Office Of Grand Ayatollah Sayyid M.S.Al-Hakeem - Books-Muslims Guide: Guidance and Edicts - Medical Issues

Books Muslims Guide: Guidance and EdictsMedical Issues

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Q1: Currently there are discussions on the possibility of cloning some human parts in the laboratory and preserving them for one individual or another at the time of need. Is this permissible? Does permission apply to genital parts or does it not, since they belong to a particular individual and it is unlawful to uncover them?
 
A: All of these are permissible, including genitalia, and it is permissible to look at them since they are not attributed to a particular individual in such a way that there is a relationship of belonging which arises from it being a part of a man's or woman's body, such as a hand, a leg, etc., when they are attached to the body. But when they are separated from it, it is problematic to consider it prohibited. The relationship in the cloning process mentioned in the question is based on the fact that the cloned part’s origin is a cell that belongs to the individual and there is no proof that such a relationship is a criterion in the said prohibition, and surely Allah is the One Who truly knows and who protects.
 
Q2: If a wife’s ovary does not function, is it permissible to take an egg from another woman who is not his wife and fertilize it by the husband’s sperms, then plant it in the ovary of his wife? If the birth takes place, will the newborn be theirs?
 
A: Based on an obligatory precaution, one should not do this. If it takes place and the fetus is formed, it will belong to the husband and to the other woman from whom the egg was taken. But it is problematic to apply the rules of inheritance between the child and them, and an agreement in distributing the inheritance must be in place.
 
Q3: A husband’s sperm is healthy and so is his semen and a woman's ovary is also healthy, but her womb that feeds the baby does not function. In this case, the wife's egg can be fertilized with the husband's sperm externally. After that, the fertilized egg is planted in the healthy womb of another woman who is not his wife. Is this permissible? Who will claim the baby once it is born? Will it belong to the one whose egg it was, who is the wife, or the one who was the surrogate mother?
 
A: Based on an obligatory precaution, one should not do this, and a woman should not host in her womb an egg fertilized by the sperm of a man who is not her husband, unless the time that passes is so long that the egg and the sperm are no longer liquid but are conventionally described as a fetus outside the womb. It is then that the woman can incubate it.
 
In any case, the newborn is claimed by both parents to whom the egg and the sperm belonged to, and he inherits them both, whereas the surrogate woman does not.
 
Q4: Seminal liquid is taken from a man. Afterwards, he got married. Is it permissible to make his wife pregnant with his semen which was taken from him before he got married?
 
A: Yes, it is permissible.
 
Q5: What is the ruling relevant to a son born through the artificial fertilization process with regard to sonhood, sustenance, inheritance, custody and others matters?
 
A: If the fertilization took place between the wife's egg and the husband's sperm, all these rulings apply.
 
Q6: Does injecting a man's seminal liquid into the womb of another woman's ovary through the artificial insemination method result in mandating adultery-related rulings?
 
A: It is not considered as adultery, and there is no penalty required for it, but it is prohibited.
 
Q7: What is the opinion of Your Eminence about the process of transplanting the testicle of a man who is sexually potent to another impotent man who needs such a testicle if we suppose such a surgery succeeds? Who will be the father of the fetus born of the sperm produced in the transplanted testicle?
 
A: The process referred to is by itself permissible, but it requires the uncovering of one's private part by the treating doctor; so, it must not be done except when it is absolutely necessary. On the other hand, the fatherhood of the son belongs to the second man in whose body the potent testicle was planted.
 
Q8: In case of impotence, doctors examine the married couple, starting with the man. If he is healthy, the woman will be examined; otherwise, examining him only suffices.
 
(A)             Is it permissible for the man to unveil his private parts to the doctor and give him sperm specimens for testing? Sometimes the sperms are taken through the method of masturbation; is this permissible?
 
A: Unveiling the private parts is permissible only if impotence causes a problem. Getting the sperms through masturbation is not lawful except if it is the only way available in this case.
 
(B)              Is it permissible to take the husband's sperm and the wife’s egg, and then insert the fertilized egg inside the woman's womb?
 
A: There is no objection to fertilizing the wife’s egg with the husband’s sperm in a tube and inserting it inside the wife's womb.
 
(C)             Is it permissible to take the sperm from inside the testicle through a surgical process and fertilize the egg – also removed from the wife – with it? Later, the wife’s fertilized egg is placed inside her. Is this permissible?
 
A: There is no objection if the sperm is taken from inside the testicle and the egg is fertilized with it, and then it is placed inside the womb.
 
Q9: Through the process of artificial fertilization more than one egg may be fertilized resulting in many embryos. This situation is different from the natural fertilization process in the womb where usually one embryo is formed; knowing that planting all of these embryos inside the mother's womb could lead to her death, is it permissible to choose one of them and destroy the rest?
 
