Thursday, 9 June 2011

Blood Transfusion and the Muslims.

Al Salamu 'Alaykum.
There are two common misconceptions regarding blood donation and blood transfusions in the wider Muslim community. On the upcoming occasion of the World Blood Donor Day (14th June), I would like to set these misconceptions to rest.
The first is that blood donations and blood transfusions are not allowed in Islam.
The second is that blood donations and transfusions can spread infectious diseases.
Both these beliefs are erroneous as the article below will show.
Part I is related to showing that blood donation and transfusion in times of necessity is allowed in Islam. This part is primarily a shortened article on the issue by Mufti Muhammad ibn Adam al Kawthari al Hanafi on his website, Part II is to show that blood donation and transfusions are safe today with guidelines in place to prevent the spread of contagious diseases like HIV and Viral Hepatitis. There are several links from wikipedia in part II for those who want to read further, Inshallah.
Part I: It is a well known principle of Islamic Law that all the organs and parts of a human body including blood are sacred and must not be tampered with. To take benefit from any part of a human without a need is unlawful.
There are two reasons for the impermissibility of taking benefit from another person’s blood. Firstly, it is sacred like all other parts of a human. Allah Most High says:
“And verily we have honored the children of Adam.” (Sura al-Isra, V.70)
Secondly, blood (when taken out) is impure and to derive benefit from something that is impure is unlawful. Allah Most High says:
“Say: “I find not in the message received by me by inspiration any (meat) forbidden to be eaten by one who wishes to eat it, unless it be dead meat, or blood poured forth, or the flesh of swine, for it is impure.” (Sura al-An’am, 145)
Due to the above two reasons, under normal circumstances it will be impermissible to transfuse the blood of one person into the body of another. Sanctity of human parts demands this, as well as the impure element in the blood.
However, Islam is a religion of mercy and caters for all the problems faced by humanity. It acknowledges the needs of people and gives concessions and dispensations wherever needed. Allah Most High says:“On no soul does Allah place a burden greater than it can bear.” (al-Baqarah, 286)

A famous principle of Islamic Law states:
“Necessity relaxes prohibition.” (Ibn Nujaym, al-Ashbah wa al-Naza’ir, P. 85)
Imam al-Haskafi says:
“The Scholars differed regarding the usage of haram medication. The apparent opinion in the (Hanafi) school is that it is haram. However it is said that it will be permissible when the medicine is known to be effective and there is no other alternative, just as there is a dispensation in drinking alcohol for a person dying of thirst, and the fatwa is given on this opinion.” (Radd al-Muhtar ala al-Durr al-Mukhtar, 1/210)
Moreover, two reasons were mentioned for the impermissibility of using human blood, one the aspect of sanctity and the other its impurity.
As far as the first reason is concerned, it must be remarked that although blood is a component part of a human body yet the manner of its transfusion or donation does not require any surgical procedures in the body, rather it is drawn and transfused by means of injection, thus it is akin to human milk that is extracted without a surgical procedure or any kind of mutilation.
In appreciation of a child’s need, Islam regarded this milk a means of nourishment for it, and the mother is obliged to feed the baby this very milk. Hence, it can be said that blood transfusion is lawful as a necessity just as Islamic law has permitted women’s milk for infants out of necessity, despite it being part of a human body.
The second reason was the impurity of blood. This has been discussed earlier, in that impure and unlawful things become permissible in cases of need and necessity.
In light of the foregoing, it would be permitted to donate and transfuse blood under the following conditions:
a) The donor is mature and sane.
b) The donor willingly donates his blood. If he is compelled to do so, it will not be permissible.
c) There is no apparent risk to the life or health of the donor,
d) There is an absolute necessity in donating blood in that there is a definite risk to the life of a patient, and in the opinion of the medical expert, there is no other way of saving his/her life,
e) There is a need for it, that is, there is no risk to the life, but in the opinion of the experts, restoration of health may not be possible without it.
f) There is no alternative.
g) It is not for the sake of beautification or any other additional benefit.
h) Transfusion of blood must not be carried out by way of buying and selling, for trading in human parts is never permissible. However, if one is in need of blood desperately and the only means to obtain the blood is to purchase it, then only will it be permissible to pay for the blood.

Buying and selling blood: As mentioned in the last part of the conditions, that it is unlawful to buy and sell blood for the purpose of transfusion. Classical scholars have explicitly stipulated that to trade in any part of a human is unlawful, and especially blood for the impure element found therein.
However, in case of necessity, if one is unable to obtain blood except by purchasing it, then it will be permissible to purchase it, but the provider will still be sinful. (Durr al-Mukhtar, 4/113)
This ruling also serves as prevention to the evil of trading in blood found in many places, where for the sake of a small amount of money; poor and desperate people sell their blood. Some go the extent where they put themselves in danger, and as mentioned earlier, it will only be permissible to donate or give blood if the donor’s life or health is not affected.
Conclusion: From all of the foregoing, we learn that donating and transfusing blood will be permissible in cases of need and necessity (along with the other conditions stipulated above. It is also impermissible to buy and sell blood. Today we see the establishment of blood banks where the blood of different people is stored and used whenever needed. The advantage of these banks is that it gives them an opportunity to store the different types of blood and then match it with the blood of the one in need. From a Shari’ah perspective, it will not be permissible for one to sell his/her blood to the bank; rather it must be donated freely.

Part II: There is mandatory testing in place for blood donations in order to prevent the spread of infectious diseases. Blood and blood components are not released to stock unless they have been tested (in addition to blood group serology requirements) and found negative for mandatory microbiological tests (HBsAg, anti-HIV, anti-HCV, HCV NAT, anti-HTLV and syphilis antibodies). Donated blood is quarantined until it is tested and shown to be free of infectious agents.The donor is also examined and asked specific questions about their medical history to make sure that donating blood is not hazardous to their health. The donor's hematocrit or hemoglobin level is tested to make sure that the loss of blood will not make them anemic. Pulse, blood pressure, and body temperature are also evaluated. Elderly donors are sometimes also deferred on age alone because of health concerns.
Apheresis is a blood donation method where the blood is passed through an apparatus that separates out one particular constituent and returns the remainder to the donor. Usually the component returned is the red blood cells, the portion of the blood that takes the longest to replace. Using this method an individual can donate plasma or platelets much more frequently than they can safely donate whole blood. These can be combined, with a donor giving both plasma and platelets in the same donation.
With these safeguards in place, it is practically impossible for infectious diseases to spread from high quality blood banks.
Wa salamu 'alaykum.  

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