ORGAN and tissue transplantation is a revolutionary medical treatment that has proven to be successful in saving lives.
Through such transplantation, patients with certain terminal diseases now have new hope of continuing to live.
Without a doubt, this form of treatment could help achieve one of the principles of Islam Hadhari, namely enhancing the quality of life.
Though this modern medical breakthrough has been heralded as effective, hospitals face a major problem in finding organs and tissues for transplantation.
The National Transplant Resource Centre, based at the Kuala Lumpur Hospital, is the coordinator for activities pertaining to organ and tissue procurement.
The centre’s statistics showed that the number of organ pledgers as at Dec 31 last year was 81,894 about 0.3% of the total population.
From this number, there were only 141 actual donors.
There is an urgent need to increase the number of organ pledgers and donors.
The issue of organ and tissue transplantation needs to be handled urgently and effectively because it involves the quality of life of the people.
Some of the organs and tissues could be obtained from living donors but the main source is cadavers.
However, there is a lack of cadaveric donors.
There are several reasons for this.
First, there is a lack of understanding among the general public on organ transplants.
This has given rise to misconceptions and anxiety on the part of family members of the deceased in allowing organs and tissues to be harvested.
Though the Health Ministry has established the Public Education on Organ Donation Sub-Committee to promote organ donation through various campaigns, much still needs to be done.
Secondly, most doctors face problems in explaining organ donation to the family members of a deceased person.
As a result, chances of harvesting organs and tissues are squandered because family members are not given the necessary information to consider the possibility of such a donation.
This is a universal problem.
For example, in Australia, 50% of family members had never been asked by doctors or nurses about donating the organs and tissues of a recently deceased person.
Thirdly, there is a lack of public understanding on the definition and concept of brain death.
Death for most people refers to heart failure which is followed by the failure to breathe.
However, with the rapid advancements made in medicine, death is now understood more clearly.
Thus, there now exists a concept known as brain death which refers to death due to a permanent failure of the brain to function.
The Health Ministry and the Malaysian Academy of Medicine have published a consensus statement on brain death as a guide for medical practitioners and as information for the general public.
However, it should be noted that in actuality, only 1% of all deaths involves brain death.
In most cases, organs and tissues are procured from those who have been diagnosed as brain dead at the hospital.
Primary organs must come from brain-dead patients who had been on the ventilator.
If the concept of brain death is not understood or accepted by the society, it would be extremely difficult to procure organs and tissues from the recently deceased.
Finally, there is confusion on the religious perspective of organ donation.
A number of Islamic scholars have highlighted the permissibility of organ donation.
Decrees on such permissibility had been made by the Islamic Fiqh Academy and Islamic scholar Dr Yusof Qardawi.
Transplantation of organs and tissues is a modern medical procedure that is not mentioned specifically in the primary sources of the shariah (Islamic law), the Quran and the Sunnah (traditions of Prophet Muhammad).
Discussions on the transplantation therefore used the ijma’ (consensus) and qiyas (analogy) approaches based on several principles of the shariah.
One of the objectives of the shariahis to safeguard and preserve life and organ transplantation is known to have saved many lives.
Some of the principles of the shariahused to issue the fatwa or decree on organ transplantation include necessities overrule prohibition, ‘choose the lesser of two evils,’ ‘public interest takes precedence over personal interest’ and ‘harm must be removed.’
In Malaysia, the fatwa on the permissibility of organ donation and transplantation was issued in June 1970.
From the perspective of Islam, organ transplantation is allowed when there is no other way save the life of a patient.
This is especially the case when the patient is suffering from organ failure.
Islam stresses that such transplantation must not harm the organ recipient or living donor.
It also says that the donor must do so with utmost sincerity for the noble aim of helping the recipient and not to attain wealth, popularity or glamour.
Organs and tissues must not be traded as Islam views such trading as haram or illegitimate.
Organ transplantation also requires permission from the donor who should not have been forced or put under any pressure.
According to Prof Dr Zaki Badawi, a renowned Islamic scholar based in London, Muslims are not only allowed to be tissue and organ donors, it is in fact their responsibility.
It is now time for Muslims to view organ donation as a fardu kifayah or collective obligation.
Currently, the majority of organ donors are non-Muslims.
Thus, more Muslims need to come forward as organ pledgers and donors.
They should be aware that when there is little or no supply of human organs and tissues for organ transplantation, doctors might have to resort to alternatives such as using organs and tissues from animals, especially pigs, as they have a relatively low rejection rate.
The question now is, are Muslims willing to use porcine organs and tissues when there is a way out in the form of organ donation?
This is the question that must be answered by all Muslims.