A: There is no harm in eliminating these embryos if souls are yet to enter them. Yes, it is an obligatory precaution to plant inside her womb as many as possible if she agrees, and it is not obligatory for her to agree to this.
 
Q10: At some hospitals, a patient may be subject to female nurses touching him as they read his pulse, measure his blood pressure, etc. What is the ruling in this case?
 
A: If the matter reaches the extent of necessity, it is permissible; otherwise, it is not.
 
Q11: Is it permissible for a male doctor to examine a female patient in the case where she believes that there is an urgent necessity for it which cannot be delayed?
 
A: The criterion in permitting a male doctor to examine a female patient is his belief of a reasonable possibility that the woman's health condition requires it, such that a female doctor cannot do it. The female patent’s certainty or her belief in the possibility in establishing his duty does not affect this matter. Rather, it effects the permissibility of allowing herself to be examined by him although it will not be obligatory for him to do so.
 
However, if her belief in the necessity of him examining her causes her not to be comfortable in being examined by the female doctor and not trusting her medical opinion, and she was in need of treatment, she will be considered to be in need of his examination and it is permissible for him then to examine her, even if he believes that the female doctor suffices for her.
 
The same applies if she was in a bad psychological condition which is feared to cause harm, because of the said belief, even if he believes that she does not need physical treatment, because she will be in need of his examination due to her psychological situation.
 
Q12: When a blood sample is taken out of a patient, a man may not find another man but a woman is present to take it, or vice versa.
 
(A)             Is it permissible to take the specimen in the absence of an emergency, even in the case of a general check-up?
 
A: If there is no urgency, such examining is not permissible if it involves prohibited physical contact or a forbidden look.
 
(B)              Suppose there is a state of doubt; does this constitute a necessity or not?
 
A: If the possibility of necessity is considerable in such a way that fear of harm arises from it, it is permissible.
 
(C)             Should an individual visit a private medical facility in the case of necessity so one can get the service from medical staff of the same gender?
 
A: Yes, it is obligatory if making the payment does not harm him.
 
(D)             What about in the case of treatment, is the permissibility of going to a hospital – where he does not have the choice of who will treat him - dependent on the absence of possibility of obtaining medical staff of same gender elsewhere?
 
A: Yes, it is dependent on not being able to get medical staff of the same gender if the treatment requires prohibited physical contact or forbidden look.
 
(E)              Suppose it depends on going for quite a distance, such as traveling from Karbala to Najaf, is it obligatory if one can do so in order to be treated by a medical staff of the same gender?
 
A: Yes, it is obligatory, if undertaking such a distance does not over-burden him.
 
Q13: Because my wife fell sick, I had to let her be examined by more than one female doctor, but she did not recover, nor did her health condition improve. I came to know about a skilled doctor who had treated the same case successfully; so, am I permitted to let him examine her knowing that her illness is of a female nature and examining her requires uncovering and touching her private parts?
 
A: It is permissible in the presence of the aforementioned supposition.
 
Q14: Is a sterile woman allowed to be treated even if this leads to uncovering her private parts to a female or a male doctor?
 
A: Apparently, the said uncovering is permissible in order to receive treatment in this and other such cases, especially if being sterile causes problems, as is most likely.
 
Q15: After a surgical operation has been performed, health staff has to observe the patient, such as measuring his blood pressure, temperature, pulse, etc., knowing that the patient is under the influence of anesthesia. What is the ruling if the staff is a man while the patient is a woman or vice versa?
 
A: What is necessary is that this is restricted to the opposite sex performing it onlywhen there is a health need that obligates it.
 
Q16: Genital operations are performed on males, such as the prostate gland, in the presence of female nurses who are anesthesia technicians. What is the ruling about their attendance to help in such circumstances?
 
A: The answer is similar to that for the previous question.
 
Q17: Some doctors ask the students to review some medical references which contain pictures and photographs of genitals of both genders for scientific benefit and research. What does the Sharia think of it?
 
A: There is no harm in looking at them in such cases except if it is done with a bad intention and with finding pleasure in doing so, in which case it is an obligatory precaution not to do so.
 
Q18: In the hospital, patients who cannot reproduce are asked to provide a specimen of their semen, and it is taken through one of the following ways:
 
A.                What does the Sharia say about the use of masturbation in this case?
 
A: Masturbation is prohibited unless one has no other option in being treated for impotence.
 
B.                 What does the Sharia say about the use of a special massaging tool for the prostate gland?
 
A: It is permissible unless this leads to somebody else looking or touching [apart from his wife] at one's private parts; it’s permissible only if being cured from impotence depends on it.
 
