Organ transplant
- Understanding Organ Transplant
Donor organ transplants or more commonly referred to is the removal of a
specific human tissue or organs from one place to another on his own or
another person's body with certain terms and conditions. The terms melipui suitability of organ donors and resipen.
Or we can say, organ donor is the removal of human organs which still
has the power of life and a healthy organ to replace unhealthy and do
not function well when treated with the technique and the normal way,
even the life expectancy penderitan almost nothing else. While the recipient is the person who will receive the tissues or organs from other people or from other parts of his own body. Ditansplantasikan organs that usually are of vital organs such as kidney, heart, and eyes. but in the development of other organs can be transplanted to help people have had so desperately need.
- Organ transplants according to the Health Law
According to Article 1 paragraph 5 of Act health, organ transplantation
is a medical procedure to remove a series of organ or tissue derived
from someone else's body or the body itself in order to replace the
treatment of organ or body tissue. Another understanding about organ transplantation is based on Law No.
23 year 1992 about health, transplantation is a medical procedure to
remove the organ or tissue derived from someone else's body or the body
itself in order to change the treatment of tissue or organs are not
functioning properly.
If viewed from the functions and benefits of organ transplantation can be categorized as a 'life saving'. Live saving the intention is to do the transplant is expected to extend the term of a person to survive the disease.
The terms of the transplant recipient, can be distinguished:
1. Autotransplantasi
Removal of a tissue or organ to another place in the body itself.
2. Homotransplantasi
Removal of a tissue or organ from a person's body to another body.
3. Heterotransplantasi
Removal of organs or tissue from one species to another.
4. Autograft
Tissue transplantation for the same person. Sometimes this is done with surplus tissue, or tissue that can renew, or more tissue is needed elsewhere (examples include skin grafts, extractions vein for CABG, etc.) Sometimes autograft performed to remove tissue and then treat it or, before returning it (examples include stem autograft cells and storage of blood prior to surgery).
5. Allograft
Allograft is a transplanted organ or tissue between two genetically non-identical member of the same species. Most human tissue and organ transplants are allografts. Due to genetic differences between the organ and the recipient, the recipient system immunity the body will identify the organ as foreign and seek to destroy it, causing rejection transplantation.
6. isograft
A subset of allografts in which organs or tissues are transplanted from a donor to a genetically identical recipient (like twins identical).
Isografts distinguished from other types of transplants because while
they are anatomically identical to allografts, they do not trigger a response immunity.
- Type of organ donor
There are 3 types of organ donation:
1. Donor in a state of healthy living.
In this type of need for careful selection and must do a general check-up (health checks are complete overall), both
the donor and to the recipient (receiver), in order to avoid transplant
failure caused rejection of the recipient's body and simultaneously
avoid and prevent risks to the donor.
2. Donor in a coma.
If the donor in a coma or allegedly going to die soon, then the donor
organ harvesting requires a means of control and life support, for
example with the help of special breathing apparatus. Then the life support equipment was lifted after the completion of the process of making organs.
3. Donor in a state of death.
In this type of organs to be transplanted taken when the donor has died
under the provisions of medical and juridical, also must be considered
endurance organs to be taken for transplant, whether it is still
possible to be able to function for the recipient or whether the cells
of the network are dead, so as no longer useful to the recipient.
- Legal aspects of transplantation
In Indonesia there are laws that discuss that Law No.36 of 2009 concerning transplantation:
Article 64
(1) Healing of disease and health recovery can be done through the
transplantation of organs and / or tissue, implants of drug and / or
medical devices, plastic and reconstructive surgery, as well as the use
of stem cells.
(2) transplant organ and / or tissue as referred to in paragraph (1) is
done only for humanitarian purposes and are forbidden to be
commercialized.
(3) The organ and / or tissue are prohibited from being transacted under any pretext.
Article 65
(1) The transplantation of organs and / or tissue can only be performed
by health workers who have the expertise and authority to do so and be
done in a particular health care facility.
