The ethical and legal challenges posed by assisted reproduction techniques are both profound and breathtaking, with most societies unable to fully comprehend one technique before another one, even more daring, emerges. The wrongful implantation of embryos in two women undergoing in vitro fertilisation treatments at two separate clinics in the UK seriously vitiates the traditional concept of who is a parent. In one case, a patient’s embryos were wrongly implanted into another woman seeking similar treatment, and in the second, a (...) woman’s eggs were fertilised using sperm from a man other than her husband.In the first mix-up, neither member of the recipient couple was the genetic parent of the child, while in the second case, the recipient mother was the genetic mother and her husband was not the genetic father. The mix-ups resulted in litigation to determine who the rightful parents were. First, I will show in this paper that, although the outcome of the application of English law in both cases was in agreement with the outcome prescribed by basic principles of Islamic law and bioethics, that agreement is based on different reasoning in the two traditions. Next, I will show that the profound ethical implications of reproductive technologies begs for a more pluralistic bioethical discourse than the one-dimensional analysis applied by secular Western societies that currently dominates the enquiry, particularly as most Western societies are more or less multicultural and multireligious. (shrink)

The discovery and invention of new medical applications may be considered blessings to humankind. However, some applications which might be the only remedy for certain diseases may contain ingredients or involve methods that are not in harmony with certain cultural and religious perspectives. These situations have raised important questions in medical ethics; are these applications completely prohibited according to these perspectives, and is there any room for mitigation? This paper explores the concept of darurah and its deliberation in the formulation (...) of fatwas on medicine issued by the National Fatwa Council of Malaysia. Darurah has explicitly been taken into consideration in the formulation of 14 out of 45 fatwas on medicine thus far, including one of the latest fatwas regarding uterine donation and transplantation. These fatwas are not only limited to the issues regarding the use of unlawful things as remedies. They include issues pertaining to organ transplantation, management of the corpse and treatment of brain dead patients. While deliberation of darurah in medicine may vary from issue to issue, darurah applies in a dire situation in which there are no lawful means to prevent harm that may be inflicted upon human life. Nevertheless, other aspects must also be taken into the deliberation. For example, consent must be obtained from the donor or his next of kin to conduct a cadaveric organ transplantation. (shrink)

The field of bioethics aims to ensure that modern scientific and technological advancements have been primarily developed for the benefits of humankind. This field is deeply rooted in the traditions of Western moral philosophy and socio-political theory. With respect to the view that the practice of bioethics in certain community should incorporate religious and cultural elements, this paper attempts to expound bioethical tradition of the Malay-Muslim community in Malaysia, with shedding light on the mechanism used by the National Fatwa Council (...) to evaluate whether an application of biological sciences is ethical or not. By using the application of the genetically modified food as a case study, this study has found that the council had reviewed the basic guidelines in the main references of shari'ah in order to make decision on the permissibility of the application. The fatwa is made after having consultation with the experts in science field. The council has taken all factors into consideration and given priority to the general aim of shari'ah which to serve the interests of mankind and to save them from harm. (shrink)

In 2015 scientists called for a partial ban on genome editing in human germline cells. This call was a response to the rapid development of the CRISPR–Cas9 system, a molecular tool that allows researchers to modify genomic DNA in living organisms with high precision and ease of use. Importantly, the ban was meant to be a trust-building exercise that promises a ‘prudent’ way forward. The goal of this paper is to analyse whether the ban can deliver on this promise. To (...) do so the focus will be put on the precedent on which the current ban is modelled, namely the Asilomar ban on recombinant DNA technology. The analysis of this case will show (a) that the Asilomar ban was successful because of a specific two-step containment strategy it employed and (b) that this two-step approach is also key to making the current ban work. It will be argued, however, that the Asilomar strategy cannot be transferred to human genome editing and that the current ban therefore fails to deliver on its promise. The paper will close with a reflection on the reasons for this failure and on what can be learned from it about the regulation of novel molecular tools. (shrink)

The ever-increasing technological advances of modern medicine have increased physicians’ capacity to carry out a wide array of clinical interventions near the end-of-life. These new procedures have resulted in new “types” of living where a patient’s cognitive functions are severely diminished although many physiological functions remain active. In this biomedical context, patients, surrogate decision-makers, and clinicians all struggle with decisions about what clinical interventions to pursue and when therapeutic intent should be replaced with palliative goals of care. For some patients (...) and clinicians, religious teachings about the duty to seek medical care and the care of the dying offer ethical guidance when faced with such choices. Accordingly, this paper argues that traditional Sunni Islamic ethico-legal views on the obligation to seek medical care and Islamic theological concepts of human dignity and inviolability provide the ethical grounds for non-intervention at the end-of-life and can help calibrate goals of care discussions for Muslim patients. In closing the paper highlights the pressing need to develop a holistic ethics of healthcare of the dying from an Islamic perspective that brings together multiple genres of the Islamic intellectual tradition so that it can meet the needs of the patients, clinicians and Muslim religious leaders interacting with the healthcare system. (shrink)

