By Sadia Tabassum (former NHS Muslim Chaplain)

I worked as a trainee Muslim Chaplain in the NHS at a time where a number of discussions were taking place around organ donation. A key focus was to encourage more ethnic minority patients to register as donors and give consent to organ transplants. These initial discussions in the NHS went onto lead to changes in legislation across the UK. There is now an opt out system as opposed to opt in to the organ donation scheme. This change was implemented in order to increase the number of life-saving procedures that could be carried out.

As a new undergraduate, it was definitely an eye opener to hear and see that there was a dire need for more organ donors from minority backgrounds to come forward. So many women, men and children from black and Asian backgrounds were on waiting lists to receive organs, many of whom were Muslim; yet finding a donor match for these patients was incredibly difficult as there was a chronic shortage of donors.

Do you think your Muslim patients would be more willing to accept an organ donation vs donating their own organs? If so, why?

Naturally many people would be willing to receive an organ with the understanding that it could save their own or their loved ones’ life. Majority of Muslim patients would also consider accepting a donor if the need arose and a donor match could be found. However, I personally found a large number of Muslim patients had not actually given serious thought to becoming donors or receiving an organ until they had actually become very sick or had family members who were unwell and in need.

Many took the position that organ donation was not allowed due to the differing opinion amongst religious scholars on its permissibility. There was not a clear consensus or understanding in the community about what organ donation entailed and what was permissible in Islam. Theological rulings differed in relation to live organ donation i.e donating a kidney and donating post death. It was in turn the role of the chaplain to present to them differing opinions and to offer a choice.

Muslims in the UK want to hear opinions around organ donation which are theologically justifiable. Muslim chaplains in the NHS are in a brilliant position to share and present the correct Islamic guidance to patients and discuss the humanitarian benefits of organ donation.

Why do you think Muslim families are less likely to have conversations around organ donation and consent?

Discussions around organ donation go hand in hand with talking about death and dying. Personally, I feel Muslim families do discuss death and dying quite openly and are taught many of the rites and rituals when a loved one passes away. Especially as our faith encourages us to ensure all our affairs are in order as death can come to us at any time. Organ donation would be another discussion following on from conversations around writing a will and inheritance.

However, discussing our mortality openly and making the necessary arrangements can be challenging and that is not just exclusive to Muslims. It is understandably a very sensitive topic and requires much wisdom and care when discussing. No one wants to sit and discuss their own mortality at the dinner table! However, all that changes when you, yourself or a close family member becomes sick and decisions which hadn't been given much thought are now presented before you.

Given the uncertainty around the permissibility of organ donation in Islam, why do you think Muslims take such a firm stance against organ donation?

There seem to be deep set beliefs around harm to the body after death and upon donation. Questions are asked of chaplains and scholars about dismembering the body to remove the organs, whether the soul will go to heaven after organs have been removed and resurrection without these organs. Many Muslims do not want to venture into fear of the unknown.

However, fatwas have been passed by Scholars here in the UK who have extensively researched the legal rulings pertaining to organ donations and they have deemed it permissible in principle, providing all requirements have been met to indicate that the soul has left the body.

Muslim women are likely to play a key role in decisions taken after a family member passes away – so, what needs to happen to encourage more discussions around organ donation in the family home?

As a mother I truly believe that if my children required an organ, I would be the first to rush to find a match. That would mean another human being has made the conscious choice to donate the required organ. In that case, should we not also be willing to donate and offer an organ too? If we can accept organs for our loved ones, we must be willing to give organs to help another too. "And whoever saves a life it is as though he had saved the lives of all mankind." (Qur'an 5:32)

There is currently a huge shortage in black and Asian organ donors which makes it increasingly difficult to find a match and help save lives. This is where Muslim mothers can play a huge role in educating their families and children and open up these conversations at home and in their communities. Muslim mothers can take the lead on this and implement change. We must all know a family member or have heard of a community member who is unwell and awaiting an organ- be that a kidney or a heart transplant.

More opportunities need to be created to have open discussions which will help to education communities on the different types of organ donation - living and after death. Whether that is via the mosques, community organisations or local health facilities.

What barriers (if any) are preventing Muslims from donating an organ?

The greatest barrier is the fear of committing an act which may go against their Islamic beliefs. Educating from a grass root level is imperative to the success of this scheme and ultimately in saving lives.

I strongly believe that if respected religious leaders were making their communities aware of the scholarly opinions - held by those well versed in both Islam and medical ethics - and were to present the positions in favour and against organ donation, then more Muslims would be empowered to choose and make a decision they are most comfortable with.

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