ISLAMIC BOUNDARIES ON REPRODUCTIVE ORGANS DONATION
On 26th March 2018, a medical team of nine plastic surgeons and two urological surgeons at the Johns Hopkins Medicine performed the first total penile and scrotum transplant in the world. The procedure involved transplanting the entire penis, scrotum (without testicles) and partial abdominal wall from a deceased donor to a veteran who was wounded in Afghanistan.
The transplant was conducted to replace his penis and scrotum that were blasted by an explosion after he accidentally stepped on an improvised explosive device hidden on the road during his patrol in 2010. After a year following the surgery, around November 2019, the transplanted penis was reported to be functioning as being expected, showing that it was a successful procedure.
Penile transplant is a type of reproductive organ donation. Reproductive organ donation, in general, may involve transplanting reproductive organs from males such as penis, scrotum, testes, and vas deferens, and reproductive organs from females including the vagina, fallopian tubes, ovary, and uterus.
Reproductive organ donation is expected to solve sexual and fertility problems. However, it also raises some ethical and moral concerns especially from the perspective of certain religions and cultures. Islam, for instance, has a firm stance when it concerns genital matters and organ donations in general.
Organ donation is a controversial topic in the Islamic fraternity. Islamic scholars strived in research to come up with a ruling that is compatible with Islamic principles. Although there is disagreement regarding the ruling of organ donation among scholars, most contemporary rulings either local or international are inclined towards allowing organ donations.
The permissibility of organ donation is based on certain principles. One of which is the removal of harms. There two types of organ donation: (1) donation from living individuals, and (2) donation from the dead. Donations from living individuals are limited to certain types of organs such as parts of the liver and one of the kidneys. In Malaysia, such type of donation only involves close relatives. Donations from dead donors involve more diverse types of organs and tissues including the heart, lung, cornea, skin and heart valves.
Both types of donations are permissible based on the principle of removing harms because donating organs or parts of organs saves the life of a person who is suffering from the end-stage of organ failure. Indeed, protecting life is important as it is one of the higher objectives of the shari‘ah. For example, in the case of a person suffering from liver failure, donating part of the liver may save him. Although it poses some risks upon the donor due to surgery, the risk is very much lower than the risk of death faced by the liver failure person.
Organ donations are performed with the intention of saving lives. Such an intention justifies the permissibility of organ donations. This is based on the principle in Islam known as “actions are judged by intentions.” Donating organs with the intention of saving is permissible and considered as a form of charity.
However, organ donation is permissible under certain conditions, such as: (1) it is done only to save lives with the absence of alternative means, (2) in the case of donations from the deceased, their cadavers must be handled with dignity, and (3) donations from the living do not cause him/her substantial damage such as permanent disability or death.
Therefore, the question arises whether reproductive organ donation holds the same argument. To better understand this issue, the Islamic perspective on reproductive organ donation must be looked at from various angles.
Firstly, it must be noted that Islam puts great emphasis on protecting and preserving lineage. Organs such as ovaries and testicles contain genetic information from the donor, thus, transplanting it to the recipient leads to confusion regarding the lineage of offsprings. The confusion of lineage complicates a number of matters including inheritance, marriage, and guardianship.
Secondly, donating genitals such as the penis is strictly prohibited because it is considered as changing the creation of God. Changing the creation of God in this sense is related to the act of castrating the genital of the donor in order to be transplanted to the recipient. Castrating genitals is prohibited by Prophet Muhammad. Furthermore, in the context of donation, it causes permanent damage to the donor which violates one of the Islamic conditions in permitting organ donation.
Thirdly, genitals such as the penis are the private parts of a person whose right to see and touch is his alone even until death. Performing transplants that involve the private part is a form of humiliation towards both the donor and recipient. Hence, Islam prohibits the donation and transplant of genitals such as the penis because it is disrespectful to the dignity of the donor and recipient.
As an overall argument, it is important to note that in Islam, typical organ donation is only permitted due to the profound necessity to save lives. Indeed, many lives depend on organ donations. Reproductive organ donations, on the other hand, does not constitute a necessity. Although it is performed with the aim at producing offsprings, it is not a form of a life-saving treatment. Additionally, producing offsprings is a form of supplementary (takmiliyyah) rather than a necessity (daruriyyah). Indeed, Islam draws a clear line between what is considered necessary and not.