(2) removal of organs and / or tissue from a donor must pay attention
to the health of the donor concerned and approved by the donor and / or
heirs or family.
(3) The provisions concerning the terms and procedures for the
implementation of transplant organs and / or tissues of the body
referred to in paragraph (1) and (2) shall be determined by government
regulation.
Article 66
Transplantation of cells, both derived from human or animal, can only be done if it had been proven safety and public health.
Article 67
(1) Collection and delivery of specimens or parts of organs can only be
performed by health workers who have the expertise and authority and
carried out in a particular health care facility.
(2) The terms and procedures for collection and delivery of specimens
or parts of organs as referred to in paragraph (1) shall be implemented
in accordance with the provisions of laws and regulations.
- Donor Organ Transplant Law in healthy condition
If the transplantation of organs taken from people who are still in a state of healthy living, the law 'Haram', arguing:
a. Allah says in the Qur'an Surah Al Baqarah verse 195:
ولا تلقوا بأيديكم إلى التهلكة
"And do not throw yourselves into destruction".
The verse reminds people, so do not be reckless and careless in doing
something, but still weighing the consequences that might be fatal to
themselves donors, although it has the objective of humanitarian action
is good and noble.
For example someone donates a kidney or an eye on others who need it
because of the relationship of family, friends or in the hope the reward
of those who require the grounds of economic crisis. In this latter problem, that donor organs are expecting reward or sell, is prohibited, due to human organ it belongs to God (milk ikhtishash), then it should not retrieval. Humans are only entitled to use it, even if that organ of another person.
People who donate their organs at the time was still a healthy life to
others, he will face the risk of irregularities, since it is impossible
Allah created eyes or kidneys in pairs if there is no wisdom and
benefits for a human being. So when the donor kidneys do not function anymore, it's hard to be helped back. So similarly, eliminating the disease from the recipients by creating a new disease for the donor. It is not allowed because the fiqh Qaeda mentioned:
الضرر لا يزال بالض
"Danger (kemudharatan) should not be removed by the danger (kemudharatan) others".
b. Qaeda Fiqhiyyah
درء المفاسد مقدم على جلب المصالح
"Avoiding damage / risk, the precedence of / over attractive benefit".
Related transplant, one should prefer to keep himself from destruction,
instead of helping others by sacrificing themselves and fatal,
eventually he was not able to carry out its duties and responsibilities,
particularly in carrying out his duty of worship.
2. Donor Organ Transplant Law in coma
Transplanting the organ donor in a coma, the law remains illegal,
although according to doctors, that the donor was going to die, because
it can hasten death and precedes the will of God, it can be said to be 'euthanasia' or hasten death. It is not heartless / immoral conduct organ transplants or taking in a state of dying.
A healthy person should try to heal people in a coma, although
according to doctors, that the person who has the coma there is no hope
for recovery.
Because there are also people who can recover even though it was only a
small part, whereas according to the medical, the patient has no hope
of life.
Therefore, taking donor organs in a coma, should not be according to Islam for the following reasons:
a.
Hadith of the Prophet, history Malik from 'Amar bin Yahya, a history of
al-Hakim, al-Bayhaqi and al-Daruquthni of Abu Sa'id al-Khudri and Ibn
Majah history of Ibn' Abbas and 'Ubadah ibn al-Samit:
لا ضرر ولا ضرار
"It may make madharat themselves and should not also make madharat on others".
Based on the hadith, harvesting organs from people in a coma / dying is
unlawful, since it can make to the donor madharat the resulting
hastened his death, which is called euthanasia.
b. Humans shall endeavor to cure the illness in order to maintain life, because life and death are in the hands of God.
Therefore, people should not take his own life or hasten the death of
another person, even though it was done by a doctor with the intention
of reducing or eliminating the suffering of patients.