Q19: If one wishes to test his reproductive ability, so the doctor asks him to provide a semen specimen; what does the Sharia say about that?
 
A: As long as it is not necessary to do that, he is prohibited from masturbating.
 
Q20: A common method of women's contraception is through the widely used IUD (Intra-Uterine Device) coil method. Experts in this field have said that it does the following:
 
1.                  It prevents the sperm from reaching the egg.
2.                  It reduces or changes uterine enzymes, thus preventing pregnancy.
3.                  It blocks the fertilized egg from attaching to the uterus wall.
 
So, could Your Eminence please explain the Sharia ruling in this issue, i.e. whether the use of the IUD coil is permissible or not?
 
A: Since preventing insemination and fertilization of the egg is permissible, while eliminating the egg after being fertilized is not, in the light of what has been stated above, it is unknown whether the use of the coil eliminates the egg after it is fertilized. Thereupon, the use of this coil is permissible, and surely Allah, Praise and Exaltation belong to Him, knows best.
 
Q21: Lately, the use of the IUD coil has been widespread; what is the Sharia ruling about it?
 
A: If it is not known that the coil kills the egg after being fertilized, it by itself is permissible. But since placing it inside the uterus requires the female gynecologist to uncover and touch the private parts, one must not resort to using it except when necessary. Or it may be placed during a routine checkup by the gynecologist when a physical examination of the private parts is required during such a visit and the uncovering and the touching is not because of the insertion of the coil.
 
Q22: Is it permissible to block the uterus if the married couple does not wish to have children?
 
A: Based on an obligatory precaution, one should not do this if it causes permanent infertility, although it is permissible if it only temporarily prevents pregnancy.
 
Q23: What is the ruling regarding the use of medications which prevent pregnancy while both parties agree to it or without their agreement, and is it permissible for those who have legitimate excuses such as sickness and the like?
 
A: Yes, it is permissible unless it leads to a serious health hazard. However, if there is no health-related necessity, based on an obligatory precaution, the husband must agree to this.
 
Q24: Are there cases in which abortion becomes permissible?
 
A: Abortion is not permissible unless the mother's life depends on it in such a way that the case revolves between the death of the mother and her fetus in one hand, and abortion on the other hand. The same is the case if the matter revolves between the life of the mother and the life of the fetus and it is known that the life of the mother has priority over the life of the fetus according to the Sharia. There is no general principle to determine this.
 
Q25: Is it permissible for a raped woman to abort the fetus?
 
A: Aborting the fetus is not permissible even if the woman was raped, because it means killing a human being, which is prohibited.
 
Q26: A woman became six months pregnant, and it was confirmed through ultrasound scan that the fetus was deformed, and the doctors said that as soon as it is born, it will die. As long as it is inside its mother's womb, its stay there causes abnormal liquids, and this is medically proven to be dangerous to the life of the mother. In this case, does the Sharia permit it to be aborted?
 
A: If it is confirmed that it will die at birth, the mother’s life has priority over the life of the fetus.
 
Q27: At a college of medicine, the students train on performing autopsy on bodies of non-Muslims?
 
A.                  What is the Sharia ruling about performing autopsy on these bodies?
B.                 Should one who touches these bodies during the autopsy perform Ghusl? What is the ruling regarding one who sees the process of the autopsy?
 
A: Performing autopsy on these bodies is permissible if they belong to non-Muslims. It is also permissible to see the autopsy process. Whoever touches them must perform Ghusl.
 
Q28: Is the use of a dead person's body for autopsy permissible for educational purposes?
 
A: It is prohibited to perform autopsy on the body of a deceased Muslim person for educational purposes, but it is permissible if he is non-Muslim.
 
Q29: In some countries, autopsy on the body of a deceased person is performed after the agreement of his guardian. If he does not sign the agreement, the body will not be released but will be kept inside refrigerators. Is he permitted not to sign and, in this case, the body remains without being buried?
 
A: If burial without autopsy is not possible, and if waiting is of no avail, the guardian is permitted to agree to the autopsy.
 
Q30: If preserving a Muslim's life depends on performing autopsy on a dead Muslim's body, and it is not possible for the autopsy to be performed on a non-Muslim's body or that of one whose Islamic faith is in doubt, and if there is no other way to preserve it, is doing so permissible?
 
A: Yes, it is permissible; rather, it is obligatory. However, the blood money of the dead person must be paid by the person who performs the autopsy as a mandatory precaution.
 
