Organ donation in UAE

06 May, 2020
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Raluca Gatina

Partner – Legal Director, Elnaggar & Partners

ORGAN DONATION IN ISLAM

Most Islamic religious leaders accept organ donation during life (provided it does not harm the donor) and after death to save a life. Most religious leaders do not accept brain death as a criterion and consider cessation of all signs of life, including heartbeat, as a precondition for declaring the death of a person.

Muslims believe that humans do not have ownership of their body or spirit, but God's gift. Judges of organ donation ethics question whether the noble act of donating an organ outweighs the desecration of a dead body. Additionally, some Muslims believe that all body parts must be present on the Day of Judgement, and organ donations would interfere with that testimony.

Scholars stating that it is permissible to donate organs have been issued by several conferences, seminars, and committees, including the international Islamic conference held in various places in the world. These resolutions were issued after a lengthy discussion among many jurists, doctors, and specialists. It is also a view of a great number of scholars and researchers. However, donating organs comes with conditions under the Shariah.

ISLAM ON DONATING ORGANS WHILE A PERSON IS STILL ALIVE

It is permitted to transplant an organ from one person's body to another, if it is an organ that can regenerate itself, like skin or blood. The main requirements are the following: the donor is mature and understands the consequences of his actions and that all other pertinent Shariah conditions are met. However, it is allowed to make use of an organ that has been removed due to illness to benefit another person.

For instance, using the cornea of an eye removed because of illness.

ISLAM ON DONATING ORGANS AFTER A PERSON HAS PASSED AWAY

It is permitted to transplant an organ from a dead person to a living person, whose life depends on receiving that organ, or whose vital functions are otherwise impaired.

The person before his death or his heirs (or by the leader of the Muslims in cases where the dead person's identity is unknown, or he has no heirs) have to approve such action.

Care should be taken to ensure that there is a proper agreement to the transplant of organs in the cases described above, on the condition that no buying or selling of organs is involved. It is not permitted to trade in human organs under any circumstances.

ISLAM ON DONATING ORGANS ON WHICH LIFE DEPENDS

It is haram to take an organ on which life depends, such as taking a heart from a living person to transplant into another person. It is haram to take an organ from a living person when doing so could impair an essential vital function, even though his life itself may not be under threat, such as removing the corneas of both eyes. However, removing organs that will lead to only partial impairment is a matter which is still under scholarly discussion.

ISLAM ON DONATING ORGANS ON WHICH LIFE DOES NOT DEPEND

 It is permissible to donate organs so long as the donation will not lead to the death of the donor. It is haram to transplant an organ from a living person when its removal may cause an essential function to cease, even though his life does not depend on it, such as taking the corneas of both eyes. However, if he will still have a partial function after removing it, then the matter is subject to further discussion and is still under scholarly debate.

ORGAN DONATION IN THE UNITED ARAB EMIRATES

The UAE allows the transplantation of human organs and tissues from both living donors and the deceased per the provisions indicated in the Federal Decree-Law No. 5 of 2016 on Regulation of Human Organs and Tissue Transplantation. This Decree-Law aims to:

  • regulate and develop transplantation operations
  • ban human organs' and tissues' trafficking
  • regulate the process of donating organs and tissues
  • prevent exploitation of the patient's or the donor's needs.

Trafficking of human organs is also prohibited under Federal Law No. 51 of 2006 on Combating Human Trafficking Crimes, Article 1 of the law provides: Exploitation includes all forms of sexual abuse, involuntary servitude, mistreatment, correction and abuse of workforce, as well as illegal trading in human organs. Under the National Program for Organ Transplantation, Ministry of Health and Prevention has set a national donors' registry. Anyone in the UAE, regardless of nationality, can become a donor or recipient of an organ during transplant surgery, and the option will be linked to each individual's Emirates ID.

Prohibitions under the law

The Decree-Law prohibits the sale of human organs and tissues or other body parts in any way for transplantation. It also bans unlicensed advertising of transplantation of human organs, tissues, and body parts.

