Dr Shibal
As many as 10.6 million Indians will be blind in at least one eye by 2020 due to corneal-related disease. This number was around 6.8 million in 2012. More than 30,000 individuals lose their vision due to either a corneal injury or ulceration each year, adding to this staggering number. The good news is that corneal blindness is reversible, and corneal transplants are the most successful of all tissue transplants worldwide.
Shortage of Eye Donors
The problem, however, is that there are no artificial corneas that can be transplanted, and these patients with profound vision loss wait for years for a donor cornea, which can be taken only after the death of a person.
On an average, India needs at least 2,00,000 corneas in a year to combat the gargantuan problem, but less than 45,000 corneas are collected each year.
In a situation as grim as this, when a celebrity pledges to donate their eyes, it is cause for celebration not only for the blind, but also those who are their primary caregivers, including doctors. The most critical part in tackling corneal blindness is creating awareness amongst the masses and encouraging them to pledge their eyes for donation.
Ex PM Rajiv Gandhi and his family, Aishwarya Rai, Amitabh Bachchan, Hari Prasad Chaurasia, Dilip Vengsarkar, Sri Sri Ravi Shankar and several eminent Indians have pledged their eyes, and supported the eye donation movement wholeheartedly.
It is therefore tragic, and extremely unfortunate that former India wicket-keeper Syed Kirmani, who pledged his eyes, made a public statement that he may not honour his pledge citing religious values, and the fact that “not everyone in India honours their pledge.”
The latter is debatable, and tragic. It is presumed that each person who pledges to donate his or her eyes, wants to donate their eyes so two or more people may benefit from their most benevolent and gracious act of charity. And for a sportsman to renege on his pledge, and dismiss it as trivial, well, it’s just not cricket at all!
The more pertinent question, of course, are the “religious values” or diktats that are often cited for not donating eyes by Muslims, presuming these are the reasons Mr Kirmani pulled back from his promise.
Debate on Organ Donation
The Holy Quran and the Hadith (recorded words of Prophet Mohammed, PBUH) are silent on organ donation. Since organ donation and transplantation is one of the wonders of modern medicine, with the first successful corneal transplant in 1905, and the first living kidney transplant in 1954, this silence stands to reason.
Which is why Islamic scholars and clerics have debated this issue and most of them are of the opinion that organ donation is an act of great charity and supported by the tenets of Islam. There are, of course, caveats, based on interpretations of the Quran, and most of which can be explained quite easily.
The Islamic Fiqh Council, during its eighth session held at the headquarters of the Muslim World League in Makkah Mukarramah from 19 to 28 January 1985, came up with their verdict, and was clear, if not unwavering, in their support of the organ donation programme. Their logic and reasoning conforms to the basic tenets of Islam, humanity, and indeed, common sense.
1. Organ donation to save another life is allowed. To quote, for example, Surat Al-Ma'idah (5:32): “And whoever saves one life it is as if he had saved mankind entirely.”
“Whosoever helps another will be granted help from Allah,” Prophet Mohammed PBUH
2. In Islam, the sacredness of the body after death is resolute and cannot be violated, say those who oppose organ donation. They often quote the Prophet’s words, Hadith, “Breaking the bone of a dead person is similar (in sin) to breaking the bone of a living person” (Sunan Abu Dawud, Sunan Ibn Majah & Musnad Ahmad). The answer to this is simple.
Harvesting corneas, or indeed, any other organ for donation, is NOT mutilation, it is not disrespectful of the dead.
The team of eye care professionals that harvests the cornea ensures that the face of the deceased is restored to its original state, with great regard to the feelings of the grieving loved ones. Everyone involved in the process respects and acknowledges the act of great altruism that they are witness to, and ensures that there is no disrespect or mutilation of the donor.
If that is not enough, Islamic jurisprudence, the principle of Fiqh and Qawa’id, based on the Quranic guidelines, states: “Necessity makes prohibition lawful” (Surah al-Nahl, V. 106; Surah al-Baqarah, v 173). That, in extenuating circumstances, restores vision for someone who cannot see and surely qualifies as one. Even if organ donation was prohibited, it would be permitted.
