Thanks be to God, Lord of all being, and God’s peace and blessings be upon the seal of the prophets and messengers, Muhammad, and upon his family and all ofhis companions.
In its specialised seminars and conferences, the Islamic Organjsation for Medical Sciences (IOMS) has always taken the initiative to put forward for debate new contemporary medical issues with the view of formulating a proper legal Islamic view and understanding of their significance and impact. These seminars and conferences are always well-attended, bringing together distinguished Muslim jurists and Shari’ah experts, medical practitioners, pharmacologists, and specialists in other human sciences.
Through this process, the IOMS has sought to form a consensus of informed opinion, based on accurate medical knowledge, as a foundation for sound Islamic rulings to be drawn up by competent jurists. It has also sought the involve- ment of other recognised and well-established scientific, cultural and health bodies such as the Islamic Fiqh Academy of Jeddah, al-Azhar University, the World Health Organisation Regional Office at Alexandria, Egypt, and the Islamic Educational Scientific and Cultural Organisation (ISESCO).
With the grace and blessings of God, the 9th Fiqh-Medical Seminar was successfully convened at Casablanca, Morocco, during 8-11 Safar 1418, corresponding to 14-17 June 1997, under the eminent auspices of the Commander of the Faith- ful, His Majesty King Hassan II. The theme of the seminar was “An Islamic View of Certain Contemporary Medical Issues”, and it was held jointly with the Hassan II Institute for Scientific and Medical Research on Ramadhan, the ISESCO, the Islamic Fiqh Academy, and the World Health Organisation Regional Office.
The Seminar opened, at Safeer Hotel in Casablanca, with recitation from the Glorious Quran, followed by speeches by” Abdul-Hadi Abu Talib, Honorary President of the Hassan II Institute for Scientific and Medical Research on Ramadhan, Dr Muhammad al-Habib Ben-Khoja, Secretary-General of the Islamic Fiqh Academy, Dr Hussain al Jazaeri, Director of the World Health Organisation Regional Office, Dr Abdul- Aziz al-Twajjeri, Director-General of ISESCO, and Dr Ab- dul-Rahrnan al-Awadhi, President of the Islamic Organisation for Medical Sciences.
The seminar proceedings covered the following topic:
- Transformation and Additives in Food and Medicine.
- Substances and actions that nullify the fasting.
Over a period of four days, medical and re]igious aspects of the above topjcs were debated, durjng whjch period, the distinguished particjpants examined and discussed in depth all the views and opjnions presented. The Seminar concluded with the suggestions and recommendations given below.
1. Transformation and Additives in Food and Medicine
The Seminar endorsed all the recommendations made at the 8th Seminar under Section II, on impermissible and defiled foods and medicines.
Furthermore, the Seminar discussed the medical and Fiqh aspects of this issue and concluded that additives in foods and medicines that originate from defiled or forbidden substances may be made permissible by two methods:
The Seminar made reference to Recommendation 11(8) made at the 8th Fiqh-Medical Seminar with respect to transformation.
Transformation, from the Fiqh point of view, is defined as “changing the nature of the defiled or forbidden substance to produce a different substance in name, properties and characteristics.” In common scientific terms, this refers to all new compounds produced by chemical reaction, such as the manufacture of soap from oils and fats, or the decomposition of substances such as fats and oils into various compounds such as fatty acids and ‘glycerol. Chemical reactions result from deliberate technical and scientific processes as well as due to invisible processes, as the Islamic Fiqh experts had pointed out, such as acetification, tanning and burning. This leads to the following conclusions:
- Additive compounds extracted from prohibited animals or defiled substances which are “transformed” as given above, may be considered as clean and permissible for consumption or as medicine.
