Human Organ Transplant Act (HOTA) 2007 (English)

بسم الله الرحمن الرحيم

الحمد لله رب العالمين ، والصلاة والسلام على سيد المرسلين وإمام المتقين نبينا محمد وعلى آله وأصحابه أجمعين. اللهم أرنا الحق حقا وارزقنا اتباعه، وأرنا الباطل باطلا وارزقنا اجتنابه . وبعد ،

1. After considering carefully the latest updates on the issue of Muslims and organ donation in Singapore, as presented by the Office of the Mufti, which included:

   1. Latest developments provided by the Muslim Kidney Action Committee (MKAC), included in the presentation by the Office of the Mufti, on the problems and sufferings of Muslim kidney patients in Singapore, and the outcomes of public awareness campaigns on the importance of rendering help to kidney patients by becoming organ pledgers, and the current number of Muslim pledgers, and whether this number can help alleviate the problems of the kidney patients in the future, and

   2. Latest developments provided by the Ministry of Health, included in the presentation by the Office of the Mufti, on the process of transplantation and the statistics and status of Muslim kidney patients, as compared to other patients in Singapore, and the benefits for the Muslim community from their inclusion in the Human Organ Transplant Act (HOTA),

2. The Fatwa Committee takes the position that it is permissible for Muslims to be included in the Human Organ Transplant Act (HOTA) for the following reasons:

   1. The general consensus of Muslim jurists is that organ transplant and donation by the deceased is permissible in Islam. Among the reasons quoted by jurists are:

      1. Islam calls for the seeking of cure and treatment for illnesses, and the most effective treatment for those who suffer from organ failure, currently, is by receiving a new organ in place of the failed one.

      2. The objectives (maqasid) of the Syariah clearly state the importance of protecting and saving human lives. This is mentioned in the Holy Quran:
         
         وَمَنْ أَحْيَاهَا فَكَأَنَّمَا أَحْيَا النَّاسَ جَمِيعا
         
         Which means “…and whomever saves one life, then it is as though he has saved the whole of humanity.” (Al-Maidah : 32)

      3. The Syariah is built upon values such as care and compassion. The Syariah thus calls for mankind to help one another, and to contribute in alleviating human sufferings and pain, such as the sufferings of kidney patients.

      4. Donating one’s organs is an act of amal jariyah (continuous charitable deed) in which the rewards accrue even after one’s death.

   2. The current pledging system for Muslims (through the opt-in in MTERA) is not helping kidney patients overcome their medical condition. Although a fatwa was issued in 2004 to simplify the process of making a pledge [by lifting the condition that a pledge must be witnessed by two family members (waris)], the number of pledgers is still very low. Whilst waiting for organ donors, patients and their family members suffer in many ways, including having to go through financial and emotional distresses. Thus, the mafsadah (harm) and mudarrah (difficulties) that these patients encounter must be alleviated in an appropriate manner. This is in accordance with numerous legal maxims in Islamic jurisprudence, such as:
      
      إذا ضاق الأمر اتسع
      
      Which means: “If a problem grows acute, then it shall be relieved”
      
      المشقة تجلب التيسير
      
      Which means: “Difficulty calls for facilitation”

   3. To safeguard public interest and welfare (maslahah), leaders of the community (waliyyul-amr) should decide for the community what is best in their interest. This is in line with the legal maxim:
      
      تصرف الإمام منوط بالمصلحة
      
      Which means: “The actions of an Imam (leader) is driven by the interest of the community.”

   4. The presumed consent or opt-out system in HOTA is a method of obtaining early consent from the donor. The donor is given the option to object and not give consent during his/her lifetime. S/he can do so by opting-out from HOTA. As such, there is no conflict with the requirement in Islamic law of consent to be made during the person’s lifetime for organ donation, as agreed upon by majority of Muslim jurists.

   5. Muslims stand to gain from inclusion in HOTA. Upon inclusion, the Muslim community will have the same opportunity as other communities in receiving transplants. Due to the waiting list system, Muslims who are not pledgers are disadvantaged, as they are not placed in the priority list for available transplants.
      
      Without inclusion in HOTA, the plight of kidney patients and those suffering from organ failure will remain. They will also need to bear the high cost of dialysis treatment.

3. The Fatwa Committee puts forth the following recommendations, alongside the position that Muslims can be included in HOTA:

   1. The relevant authorities should ensure a transparent and fair system of choosing recipients for available organs.

   2. The relevant authorities should ensure an extensive public education on organ donation and HOTA. Each individual Muslim should receive information on how HOTA will affect them, together with a clear explanation on the opting-out scheme.

   3. The relevant authorities should seek the opinion of the Fatwa Committee on prospective amendments to the HOTA which will affect Muslims.

   4. The Muslim community must be given a clear explanation on the hukum (ruling) and need for organ donation. This can be done through public education before and after the fatwa has been issued.

والله أعلم ، وبالله التوفيق ، وصلى الله على سيدنا محمد وعلى أله وصحبه وسلم.