Although germline editing has been the subject of debate ever since the 1980s, it tended to be based rather on speculative assumptions until April 2015, when CRISPR/Cas9 technology was used to modify human embryos for the first time. This article combines knowledge about the technical and scientific state of the art, economic considerations, the legal framework and aspects of clinical reality. A scenario will be elaborated as a means of identifying key ethical implications of CRISPR/Cas9 genome editing in humans and (...) possible ways of dealing with them. Unlike most other discussions of CRISPR/Cas9 germline editing, which are generally based on deontological arguments, the focus in this case will be on a consequentialistic argument against certain applications of germline and somatic editing that takes not only the potential benefits and risks but also socioeconomic issues into consideration. The practical need for an indication catalogue, guidelines for clinical trials, and for funding of basic research will be pointed out. It will be argued that this need for regulatory action and discussion does not stem primarily from the fact that CRISPR/Cas9 germline editing is revolutionary in terms of its ethical implications and potential for human therapy, although this is the prevailing view in the current discussion. Understanding the value and interest dependency of arguments put forward by different stakeholders and learning from past debates related to similar technologies might prove a fruitful method of reaching judgments and decisions that come closer to a consensus upon which society as a whole can agree - which after all should be the true goal of an ethical debate and of bioethics. (shrink)

The publication of the first study to use gene editing techniques in human embryos (Liang et al., 2015) has drawn outrage from many in the scientific community. The prestigious scientific journals Nature and Science have published commentaries which call for this research to be strongly discouraged or halted all together (Lanphier et al., 2015; Baltimore et al., 2015). We believe this should be questioned. There is a moral imperative to continue this research.

The bioethical principle of autonomy is problematic regarding the future of the embryo who lacks the ability to self-advocate but will develop this defining human capacity in time. Recent experiments explore the use of clustered regularly interspaced short palindromic repeats /Cas9 for germline engineering in the embryo, which alters future generations. The embryo’s inability to express an autonomous decision is an obvious bioethical challenge of germline engineering. The philosopher Joel Feinberg acknowledged that autonomy is developing in children. He advocated that (...) to reserve this future autonomy, parents should be guided to make ethical decisions that provide children with open futures. Here, Feinberg’s 1980 open future theory is extended to the human embryo in the context of CRISPR germline engineering. Although the embryo does not possess the autonomous decision-making capacity at the time of germline engineering, the parental decision to permanently change the unique genetic fabric of the embryo and subsequent generations disregards future autonomy. Therefore, germline engineering in many instances is objectionable considering Feinberg’s open future theory. (shrink)

Emergence of novel genome engineering technologies such as clustered regularly interspaced short palindromic repeat has refocused attention on unresolved ethical complications of synthetic biology. Biosecurity concerns, deontological issues and human right aspects of genome editing have been the subject of in-depth debate; however, a lack of transparent regulatory guidelines, outdated governance codes, inefficient time-consuming clinical trial pathways and frequent misunderstanding of the scientific potential of cutting-edge technologies have created substantial obstacles to translational research in this area. While a precautionary principle (...) should be applied at all stages of genome engineering research, the stigma of germline editing, synthesis of new life forms and unrealistic presentation of current technologies should not arrest the transition of new therapeutic, diagnostic or preventive tools from research to clinic. We provide a brief review on the present regulation of CRISPR and discuss the translational aspect of genome engineering research and patient autonomy with respect to the “right to try” potential novel non-germline gene therapies. (shrink)

Advancement of modern agricultural biotechnology has brought various potential benefits to humankind, but at the same time ethical concerns regarding some applications such as genetically modified foods have been raised among the public. Several questions are being posed; should they utilize such applications to improve quality of their life, or should they refrain in order to save themselves from any associated risk? What are the ethical principles that can be applied to assess these applications? By using GMF as a case (...) study, this paper discusses possible answers to these questions from Islamic perspective. Such answers are based on the understanding of the Islamic concept of maslahah and mafsadah as well as the Islamic principles of priority. There is no specific GMF that has been declared as unlawful by Muslim scholars thus far. Nevertheless, they generally state that any GMF that contains unlawful substance is prohibited in Islam. Such statement can be understood since Islam puts highest priority to preserve shari’ah which prescribes the lawful and unlawful things in human life. Priorities have also been given to preserve human health and environment therefore any GMF that may inflict harm on both entities is also considered as unlawful. (shrink)

The ethical and legal challenges posed by assisted reproduction techniques are both profound and breathtaking, with most societies unable to fully comprehend one technique before another one, even more daring, emerges. The wrongful implantation of embryos in two women undergoing in vitro fertilisation treatments at two separate clinics in the UK seriously vitiates the traditional concept of who is a parent. In one case, a patient’s embryos were wrongly implanted into another woman seeking similar treatment, and in the second, a (...) woman’s eggs were fertilised using sperm from a man other than her husband.In the first mix-up, neither member of the recipient couple was the genetic parent of the child, while in the second case, the recipient mother was the genetic mother and her husband was not the genetic father. The mix-ups resulted in litigation to determine who the rightful parents were. First, I will show in this paper that, although the outcome of the application of English law in both cases was in agreement with the outcome prescribed by basic principles of Islamic law and bioethics, that agreement is based on different reasoning in the two traditions. Next, I will show that the profound ethical implications of reproductive technologies begs for a more pluralistic bioethical discourse than the one-dimensional analysis applied by secular Western societies that currently dominates the enquiry, particularly as most Western societies are more or less multicultural and multireligious. (shrink)