Bio-Ethics in Islam
Dr. Omar Alfi and Dr. Hassan Hathout, March 30, 2008

For Muslims, there is no separation between the science of ethics and the science of religion. What goes against religion, for us would be unethical. Unfortunately, the situation is not like that in the West because of the concept of separation of church and the state. In Islam there is no church, and the state in Islam is responsible for everything.

"Say: “Go all over the earth and behold how [wondrously] He has created [man] in the first instance:" (Quran 29:20). Here Quran is talking about science. The ethics in Islam are based on the concept of halal (permissible) and haram (forbidden).

Prenatal Diagnosis

The Prenatal Diagnosis was started in 1970 to examine the fetus during pregnancy using Ultrasound, performing Amniocentesis, which is tapping off amniotic fluid from the amniotic sac surrounding the developing fetus to examine the chromosomes. If the chromosomes are found abnormal, almost always, the termination of pregnancy is recommended.

About 15% of all pregnancies do not result in child birth, which is a significant number. Once the egg is fertilized, it undergoes rapid cell divisions until it forms a part on the one side called Inner Cell Mass (ICM) that develops into fetus. The others parts will develop to form membranes, placenta and so on.

Prenatal Diagnosis is allowed in Islam. Abortion is allowed when necessary.


Stem Cells

The discovery of stem cells came less than 20 years ago. It is believed that the stem cell discovery will far exceed the discovery of the law of gravity by Newton. It is an amazing concept that is growing very rapidly.

We know that the fertilized egg that keeps multiplying and forming a bunch of cells called Inner Cell Mass (ICM)develops into fetus. These cells are basically very powerful in the sense of their abilities. These are called embryonic stem cells. From these few embryonic stem cells every organ in our body is formed.

If any cell in our body divides it will give two daughter cells of the same specialized tissue but stem cell is a special kind of cell that when it divides it will give another stem cell and specialized tissue. All our body is formed based on embryonic cell at the beginning and it maintains a line of stem cells. A small percentage of these stem cells stays in our body while everything else forms head, body, muscles and bones etc. This discovery of embryonic stem cells created a humongous interest but at the same time a humongous concern about the ethical issues.

Embryonic stem cell research is controversial because starting a stem cell line requires the destruction of a human embryo. If it becomes a very successful medical thing, then there would be a great need and demand for it. If there is a great demand for it, then new businesses will come out getting eggs and fertilizing it. Rather than making pregnancies to produce babies, they can be used to form embryonic stem cells, which will be sold at very high price and becomes terrible ethical issue. This devalues life.

United States (US) government prohibits the use of federal funds for stem cell research due to this ethical issue. However, it is legally allowed to do stem cell research in US. In spite of the prohibition by the US government for federal funding, California is the only state in US that foresaw the potential in stem cell research. About two years ago, California voters passed Proposition 71, a $3 billion bond measure for funding stem cell research. California is the top state in US and the top state in the world in a sense that is attempting this stem cell research and therapy with a very interesting objective, apart from or in addition to general health of the people etc., that it would save lots of money on medical expenses. If they can treat people early enough, one doesn’t have to waste money on sick and old people and that was the main motivation for the California Proposition.

With these embryonic stem cells, every organ in our body has what is called adult stem cells, which are not embryonic. The adult stem cells can be regressed back very close to the embryonic stem cells. This is the new direction and thanks to California stem cell researchers. We need to utilize these adult stem cells and improve on the functions related to regeneration.

Life Support

A living person is a living person under all conditions until the brain stem (center of heart beat, respiration) dies. Even if one keeps the heart beating using artificial animation, he is considered to be a dead person.

Electroencephalogram (EEG) is a test that measures and records the electrical activity of the brain. Electric waves in the brain could indicate whether a person is dead and usually in addition to the waves, the doctors would try lower or discontinue the support of other organs and see whether the respiration starts going down by itself or not, which are the indicators of brain stem i.e. respiration, blood pressure and heart beat rate.


Cloning

The most common consensus that was agreed in a meeting that took place two years ago about Islamic ethics is that Cloning is not agreeable Islamically and even non-Islamically. However, the same concept of cloning can be done to clone one’s own stem cells to develop part of the kidney or other parts. The cloning of stem cells is the new direction that is focused in California and in the world elsewhere.

In other words, reproductive cloning is not acceptable but therapeutical cloning can be used to cure diseases.


Longevity

The average expected age of a teenager now is 100 plus years, before that it used be 50, 60 or 70 years. The concept here is not just for hundred years but there is that magical "infinity" thing, i.e. the concept of relative immortality. There is a potential for that and we don't know how the world will look if people live up to 900-950 years of age like the people of Prophet Nuh (PBUH) did. If the population lives that longer, the ethical aspects will see a humongous revolution and will be interesting.

There are two areas for longevity. One is the improvement in health care i.e. the teenagers are expected to survive until 120 years.

The other factor is that in the chromosome, the tip of the chromosome is known as Telomere. When the cell divides, the chromosomes divide into two daughter cells and what holds these chromosomes till the last minute so that they are forming perfectly parallel is the telomere. With each division, a tiny part of telomere is wasted. Accordingly when we are born, every cell has a finite capacity to divide. By the time we reach 50, 60 or 70 years of age, we start getting Alzheimer, Parkinson's disease because the related cells are dying. However, if we can regenerate the telemore, we will be able to overcome this issue. There is an enzyme called telomerase that regenerates telemore. If we can do that without damage to the individual, we can keep cells diving almost indefinitely.

The cancer cell when it develops, it overcomes the death of the cell by stimulating the telomerase and cancer cell can stay beyond the life of the individual. If we can have the telomerase work without developing the cancer cell then the solution is there.

Organ Transplantation

It started with heart, liver, lung, artillery, kidney etc., to replace defective organs in the patients, and it has several biological and medical difficulties, including the acceptance of that organ rather than body rejecting it as a foreign substance. It requires humongous effort, experience and expenditure.

Organ transplantation is allowed provided the donor will not be seriously afflicted or looses his/her life. If the organ can be dispensed with, it would be great charity. It comes under the shelter of the Quran that says, “if anyone slays a human being unless it be [in punishment] for murder or for spreading corruption on earth-it shall be as though he had slain all mankind; whereas, if anyone saves a life, it shall be as though he had saved the lives of all mankind.” (Quran 5: 32)

Organ donation for medical research is also considered charity because medical research is a collective method of saving patients.


Excerpts from the Sunday lecture addressed by Dr. Omar Alfi and Dr. Hassan Hathout at the Islamic Center of Southern California, Los Angeles on March 30, 2008. Dr. Alfi addressed the Biology part and Dr. Hathout addressed the Islamic ethics part of the lecture.