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memri
June 13, 2016 No.
1256

Saudi Shura Council Draws Fire For Rejecting Organ Donation Bill

By: E. Ezrahi*

Introduction

On May 22, 2016, the Saudi government daily 'Okaz reported that the Shura Council had rejected a bill that, if passed, would allow Saudis to add an organ-donor designation to their drivers' licenses; the bill was rejected on the grounds that this issue is "religiously controversial." According to the newspaper, several Shura members supported the bill due to the increase in road accident deaths, as well as to the growing need for donor organs; others maintained that the Shura Council should not decide issues that are in dispute within the religion.[1]

The news came against the backdrop of reports about the annual growth in the number of Saudis waiting for donor organs. According to 'Abd Al-'Aziz Al-Turki, who heads the Ithar organization for promoting organ donation in eastern Saudi Arabia, thousands of patients are on waiting lists, and demand is constantly on the rise. He assessed that by 2018, a total of 20,000 donor organs would be needed for Saudi patients.[2] Additionally, Dr. Faisal Shaheen, director of the Saudi Center for Organ Transplantation, referred to a 2015 report, stating that the number of organ transplants performed in the kingdom has been increasing significantly every year.[3]

Both Al-Turki and Shaheen noted that because of this grave situation, their organizations have been running campaigns promoting organ donation in the country. Dr. Shaheen said that many Saudi citizens come to his center to enroll in the donor program and sign an organ donor card, and that since the center launched the campaign some four million such cards have been signed. He added that all medical centers and dialysis units can enroll people in this donor program and distribute cards.[4]

 
 Saudi organ donor card (Al-Riyadh, Saudi Arabia, May 8, 2016)

With regard to the religious aspect of the issue, as early as 1982, Saudi Arabia's Supreme Council of Clerics, the kingdom's highest religious authority, issued a fatwa (ruling) permitting organ donations from both living and deceased donors, as necessary, in accordance with the operation's chances of success, and as long as no risk was posed to the life of a living donor.[5] Another fatwa by the Supreme Council of Clerics, from 1996, stated that an individual is considered dead only after his heart has stopped beating, not when physicians pronounce that brain death has occurred.[6] This led many Shura Council critics to argue that there is indeed religious sanction for organ donation, and that the rejection of the bill was unnecessary. Thus, council member 'Abdallah Al-Mutlaq said at a conference discussing society's role in encouraging organ donation that he would donate his own organs after his death, and even produced his organ donor card. Another Shura Council cleric, Sheikh Saleh bin Humayed, confirmed that organ donation was religiously permissible but stressed that doctors must confirm a donor's brain death before harvesting organs.[7]

Official elements in the kingdom also expressed support for organ donation. At a meeting that he conducted on the issue, Eastern Saudi Arabia emir Sa'ud bin Naif praised the development of the transplant infrastructure in the area and the increase in the number of transplants. He called for continuing to carry out the procedures, and stressed that anyone donating their organs was doing a good deed and would be rewarded for it, as per the Koran and the Sunna. Also at the meeting, Sheikh Khalaf bin Muhammad Al-Mutlaq, a member of the Committee for Issuing Fatwas in Eastern Saudi Arabia, announced that he intended to donate his organs after death and calling organ donation a deed that is greatly rewarded by Allah and that helps save the lives of patients who suffer for years while awaiting a donated organ.[8]

 
'Abdallah Al-Mutlaq signs organ donor card (Al-Riyadh, Saudi Arabia, March 8, 2013)

However, the sympathy and support for the organ donation bill did not convince the Shura Council, which rejected it, claiming that the issue was not religiously settled. The decision sparked criticism, including from former Mecca Religious Police commander Ahmad Al-Ghamidi, who said in a television interview that the Shura Council must not stop its legislative work due to mere religious disputes on some issue or other, because it is an independent body, whose authority is granted it by the king. Organ donation, he stressed, is a moral issue relating to the public good, and therefore the rejection of this bill indicates problems within the council. He added that the Supreme Council of clerics had once issued a fatwa permitting a person to donate their organs under certain conditions [referring to the fatwa from 1982], but noted that the council's fatwas concerning the donation of the organs of a person who is declared brain dead are not properly grounded in medical expertise.[9]

The decision was also criticized by Dr. Shaheen, the Saudi Center for Organ Transplantation director; he said that it would damage the country's organ transplant infrastructure and expressed his willingness to debate all the council members who had voted it down should the issue be reopened for debate. He even stressed that without fatwas permitting organ donation, his center would never have begun operating in the first place.[10]

Articles critical of the Shura Council decision, and the council members, appeared in the Saudi press. One stated that the idea of rejecting debate on various life-and-death matters, particularly one as crucial as this, due solely to the absence of definitive religious rulings is unrealistic. Others noted that in cases of religious disagreement, preference should be given to the opinion that gives life, as opposed to denying life, and called for changing how the Shura Council addresses important matters such as organ donation.

The following are excerpts from the articles in the Saudi press critical of the Shura Council's rejection of the bill allowing an organ donor designation to be added to Saudi drivers' licenses:

Saudi Writer: "If We Rejected Everything In Life Because Of An Absence Of Religious Ruling On It - Life In The Islamic World Would Grind To A Halt"

Columnist Khaled Al-Suleiman wrote in the official Saudi daily 'Okaz: "When I was a young student, I responded in the affirmative to a campaign encouraging posthumous kidney donations, out of youthful enthusiasm and after being charmed by the personality of the astronaut Sultan bin Salman, who led the campaign. The campaign issued donor cards to those consenting to kidney donation after they died. After receiving my card, I immediately showed it to my grandmother... and awaited her praise - but she grabbed it, ripped it up, and berated me for allowing [doctors] to rip my body to shreds after death.

