Mohammed Ghaly

Religio-ethical discussions on organ donation among Muslims in Europe: an example of transnational Islamic bioethics

This article analyzes the religio-ethical discussions of Muslim religious scholars, which took place in Europe specifically in the UK and the Netherlands, on organ donation. After introductory notes on fatwas (Islamic religious guidelines) relevant to biomedical ethics and the socio-political context in which discussions on organ donation took place, the article studies three specific fatwas issued in Europe whose analysis has escaped the attention of modern academic researchers. In 2000 the European Council for Fatwa and Research (ECFR) issued a fatwa on organ donation. Besides this “European” fatwa, two other fatwas were issued respectively in the UK by the Muslim Law (Shariah) Council in 1995 and in the Netherlands by the Moroccan religious scholar Muṣṭafā Ben Ḥamza during a conference on “Islam and Organ Donation” held in March 2006. The three fatwas show that a great number of Muslim religious scholars permit organ donation and this holds true for donating organs to non-Muslims as well. Further, they demonstrate that transnationalism is one of the main characteristics of contemporary Islamic bioethics. In a bid to develop their own standpoints towards organ donation, Muslims living in the West rely heavily on fatwas imported from the Muslim world.

The role of religion in decision-making on antenatal screening of congenital anomalies: A qualitative study amongst Muslim Turkish origin immigrants

OBJECTIVE to explore what role religious beliefs of pregnant Muslim women play in their decision-making on antenatal screening, particularly regarding congenital abnormalities and termination, and whether their interpretations of the religious doctrines correspond to the main sources of Islam. DESIGN qualitative pilot study using in-depth interviews with pregnant Muslim women. SETTING one midwifery practice in a medium-sized city near Amsterdam participated in the study. PARTICIPANTS 10 pregnant Muslim women of Turkish origin who live in a high density immigrant area and who attended primary midwives for antenatal care were included in the study. DATA COLLECTION AND DATA ANALYSIS to explore the role of religion in decision-making on antenatal screening tests, a topic list was constructed, including four subjects: being a (practising) Muslim, the view on unborn life, the view on disabled life and the view on termination. To analyse the interviews, open and axial coding based on the Grounded Theory was used and descriptive and analytical themes were identified and interpreted. FINDINGS all 10 interviewees stated that their faith played a role in their decision-making on antenatal screening, specific to the combined test. They did not consider congenital anomalies as a problem and did not consider termination to be an option in case of a disabled fetus. However, the Islamic jurisprudence considers that termination is allowed if the fetus has serious abnormalities, but only before 19 weeks plus one day of gestation. KEY CONCLUSIONS religious convictions play a role regarding antenatal screening in pregnant Muslim women of Turkish origin. The interviewees did not consider a termination in case of an affected child. Women were unaware that within Islamic tradition there is the possibility of termination if a fetus has serious anomalies. Incomplete knowledge of religious doctrines may be influencing both decisions of antenatal screening and diagnostic tests uptake and of terminating a pregnancy for fetuses with serious anomalies. IMPLICATIONS FOR PRACTISE counsellors should be aware of the role of religious beliefs in the decision-making process on antenatal screening tests.

Physical and Spiritual Treatment of Disability in Islam: Perspectives of Early and Modern Jurists

ABSTRACT This study investigates early and modern sources of Islamic law, looking for their viewpoints and attitudes towards treating disabilities. Two main methods of treating disabilities have been traced. The first method, termed in Islamic sources as physical medicine, is based on using medicines and drugs as known within the realms of the science of medicine. The second method, called spiritual medicine, makes use of specific religious deeds or formulae, including, for instance, texts from the Quran and words ascribed to the Prophet of Islam. This study presents a detailed overview of these two methods within Islamic law, the attitudes of Muslim jurists towards these two methods, and, finally, “treatments” developed within each method to prevent the occurrence of disability or to cure it.

Prenatal screening for congenital anomalies: exploring midwives' perceptions of counseling clients with religious backgrounds

BackgroundIn the Netherlands, prenatal screening follows an opting in system and comprises two non-invasive tests: the combined test to screen for trisomy 21 at 12 weeks of gestation and the fetal anomaly scan to detect structural anomalies at 20 weeks. Midwives counsel about prenatal screening tests for congenital anomalies and they are increasingly having to counsel women from religious backgrounds beyond their experience. This study assessed midwives’ perceptions and practices regarding taking client’s religious backgrounds into account during counseling. As Islam is the commonest non-western religion, we were particularly interested in midwives’ knowledge of whether pregnancy termination is allowed in Islam.MethodsThis exploratory study is part of the DELIVER study, which evaluated primary care midwifery in the Netherlands between September 2009 and January 2011. A questionnaire was sent to all 108 midwives of the twenty practices participating in the study.ResultsOf 98 respondents (response rate 92%), 68 (69%) said they took account of the client’s religion. The two main reasons for not doing so were that religion was considered irrelevant in the decision-making process and that it should be up to clients to initiate such discussions. Midwives’ own religious backgrounds were independent of whether they paid attention to the clients’ religious backgrounds. Eighty midwives (82%) said they did not counsel Muslim women differently from other women. Although midwives with relatively many Muslim clients had more knowledge of Islamic attitudes to terminating pregnancy in general than midwives with relatively fewer Muslim clients, the specific knowledge of termination regarding trisomy 21 and other congenital anomalies was limited in both groups.ConclusionWhile many midwives took client’s religion into account, few knew much about Islamic beliefs on prenatal screening for congenital anomalies. Midwives identified a need for additional education. To meet the needs of the changing client population, counselors need more knowledge of religious opinions about the termination of pregnancy and the skills to approach religious issues with clients.

The ethics of organ transplantation: how comprehensive the ethical framework should be?

Organ transplantation is one of the major medical achievements of the twentieth century (Mancuso 2006:138). The discovery of effective immunosuppressive drugs in the late 1970s was an important step towards increasing the success rate of organ transplants and thus paved the way for organ transplantation to become a medical routine affair in the twenty-first century (Schmidt 2003: 319). The current prevalence of organ transplantation was clearly to see in a recently published study which assembled worldwide data on living kidney transplantation. The study showed steady rise of living kidney transplantation in most regions of the world. According to statistics given by this study, ‘‘The number of living kidney donor transplants grew over the last decade, with 62% of countries reporting at least a 50% increase. The greatest numbers of living donor kidney transplants, on a yearly basis, were performed in the United States (6435), Brazil (1768), Iran (1615), Mexico (1459), and Japan (939). Saudi Arabia had the highest reported living kidney donor transplant rate at 32 procedures per million population (pmp), followed by Jordan (29), Iceland (26), Iran (23), and the United States (21)’’ (Horvat et al. 2009:1088). When a medical treatment, like organ transplantation, becomes so prevalent and manages to achieve impressive success rates in improving the quality of patients’ lives worldwide then intriguing ethical questions will be raised by default. The main thesis of this thematic issue is that the ethical framework of organ transplantation should be as comprehensive as possible and thus should not be confined to conventional set of ethical questions related to the donor–recipient relationship. The first article in this thematic issue argues that media ethics should be incorporated in this ethical framework. The second article asks for more critical consideration to the requirement of consent, which underlines the authority of people in regard to their bodies. The third article speaks of a need to offer pyschological care to the living kidney transplantation partners before and after transplantation. The fourth and fifth articles elaborate on the need to involve the religious aspects in the ethical discourse on organ donation.