Ditulis oleh : Shaikh Mohd Saifuddeen Shaikh Mohd Salleh Diterbitkan :
However, it did not garner much attention until this year when a 30-year old Russian, Valery Spiridinov, who suffers from a terminal degenerative muscle disease volunteered to be the first person to have his head transplanted to a donor body.In theory, the procedure would have Spiridinov’s fully functioning head and brain be transplanted to a donor body who is brain dead.Not surprisingly, this resulted in much publicity and debate as to whether the procedure is scientifically possible and ethically acceptable.
In terms of the science of transplant, there had been attempts of head transplant involving animals. In the 1950’s, there had been experiments by Russian scientists who transplanted the head of a dog onto another dog resulting in a dog with two heads. Similar attempts were carried out in Japan involving rats.
Perhaps the most successful attempt involving animals was recorded in 1970 involving a monkey which was carried out by Robert White. In that procedure, a monkey’s head was transplanted to another monkey’s body, but there was no technology back then to reattach the spinal cord, resulting in the monkey to be paralysed before it died eight days later due to rejection.
Aside from science fiction stories such as Frankenstein’s monster, there have not been any known attempt to transplant a whole human head to another body. Human head transplant lies in the domain of speculative science, at best.
The controversial technique as proposed by Dr. Canavero invites a number of ethical concerns. Chief among these concernes is the issueof personhood: What is the donor, and what is the recipient? Is this a person that the body belongs to, or a person that the head belongs to?
Then there is the issue of surgical success: What is the guarantee that there would be success, and would this procedure benefit the patient? Would the benefits outweigh the risks?
Equally critical is the issue of cost: The procedure is estimated to cost more than US$10 billion. Who would foot the bill? If there are donors, what would they gain from this procedure?
Until and unless these ethical concerns are properly addressed, it would be difficult to make a case for the whole human head transplant.
From the perspective of Islam, organ and tissue donation and transplantation are onlyallowed when there is a real urgent need (dharurah) to save a patient’s life. This means that when transplantation is allowed, there must be a very strong justification that this is the only way to save the patient’s life.
Patients in need of transplantation are those who are suffering from end-stage organ failure, and the only viable option available is transplantation.The legal maxims (qawa‘id al-fiqh) used in determining the permissibility of organ transplantation include “deeds are judged by their goals and purposes” whereby the goal of organ transplantation is to save lives, and not performed with the intent to humiliate or agonise the deceased.
The second maxim highlights the need “to eliminate harm.” Transplantation that takes place must have a high possibility to save the life of the recipient. This contributes towards the objective of preserving human life, which is one of the higher objectives of Shariah.
Next is the maxim of “hardship begets facility,” which essentially means that organ transplantation is a facility made available to help patients with end-stage organ failure. The Shariah permits one in a dire situation(dharurah), such as the risk of losing one’s life, to carry out what is originally unlawful (haram) in order to eliminate the harm that he faces.
These legal maxims form a number of strict criteria that must be followed before a transplantation is deemed permissible in Islam. The first of these criteria is that there exists
a real and urgent medical need for the transplantation to take place in order to save a patient’s life.
Another important criteria is that the death of the donor must first be ascertained. At the same time, there is no conspiracy to commit murder in order to obtain the needed organs, and that no organ trading or commercialisation is involved. On top of that, it must be ensured that doctors and third parties must not reap any monetary benefits from the transplantation.
Permission must also be obtained from donors and their next-of-kin before donation takes place. Such permission must be given by donors and their next-of-kin willingly and not in a state of duress, confusion or coercion.
Equally critical is to ensure that the doctors involved in the transplantation must be experts in their fields, and are able to weigh the benefits and risks of the procedure. This is important in order to ensure that there is a high degree of success in performing the transplant.
Last but not least, Islam stresses on the importance of according respect to the deceased donor when procuring organs.
Going back to the issue of whole human head transplantation, whether Islam permits this procedure or not is still up for debate. Having said that, a number issues must first be addressed.
The first of these issues is to ascertain that there is a real urgent need for the transplant to take place, and that it has a high degree of certainty in saving the patient’s life.
It must also be ascertained that the benefits outweigh the risks, and that this is the only option available to save the patient to eliminate the harm that he faces.
Finally, it must be ensured that no third party will reap financial gains from this controversial procedure.
As there are still many uncertainties including the high risk of organ rejection that the patient will face should the transplantation take place, it is highly likely that the benefits are greater than the risks.
Based on this reasoning alone, there is no justification for the human head transplantation to be permissible. The negative perception on whole human head transplant would most likely jeopardise the effort of procuring critical organs such as heart, liver, lungs and kidneys – which are more urgent – to save almost 18,000 patients on the waiting list in Malaysia.Do not let speculative science distract ourselves from the more pertinent issue in need of our attention.