivocally addressed in the Qur’an and Sunnah, scholars will make reasoned opinions based on the key principles, evidence, and precedents found within Islam along with their societal context. This deliberative process is known as ijtihad.
What is the basis for the difference?
Not permitted
This view is based on the idea that organ donation threatens human dignity (ḥurma and karāma) and supports this view with statements from the Prophet Muhammad (SAW).
Some consider the harvesting of organs as a form of mutilation. This is a minority opinion, especially when considering modern surgical techniques employed by qualified surgeons that perform the harvesting.
Generally not permitted, with some exceptions
This view is supported by Qur’anic and legal precedents that overrule prohibitions when a dire necessity (ḍarūra) exists. Cases where organ transplant is life-saving, and thereby another person’s donation of an organ is necessary, are held to meet the standard of dire necessity.
Generally permitted, with conditions
This view bases its position on the idea that a legitimate human public interest (maṣlaḥa), namely duration and quality of life, is furthered by organ donation. They also marshal scriptural and legal support for their views.
Most scholars believe such a donation is a sadaqah jariyah, a continuous good deed that God will reward. They further maintain that saving a life is a necessity and as such it constitutes further authority to support the permissibility of organ donation.
When is a person considered “dead” in the context of organ donation?
Why is this important?
It determines which organs are allowed to be donated at a certain time (i.e., if a person is still considered living, then no life-sustaining organs, e.g., heart, can be removed)
From a medical perspective, time is of the essence when it comes to surgically remove organs as there is limited time that a particular organ remains a viable candidate for transplantation. As such, the point at which “death” is determined can have a meaningful impact on which organs will practically be able to be donated and transplanted.
Criteria for death
Cardiopulmonary cessation
FCNA along with other organizations, including the Islamic Organization for Medical Science and the Islamic Fiqh Academy of the Muslim World League (IFA-MWL), judged that legal death occurs upon cardiopulmonary cessation. The “brain dead” state represents an intermediate state between living and death; therefore removal of organs reserved for a deceased individual is not allowed at that time.
“Brain Death”
The Islamic Fiqh Academy of the Organization of Islamic Cooperation (IFA-OIC) concluded that neurological criteria for death were acceptable in Islamic law, where “brain death” meant that “all vital functions of the brain cease irreversibly and the brain has started to degenerate as witnessed by specialist physicians” a person can be declared legally dead.
Why the difference?
As demonstrated above, Islamic jurists do not have a unanimous opinion on what constitutes death. The principal point of contention in these and other juridical councils revolved around whether medical science carries sufficient epistemic weight to create new “Islamic” standards for legislating death.
Related discussions touched on (1) the physiological meaning of “brain death,” (2) relationships between the departure of a human being’s soul and physical signs and brain functions, and (3) how much they need for organ donors should impact the standards for declaring death. Contemporary jurists continue to debate these questions and hold diverse views. Moreover, although many Muslim countries have, particularly those with active organ donation programs, adopted the IFA-OIC view and legislated neurological criteria for death, others defer.
What is the difference between an organ donation and a tissue donation?
When someone donates their organs, they are donating a heart, kidney, lung, liver, pancreas, or other organs to an individual who needs an organ transplant.
Tissue donations involve a person providing corneas, bone, skin, and other soft tissues for transplantation purposes.
What organs and tissues are medically possible to be donated?
Organ donors who are recently deceased can donate their lungs, liver, kidneys, intestines, pancreas, or heart. Recently, the national organ transplant list added faces and hands to the list of organ donations.
Tissues that can be donated include ligaments, tendons, cartilage, veins, heart valves, skin, corneas, and components of the middle ear.
Are there restrictions on what can be donated based on the Sharia?
Aside from the prohibition of donating a vital organ while living or donating reproductive organs, organs that if removed would cause considerable harm to the donor via disability or high risk of mortality cannot be donated.