Conditions for living donors

Living donors must be legally competent persons. They should unconditionally express that they are donating their organs by their own free will. It should also be confirmed from an authorized medical committee that no harm can fall on them from the donation. Donation by living donors is restricted to relatives within the fourth degree, and couples married for at least two years. Living donors can unconditionally backtrack on their decision at any time; however, they may not recover a donated organ once it is removed.

Conditions for deceased donors

For the deceased, it is not permissible to remove an organ unless the donor's wish is conclusively confirmed before death and formally documented either by the notary public or through the Emirates Identity card or through their DIFC Will. Additionally, organ removal can only be done following the confirmation of death. By law, the identity of both the donor and recipient must remain confidential.

UAE regulations on organ donation

  • Any person residing in the UAE from any nationality can donate organs through the approved and legal channels in the UAE. Transplants are allowed for solid organs, including heart, kidneys, liver, lungs, pancreas, intestine, and thymus, and for tissues including bones, tendons, cornea, skin, heart valves, nerves, and veins.
  • Sale of human organs and tissues and their advertising for transplantation purposes are banned.
  • Donation of organs and tissues by a living person can only be made if the donor is legally competent, and to a recipient related within the fourth degree or between couples married for at least two years.
  • Bone marrow can be donated by minors if it is transplanted in parents, siblings, or children of the donor. Written consent from the donor's guardian is required.
  • People can record their decision about becoming an organ and tissue donor for transplantation after death on the Emirates Identity Card or any other documents. They can also unconditionally backtrack on their decision.

Consent

For a deceased donor who did not register their wish, the consent of a resident relative of the donor is required. This consent is invalid if the deceased expressed a refusal to donate while alive. A donor may change his mind before removing an organ, a part of it, or a tissue, but may not recover a donated organ once it is removed. The identity of both the donor and recipient must remain confidential by law. Violation of this will invite fines and prison terms.

Fines

Surgeons who extract organs or tissues by force or fraud will face life imprisonment and at least a Dh20-million fine if the surgery leads to the death or complete disability of the person whose organ or tissue is removed.

Process of organ donation

Once a patient is identified as brain-dead, the National Transplant Committee deploys a trained sub-group of professionals to inform the family of the deceased and obtains the required consent.

The health facility then contacts all organ transplantation centres in the UAE and regionally to see if any of the available organs are required by patients on their waiting list — and if there is a potential match given the donor's blood type, HLA type, age, and weight.

The transplant centre sends out a team of two surgeons and a nurse to recover the organ.

If the facility is more than 40 minutes away by road, the hospital seeks the help of the Abu Dhabi Police air ambulance to hasten the transport of harvested organs.

Meanwhile, the matched recipient is asked to come into the transplant facility to be tested again and to prepare for possible transplant surgery.

While kidneys remain viable for transplant up to 24 hours after harvesting, a heart must be transplanted within four to six hours, lungs within six to eight hours, and livers within eight to ten hours after harvesting.

After the organs are brought in, surgical teams set to work. The time required for the transplant procedure varies.

Each maintains its own waiting list of patients who require organ transplants, including vital details to make a match, such as the patient's blood type, HLA type (antigens on white blood cells that determine tissue compatibility for organ transplantation), age and weight.

The UAE currently has three certified centers for organ transplantation at the Cleveland Clinic Abu Dhabi, the Shaikh Khalifa Medical City, and the Mediclinic City Hospital Dubai.

ANSWERING TWO SENSITIVE QUESTIONS ABOUT ORGAN DONATION IN ISLAM

Is someone's faith/beliefs respected during the organ donation process?

Families approached about organ donation are asked whether they would like a faith/ belief representative to participate in the discussion. During the discussions with families, nurses routinely explore any faith or cultural considerations or concerns and work very hard to address these. This may include questions such as whether a family or religious figure will have time to say prayers, how washing or dressing requirements in line with one's faith will be met and whether a swift burial will still be possible.

Does organ donation affect burial?

After donation, the body is always returned to the family of the deceased in the same way as any death in a hospital where the donation has not taken place. The family is then free to make whatever arrangements they feel appropriate or to follow the donation decision if one had made these known to them before their death. Donation does not delay this happening.

 

Raluca Gatina

Partner – Legal Director

Elnaggar & Partners

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