The Ruling on Organ Transplantation from Another Person’s Body According to Shaykh al-Buthi

Organ transplantation from another person’s body is no longer an unfamiliar method in the world of modern medicine. It has become one of the alternatives for saving the life of a patient who suffers organ failure. How does fiqh view this medical procedure?

There are two issues that underlie the legal ruling on organ transplantation: the ruling on adding something to a damaged body part, and the case in which that added thing comes from another person’s body.

Regarding replacing a damaged body part with something else, the scholars agree that this is permissible so long as the substitute is not made of gold or silver. However, if there is a state of necessity, then even using gold is allowed. The basis for this permissibility is the hadith of the Companion ʿArfajah ibn Asʿad, who was instructed by the Messenger of Allah ﷺ to use a prosthetic nose made of gold:

أنَّ عرفجةَ بنَ أسعدَ قُطِعَ أنفُهُ يومَ الكُلَابِ فاتَّخذَ أنفًا من وَرِقٍ فأنتَنَ عليهِ فأمرَهُ النبيُّ صلَّى اللهُ عليهِ وسلَّمَ فاتَّخذ أنفًا من ذهبٍ

Meaning: “ʿArfajah ibn Asʿad had his nose cut off on the Day of al-Kulab. He then used a nose made of silver, but it became infected. So the Prophet ﷺ instructed him to use a nose made of gold.”
(Narrated by Ibn al-Mulaqqin)

However, if the replacement consists of another person’s body part, then the issue requires further distinction. First, if the organ donor is still alive, the transplantation procedure must take the continuity of the donor’s life into account. Doctors must ensure that after the organ donation, the donor’s life can still proceed normally. If this condition is not met, meaning that the donor’s life is likely to be endangered after the organ is taken, then the transplant procedure is not permissible, even with the donor’s consent.

The reason is that a human being’s life is the right of Allah سبحانه وتعالى, not the property of the human being himself. A person is only given the right to make use of that life. Therefore, a donor is not justified in consenting to the removal of an organ if doing so would threaten his own life:

وَعِلَّةُ الحُرْمَةِ وَاضِحَةٌ, هِيَ أَنَّ الإِنْسَانَ لَا يَمْلِكُ الإِيثَارَ فِي نِطَاقِ حُقُوقِ اللهِ عز و جل. وَأَصْلُ الحَيَاةِ حَقٌّ لله سبحانه وتعالى, فَلَيْسَ لِلْإِنسَانِ الَّذِي يَتَمَتَّعُ بِهَا أَن يَهِبَهَا أَو يُؤَثِّرَ بِهَا أَحَدًا غَيْرَهُ

Meaning: “The reason for the prohibition against endangering the donor’s life is clear, namely that a human being has no right to sacrifice himself in matters that fall within the rights of Allah. Since life in its أصل is the right of Allah, it is not permissible for a person who enjoys it to give away his life or sacrifice it for someone else.”
(Saʿid Ramadan al-Buthi, Qadhaya Fiqhiyyah Muʿashirah, Damascus: Dar al-Farabi, 2001, p. 121)

Nevertheless, if doctors determine that the donor’s life will remain safe after the organ transplant, then according to Shaykh Muhammad Saʿid bin Ramadan al-Buthi, the donor has the right to willingly give part of his body to another person as an act of altruistic preference (al-īthār).

Second, if the donor is already dead, then the authority to sacrifice the deceased’s organ for the benefit of another person (al-īthār) passes to his heirs. If the heirs grant permission, then doctors may take an organ from the corpse for transplantation into the patient’s body. However, if the heirs refuse, then the organs of the deceased may not be used.

In this matter, Shaykh al-Buthi differs from some scholars who absolutely prohibit organ transplantation from a corpse on the grounds of preserving the dignity of the dead. According to al-Buthi, immaterial rights such as maintaining the honor of the body are rights that can be inherited, and thus the decision rests in the hands of the heirs.

فَإِذَا مَاتَ الإِنْسَانُ آلَ حَقُّ كَرَامَتِهِ اَلشَّخْصِيَّةِ هَذَا إِلَى وَرَثَتِهِ. فَهُمْ اَلْمُخََّوَلُونَ فِي رِعَايَاتِهَا وَالمُحَافَظَةِ عَلَيْهَا أَوِ التَّنَازُلِ عَنْهَا بِالإِيثَارِ ضِمْنَ حُدُودِهِ الشَّرْعِيَّةِ الَّتِي سَبَقَ بَيَانُهَا

Meaning: “When a person dies, the right to his personal dignity passes to his heirs. They are the ones entrusted with caring for it, preserving it, or lowering its standard as an altruistic sacrifice to help others, within the limits of the Sharia that have previously been explained.”
(al-Buthi, Qadhaya Fiqhiyyah, p. 132)

This transfer of authority is analogized to the transfer of the right of a deceased person falsely accused of zina (al-maqdhūf) to his heirs, who may then demand the punishment of the accuser (al-qādhif) or pardon him.

وَلَعَلَّ مِنْ أَبْرَزِ الأَمْثِلَةِ المُنْدَرِجَةِ فِي هَذَا الحَقِّ, مَوْتُ المَقْذُوفِ قَبْلَ مُطَالَبَتِهِ فِي إِقَامَةِ الحَدِّ عَلَى القَاذِفِ, فَإِنَّ الحَقَّ يَنْتَقِلُ إِلَى وَرَثَتِهِ

Meaning: “Perhaps the clearest example included under this transferable right is the case where a person accused of zina (al-maqdhūf) dies before demanding the punishment against the accuser (al-qādhif). In that case, the right passes to his heirs.”
(al-Buthi, Qadhaya Fiqhiyyah, p. 132)

Just as the right to demand punishment or to pardon in a case of false accusation of zina can pass to the heirs, the right to refuse donation or to sacrifice part of one’s organs for another person (al-īthār) can likewise be inherited. والله أعلم.