Organ donation (7)

In this blog, we will start looking at the issue of amputating organs from a live person. There are 5 angles to look at this according to Ayatullah Muhsini:
• Is amputation allowed at all
• The one from whom the amputation is done
• The amputated organs
• The one to whom the amputation is done
• The goal of transplantation

In this blog, we will focus on the first point: is amputation from a live individual allowed at all? Firstly, it is not allowed to cause harm (idrar) in shari’a, whether to oneself or to another person. And the importance of saving someone else is through normal means not through amputating the organs of other people and transplanting them into the person who is injured!

There is a principle in Islam called “la darar wa la dirar” (1) which basically means that Islamic law will never cause harm, and if it does, it is not Islamic law. The question that we are asking, is whether this is applicable in this case. So let’s consider the three types of causing harm (idrar):

1. causing oneself to die in any way – this is Haram and there is no doubt in this. You are not allowed to help someone in need, even if you are about to die in a few minutes (although there is discussion on this point especially on the definition of death).

2. causing damage to important organs e.g. hand, leg, tongue, removing your eye and similar things that you know Allah would not be content with things like causing yourself to get serious diseases e.g. TB, cancer, aids, leprosy – this is Haram based our certainty that Allah would not be content with it (whether or not there is specific evidence in the texts for this or not); although it is sometimes based on ihtiyat e.g. in the case of removing your eyes to transplant it into the head of a great scholar of religious stature who is blind. However, there is a question whether giving e.g. one eye only falls into this category. Ayatullah Fadallah, for example, allows it but Ayatullah Jannaati does not. As you can see, it is a judgement call as to whether this falls into the this category or the one below.

3. causing harm in a fashion less than the above two and this is not Haram because there is no evidence to say it is Haram. The principle of “la darar wa la dirar” does not mean it is always haram to harm oneself e.g. it is allowed to eat a specific type of greasy burger with chips, or choosing to walk up a steep flight of stairs when your ankle is hurting. Therefore, it is allowed based on Asalat al-bara`a (i.e. the principle that everything is allowed, unless you know otherwise) or based on the understanding of the rational people that people have dominion over their wealth and themselves. As for the third case, it is allowed, and if someone’s life depends on it, then it becomes wajib.


Now consider the case where someone who gives one of his kidneys and is not cause any harm to the donor in actuality but he fears for himself that he may get ill in the future and require a kidney but might not be able to get one. Is that person allowed to be a donor? There are two points of interest:

1. It is possible to use istis-hab and assume the initial state of not being ill
2. However, this is not relevant to the state of pain/fear

This means that it is not allowed to give it due to the harm caused, even if the other person is his son, and this fear is of severe discomfort (haraj) for the father.

You have two rules in contradiction: the la haraj (no severe discomfort) rule, and the rule of not being allowed to harm onself. Some may say that there is an issue with the usage of the la haraj principle here (details in earlier part of the book), but one might also argue that the potential of this kind of harm in the future is unlikely and does not require the rational person to push it.

(1) al-Kafi, vol 5, page 280, 292 in the electronic version