Islam and end-of-life practices in organ donation for transplantation: New questions and serious sociocultural consequences

Abstract

Advances in knowledge about human biological processes bring into question whether either brain (heart-beating) or circulatory (non-heartbeating) criteria of death ensure that donors are really dead before organ procurement. The utility of conflating the "prognosis" (incipiently dying or destined to die) with the "diagnosis" of death (really dead) to justify organ donation has been morally defended in both the medical and the ethics literature. Major religions emphasize the sanctity of human life but permit organ donation if it is performed after death. Thus, the moral justification of end-of-life practices in organ donation poses serious ethical and religious challenges. Legislation has been introduced in several countries, including the United States, to permit the administration of life support systems for organ preservation without prior consent for organ donation. Such administration of life support systems for organ preservation interrupts traditional Islamic practices about the care of the dying and the deceased. We conclude that: 1) many practical aspects of end-of-life organ donation conflict with the Islamic faith's core principles of care for the dying and their families; 2) defining the societal role of transplantation medicine is not uniquely a matter of accounting for technical capabilities and expertise, but must include the recognition of cultural, social, and religious values that constitute morality and guide best scientific evidence; 3) Muslim scholars should critically evaluate new evidence about end-of-life practices in organ donation, their effects on the care of terminally ill patients and their families and the consequences on the cultures of Muslim communities worldwide. © Springer 2009.