At the second Amman Workshop on Blood Donor Motivation and Blood Collection. Dr. M. Sartaway presented a paper entitled Islamic rulings on blood transfusion which presented several important conclusions concerning blood donation and the principles of Islam.
* While spilled blood is considered impure, donated blood is not spilled and the status of impurity does not apply to it.
* Blood transfusion between a man and his wife will not invalidate their marriage.
* It is forbidden to sell blood. However, if a person who is fit to donate blood refuses to do so without payment, it is permissible to pay on the part of the payer, but the payee commits an offence by mixing a bad deed with good one.
* Giving blood does not invalidate fasting; giving blood by transfusion to a fasting person does not invalidate the latter’s fast.
Dr. Sartaway argues logically for the need for blood from a human being to save the life of another. Moreover, he argues that if giving blood to patient is necessary for survival or for relief, then, according to Islam it is mandatory to do so. This follows the basic Islamic principle which makes it imperative to preserve life, and the underlying Islamic rules “Harm must be eliminated” and “necessity overrule constraints” blood donation is in agreement with the principle of Islamic social justice.
Since Dr. Sartaway’s text has such significance for blood transfusion in the Islamic world, the Arabic text is reproduced in full.
Islamic Rulings on Blood Transfusion
Remarkable advances have been achieved in medicine, in pursuance of human welfare. These have giving rise to a number of new issues which had never been tackled or judged by early Muslim scholars, since they did not exist at their time. However, since Islamic law is meant to regulate acceptable human behavior, it is imperative to arrive at rulings with regard to incipient medical issues such as: organ transplant in vitro. Fertilization (test-tube babies), surrogate motherhood, sterilization, blood transfusion, etc.
Muslim scholars have attempted to derive clear Islamic rulings on these and other issues, in the light of the principles of Islamic Faith and the general rules of Islamic law.
Islam enjoins preserving human life and protecting it against all potential harm, affection and hardship, and it insists on ensuring peace and security for human beings. This article is an attempt to identify the Islamic view of one of these incipient medical issues, namely, blood transfusion.
In most cases, blood transfusion is considered necessary and indispensable, since, from the medical point of view, it may be impossible for a particular patient to survive without it.
It is well known that blood cannot be produced artificially, as it consists of living cells which scientific research remains unable to synthesize. Nor can any use be made of animal’s blood in this respect, because of its natural difference from human blood. Therefore, only the blood of a human being can be used to save the life of another.
Islamic law urges every Muslim to be in constant support of his brother, and even makes such support a legal requirement in many cases. According to a Hadith (saying) by the Prophet Muhammad, (peace be upon him) “He who relieves a believer of one form of distress in this life shall be relieved by God of a greater distress on the Day of Resurrection”; and “God will help any servant of His, as long as he continues to help his brother”.
The Prophet (peace be upon him) enjoined Muslims not to abandon their fellow community members when they are faced with death or destruction: “A Muslim is a brother to every Muslim: he neither lets him down, nor does him injustice, nor gives him away”, i.e. he does not let his brother fall victim to the enemy, or to a killer disease if he can prevent it.
Endeavoring to save the lives of Muslims, by protecting them from fatal dangers, and keeping them away from what is harmful, is one of the greatest obligations to he Almighty. God says “Whoso quickened a human being, it shall be as if he had quickened all mankind”. Quicking a human being is achieved by saving his/her life from destruction, a case which is typically applicable to blood transfusion to a patient from a healthy person.
Therefore, if giving blood to a patient is necessary for his survival, or to relieve his complaint, then, according to Islam, it becomes mandatory, as a case of implementing a basic Islamic principle which makes it imperative to preserve human life. Two important main Islamic rules are also applicable here, namely: “Harm must be eliminated,” and “Necessity overrules constraints”. Furthermore, it is in agreement with the principles of social justice as implied in countless evidence.
Yet, if the use of blood in medical treatment is necessary, then having an adequate stock of blood and storing it are also necessary. It is an Islamic rule that when something is indispensable for meeting an obligation, then this very thing or action becomes obligatory. A great number of accidents take place every day, most of which require emergency treatment which cannot be completed without blood transfusion. Therefore, quantities of blood must be made available in hospitals. Hence, blood banks have been established.