- Chemical components extracted from prohibited or defiled substances, such as blood or sewer water that have not undergone a chemical transformation, according to the terms given above, are not permitted for consumption or for use as medicine. This includes the following:
All foodstuffs containing blood as a primary ingredient, such as blood sausages, black pudding, hamburgers, baby foods, pastries, soups and sauces. As for blood plasma, a cheap egg-white substitute usual- ly used in pastries, pies, soups, sausages, hamburgers, cakes, biscuits, puddings, bread, dairy products, and baby foods and medicines, and may in some cases be added to flour, the Seminar decided, however , that it has different properties and charac- teristics from blood and would, therefore, not be subject to the same ruling. Some participants, however, did not agree with this view.
B. Consumption or Assimilation
This refers to the blendjng of a small amount of a prohibited or defiled substance with a dominant clean and permissible one resulting in the obliteration of the prohibited or defiled substance altogether. This would be the case if the properties of the dominant substance, such as taste, colour and smell overwhelm the weaker substance which is completely assimilated into the dominant one, as in the following examples:
- Additives containing very small amounts of alcohol which are used in foods or medicines, such as colourings, preservatives, emulsifiers and anti-acids.
- Lecithin and cholesterol, extracted from defiled non- transformed substances may be used in food and medi- cine in very small quantities, having been assimilated into a dominant clean and permissible mixture.
- Enzymes obtained from pigs, such as pepsin and most digestive yeasts, used in negligible (infinitisemal) quantities in food and medicine.
The Seminar concluded the following:
- Artificial solvents, carriers and thrusting substances used in pressurised containers for a beneficial or legitimate purpose, are permissible. However, if they are used to obtain drugging or hallucinatory effects, through inhalation, they would be impermissible, due to their effects.
- There is no objection in the Shari’ah to the use of gold ” by men for purposes of medical treatment, such as dental crowns, bridges …etc.; but not solely for cos metic or adornrnen t purposes which is not permissible.
- In principle, the Shari’ah forbids the wearing of natural silk by men, with the exception of medica] cases such as allergies, scabies, itching.
- The use of heart valves of pigs is permissible, as a matter of necessity.
2. Human Cloning
The IOMS convened a seminar in 1983 on “Reproduction in Islam”, in which two papers were presented dealing with the possibility of human cloning as a Tesult of successful cloning in plants, frogs and small marine animals. The Semi”1 nar made the following recommendation:
“To exercise prudence in giving a Shari’ah- based opinion on human cloning (as achieved in animals) and to call for further medical and Islamic investigation of these issues. It would be possible to apply genetic engineering of micro-organisms using the recombinant DNA technology to produce medicinal substances in abundant supply .”
Since 1993, when an identical twin was produced by splitting a fertilised egg, and later when cloning of ‘Dolly’ the sheep was announced in February 1997, cloning has returned into the forefront of medical debate with much intensity and urgency. Then followed an announcement on the successful cloning of two monkeys at the University of Oregon in the United States of America. Since the techniques used in these operations are supposedly adequate for use on humans, the matter has assumed fresh urgency and provoked strong reactions.
Although no announcements of human cloning have yet been made, the need to pre-empt that possibility and understand its potential implications and draw up appropriate legal and moral responses to it, has moved several Western countries to ban or suspend, for a number of years, experiments involving humans in order to allow further investigation of the matter .
For these reasons, the IOMS has taken the initiative to put this matter up for discussion at the Seminar .
B. Defining Cloning
Cloning is the production of two or more beings that are complete genetic copies of one another. There are two types of cloning:
I. Cloning by induced identical twinning. As the fertilized egg splits into two cells, each of them is then induced to make a fresh start and behave as if it were the original fertilised egg. Each half would then grow into a separate foetus, and having come from the same fertilised egg, they would be carrying exactly identical genetic components.
II. Ordinary cloning, which is achieved by injecting a nucleus from a somatic cell of an adult animal into an egg whose nucleus had been removed. The cell would then grow into a foetus that would be a true genetic copy of the adult living animal from which the somatic cell nucleus was taken.