And this just might be a personal interpretation of Islam and the charity it preaches, surely Allah would be pleased by the grace of giving, even in death, the gift of sight to someone can’t see.
3. The donation of organ by the donor must be voluntary and without any compulsion. It is indeed prohibited in Islam to sell organs for donation, and as a corollary, to buy them.
It is unlawful to sell the hair of a human, as it is to take benefit out of it, for a human is honoured and sacred, and it is not permissible to disgrace any part of a human’s body
Al-Hidaya 4.39, Imam al-Marghinani
As can be expected, ORBO, the Organ Retrieval Banking Organisation, Eye Bank Association of India, and Transplantation of Human Organs Act, 1994, all agree that trading in human organs is not allowed, nor is any coercion acceptable, and is punishable by law.
4. The act of organ donation must not cause the donor irreversible harm, or loss of life.
The Shariah rule states that any harm must not be removed by another similar or more serious harm, since the donation of organ would be a suicidal act, which is not permissible. This remains a grey zone because there are serious gaps in contemporary medical understanding and clinical diagnosis of brain death and its endorsement as human death in Islam.
However, donations from the deceased, as is true for the cornea, are not even within the purview of this lack of clarity.
5. Resurrection of Muslims during Judgement Day, Qayamat, and parallels with the Hindu concept of rebirth, have been major deterrents to eye donation. Muslims believe they may not be able to see on resurrection, and Hindus believe they may be born blind in their next birth if they donate eyes.
The idea is as hilarious as it is baseless and tragic.
When we are dead and have become dust and bones, shall we (then) verily be resurrected.
Surat As Saffat 37:16
Who will give life to bones while they are disintegrated?
Surat Ya-Sin 36:78
A merciful, benevolent and omnipotent God who can resurrect your body from dust will deny you the gift of sight in the afterlife or the next life because you performed an act of charity?
6. The organ transplant is the only possible medical option for the treatment of the needy patient. Given that corneas are so difficult to come by, a transplant is only suggested in the most desperate cases, and children and those with bilateral blindness are usually a priority for corneal transplants, as are those who have waited for one for the longest time.
7. Organ donation and transplantation is permissible when success of the transplant operation is almost certain. With currently available technology, transplants are not only successful but they provide the recipient a quality of life that cannot be even imagined by those who have not been visually deprived. For the skeptics, here are the statistics:
Almost everyone who receives a corneal transplant enjoys at least a partial restoration of vision, with more than 93 percent and 74 percent transplants remaining completely functional at one and five years respectively, and also thereafter.
Appreciating the Spirit of Giving and Charity
Even the most conservative Islamic countries are actively collaborating with healthcare providers across the world and formulating ethical Islamic jurisprudence views and rules in the rapidly expanding field of organ donation and transplantation. As is true for all religions, communities and conglomerations, Islam also appreciates the spirit of giving and charity. And what can be greater than the gift of sight, of life, of freedom from pain and disease?
If you are still in doubt about what a wonderful gift the gift of sight is, today, close your eyes, and walk from your bed to the toilet. Open your eyes after you’ve stubbed your toes twice. You will not need religious sanction to pledge to donate your eyes. It’s easier than you think.
All you have to do is listen to your conscience and call 1919, toll free, to pledge your eyes, or even to discuss your apprehensions with an eye bank counsellor who will be the happiest to handhold you through it.
As for Mr Kirmani, we hope he sees the light that is Islam, which will guide him to make the right decision, when it is time for him to meet his Maker. It will do us all good to remember the Prophets words, Hadith, when in doubt.
The value of deeds depends on the intentions underlying them.
Nahj al-Fasaha
(The writer currently works as Senior Consultant Eye Surgeon at Fortis Memorial Research Institute, Gurgaon, with a special interest in glaucoma and ocular surface diseases. Dr Shibal has a keen interest in comparative theology of the Semetic religions, their doctrines and practices. This is an opinion piece and the views expressed above are the author’s own.)
This first appeared on TheQuint.com