Egyptian Liberal: Religious Authorities Should Not Meddle In Medical And Scientific Affairs

Following reports that a kidney from a genetically-modified pig was successfully attached to the body of a patient in the U.S.,[1] religious authorities in Egypt debated whether Islam permits the transplantation of pig organs into humans.  The Al-Azhar Fatwa Global Center was quick to issue a fatwa (religious ruling) stating that Islam commands to safeguard human life and health, but that "the shari'a forbids medical treatment utilizing impure and harmful things." The fatwa added that "treatment using pig organs, for instance by transplanting a pig kidney into a human, is forbidden [by the shari'a], except in cases of urgent need or necessity. In those cases it is permitted on two conditions: first, that there is no pure alternative, and second, that the harm caused by the transplantation is less than the harm caused by avoiding the transplantation of the organ."[2] Dar Al-Ifta, Egypt's official fatwa-issuing body, likewise stated that pig-organ transplantations are permitted if no alternative exists, since the sanctity of life is a principle of the shari'a.[3]

Post by Al-Azhar on pig organ translpantations (Source: Facebook.com/EgyptDarAlifta, October 24, 2021)

Similar views were voiced by other Egyptian clerics as well.[4]

Other clerics disagreed. For example, Dr. Ahmad Karima, professor of Islamic law and comparative jurisprudence at Al-Azhar University, said that transplanting a pig organ into a human is forbidden, and wondered why there are no Islamic research centers to carry out research compatible with Islamic law.[5] 'Atiyya Lashin, member of Al-Azhar's Central Fatwa Committee, also said that such transplantations are incompatible with the shari'a and are essentially a sin.[6]

Responding to this debate, liberal Egyptian journalist and physician Dr. Khaled Al-Montaser came out against the blunt intervention  of Egypt's religious institutions in this medical-scientific issue, stating that religion and science apply different criteria. Clerics' involvement in medical affairs is not only unhelpful but complicates matters, he said. He called on the Arabs and Muslims to learn from Europe, which experienced these struggles long ago and eventually settled them by separating religion from science and keeping clerics from meddling in medical research.  In another article he published one day later, Al-Montaser wrote that science seeks to save humanity and "to overcome man's chronic fear of change and innovation."

Surgeons attach a pig kidney to the body of a patient in a U.S. hospital (Source: Skynewsarabia.com, October 20, 2021)

The following are translated excerpts from Montaser's articles.

"I [recently] saw a program about the transplantation of a kidney from a genetically-engineered pig into a brain-dead woman in the U.S., [a case] that preoccupied the medical  community this week and made headlines on the news and in the papers. Expecting to see doctors and experts interviewed on the show, I was surprised to see that two of the guests were Al-Azhar sheikhs!  Sheikhs [discussing] such a complicated medical issue, [namely] the transplantation of a foreign organ that had been genetically altered to eliminate a sugar molecule called alpha-gal [from surface of the cells] that could cause the rejection of the transplanted kidney, and the monitoring of the [patient's] creatinine levels for 54 hours. These fine medical details…  require providing the viewers with an excellent scientific explanation,  but [instead] there were just two sheikhs. One of them said that [Islam] forbids using pig organs for any medical purpose. To be fair let me say that, irrespective of this show, it has become commonplace for people to request a fatwa on every [little] thing, from stepping into the toilet to the details of their intimate relations. When it comes to medicine in particular, we find to our astonishment that all our medical affairs are the subject of fatwas, although I don't understand how the two [fields] are connected.

"When you ask for a fatwa on a medical issue, you are like someone who tries to measure the length of a dress in kilograms. These are measurements of a different kind. Making this distinction does not mean that science is better than religion. But their criteria are different: science applies the criterion of skepticism, whereas religion deals in certainties.

"This [practice] of seeking medical fatwas has harmed us in the past. When it came to female genital mutilation [FGM], we were surprised when a former sheikh of Al-Azhar issued a fatwa that complicated the matter by stating that FGM should be performed.[7] Had we heeded his fatwa, we wouldn't have passed the important law which criminalizes this barbaric practice. There is [also] the issue of sex-reassignment surgery [which some clerics have forbidden], [8] a painful psychological problem… These transgender patients are victims of religious rigidity that treats them as though they are a curse. Many of them are driven to suicide in an attempt to resolve the conflict and escape the situation where every door is closed to them.

"The [attempts] to pass an organ transplant law [in Egypt] came to a halt over 25 years ago,  and later, [after the law was finally passed in 2010], its implementation was delayed for another decade due to a fatwa which stated that the body belongs to Allah and [therefore that] posthumous organ donation is forbidden.[9] We all remember that, when IVF treatments first appeared, there were religious objections, until reality imposed itself.

"Europe went through these struggles before us, and settled them hundreds of years ago by separating the scientific sphere from the religious one and keeping clerics from meddling in scientific research. Europe did suffer from the [meddling] of clerics in medicine. There was fierce objection to the study of anatomy, as well as to the smallpox vaccine, and even to the administration of painkillers [during childbirth], because [the Bible says] 'In sorrow thou shalt bring forth children,' etc. 

"[It was] a long and bitter struggle, but they managed to end it with a victory for science. But we [Arabs] are still stuck in the same maze and keep coming back to the beginning by returning to the same old fatwas and ideas, as though we are endlessly trapped on a water-wheel that draws [water] from a well and spills it back into the same well. When will [the struggle] be decided? Allah knows."[10]

In an article published the next day in Al-Ahram, Montaser wrote: "Avoiding the consumption of pork is a religious mater. But is antipathy to the pig as an animal a religious matter? The issue of transplanting a pig's kidney [into a patient] as a treatment for kidney failure sparked an uproar and fierce attacks [in Egypt], with people demonstrating an alarming degree of contempt and aggression towards this poor animal, as though it is the reason for all the world's disasters!...

"Any medical report about the pig's beneficial contribution to humanity still upsets and disgusts the Egyptians. That is why we must understand this revolutionary medical experiment that will open up new horizons in [organ] transplantation, and understand the important role of this animal in saving humanity…

"Science tries to throw the human race a lifeline. It proceeds without heeding the pronouncements of yellowing books or of rigid traditions, seeking to overcome man's chronic fear of change and innovation. Its philosophy is to question and inquire, rather than offer certainties and rote learning."[11]