International Association Of Bioethics

The purpose of this webpage is to provide authentic and generally agreed upon guidelines in matters of medical practice in accord with the five schools of Islamic Religious Law: the Maliki, Hanafi, Shafi’i, Hanbali and Ja’fari (Imami Shi’i). The divergence in religious rulings between legal schools are stated only where necessary.

Health Care

Birth Rites
A baby is bathed immediately after birth, before giving it to the mother. The father (or mother or the imam) then whispers the call to prayer in child’s ears so that the first sounds it hears are about Muslim faith. Circumcision of the male child is recommended within the first seven days. If for some medical reason this is not possible it can be performed before puberty. A baby born prematurely but at least 130 days gestation is given the same treatment as any other infant.

Dietary Regulations
No pork or pork products, such as lard, is allowed, nor alcoholic beverages or any food prepared with alcohol, such as some kinds of cakes or desserts. All permissible meat slaughtered in a special way by a Muslim is known as halal or zabiha. Also in seafood only fish with scales is permissible for food. There is no prohibition against shell fish like shrimp, lobster, and so on.

Determination of Death
Since the introduction of advanced medical technology, besides the traditional definition of death which occurred when the heart and lungs stopped functioning, some Muslim schools of thought (mainly Sunni* and some Shia* Muslims) have accepted brain death as a valid definition when the brain ceases to function and brain cells begin to die. As such, artificial means may be used to preserve the body long enough to remove viable organs that are to be donated according to the conditions stated below.
*Sunni Muslims form the majority and differ with the Shia Muslims, a minority, in some matters of practice. They share the basic beliefs in God, the Prophet, the Koran, and the Final Day of Resurrection.

Necessary to Life Interventions
It is permissible to use life support to save and lengthen life. Such equipment may not be disconnected for that will be construed as causing death. On the other hand, there is no obligation to continue these interventions just to prolong the imminent death. The purpose of extraordinary medical intervention is to maintain the process of life, not to avoid or postpone death. It is forbidden to cause harm to the patient with equipment and drugs when the futility of such procedures is established by medical team. Under those circumstances it is permissible to unplug life-support systems. `Mercy killing’ or `Physician Assisted Aid in Dying’ of terminally ill patients is prohibited.

Postmortem Examination
Autopsies performed for medical research and training is permissible. It is also permissible for determining the cause of death and for the discovery of new remedies. It is necessary to clearly explain the reasons for postmortem to the family. Donation of body parts or organs are allowed if there is a will to that effect or if the family permits. Blood transfusions are also permitted, including those from non-Muslims. Ritual preparation of the body is commenced after completion of the autopsy. Some families will wish to take their dead back to their country of origin for burial.

Death Rites
The dying Muslim patient may wish to sit or lie with hisher face towards Mecca (north-east from Charlottesville), and moving the bed if necessary to make this possible is appreciated. Family members and elders in the community, including the Imam, may ask to be present so that they can provide moral support, religious guidance in matters of living will and recite Muslim scripture, the Koran round the bed. A relative or another Muslim may whisper call to prayer into the dying person’s ear. In the case of female client the Imam and other male members of the community may come only if requested. As soon as death occurs the body should be covered completely and placed, if possible, with feet towards Mecca. There are special procedures for washing and shrouding the body. Muslims are required by their religious law to prepare the body for burial. Only when no community member can be contacted, the health care providers may perform these procedures. It is recommended that burial be performed as soon as possible, especially in summer months. Cremation is forbidden even if there is a will to that effect.

Abortion and Birth Control
Abortion is permitted where the mother’s health is in imminent danger. In addition, before the fetus attains personhood, that is during the first 120 days, abortion is permissible if the woman would stop lactating for another child. Rape is also a valid reason for abortion if there is a fear of psychological damage and problems that could lead to physical symptoms. Birth control is also permissible if the prescribed method does not have any adverse impact on the health of either spouse and if it does not lead to permanent sterilization.

Personal Devotions
Muslims perform prayers five times a day: before sunrise, noon, afternoon, sunset and evening. A sick person is allowed to combine noon and afternoon, and sunset and evening prayer. If conditions permit washing is required. For clients on bed rest only symbolic ablution (known as tayammum) is sufficient. Provision of privacy is important especially for female patient during prayer.