"My grandmother's view eventually changed, and I saw her praise my cousin when he donated the organs of his little daughter who had died. I too changed my view, and today my view on the issue of organ donation no longer needs either youthful enthusiasm or a shot of celebrity charisma, but is based on the certain recognition that organ donation is a crucial humanitarian act that gives others reasons to live!

"According to several newspapers, the Shura Council rejected a bill enabling those wishing to donate their organs to designate this on their driver's license. Sources told 'Okaz... that one reason for rejecting this bill was some [council] members' claim that there was no definitive religious ruling on this issue!

"If we rejected everything in life because of an absence of religious ruling on it, life in the Islamic world would grind to a halt. Disagreements among clerics on [various] topics have existed for over 1,400 years, and it makes no sense for Shura members to wait for consensus among all clerics on an issue in order to carry it out!"[11]

 
(Image: Al-Riyadh, Saudi Arabia, May 8, 2016)

Saudi Columnist: In Religious Disagreements You Must Choose The Opinion That Grants Life, Not One That Denies It

'Okaz columnist Hamoud Abu Taleb penned an article titled "Rejecting a Law of Life!" that also criticized the decision: "Despite a multitude of bills rejected by the Shura Council for reasons and disagreements described as 'religious,' I did not imagine that this excuse would be used to reject a bill that gives people on their deathbed a hope for life... First, I do not know how the medical committee in the Shura Council functioned on this matter. Did it inform the opponents [of the law] that Saudi Arabia has over 16,000 patients on the waiting list to receive a kidney, 500 waiting for a heart, 700 for a liver, 500 for a lung, and 500 for a pancreas? This is according to a report published two years ago, so the numbers are certainly greater by now.

"Second, 16 years ago, the Islamic Fiqh Academy published a fatwa permitting organ donations from the deceased. If this is true [for the dead], then why can't a person receive the reward in this world and the next [for donating organs] voluntarily while still alive? Third, do the opponents know the endless amount of problems involved with organ transplants abroad and how patients are exploited in the most heinous ways merely to get them to [eventually] return [to Saudi Arabia] as corpses or in worse condition [than they left]? Fourth, religious disagreements are merely religious opinions and not definitive sacred texts. If there is a disagreement on an issue such as this, should we choose the opinion that grants hope for human life, or one that denies it? [Since Koran 32:5 states:] 'whoever saves one [soul] - it is as if he had saved mankind entirely.'

"Fifth, there is nothing wrong in consulting relevant elements when discussing sensitive matters. However, here we are discussing the decision of a person who wants to give life to another person, using nothing but words written on his driver's license. Does this justify this stormy disagreement? Sixth, the opponents [of the law] should visit the Saudi Center for Organ Transplantation, or be the guests of its director, Dr. Faisal Shaheen, in order to see that the problem is more important and grave than religious disagreements that we relied on to reject the bill."[12]

Saudi Writer: Shura Council Should Change Its Conduct When Discussing Important Issues Like Organ Donation

Hashem 'Abdallah Hashem, a columnist for the official daily Al-Riyadh, also expressed surprise at the Shura Council's decision and condemned it in light of the suffering of patients awaiting a transplant: "One would expect the Shura Council to support an important bill such as this, and act to approve it, after tarrying for a long time, by increasing [its] cooperation with the Supreme Council of Clerics and the interior and health ministries. This, because we must end the suffering of hundreds of thousands of patients due to a lack of organs [to transplant] that are sourced safely and properly within the country, as opposed to traveling to other countries in Asia and Africa to acquire them, or travelling [abroad] to undergo a transplant of improper and unmatched organs...

"It is time to make a decision on these issues, which are more important than all other considerations and calculations, since we currently need a combination of efforts in order to think differently, remove all difficulties and obstacles, and find better solutions in light of a proper understanding [of this issue]. Therefore, I hope we reexamine the procedures, mechanisms, and steps by which the Shura Council operates while addressing issues and topics [on its agenda], particularly more complex ones. [This,] in order for the Shura Council not to be perceived as an additional obstacle to the passage of important laws such as this..."[13]

 

* E. Ezrahi is a research fellow at MEMRI.

 

Endnotes:

 

[1] 'Okaz (Saudi Arabia), May 22, 2016.

[2] Al-Yawm (Saudi Arabia), May 25, 2016.

[3] Al-Riyadh (Saudi Arabia), May 8, 2016.

[4] Al-Riyadh (Saudi Arabia), May 8, 2016; Al-Yawm (Saudi Arabia), May 25, 2016.

[5] A summary of this fatwa can be found on the website of the Saudi Center for Organ Transplantation (scot.gov.sa). Another fatwa on the website, issued by the International Islamic Fiqh Academy in October 1986, states that a person is considered dead if their heart stops beating or if brain death has occurred, and after doctors have confirmed that their condition is irreversible.

[6] For the fatwa in Arabic, see alifta.net.

[7] Al-Riyadh (Saudi Arabia), March 8, 2013,

[8] Al-Yawm (Saudi Arabia), May 25 2016.

[9] Rotana.net, May 23, 2016; Anaween.com, May 23, 2016.

[10] Rotana.net, May 24, 2016.

[11] 'Okaz (Saudi Arabia), May 23, 2016.

[12] 'Okaz (Saudi Arabia), May 24, 2016.

[13] Al-Riyadh (Saudi Arabia), May 25, 2016.