An Islamic Debate on Bioethics within the Framework of Sharia
With the emergence of new medical technologies, controversy and even heated debate with respect to the ethical issues involved has broken out in Germany and other parts of the world. In addition, these technologies call into question our existing conceptions of human life. Can one observe similar developments in Muslim countries as well?
Thomas Eich: Yes. All medical innovations are just as hotly discussed in societies with a Muslim majority as they are here, for example, in Germany. Almost all recent medical technologies are already available in these countries or, alternatively, accessible through medical tourism. In addition, Muslim countries or confederations such as the Organization of Islamic Conferences are firmly integrated into worldwide bodies such as the UN, UNESCO, and the WHO, and are therefore involved in global debates on issues such as cloning.
The concept of human dignity holds a special place in the public discussion on bioethics in Germany. Is this also the case for the Islamic bioethical debate?
Eich: The concept of human dignity plays a fundamental role in the Islamic bioethical debate. However, there is a clear difference from the debate in Germany, where a particular act, such as research on embryonic stem cells, is viewed as a violation of human dignity because it instrumentalizes the person.
In the Islamic debate on bioethics, particular acts in themselves are not usually judged as violating human dignity. Rather, the concern is that they could produce consequences that violate certain basic principles of the Sharia, such as maintaining the purity of biological lineage.
What is the basis for conceptual norms in the Islamic world when it comes to bioethical issues? Does the Koran provide unequivocal answers or recommendations on whether genetic technologies, stem cell research, cloning technology, abortion, and artificial insemination are permissible?
Eich: No, with respect to these issues, the Koran express no clear position or, in some cases, no position whatsoever. For this reason, Islamic legal scholars reach their judgements by analogical reasoning based partially on passages from the Koran, but primarily on the Sunna, the words and deeds of the Prophet as recorded by his first adherents. In addition, individual technologies can be judged using the basic principles of the Sharia, such as the principle of damage prevention.
In your book "Moderne Medizin und islamische Ethik" ("Modern Medicine and Islamic Ethics"), you collected and translated articles by Muslim legal scholars, thereby documenting the highly divergent views within the Islamic bioethical debate. How do judgements by legal scholars function?
Eich: The legal scholars start off with the principle that everything that does not clearly violate an unambiguous prohibition can, as a first step, be classified as permitted. An example of this would be the ban on heterologous insemination, meaning artificial insemination outside the framework of a legal marriage. Sunni legal scholars regard this as partially fulfilling the conditions for the offence of adultery and therefore ban this technology. As a second step, it must be determined if a new technology indirectly leads to a violation of a prohibition.
In this case, a wide spectrum of considerations must be taken into account. A frequently used strand of argument is that a technology should be banned if it could lead to physical harm, such as the deformation of an infant. In this process, legal considerations, above all, play a great role. This means that the potential advantages and damage caused by a technology are weighed against each other.
An example here would be the introduction of a program of pre-marriage genetic tests with the aim of combating certain diseases such as beta-thalassemia. Into the balance comes the consideration that such programs could lead to damage, as results might lead to planned marriages being cancelled. Yet, the advantage of fewer cases of beta-thalassemia is regarded as being more important.
How binding are the interpretations of legal scholars? Is there a basic consensus in the current debate on bioethics in the Islamic world on the limits of medical intervention?
Eich: The interpretations of legal scholars are more or less directly binding only in a limited number of countries, such as Saudi Arabia or Iran. In addition, there are other countries, such as Egypt, where religious institutions have a deciding function in legitimating new laws and also the decrees of the ministry of health.
As a rule, legal scholars see the limits of medical intervention as being where they regard harm to society or interference in God's creation taking place. Decisive here is the definition of God's will. This can be illustrated with the example of sex change procedures. Sunni scholars operate from the principle that in the divinely ordained order of things, only two clearly differentiated genders exist.
