Journal - International Society for the History of Islamic Medicine

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Farouk MAHMOUD ISLAMIC MEDICAL ETHICS IN ASSISTED CONCEPTION tify genetic variation …Continual development and improvement of existing gene chip technology will enable … to identify the genetic basis of male and female infertility… The identification of an individual’s genetic blueprint at birth will provide the clinician with powerful tools to assess disease risk …” (1). From an Islamic perspective, this pro-active technology is desirable but poses two problems. There is potential damage to normal embryos and does the discarding of affected embryos create an ethical problem. This is another area the jurists are yet to comment. It must be emphasised that though this technique affords sexing, Islam prohibits choosing of the sex. “… He creates what he wills. He bestows female (offspring) upon whom he wills and bestows male (offspring) upon whom he wills. Q 43:49 Cloning-Islam - Baby from Both Man and Woman In cloning, the nucleus from a somatic cell, is injected into an enucleated egg and thus an embryo is artificially created. The nucleus could be obtained from the husband, albeit a skin cell (not from the sperm) and injected into the enucleated egg of the wife and the zygote is transferred into the womb of the wife. Genetically, the offspring will be identical to the father, for the mother contributes no genetic material except mRNA and mitochondrial DNA from the cytoplasm. There is no mixing of genes, no confusion of family lineage and the pregnancy occurs under the sanctity of marriage and the mother nurtures and delivers the baby. Though the wife takes part in the genesis of the offspring it does not contribute any genetic material. Although ethically, human cloning is not acceptable, what is the Islamic perspective? Also, can these clone embryos be used for research purposes? The concept of cloning poses an interesting, or rather, tantalizing dilemma for the jurists of Islam. Stem Cell Technology Stem cells which are totipotential could be obtained from the inner cell mass from surplus IVF embryos or generated by cloning adult cells. “Stem cells … ability to generate additional stem cells … generate differentiated cell types with specific functions … a substantial amount of reprogramming between cell fates is possible”(2) The therapeutic potential is enormous; damaged or diseased organs could be replaced viz. spinal cord injury, diabetes mellitus, Parkinson’s disease, cardiomyopathy, stroke victims, arthritis and others. In the field of research, it could provide a window for observing embryogenesis, teratogenesis and embryotoxicity. Does Islam permit the use of surplus IVF embryos for research. Discussion The aim of this article is to address the question of alleviating the anguish and grief of the barren couples who need one or other of the newer technologies of assisted conception. The infertile couple look towards assisted conception as their last resort and do deserve sympathy and understanding of their need to procreate It is important to recognise that the religiosity of the couple would dictate the need for religious blessing of a particular method of assisted conception. Also, we are aware that among those who cross borders to overcome legal restrains in their ‘home states’, some are Muslims. However, among Muslims it would be true to say that even non-practising members would still lean towards a Sharia-compatible method to salve their conscience. Some Sufis who would adopt a passive stance and leave it in the hands of Allah but the Prophet (SAWS) promoted the seeking of a cure with the following statement “For every disease (except old age), God has provided a cure”. While it is true that despite what man attempts to do, Allah determines the final outcome “… Allah may grant to mankind, none can withhold it; and whatever He may withhold, none can grant it thereafter …” Q 35: 2 Therefore Allah will grant progeny or leave barren as He wills. The Qur’an and the Prophet certainly promote procreation and so does the Prophet. “Marry, procreate and abound in number”. It has been suggested that assisted conception, particularly in vitro 42 JISHIM 2004, 3
ISLAMIC MEDICAL ETHICS IN ASSISTED CONCEPTION fertilisation methods, interfere with nature and God’s work. But this has been refuted with the argument that when man succeeds, it is because of Allah’s barakah (grace). The Qur’an is immutable and so are the authentic ahadith. Therefore, the jurists have to find answers to resolve reproductive issues in the Qur’an or hadith; if this is not available, Ijma, Qiyas or istihsan, istislah or urf may help arrive at a solution. A Fatwa is not binding and a Muslim could get a second or third opinion (fatwa). While this is generally desirable, as a form of independence of Islamic thought, it does leave room for variance and non-uniform resolutions. Perhaps, after the preliminary deliberations by individual jurists, a final resolution in a central global, Fiqh academy may lead to uniformity. Conclusion This article highlights some areas of reproductive medicine which are not in concordance with Islam. Cryo-storage of embryos serve a useful function in maximising IVF whereby the yield of a single attempt could be used for transferring embryos many times over and as and when one wishes to. Moreover, embryos or gametes (sperm and ova) could be preserved prior to radio or chemotherapy. Notwithstanding JISHIM 2004, 3 Farouk MAHMOUD this, the status of embryos remains in limbo, as a means to an end. Though polygamy may provide an acceptable solution to the question of ovum donation or surrogacy, it is not an answer that would be welcome today; the author certainly would not advocate it and even Muslim countries are making it illegal, except in special circumstances. Polygamy has been mentioned above as an intellectual exercise, rather than a solution. Does Islam permit the donation of surplus ova and embryos to other infertile couples, non-Muslim of course; after all, it is a potential life and why not some other barren couple be denied the joy and happiness it could bring? Finally, what is the Islamic position regarding the us of surplus embryos for purposes of research? Being eclectic, Islamic medicine utilises the research done by others. Why should we not contribute towards it? REFERENCES 1. Cram D., Kretser D. Genetic diagnosis: The Future in Assisted Reproductive Technology-Accomplishments and New Horizons. Chapter 12. Cambridge University Press 2002: 202. 2. Lawler A.M., Gearhart J.D. Embryonic Stem Cells in Assisted Reproductive Technology-Accomplishments and New Horizons Chapter 10. Cambridge University Press 2002: 167-8. 43
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