Islamic Center of Southern California

The Arguments of Islamic Law Rulings on Recent Medical Issues

Topic Seventeen

Transplanting and Implanting Cells of the Brain and Nervous System 93

Definition

With the progress it has achieved, medicine has succeeded in implanting almost all human organs, other than the brain and its cells, whether they are external organs, such as arms and legs, or internal ones, such as the heart and the liver. This has been achieved after the increasing success of administering the drug cyclosporine, which has to a great extent helped in overcoming the problem of the body's rejection of foreign organs.

In spite of the failure of physicians up till now to implant a brain, although they still entertain the hope, some indications of success have occurred in implanting some brain cells or tissues to replace damaged ones, in a procedure similar to skin grafts. 94

The gist of the matter is that certain diseases cause damage to some brain cells, due to some chemical or hormone secretions. Is it then lawful to replace such damaged cells with healthy ones taken from the same person, as in the case of transplanting adrenal gland cells, or from somebody else, as in the case of transplanting cells from an early fetus in its tenth or eleventh week of pregnancy?

This shows the connection between this topic and some aspects of the subject of "abortion," but what is intended here is to determine the Islamic ruling on the principle of implanting cells of the brain and nervous system.

The Legal Position Chosen by the IOMS and Its Argument

On the subject of "Transplanting and Implanting Cells of the Brain and Nervous System," The IOMS - in its sixth seminar held in 1989 under the title, "An Islamic Perspective of the Implanting of Certain Human Organs" - supported the point of view of participant jurists, or at least most of them, which finds it lawful to transplant brain cells taken from the adrenal gland of the same person, from cultured stem cells, or from animals and considers it unlawful to transplant stem cells from embryos while in their mother's uterus, even before the breathing in of the spirit. The seminar stated in its recommendation the following:

The seminar considered the subject of implanting cells of the brain and nervous system (which is not intended to mean the transplanting of cells from one human being to another). The purpose of such implanting is either to treat the failure of certain brain cells to secrete their chemical or hormone substances in sufficient quantities, where the failure is made up for by replacing these with similar cells from another source, or to bridge a gap in the nervous system caused by some injury, in a manner similar to the replacement of a damaged piece of wire with another.

The first source for the desired tissues is the adrenal gland of the patient himself. The seminar sees nothing wrong in such a case, which has the advantage of immunological acceptance, because the cells are from the same body.

The second source of the tissue is the living cells of an early fetus (in its tenth or eleventh week). There are various methods of getting such cells.

The first method is taking them from an animal fetus. This method has succeeded with various animal species, and it is hoped to be successful when the necessary precautions are taken to avoid immunological rejection. The seminar finds nothing legally objectionable in this method if its success is possible.

The second method is taking them directly from a human fetus in its mother's uterus by surgically opening the uterus. The method causes the fetus to die as soon as the cells are removed from its brain. The seminar finds this legally forbidden, unless it is carried out after a legitimate abortion to save the mother's life and under the conditions listed in discussing the subject of making use of fetuses.

The third method is one that may be introduced in the near future. It is that of using cultures to cultivate generation after generation of brain cells. The seminar finds that legally acceptable if the source of the cultivated cells is legitimate.

The Position of the Islamic Jurisprudence (fiqh) Academy

In its seventeenth session, held in Mecca in 2004, the council of the Islamic Jurisprudence (fiqh) Academy discussed the subject of "Transplanting and Implanting Stem Cells." It pointed out the sources of such cells in accordance with the recommendations of the earlier mentioned IOMS sixth seminar of 1989. The third resolution of the council, dated December 17, 2003, says:

Stem cells, the cells of origin from which a fetus is created, have the potential, by God's will, to form all kinds of body cells. Scientists have recently been able to identify, isolate, and cultivate these cells, for therapeutic purposes and various scientific experimentation. These cells can be used to treat some diseases. They are expected to have in the future a great impact in treating many diseases and congenital deformities, including some types of cancer, diabetic urine, kidney and liver failure, and others.

These cells can be acquired from several sources, such as:

1. An early embryo in the stage of the bacterial ball (blastula), which is a ball of productive cells from which all body cells generate. The surplus zygotes in test-tube baby procedures are the main source. A donor's ovum may deliberately be inseminated by the sperm of another donor to produce a zygote, let it grow into a blastula, and then extract brain cells from it.

2. Aborted fetuses at any stage of the pregnancy.

3. A placenta or chorda umbilicalis.

4. Children and adults.

5. Therapeutic cloning by taking a body cell from an adult, extracting its nucleus, and implanting it into an ovum whose nucleus is already removed, in order to reach the blastula stage, from which stem cells can be obtained.

After listening to the submitted papers and the opinions of members, experts, and specialists and getting to know this type of cells, their sources, and ways of using them, the council reached the following decision:

First: it is lawful to acquire and cultivate stem cells and to use them for the purpose of treatment or for conducting permissible research, if their sources are legitimate. The following are examples of such sources:

1. adults, if they give their consent and the procedure involves no risk for them;

2. children, if their guardians give permission for a legitimate benefit and without involving any risk for the children;

3. a placenta or chorda umbilicalis, with the permission of the parents;

4. a fetus aborted spontaneously or for a therapeutic reason allowed by Islamic Law, with the permission of the parents, calling to mind here what the seventh resolution of the Academy's twelfth session stipulates concerning the cases in which abortion is allowed; and

5. surplus zygotes in a test-tube baby procedure, if there are any and they are donated by the parents, emphasizing, however, that such cells may not be used for an unlawful pregnancy.

Second: It is unlawful to acquire and use stem cells when their source is

1. a deliberately-aborted fetus, for no medical reason that is considered valid in Islamic Law;

2. the deliberate fertilization of an ovum of a donor and a sperm of another donor; or

3. "therapeutic cloning."

93 The word "transplanting" is added to the title because the topic includes the two rulings on transplanting and implanting. This subject was discussed at a late stage in IOMS history, in 1989, as one of the subjects of its sixth seminar, following many other subjects. I placed it at this point, however, because it is connected with the previous topic, the donation and sale of human organs, discussed by the IOMS in its third seminar in 1987. This is due to a desire on my part to have some harmony in the arrangement of subjects. In the chronological order the subject of the donation and sale of human organs is followed by the subject of "plastic surgery."

94 Dr. Mukhtaar Al-Mahdi's paper, The Sixth Seminar, pp. 55, 61, and 73.

95 Dr. Hassan Hathout in his contribution to the discussions of the sixth seminar, p. 157; Dr. Mukhtaar Al-Mahdi's paper, ibid., p. 70. Islamic Center of Southern California