Religious Objects
Prayer rug and the Koran must not be touched by anyone ritually unclean (e.g., with blood or urine on hand), and it is preferable that nothing should be placed on top of it. Some Muslims wear amulet, a black string or silver or gold chain on which sections of the Koran are attached. These, if requested by the client, should not be removed and must remain dry.

Special Care of Women
Matters concerning family (abortion, birth control) require both spouses to agree and consent forms are to be signed jointly. Women are very modest and frequently wear clothes that cover all of their body. During a medical examination, the women’s modesty should be respected as much as possible. Whenever possible Muslim women prefer female doctors. For 10 days after giving birth and 5 to 6 days after menstruation, a woman is exempt from ritually prescribed prayer since this is a time of cleansing for her, although she may request privacy for personal devotions.

Ethics Of Human Cloning

The Islamic views presented about cloning in this article are formulated with a necessary caution. In the absence of a central institution resembling the pope or the Vatican, juridical-ethical opinions in the matters of the Shari`a, the religious law of Muslims, tend to suggest plurality based on independent research and interpretation of legal scholars in the community. Although ethical issues associated with assisted reproductive technologies such as in vitro fertilization has been dealt with in some detail by Muslim jurists belonging to the major five legal rites, four Sunni and one Shi`i school, to the knowledge of this writer, the subject of possible human cloning has not yet been discussed.The facts about cloning are just now emerging. In the light of better understanding of the facts regarding cloning, both through embryo splitting as well as nuclear transplantation, and the impact it could have upon the way Muslims conceive of human life and its purposes, it is reasonable to expect revisions in the ethical and legal assessment of these experiments among the scholars of Shari`a. The article has summarized theological, ethical and legal dimensions of the issues associated with cloning in Islam with due attention to the possible differences in the interpretation between the Sunni and the Shi`i legists.

The Theological Dimension of the Issue:

Let us begin with the theological dimension presented in the teachings of the Qur’an and see if there is any room for human intervention in the workings of nature associated with reproduction. In Chapter 23, verse 12-14, we read:

We created (khalaqna) man of an extraction of clay, then we set him, a drop in a safe lodging, then We created of the drop a clot, then We created of the clot a tissue, then We created of the tissue bones, then we covered the bones in flesh; thereafter We produced it as another creature. So blessed be God, the Best of creators (khaliqin)!

Muslim commentators have drawn some important conclusions from this and other passages that describe the development of embryo to a full human person. First, human creation is part of the divine will that determines the embryonic journey to a human creature. Second, it suggests that perceivable life is possible at the later stage in biological development of the embryo when God says: “thereafter We produced him as another creature.” Third, it raises questions whether fetus should be accorded a status of a legal person once it lodges in the uterus in the earlier stage. Fourth, it allows for a possible distinction between a biological and moral person because of the silence of the Qur’an over when the ensoulment occurs in this process. Majority of the Sunni and some Shi`i scholars, make a distinction between two stages in pregnancy divided by the end of the fourth month (120 days) when, according to some traditions ascribed to the Prophet, ensoulment takes place. On the other hand, majority of the Shi`i and some Sunni legists have exercised caution in making such a distinction because they regard the embryo in the pre-ensoulment stages as alive and its eradication a sin.

The classical formulations based on the Qur’an and the Tradition provide no universally accepted definition of the term `embryo’ with which we are concerned in our deliberations today. Nor do these two foundational sources of the Shari`a, lend themselves to recognize the modern biological data about the beginning of life from the moment of impregnation. A tenable conclusion, derived by rationally inclined interpreters of the above-cited verse of the Qur’an, suggests that as participants in the act of creating with God, (God being the Best of the creators) human beings can actively engage in furthering the overall well estate of humanity by intervening in the works of nature, including the early stages of embryonic development, to improve human health.

Nevertheless, the Qur’an takes into account the problem of human arrogance which takes the form of rejection of God’s frequent reminders to humanity that God’s immutable laws are dominant in the nature and human beings cannot willfully create “unless God, the Lord of all Being, wills.” (81:29) “The will of God” in the Qur’an has often been interpreted as the “processes of nature uninterfered with by human action.” Hence, in Islam human manipulation of genes made possible by biotechnical intervention in the early stages of life in order to improve the health of the fetus or cloning in the meaning of embryo splitting for the purpose of improving the chances of fertility for a married couple is regarded as an act of faith in the ultimate will of God as the Giver of all life.