The Seminar discussed at length the medical aspects of this , matter, and arrived at the following main conclusions relating to cloning:
- In 1993, human twins were produced by the splitting method, which stimulates the fertilised egg to follow its natural course towards producing identical twins. Each of the initial two daughter cells would then behave as a new fertilised egg in its own right and would grow by dividing itself to form a separate foetus. If the two foetuses were planted in the womb, the result would be identical twins. The debate was not completed since the two scientists in charge of the experiment refrained from planting the eggs in the womb. In fact, they chose to experiment with a defective cell that would divide only until an early stage, due to the sensitivity and seriousness of experimenting with human foetuses- More time is, therefore, required to establish a proper ethical and legal framework for this type of work.
The Seminar had no objections, in principle, to this method of fertilisation, but deemed it too early to evaluate its advantages and disadvantages. Of its immediate benefits is the application of diagnostic methods on either twin or some ofits cells to establish their normalcy before introduction into the womb. It could also be useful in treating certain infertility cases, subject to all the controls governing test-tube baby procedures. The Seminar discussed thoroughly the new techniques of cloning, in the light of the case of Dolly the sheep and looked at some of the consequences of producing a foetus (later to be born), which is an exact genetic copy of the original, except for the presence of a very few cytoplasmic genes in the cytoplasm of the recipient egg.
- It emerged that .cloning would be fraught with risk, if ever its application is approved. The risks include the infringement on the individuality and identity of the person, undermining the stability of the social order, and the destruction of the bases of blood relationships and established age-old family ties, recognised by the Islamic Shari’ah and all other religions as the foundation of the family and of social order. This would have serious repercussions on the principles governing blood ties, marriage and inheritance, as well as on civil, criminal and other laws. Numerous hypotheses and possibi- lities were cited in this connection.
The Seminar rejected outright as haram any proposals that would impinge on the legal marriage contractor -introducing a third party into it.
Some distinguished Islamic jurists cited certain ideological, ethical and juridical rulings and principles that had direct relevance to the cloning issue.
- Reference was also made to the fact that public reaction to cloning in certain Western countries, including those where its researches were carried out, was extremely strong and reflected deep reservations. Some of these countries had already banned research on human cloning, while others have withdrawn state funding from such research. Some, however, had suspended research for a number of years and assigned specialist commit- tees to re-examine the issue. The Seminar was concerned that private funding and pharmaceutical com panies might ignore these considerations and pursue research in third world countries, exploiting them to carry out human cloning experiments, as they had done in other cases on many occasions in the past.
- The Seminar emphasised that Islam imposes no restrictions on scientific research, but considers it a religious duty and encourages it as a means of understanding God’s traditions in His creation. However, Islam advo.cates that the doors of scientific study should not be left wide open for the application of the results of research in the public domain without proper examination by Shari’ah experts. Not everything that is practicable is necessarily applicable, but should be free of any harmful effects and in line with the rules of Shari’ah.
Since some of the untoward effects do not become apparent untjl some time later, it is important to give full consideration and adequate time to the issues involved and take all possible precautions.
- Based on these unanimously agreed considerations, some participants were of the view that human cloning was not permissible in any w.ay, shape or form. Others, however, thought that certaIn, present and future, exceptions may be made, if their benefits are proved and they could be accommodated by the Shari’ah, provided each case is considered on its own merits.
- In any case, human cloning is still a long way away, and the evaluation of its immediate advantages and disad- vantages may vary with the passage of time. It would, even, be premature to say that after so many years of genetic engineering in plants, its safety for humans has been definitely established. Its applications in animals is as yet in its very early stages. Unpredictability is probably the greatest concern in this respect. Mankind should not forget the lessons of splitting the atom whose unexpected consequences emerged only after some time. Close monitoring of plant and animal cloning experiments must, therefore, continue for a consid erable time.
- The Seminar noted with reg!et that the Muslim world continues to follow blindly in the footsteps of the West in the fields of modern biological sciences. It called for the establishment of the necessary academic institutions to undertake this work according to the teachings of the Shari’ah.
