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从伊斯兰教角度来看器官捐赠、循环死亡判定后的捐赠和异种移植的伦理问题。

The ethics of organ donation, donation after circulatory determination of death, and xenotransplantation from an Islamic perspective.

机构信息

Initiative on Islam and Medicine, University of Chicago, Chicago, IL, USA.

Department of Medicine, Section of Emergency Medicine, University of Chicago, Chicago, IL, USA.

出版信息

Xenotransplantation. 2018 May;25(3):1-12. doi: 10.1111/xen.12421.

Abstract

Donation after circulatory determination of death (DCDD) and xenotransplantation are advanced as possible solutions to the growing gap between the number of individuals in need of organ transplantation and the pool of donors. Investigating how various publics, including religious leaders, might view these "therapies" is essential for broad public and professional support and will be needed in order to make these solutions viable. This study, therefore, presents normative Islamic bioethical perspectives on donation after circulatory determination of death and xenotransplantation. First, we will discuss foundational Islamic ethico-legal debates regarding organ donation. These debates can be grouped into three broad positions, those who consider organ donation categorically impermissible as a violation of human dignity (ḥurma and karāma), those who agree that organ donation is impermissible in principle, but allow it conditionally on the basis of dire necessity (ḍarūra), and those who permit organ donation based on notions of public interest (maṣlaḥa). Next, we will reflect upon the additional ethical dimensions DCDD and xenotransplantation add to these debates. We contend that the condition of minimal harm to the donor and the definition of death need to be accounted for within Islamic perspectives on DCDD. Xenotransplantation, on the other hand, highlights concerns about using pigs for therapeutic purposes. We conclude by commenting on additional questions that remain to be addressed in the Islamic bioethical debate over these practices and with recommendations for further research.

摘要

在循环死亡判定后的捐献(DCDD)和异种移植被认为是解决器官移植需求人数与供体数量之间日益扩大差距的可行方法。研究包括宗教领袖在内的不同公众对这些“疗法”的看法对于广泛的公众和专业支持至关重要,并且需要这些解决方案是可行的。因此,本研究提出了关于循环死亡判定后的捐献和异种移植的规范的伊斯兰生物伦理观点。首先,我们将讨论关于器官捐献的基础的伊斯兰伦理法律辩论。这些辩论可以分为三个广泛的立场,那些认为器官捐献绝对不可接受,因为这违反了人类尊严(ḥurma 和 karāma)的人;那些认为器官捐献原则上不可接受,但在极度必要的基础上允许它的人(ḍarūra);以及那些基于公共利益观念允许器官捐献的人(maṣlaḥa)。接下来,我们将反思 DCDD 和异种移植给这些辩论增加的额外伦理维度。我们认为,在伊斯兰对 DCDD 的观点中,需要考虑到对供体的最小伤害条件和死亡的定义。另一方面,异种移植强调了使用猪进行治疗目的的担忧。最后,我们对这些实践在伊斯兰生物伦理辩论中仍然存在的其他问题进行了评论,并提出了进一步研究的建议。

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