The Ethical Dimension of the Issue:

As we move on to understand the ethical issues associated with cloning, at the center of the debate in Islam is going to be the question of the ways in which cloning might affect interhuman relationships. In large measures, Muslim concerns in this connection resonate the concerns voiced by Paul Ramsey about the social role of parenting and nurturing interpersonal relations. Islam regards interpersonal relationships as fundamental to human religious life. In fact, the Prophet is reported to have said that nine-tenth of religion constitutes inter-human relationship, whereas only one-tenth is God-human.

Since the George Washington University Medical Center success in duplicating genetically defective human embryos by blastomere separation in 1993, Muslims have raised questions about manipulation of human embryos beyond IVF implantation in terms of their impact upon the fundamental relationship between man and woman and the life-giving aspects of spousal relations that culminate in parental love and concern for their off-spring. The Qur’an declares sex-pairing to be a universal law in all things. (51:49) Muslim focus of the debate on genetic replication is concerned with moral issues related to the possibility of technologically created incidental relationships without requiring spiritual and moral connection between a man and a woman in such embryonic manipulation. Can human advancement in biotechnically created relationships jeopardize the very foundation of human community, namely, a religiously and morally regulated spousal and parent-child relationship under the laws of God? Hence, the more intricate issues associated with embryo preservation and experimentation have received less emphasis in these ethical deliberations. To be sure, since the therapeutic uses of cloning in IVF appears as an aid to fertility strictly within the bounds of marriage, both monogamous and polygamous, Muslims have little problem in endorsing the technology. The opinions from the Sunni and Shi`i scholars studied for this presentation indicate that there would be almost a unanimity in Islamic rulings on therapeutic uses of cloning, as long as the lineage of the child remains religiously unblemished.

Besides the relationship issue, in the world dominated by the multi-national corporations Muslims, like other peoples around the globe, do not treat technology as amoral. No human action is possible without intention and will. In light of the manipulation of genetic engineering for hugenics in the recent history, it is reasonable for the Muslims, like the Christians and the Jews, to fear political abuse of the reproduction technology through cloning. With its emphasis on spiritual egality, Islam has refused to accord validity to any claims of superiority of one people over the other. The only valid claim to nobility in the Qur’an stems from being godfearing.

It is obvious that ethically cloning for purposes other than therapeutic lays enormously grave responsibility on humans in terms of genetic improvement of quality of human life, the authority that can make these decisions with necessary foresight and wisdom, and the criteria that can be used in evaluating the risks and benefits of such interventions.

The Legal Dimension of the Issue:

In Islam although religious, ethical and legal dimensions are interrelated, it is important to understand the legal aspects of cloning that Muslim legists would evaluate carefully in their legal reasoning to deduce the judicial decisions on the subject. The legists are expected to evoke the two fundamental principles of `equity’ (istihsan) and `public interest’ (maslaha) to furnish a religious basis for independent legal decisions about the subject. These two principles function as supplementary procedures to derive rules that can be applied to formulate new decisions and override the strict letter of law. In addition, three major subsidiary principles or rules applied to resolve ethical dilemma and derive judgements related to bioethical issues are: (1) `protection against distress and constriction’ (`usr wa haraj); (2) `refraining from causing harm and loss to oneself and others’ (la darar wa la dirar), and (3) `averting causes of corruption has precedence over bringing about benefit’ (dar’u al-mafasid muqaddam `ala jalb al-masalih).

It is obvious that in light of the limited knowledge that we have about who would be harmed by cloning or whose rights would be violated, Muslim legal rulings are bound to reflect a cautious and even prohibitive attitude to the cloning beyond treatment of infertility or assessment of genetic or other abnormalities in the embryo prior to implantation. Whereas recent breakthrough in mammal cloning provides unique opportunity to the scientists to fathom the secrets of God’s creation, it also carries with it grave and unprecedented risks. Nevertheless, since we do not will unless God wills, can this breakthrough in cloning be regarded as part of the divine willing to afford human kind yet another opportunity for moral training and maturity? The Qur’an seems to be suggesting that embryo splitting is just that opportunity for our over all maturity as members of the global community under God.