This is the argument for blood donation. On the other hand, a patient may not refuse to take the necessary amount of blood since, by so doing, he puts his life at risk, something which is totally forbidden by God: “Do not kill yourselves; God has been to you Most Merciful (IV:29. “Do not cast yourself to ruin by your own hands” (II: 195).
It is also worth mentioning here that in the Hadith, there is an earnest call for phlebotomy and cupping in patient treatment, because of their proven benefits to man. This indicates that blood donation is not only harmless to the donor, but it is also useful to him, as it activates the process of replenishing blood cells.
The Prophet (peace be upon him) says: “Cupping is a most useful type of medical treatment”. He also says: “If any of your methods of treating the ill is effective, an incision by a phlebotomy scalpel is certainly one”.
Drawing blood by a syringe is similar to drawing it through phlebotomy; yet the blood taken by a syringe from one person can be beneficially used by transfusion into the veins of another person, while phlebotomy remains short of this.
To sum up, blood donation is a collective duty, i.e. if it is done by a few people, and the blood donated is sufficient to meet the existing and expected needs of the community, then the rest of the community have nothing to account for. But if the blood donated falls short of meeting these needs, all members of the community are guilty of an offence, since they will be considered as having abandoned to their fate those who are ill or battle and accident-stricken.
In certain cases blood donation becomes an individual duty. This applies, for example, in a situation where there is a patient whose blood group is matched by that of one single person within easy reach. Blood donation becomes this person’s individual obligation. If he fails to fulfil it, he shall be considered as having committed a sin.
A great number of Muslims scholars have ruled blood donation permissible.
No reliable opinion has been pronounced to the contrary.
Nevertheless, it should be mentioned here that putting this Islamic view into practice is subject to certain medical conditions known to professional people, such as: (a) donation must not be harmful to the donor, as in the case when the donor is young or anaemic, or when the amount of blood taken from him is likely to cause him adverse effects; (b) no blood should be given to a patient unless it is sure to benefit him. This can be guaranteed by carrying out the tests necessary to prove that the blood given is free of any pathological factors.
Legal consequences of blood donation
Questions that must be asked are:
- Is the blood drawn out of the body by a syringe impure? If so, is it permissible to use it for medical purposes?
There is consensus among scholars that blood becomes impure once it is out of the body. This is in accordance with the Quranic verse listing items prohibited to Muslims: “… Or blood poured forth” meaning: spilled blood. Blood drawn out by a syringe, however, is not spilled and consequently the status of impurity dose not apply to it. Texts quoted from the Hadith enjoining the purifying of clothes and the body of blood drops or stains, consider such blood as “poured forth” or spilled. But, even if blood drawn by a syringe is considered impure, Muslim scholars tolerate medication with impurities in cases of need.
- Does blood transfusion entail prohibition of marriage between donors and recipients?
Some of the Hadith make it clear that certain marriages are invalidated as a result of a child having been breast-fed by a woman other than his mother. This ruling has been explained, in detail, in books of Fiqh (Islamic Jurisprudence). The reason for such prohibition is the fact that breast-feeding helps bones and muscles to grow; such growth takes place while the infant is nourished with milk, before it depends solely on ordinary food.
A Hadith of the Holy Prophet states that “the marriage-prohibiting breast-feeding is only that which helps bone and muscle growth.” Blood transfusion does not bring about such growth, because the function of the blood is carry nutritive substances to the cells of the body, and not to directly contribute to nourishing and sustaining the body. Therefore, if blood transfusion takes place between a man and his wife, it will not invalidate their marriage.
- Is selling blood permissible?
God has given man a position of honour: “We have honoured the sons of Adam” for this reason, the selling of the human body, its organs, or blood is forbidden. However, if a person, who is fit to give blood, refuses to donate his blood unless he/she is financially compensated, it is permissible in this case to pay for the blood. Giving such a payment does not constitute an offence on the part of the payer, while the payee commits an offence and puts himself in the position of one who mixed a good deed with a bad one.
- Does drawing blood with a syringe break the fast (of a Muslim)?
Donating blood does not invalidate fasting, nor does giving blood by transfusion to a fasting person invalidate the latter’s fast.
Reference; Principal of Blood Transfusion, World Health Organization