This means that when a person exhibits the outward characteristics of both sexes, then it can only be a matter of the "true sex" of the person being masked by the characteristics of the other sex. According to this view, a hermaphrodite could be, depending on medical results, a man that also exhibits female sexual characteristics. In this case, an operation would be permitted, because it would not intervene with the divine creation, but rather serve to make the divine order clear again.
By contrast, a sex change procedure arising from psychological factors (i.e. a man views himself as born in the wrong body and therefore wants to change his sex) is, according to Sunni scholars, a clear violation of the divine order and interference in God's creation. As such, they forbid such procedures.
How divergent are the interpretations offered by Shiite and Sunni legal scholars?
Eich: In a number of areas, they are very divergent. For instance, Shiite scholars allow for sex change procedures on psychological grounds. Heterologous insemination is also permitted in Iran.
Is the setting of ethical standards and the analysis of medical issues limited to just a few Islamic religious scholars?
Eich: There are currently a number of legal scholars that have specialized in bioethical issues. These include Muhammad Mukhtar al-Salami from Tunisia, Ra'fat Uthman from Egypt, and the Kuwait-based Abd al-Fattah Idris. Other well-known legal scholars such as Ayatollah Fadlallah, Yusuf al-Qaradawi, and Wahba al-Zuhayli occasionally speak out on these issues from within the framework of their wide-ranging interpretive spectrum.
Investment is increasing in biomedical research and treatment in the Middle East, Pakistan, Iran, and also in Turkey. Is a regional dominance in research efforts and success emerging in the Islamic world?
Eich: Yes. I would rank Iran and Saudi Arabia as the two leading locations in this sphere.
Islamic points of view on bioethical issues have played a minor to non-existent role in the German media and the public debate here. Are things any different within the international research community?
Eich: States with a Muslim majority are firmly anchored in the UN and UNESCO, and they provide the international discussion process with input on Islamic points of view.
To what extent does the manner in which a country evaluates bioethical issues have political and economic ramifications?
Eich: In terms of the growth in medical tourism, the economic benefit of introducing a particular therapy or form of treatment, such as for infertility, is clearly apparent. The clientele varies according to the treatment. In the case of fertility treatment, regional travel plays a predominant role – the vast majority of patients seeking IVF treatment in Jordan come from the country itself or the neighbouring Arab states, not from Europe. In the case of other therapies, such as cancer treatment, Saudi Arabia attracts patients from around the world.
In my view, the political dimension in the interpretation of bioethical cases lies primarily in how the public discussion on these issues has opened a debate on what it means to be human and on fundamental societal issues such as "How do we define the family?" or "When should a person be declared dead?"
Globalisation and Muslim migration to Europe have led to a discourse on modernization in Islam and have given rise to the concept of "Euro-Islam." In this context, is it possible to observe the emergence of Euro-Islamic interpretive approaches when it comes to bioethical issues?
Eich: No, the Islamic contribution to the European and North American debates on bioethics remains to a great degree limited to the debates and decisions in the Middle East. The most developed such bioethical discourse is taking place among Muslims in North America.
Islamic ethics and secular society are generally regarded as difficult to reconcile. Do you nevertheless see in bioethical discourse an opportunity for interreligious and intercultural dialogue?
Eich: I don't believe that bioethical issues are well suited for interreligious dialogue. These issues are inherently bound to a great pressure to quickly find principled and practical solutions in medical practice. Interreligious dialogue simply requires much more time, especially as many countries lack a sufficient institutionalized infrastructure. On the other hand, I view an intercultural dialogue on bioethical matters as absolutely essential.
Interview: Sarah Zada
© Qantara.de 2009
Thomas Eich teaches Islam Studies at the University of Tübingen. From September 2008 to February 2009, he was a Feodor Lynen Research Fellow at Georgetown University in Washington DC, USA.
"Moderne Medizin und Islamische Ethik. Biowissenschaften in der muslimischen Rechtstradition" ("Modern Medicine and Islamic Ethics. Life Sciences in the Muslim Legal Tradition"). Texts selected, translated, and with comment by Thomas Eich, Herder-Verlag, Freiburg 2008
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