Islamic Center of Southern California

The Arguments of Islamic Law Rulings on Recent Medical Issues

Topic Thirty Eight

Family Genetic Counseling

Definition

Genetic or hereditary counseling is that which aims at supplying its seekers with accurate knowledge to assess the likelihood and the percentage of possibility as regards genetic or hereditary disorders, leaving decisions to be made by the parties concerned, in consultation with their physicians, without any attempt to influence that decision one way or another.

The progress achieved in medicine has demonstrated that many incurable diseases and disorders are caused by hereditary factors. One way of preventing such diseases is to guard against such incidence. This can be done by examining a couple engaged to be married. The physician in charge should point out to the couple the possibilities that their offspring would be exposed to and the method to deal with future risks. The best known diseases suspected to have a genetic basis include thalassemia, which is Mediterranean anemia; Alzheimer's disease, a type of senility that causes loss of memory and ends with various types of paralysis; and sickle-cell anemia, which requires lienectomy and bone surgery.

A hereditary disease is transmitted by a single gene, which may come from one of the parents or both, or a genetic mutation may occur, altering the structure of the gene and changing it from a normal to defective one. Such mutations happen frequently, but the body often resists them, and some mutations do not cause any disorder.

In 1994, Scientists have been able to figure out the number of hereditary diseases transmitted by a single gene as 6,678, out of which 4,458 are prevalent diseases (a prevalent disease is that which is transmitted by one parent only and therefore affects 50% of the offspring according to Mendel's law) and 1,750 are recessive diseases (where both parents carry the defective gene and they are carriers of the disease but not afflicted with it, and so they transmit it to 25% of their offspring according to Mendel's law). In addition, there are 412 diseases that are transmitted by the X chromosome of the mother. They are transmitted to half the male offspring, but females are not infected by them and only carry it. There are also 59 diseases transmitted by the mitochondria (small DNA cellular structures found in the cytoplasm of eukaryotic cells, outside the nucleus, and responsible for metabolism and cellular respiration). Those were the diseases found out in 1994, and undoubtedly the list grows on a daily basis, with the discovery of more hereditary diseases every few days due to the accelerated pace of scientific research in genetics. In 1998, the number exceeded 8,000 hereditary diseases.

The Legal Position Chosen by the IOMS and Its Argument

The IOMS, in its twelfth seminar in 1998, decided that genetic counseling is not compulsory, but it recommended such counseling to people who intend to marry in secret. It also warned against the marriage of relatives in families where some members are afflicted with a hereditary disease.

The recommendations of the twelfth seminar say:

Fifth: Hereditary (Genetic) Counselling.

The seminar has discussed this subject, and it recommends the following:

A. Family genetic counseling services should be made available on a large scale to families and those who plan to get married. These services should be staffed by qualified specialists. In addition, public awareness should be promoted and people should be educated by every possible mean to guarantee benefits to all.

B. Genetic counseling should not be compulsory, and its findings should not result in any compulsory measure.

C. The findings of genetic counseling should be kept completely confidential.

D. Services of genetic counseling should be expanded in medical and health institutes, schools, the media, and mosques after sufficient training is given to counselors to expand their knowledge and make them qualified.

E. Since statistics show that the marriage of relatives (as permitted in Islamic Law) may result in a higher rate of transmission of congenital anomalies, the public should be made aware of this so that choices would be informed, particularly in the case of families where some members are afflicted with a hereditary disease.

Sixth: Diseases for Which the Genetic Test Is Compulsory and Those Where It Is Optional.

1. The seminar believes that efforts should be made to spread awareness of genetic disorders and diseases and limit their incidence.

2. The seminar calls for the encouragement of genetic tests before marriage through the promotion of greater awareness in auditory and visual media, symposia, and mosques.

3. The seminar urges health authorities to increase the number of human genetics units, in order to make physicians available for genetic counseling, and to extend to all pregnant women health services in the field of genetic diagnosis and treatment in order to improve procreative health.

4. No person should be compelled to have a genetic test. Islamic Center of Southern California