Shafaqna (Shia International News Association) – The Grand Ayatollah Sistani answered some questions regarding Medical issues.According to Shafaqna the questions and answers are as follows:
Question 1: The serious harm of narcotic drugs to the user or society in general (whether from being addicted to them or other [sociatal, familial, and ethical] reems) is well known. Therefore, the doctors and health care professionals are strongly opposing the misuse of drugs and the laws governing the society is also strongly against it. So, what is the view of the noble shari‘a on this matter?
Answer: By considering the serious harm of narcotic drugs, it is forbidden to use them due to the great damage they cause. Based on obligatory precaution, it is compulsory to refrain from using them in any way [even if there is no harm], except for medical purposes and the like; in the latter case, it can be used only to the extent of need. And Allãh knows the best.
Question 2: Medical literature states that smoking is the main cause for heart and cancer diseases, and it also shortens the life span of the smoker. So, what is the rule on smoking concerning (a) the beginner, (b) the compulsive smoker, and (c) the passive smoker? In the third case, the medical experts say that the smoke also harms a person sitting besides a smoker. What would be, the ruling if he considers passive smoking to be of considerable harm?
Answer: Smoking becomes harãm for the beginner if it entails serious harm, even at the future, regardless of whether that serious harm is certain, most probable, or just probable so much so that sensible people would demand caution. However, with the protection from serious harm (for example, by smoking less frequently), there is no problem in it. If continuing to smoke will cause serious harm to the compulsive smoker —as explained above— it is necessary for him to refrain from it unless the harm in quitting is similar, greater than to the harm in continuing, or the great difficulty that he will face in quitting is such that it cannot be normally tolerated. The same rule as explained in (a) for the beginner, applies in this case also.
Question 3: Some people believe that a brain-dead person is a dead person, even if the heart has not yet stopped and that it will definitely stop after that. This is what the doctors say. Is a person who has been pronounced brain-dead be considered dead, even if his heart is still working?
Answer: The criterion in applying the term “dead” in so far as the application of religious laws goes is the common perception of people, in the sense that they would call him “dead”. And this is not proven in the situation mentioned in the question.
Question 4: The medical profession demands that the doctor checks his female patients carefully; and since getting undressed for medical check up is common in some European countries, is it permissible to engage in medical practice here in such circumstances?
Answer: It is permissible, if one refrains from forbidden looking and touching, except where the check up of the patient requires them.
Question 5: Sometimes the practising physician feels that he has to uncover certain parts, other than the private parts, of the female patient [for examination]. Is it permissible for him to uncover her body in the following circumstances: When a female physician is available, yet costly? When the patient is not in danger, although she is sick regardless?What is the rule if the part that the physician has to examine is a private part?
Answer: If visiting a female physician is possible, it is not permissible [for a female patient to uncover her body for a male physician], unless the cost is so much that it will hurt her financial situation. It is permissible, if not visiting that male physician will harm [her health-wise] or put her in a serious inconvenience that is not normally tolerated. The rule is the same as explained above; and in both the cases, he must only uncover the parts that need examining. And if it is possible to treat the case without looking directly at the parts that are harãm to look at (for example, if he can see through a monitor or a mirror), that should be the course of action, based on precaution.
Question 6: Some experts of genetic engineering claim that they can improve the human race by altering the genes in the following ways: Removing the ugliness of the face; Replacing it with beautiful characteristics; By both of the above.Is it permissible for the scientists to engage in these kinds of activities? Is it permissible for a Muslim to allow the doctors to alter his genes?
Answer: If there are no side effects, then, in principle, there is no problem in it.
Question 7: Pharmaceutical companies in the West run tests on the drugs they manufacture before selling them in the market. Is it permissible for a doctor to use a drug on his patient —without the knowledge of the patient— before its testing period is over thinking that that particular drug would cure the disease?
Answer: It is necessary to inform the patient about the situation and seek his consent on using the drug on him, except when he is sure that the drug would not cause side effects and that the doubt is only about its benefit [or otherwise].
Question 8: In certain cases, some governmental agencies demand that autopsy be performed on the body of the deceased to establish the cause of death. When is it permissible to agree to their demand and when is it not?
Answer: No heir of a deceased Muslim is allowed to give consent for autopsy to be carried out on the body of the deceased for the purpose mentioned above and other similar purposes; and it is necessary for him to prevent the autopsy if possible. Of course, if another important factor at play that of equal or more importance than this basic rule, it is permissible.
Question 9: Is donating an organ by a living person to another living person (for example, a kidney) or by a dead person, by virtue of his will, to a living person permissible? Would the ruling be different, if it were from a Muslim to a non-Muslim or vice versa? Is the ruling confincal to certain organs to the exclusion of others?
Answer: As far as donating an organ by a living person to another person is concerned, there is no problem in it if it does not entail a serious harm to the donor. (For example, donating one kidney by a person who has another healthy kidney.)As far as removing an organ from a deceased (as directed in his will) for the purpose of transplanting it into a living person is concerned, there is no problem in it so long as: The deceased was not a Muslim or someone who is considered a Muslim. Or the life of a Muslim depended on such transplantation.Apart from these two cases, there is a problem in enforcing the will [of the deceased] and in allowing the removal of the organ. However, if the will had been made [by the deceased], there will be no indemnity on the person removing the organ from the dead body.
Question 10: If an organ of an atheist is transplanted in a Muslim’s body, would it be considered ritually pure (tãhir) when it is considered, after transplantation, as part of the Muslim’s body?
Answer: An organ extracted from the body is ritually impure (najis) irrespective of whether it came from a Muslim or a non-Muslim. And when it becomes, by rejuvenation, part of a Muslim’s body or of someone who is considered a Muslim, it becomes tãhir.
Question 11: Insulin used for treatment of diabetics is sometimes extracted from the pancreas of pigs. Can we use it?
Answer: There is no problem in injecting insulin in the muscles, veins or under the skin.
Question 12: Is it permissible to transplant the liver of pig in a human’s body?
Answer: It is permissible to transplant pig’s liver into the body of a human being. And Allãh knows the best.
Question 13: Is the process of test-tube babies allowed? In the sense that the wife’s ovum and the husband’s sperm are extracted to be fertilized outside the body, and then placed in the womb [of the wife].
Answer: In principle, it is allowed.
Question 14: There are certain hereditary diseases that are transferred from parents to children and pose a danger to their lives in the future. Modern science has acquired the means of preventing some of such diseases by fertilizing the woman’s ovum in a test tube and examining the genes to eliminate the problematic ones. Then it is returned the woman’s womb. The remaining genes [i.e., ova] are destroyed. Is this religiously permissible?
Answer: In principle, there is no problem in it.
Question 15: In the process of fertilization in a lab, more than one ovum is fertilized at a time. Secured in the knowkolge that implanting all fertilized ova in the mother’s womb will endanger her life. Is it permissible for us to use only one fertilized ovum and destroy the remaining ones?
Answer: It is not obligatory to implant all the fertilized ova in a test tube into the womb. Therefore, it is permissible to use one ovum and destroy the remaining ones.
Question 16: Is it permissible to engage in embellishing the face and the body [of another person]?
Answer: It is permissible, provided that one refrains from looking and touching what is harãm to look at or touch.
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