Q31: A patient with a chronic illness needs an artificial respiratory system, so much so that the continuation of his heart's palpitation depends on this system and on medications that increase the pressure and pulse. Also, he reaches a status which is described as being "brain dead": He does not feel, and there is no movement. This is confirmed through cerebral scans which show that there are no electrical pulses in the brain. In this case, is it permissible to stop the use of the system and of treating him with medications?
 
A: If these systems and aids are keeping the heart beating and the blood circulating, it is permissible to turn them off, and if they help keep the heart functioning and the blood circulating while there is a remnant of one's life, turning them off is not permissible. With doubts as to which of these situations apply, the latter will apply, i.e. turning the machine off is not permissible.
 
Q32: One artificial respiration system is available and it is used for a patient for whose recovery there is no hope. If he becomes brain dead, and if another patient in whom there is hope of recovery and his life depends on the use of that respiration system, is it permissible in this case to take the system from the brain dead person and give it to the other patient?
 
A: Yes, it is permissible; actually, it is obligatory if the other patient's life must be preserved.
 
Q33: With regard to the brain dead person, is it permissible to donate his organs to patients who needs them desperately in the following cases:
 
A.                If the brain dead person expressed his wish before his death to donate his organs and wrote this in his own handwriting, whether his family accepted this or not?
 
B.                 If the family of the deceased person wanted it in order to get money, and it is not known whether the brain dead person accepts or refuses?
 
C.                If the doctor does so without the knowledge of the deceased person's family?
 
A: It is not permissible to move the organs of the deceased Muslim person to someone who is alive, even if he indicates so in his will unless the life of that living Muslim depends on it. In the latter case, there is no need for the deceased person's will or to the consent of his family. However, if the need can be met by taking organs from one of two persons; one of whom had stated it in his will or his family agreed to it while the other did not; it is a mandatory precaution to prefer the first one.
 
Q34: Is it permissible to transplant the liver of a pig into the body of a Muslim?
 
A: Yes, it is permissible if it is needed, such that another liver from a Tahir body is not available.
 
Q35: Is it permissible to sell blood if the buyer will benefit from it?
 
A: Yes, it is permissible to sell it if there is a lawful benefit from it, such as injecting it into the vein of one who needs it.
 
Q36: Is it lawful to sell a woman's eggs in order to benefit from them in medical experiments?
 
A: Yes, it is lawful, but it is prohibited to uncover her private parts if taking the eggs requires doing so.
 
Q37: Some individuals go through cosmetic surgeries to their noses, etc., does the Sharia prohibit this?
 
A: It is not prohibited.
 
Q38: Is it permissible for one to sell the organs?
 
A: Based on a mandatory precaution one should not sell the organs. If there is a fear about harm resulting from organ extraction, then it is unlawful.
 
Q39: Is a surgeon liable if his operation does not succeed, although he did his best and was not negligent? If people generally do not hold him liable, is this an implicit condition which negates his liability?
 
A: A surgeon is liable if he acts negligently, or even if he did not, except when the patient or his guardian – if the patient is a minor or is unconscious at the time of the operation – clears him of such liability. Normal conduct of people with respect to agreeing to the doctor not being liable is not sufficient to clear the latter from such liability, if the patient or his guardian does not agree to it.
 
Q40: A patient visited a doctor who gave him a prescription which he handed over to a pharmacist. But the pharmacist gave him someone else's medicine out of negligence, so the patient died because of this mistake. Is the dead patient's family entitled to blood money? Is this negligence categorized as accidental killing or is it intentional?
 
A: If this negligence is due to his carelessness in fulfilling his duty, the payment of blood money is due, since he was careless in giving the lethal medication. But a mere mistake without such negligence does not result in any liability.
 
Q41: In case of a Siamese twin birth, can the life of one of them be sacrificed in order to save that of the other?
 
A: If keeping them attached leads to the death of both of them, one of them has to be sacrificed in order to save the other's life; otherwise, it is prohibited.
 
Q42: Some people agree to donate their blood for the sake of gaining other benefits and they may even be unwilling to donate their blood:
 
What is the ruling about the blood taken from persons unwilling to donate it? What about the medical staff who extracts the blood?
 
A: Dealing with the blood is prohibited without the consent of the donor even if he consents to it after the blood is drawn out of him. Similarly, the medical staff is permitted to draw the blood after the owner of the blood agrees to it even if he does so in order to obtain other benefits.
 
Q43: What is the ruling regarding taking medicine that contains alcohol?
 
A: It is permitted to take them only in extreme necessity which reaches the extent of a life threatening risk and if there is no other permitted medication available to save the individual.
 
Q44: The insulin used in treating diabetes is sometimes extracted from a pig's pancreas; so, is a Muslim permitted to use it?
 
A: It may be used non-orally. As for oral use, it must be restricted to the amount that is necessary.

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