3. Donor Organ Transplant Law In Case of Death
Taking donor organs (heart, eyes or kidneys) deceased juridical and
medical, legal permissible, which is permissible according to Islamic
perspective on condition that:
- Recipient (the recipient organ donation) in a life-threatening emergency when it is not done the transplant, while she already treated optimally both medical and non-medical, but to no avail. It is based Qaida fiqhiyyah:
الضرورات تبيح المحظورات
"Emergency will allow the forbidden".
Also based Qaida fiqhiyyah:
الضرر يزال
"The danger that must be eliminated".
- Also suitable organ transplant recipient and will not cause more serious complications of the disease compared to her previous state. Besides, there must be the will of donors to his heir, to donate their organs when he died, or have the permission of the heirs.
So is in accordance with the fatwa Indonesian Ulema Council dated June
29, 1987, that the conditions are no other options are better, then the
retrieval of heart valves who have died for the sake of those who are
still alive, can be justified by Islamic law provided that there is
permission from the concerned (through wills while still alive) and
permit family / heirs.
The MUI fatwa was issued after hearing the explanation directly Dr.
Tarmizi Hakim UPF cardiac surgery Heart Hospital "Harapan Kita"
technical decision on heart valves as well as matters relating to him in
the courtroom MUI on 16 May 1987. Fatwa Commission itself held
discussions on the issue several times and the last on June 27, 1987.
As for the arguments that can be the basis of the permissibility of organ transplants, among others:
a. Al-Quran surah Al-Baqarah verse 195
namely that Islam does not justify someone let himself in danger,
without trying to find a cure medical and non-medical, including efforts
to transplant, which gave hope to survive and be healthy again.
b. Al-Quran Surah Al-Maidah, verse 32:
ومن أحياها فكأنما أحيا الناس جميعا
"Whoever saved a life, it is as if he maintains all human life".
The verse indicates that humanitarian action (such as transplant) is
highly appreciated by the religion of Islam, of course, in accordance
with the terms mentioned above.
c. Al-Quran Surah Al-Maidah verse 2
"And please-menolonglah you in goodness and do mutual assistance in sin". It also paragraph 195, suggesting that we are doing well. It means: "And do good as Allah loves those who do good".
The body of the deceased to donate organs is an act of mutual
assistance in the goodness, because it gives benefits to people who
really need it.
Basically, the work transplant prohibited by Islam, because Islam
glorifies humans based on Surah al-Isra verse 70, also respects the
human body has become a corpse even though, based on the hadith of the
Prophet. "Indeed solve cadaver bone Muslims, the same as solving the bone while still alive." (HR. Ahmad, Abu Dawud, Ibn Majah, Ibn Mansur Said and Abd. Razzaq of 'Aisha).
But according to Abdul Wahab al-Iskandar;
although transplantation work was forbidden even to people who have
died, for the benefit because helping others is sorely needed, the legal
permissible / allowed during the transplantation work was no element of
damaging the bodies as an insult kepadanya.Hal fiqhiyyah Qaeda is based
on:
إذا تعارضت مفسدتان روعي أعظمهما ضررا بارتكاب أخفهما
"When met two things that bring mafsadah
(destruction), then maintained that bring the greatest madharat, by
doing the lightest madharatnya of two madharat".
d. Hadith of the Prophet.
تداووا عباد الله فإن الله لم يضع داء إلا وضع له دواء غير داء واحد الهرم
"Berobatlah you O servants of Allah, because Allah
does not put a disease unless he has laid cure, other than one disease,
namely old disease".
(HR. Ahmad, Ibn Hibbaan and al-Hakim of Usamah ibn Shuraih)
Therefore, efforts to eliminate the disease as a transplant, the legal
permissible, provided it does not violate the norms of Islam.
In another hadith, the Prophet said also:
"Every disease has a cure, when the drug was appropriate, so that the disease will be cured with the permission of Allah". (HR. Ahmad and Muslim from Jabir).
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