- The Seminar sees no objection to the application of cloning and genetic engineering techniques on plants and animals within the considered restrictions.
The Seminar passed the following recommendations:
I. All cases introducing third parties into a marriage, whether a womb, an egg, a sperm or a cloning cell are not permissible.
II. Ordinary human cloning, in which the nucleus of a living somatic cell from an individual is placed into the cytoplasm ofan egg devoid of its nucleus, is not to be permitted. If exceptional cases emerge in the future, they should be considered to verify compliance with the Shari’ah.
III .All Muslim countries are called upon to formulate the necessary legislation to prevent foreign research institutes, organisations and experts from directly or in directly using Muslim countries for experimentation on human cloning or promoting it.
IV. The Islamic Organisation for Medical Sciences and other similar bodies are called upon to monitor all scientific developments in the field of cloning and ) define its terminology and organise seminars and meetings, as required, to determine and articulate the Islamic rulings and principles pertaining thereto.
V. Specialised committees should be set up to look into the ethics of biological research and adopt protocols for study and research in Muslim countries, and prepare a document on foetal rights as a prelude to formulate legislation on the rights of the foetus.
3. Substances and actions that nullify the fasting
According to the Quran and the authentic Sunnah of the prophet (pbuh) three actions nullify fasting: eating, drinking and sexual intercourse. Therefore, the passing of any solid or liquid sybstance that can be described as food or drink, in any quantity through the gullet would nullify fasting. Accord ingly, the p.articipants agreed unanimously that the following do not nullIfy fasting.
- Eye and ear drops, and ear wash.
- Nitroglycerine tablets placed under the tongue for the treatment of angina.
- Insertion into the vagina of pessaries, medical ovules, vaginal washes, vaginal speculum, and doctor’s or midwife’s fingers during pelvic examination.
- Insertion of the urethroscope into man or woman radio-opaque media for X-ray diagnosis or bladder irrigation.
- Tooth drilling, extraction, cleaning or the use of mis-wak and toothbursh, provided nothing is swallowed into the stomach, do not nullify fasting.
- Injections through the skin or muscle or joints or veins, with the exception ofintravenous feeding.
- Blood donation or receiving blood transfusion.
- Oxygen and anaesthetic gases.
- All substances absorbed into the body through the skin, such as creams, ointments, and medicated plaster.
- Drawing blood samples for laboratory testing.
- Catheter and media for arteriography of heart or other organs.
- Endoscopy for diagnostic or intervention purposes.
- Mouth wash, gargle or oral spray, provided nothing is swallowed into the stomach.
- Hysteroscopy or insertion of an intrauterine device.
- Biopsy of the liver or other organs.
A majority ofparticipants added the following:
- Nose drops, nose sprays, and inhalers.
- Anal injections, anoscopes, or digital rectal examination.
- Surgery involving general anaesthetic, if the patient decided to fast.
- Machine or intraperitoneal renal dialysis.
- Use of gastroscope, provided it does not entail the introduction of liquids or other substances into the stomach.
On the conclusion of its business, the Seminar was pleased to express its deeply-felt thanks and appreciation to His Majesty, King Hassan II of the Kingdom of Morocco, for his kind support of the Seminar which was hosted by the Kingdom of Morocco. The Seminar prays to God to grant His Majesty and His Heir victory and glory, and the people of the Kingdom of Morocco prosperity and progress. The Seminar further thanks His Majesty’s Government and officials for their warm welcome and generous hospitality.
The Islamic Organisation for Medical Sciences wishes to express its sincere thanks to all the participating organisa- tions, including Hassan II Institute for Medical and Scientific Research on Rarnadhan, the ISESCO, the Institute of Islamic Fiqh, Jeddah, and the World Health Orgarusation Regional Office. The IOMS would also like to extend its thanks to all the Islamic jurists, doctors and scientists who have contributed to the successful outcome of this Seminar, praying to God to reward them in a most generous and compassionate way. God’s peace and mercy be upon you.