Living donations
Especially for living donations, determinations must be made on a case-by-case basis and in conjunction with medical professionals. In general while living, a twinned nonvital organ, for example, a kidney may be donatable unless it carries a risk to the patient, as would a partial liver or pancreas donation.
After Death
Bone, cornea, and tissue may be donated. Islamic scholars have yet to research whether face or partial brain transplants are allowed and thus FCNA suspended judgment on the ruling.
Donating to “Science”
Is it permissible to donate organs or the entire body to scientific research according to the shariah? [more to come on this soon!]
When can an organ or tissue donation happen?
Both organ and tissue donations commonly occur upon the accidental or expected death of a donor. Organs must be removed as soon as possible once a donor has died. Some organs can be kept alive in special conditions for a short time. Donated hearts or lungs must be transplanted within six hours of removal.
Soft tissue donations should be removed from the deceased within 48 hours of the time of death. However, bone, skin, veins, and heart valves can be kept frozen for up to 10 years before being transplanted.
How can you find out if a loved one is an organ or tissue donor?
Unless a loved one tells you they are an organ or tissue donor, you won’t know unless you perform a search online using the loved one’s driver’s license ID number. Adults over 18 years old are eligible to sign up as organ or tissue donors when they apply for a driver’s license or register online with their state’s organ/tissue donor registry.
What if my loved one consented to be an organ/tissue donor but next of kin do not want to donate?
When someone gives their consent to be a donor and they are at least 18 years old, their consent cannot be overruled. The only exception to this rule is if the deceased person’s organs or tissues are not suitable for transplant purposes. In this case, most states provide the next of kin the option to either donate the organs or tissues to research or have them remain in the deceased’s body.
Can next of kin donate the organs or tissues of a loved one even if that person isn’t a registered donor?
Although it is not mandatory, some hospitals may ask for your consent before removing tissues or organs from a loved one’s body. If your loved one is not a registered donor but can provide healthy organs and tissues for transplantation purposes, health professionals may also ask for your consent.
FCNA’s View
It is prohibited to use human organs without the prior authorization and informed consent of the donor. For living donors, this authorization is required explicitly, for deceased donors, their prior wishes for donation need to have been documented and consultation of the family (particularly the wali [guardian]) of the potential donor’s understanding of these wishes needs to be considered.
Who performs organ or tissue removal?
Any surgeon qualified to remove organs and tissue for transplantation reasons can perform the removal. This applies to surgeons qualified for providing donor banks with tissues as well.
Is the quality of care reduced when a hospital knows you are an organ/tissue donor?
No. You will receive the same quality of care in hospitals regardless of your donor status.
Can I choose who receives my organs or tissues?
If a donor and the recipient are still alive at the time of the donation, the donor can choose the recipient. When someone alive donates an organ or tissue, the donation is called an ancillary donation, meaning the donor can survive without the organ or tissue. However, once a donor is medically declared deceased, the recipient of the organ or tissue becomes whoever needs the donation the most.
Who can legally donate an organ?
Anyone 18 or older who is registered to be an organ/tissue donor can legally donate an organ/tissue. Individuals under 18 must have the consent of a parent or guardian to donate their organs or tissues.
What health conditions may prevent organs/tissues from being donated?
Metastasized cancer, severe infections, diabetes, heart disease, kidney disease, and other serious chronic conditions can prevent an organ/tissue from being donated. The HOPE Act allows some transplant centers to transplant tissue or organs from people with HIV into recipients with HIV.
Does donating disfigure the body?
No. Removing donated organs and tissues is done by experienced surgeons who can restore the appearance of incision areas. The body of a person who donated their organs/tissue can be displayed during a funeral viewing with no signs of trauma to the body.
Does the donor have to pay for the removal of their tissues or organs?
No. There is no cost to donors or the relatives of donors. In most cases, the recipient of an organ or tissue pays for the donation and transplantation surgery using personal health insurance, Medicaid, Medicare, or philanthropic organizations.
