Transplantation ethics from the Islamic point of view.

Center for Study and Research of Medical Ethics, Ministry of Health and Medical Education, I.R. Iran.
Medical science monitor: international medical journal of experimental and clinical research (Impact Factor: 1.22). 05/2005; 11(4):RA105-9.
Source: PubMed

ABSTRACT Organ transplantation has been transformed from an experimental procedure at Western academic centers to an increasingly common procedure in private and public hospitals throughout the world. Attendant with advancements in organ harvesting, preservation, and transplantation come moral issues. Islam is a holistic religion that takes into account social affairs of man as well as spiritual ones. Islam has a long history of ethics literature including the subgenre of medical ethics. Historical considerations are discussed as to why Muslim thinkers were late to consider contemporary medical issues such as organ donation. Islam respects life and values the needs of the living over the dead, thus allowing organ donation to be considered in certain circumstances. The sources of Islamic law are discussed in brief in order for non-Muslims to appreciate how the parameters of organ transplantation are derived. The Islamic viewpoint, both Shiite and Sunni, is examined in relation to organ donation and its various sources. The advantages and disadvantages of brain dead and cadaveric donation is reviewed with technical and ethical considerations. The Islamic concept of brain death, informed and proxy consent are also discussed. We discuss the concept of rewarded donation as a way to alleviate the current shortage of organs available for transplantation and consider secular and religious support for such a program. Suggestions are made for greater discussion and exchange of ideas between secular and religious thinkers in the Islamic world and between the Islamic world and secular Western countries.

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    ABSTRACT: Organ transplantation in the Middle East and North Africa has evolved to serve two major needs. The first is to sustain life where severe disease or disorders would mean death without organ replacement as in congenital heart disease. The second need is to provide cost-effective treatment and a quality of life without constant tertiary care and maintenance treatment. Renal transplantation caused by chronic kidney disease and failure is one such example. Qatar in the Middle East and North Africa is one of six countries comprising the Gulf Cooperation Council (GCC) in the Arabian Gulf Region, which has developed an active transplant program. It has one main challenge as other global nations, namely a disparity between organ availability and need, or supply and demand. A survey of university students' and employees' awareness of organ transplantation and donation was completed in 2013 at Education City, Doha, Qatar. Three hundred out of four hundred surveys were returned, or 75% of the total distributed. A literature review was carried out and comparisons made to the subsequent findings. Participants comprised 89% students and 11% employees. Of the participants, 90.6% were aware that donated organs were potentially life saving, and 72.7% knew about brain death. While most figures seemed comparable to other regional results, two significantly new findings emerged. More females (62.3%) than males (47.1%) believed that Islam supported organ donation, and 72.4% believed that there was no conflict between their faith and organ donation. Awareness campaigns and use of social media were thought to be the most effective way of disseminating organ donation knowledge. Read More:
    12/2014; 2014(6). DOI:10.5339/jlghs.2014.6
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    ABSTRACT: Background Posthumous organ procurement is hindered by the consenting process. Several consenting systems have been proposed. There is limited information on public relative attitudes towards various consenting systems, especially in Middle Eastern/Islamic countries. Methods We surveyed 698 Saudi Adults attending outpatient clinics at a tertiary care hospital. Preference and perception of norm regarding consenting options for posthumous organ donation were explored. Participants ranked (1, most agreeable) the following, randomly-presented, options from 1 to 11: no-organ-donation, presumed consent, informed consent by donor-only, informed consent by donor-or-surrogate, and mandatory choice; the last three options ± medical or financial incentive. Results Mean(SD) age was 32(9) year, 27% were males, 50% were patients’ companions, 60% had ≥ college education, and 20% and 32%, respectively, knew an organ donor or recipient. Mandated choice was among the top three choices for preference of 54% of respondents, with an overall median[25%,75%] ranking score of 3[2,6], and was preferred over donor-or-surrogate informed consent (4[2,7], p < 0.001), donor-only informed consent (5[3,7], p < 0.001), and presumed consent (7[3,10], p < 0.001). The addition of a financial or medical incentive, respectively, reduced ranking of mandated choice to 7[4,9], p < 0.001, and 5[3,8], p < 0.001; for donor-or-surrogate informed consent to 7[5,9], p < 0.001, and 5[3,7], p = 0.004; and for donor-only informed consent to 8[6,10], p < 0.001, and 5[3,7], p = 0.56. Distribution of ranking score of perception of norm and preference were similar except for no-organ donation (11[7,11] vs. 11[6,11], respectively, p = 0.002). Compared to females, males more perceived donor-or-surrogate informed consent as the norm (3[1,6] vs. 5[3,7], p < 0.001), more preferred mandated choice with financial incentive option (6[3,8] vs. 8[4,9], p < 0.001), and less preferred mandated choice with medical incentive option (7[4,9] vs. 5[2,7], p < 0.001). There was no association between consenting options ranking scores and age, health status, education level, or knowing an organ donor or recipient. Conclusions We conclude that: 1) most respondents were in favor of posthumous organ donation, 2) mandated choice system was the most preferred and presumed consent system was the least preferred, 3) there was no difference between preference and perception of norm in consenting systems ranking, and 4) financial (especially in females) and medical (especially in males) incentives reduced preference.
    BMC Medical Ethics 11/2012; 13(1):32. DOI:10.1186/1472-6939-13-32 · 1.60 Impact Factor
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    ABSTRACT: There is worldwide shortage of organs for solid-organ transplantation. Many obstacles to deceased and live donation have been described and addressed, such as lack of understanding of the medical process, the issue of the definition of brain death, public awareness of the need for transplants, and many others. However, it is clear that the striking differences in deceased and live donation rates between different countries are only partly explained by these factors and many cultural and social reasons have been invoked to explain these observations. We believe that one obstacle to both deceased and live donation that is less well appreciated is that of religious concerns. Looking at the major faiths and religions worldwide, it is reassuring to see that most of them encourage donation. However, there is also scepticism amongst some of them, often relating to the concept of brain death and/or the processes surrounding death itself. It is worthwhile for transplant teams to be broadly aware of the issues and also to be mindful of resources for counselling. We believe that increased awareness of these issues within the transplant community will enable us to discuss these openly with patients, if they so wish.
    10/2012; 2(5):69-73. DOI:10.5500/wjt.v2.i5.69


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