بِسۡمِ اللهِ الرَّحۡمٰنِ الرَّحِيۡمِ
Islām views itself as the perfect monotheistic religion, guided by its Sharīʿa, which provides comprehensive guidance on all aspects of human life. Contemporary Muslim scholars face the challenge of adapting Islāmic jurisprudence to modern realities while maintaining continuity with tradition, often invoking doctrines like "necessity" and "public benefit."
Human dignity, a central theme in religious morals, is emphasized in the Holy Qur’an, rooted in religious Scriptures rather than human reasoning, according to the Ashʿari theological school. The Qur’an serves as the primary source of Sharīʿa, followed by the Sunna of the Prophet Muhammad, with consensus among Muslim jurists holding practical significance. When these sources are unavailable, jurists may resort to analogical deduction.
Islāmic bioethics, an extension of Sharīʿa, involves religious scholars in Islāmic states due to the necessity of alignment with Sharīʿa. However, the development of bioethics in these states has been slow. Sunni Muslims lack a supreme authority for issuing rulings on biomedical issues, resulting in varying interpretations and contradictions. Additionally, different schools of jurisprudence within Islām further complicate matters.
Muslims in Western countries rely on fatāwa issued in Islāmic states, with prominent organizations such as the Islāmic Organization for Medical Sciences playing a significant role in issuing rulings on bioethics. The concept of collective ijtihād has emerged, involving collaboration between traditional Islāmic scholars and experts in science to address modern challenges, given the increasing complexity of scientific advancements.
It is imperative for medical practitioners to acquaint themselves with the pronouncements of international organizations dedicated to issuing legal rulings (fatāwa) on bioethical matters, to the advantage of both Muslim doctors and the wider public. These rulings undergo thorough deliberation by esteemed experts, encompassing individuals with expertise in both religious and medical domains of international repute. It is noteworthy that these discussions often span several days, reflecting a meticulous examination of the subject matter. Observing the depth of insight and the meticulous attention to detail evident in these deliberations is frequently awe-inspiring.
Contents
1. Seeking Medical Treatment
2. Providing Medical Treatment
3. Doctor-Patient Interaction
4. Contraception
5. Abortion
6. Artificial Reproductive Techniques
6a. Third-party involvement in reproduction
6b. Cryopreservation
6c. Surrogacy
6d. Gender selection
7. Organ Transplantation & Associated Issues
7a. Collection of fatāwa
7b. Blood transfusion
7c. Autotransplantation
7d. Allotransplantation
7e. Cadaveric transplantation
7e(i) Brain death - An Islāmic Perspective
7f. Transplantation of organs of the reproductive system
7g. Transplantation of brain cells and nervous tissue
7h. Obtaining cells/tissue from a human fetus
7i. Prominent fatāwa on brain death
7j. Recipient Prioritisation/ Prohibition
7k. Organ donation as part of Will, Donor card and Opt-Out Organ Donation Schemes
8. Burying of limbs/placenta etc
9. Cloning
10. Stem Cell Research and Genetic Engineering
11. The Use of Unlawful or Judicially Unclean Substances in Food, Medicines and Vaccines
1. Seeking Medical Treatment
When seeking medical treatment for a disease, a Muslim must adhere to the principles of Islam. The chosen methodology should align with Sharia principles, except in extraordinary circumstances where the legal principle of necessity (darurah) may need to be invoked. Sharia's general principles dictate that the end does not justify the means, and it prioritizes preventing harm over accruing benefit (dar’ al-mafsadah muqaddamun ‘alaa jalb al-mafa’ah). Therefore, treatment options must be carefully evaluated to ensure that the treatment does not exacerbate the disease.
Islam encourages its followers to maintain their health and not lose hope, while also emphasizing the concept of predestination (qadar). Medicine is viewed as part of Divine determinism (qadar), not altering predestination but rather being a component of it. According to Ibn Qayyim, seeking treatment and using medicine does not contradict submission to the Divine will, just as individuals protect themselves from hunger, thirst, heat, and cold with the remedies provided by Allah (food, water, clothing, etc.).
The saying "There is no disease that Allah has created, except that He also has created its treatment" (Bukhari) underscores the Islamic perspective on seeking medical treatment. However, some individuals, both Muslims and non-Muslims, resort to superstitions such as magic, sorcery, astrology, and divination when faced with illness. Practices like using amulets, seeking divinations, consulting fortune tellers, and seeking supernatural cures from individuals claiming special powers or knowledge of the unseen may undermine the belief in monotheism (aqidah of tauhid).
2. Providing Medical Treatment
The practice of medicine has held a prominent position throughout Islamic history, ranking second in importance only to the study of Sharia. Some scholars regard the practice of medicine as a fard kifaya, signifying a communal obligation within the Muslim community.
It is a core belief among all Muslims that Allah is omnipotent, being the ultimate source of both illness and cure. Therefore, the role of the doctor is to administer the remedies and treatments provided by the Almighty. However, the responsibilities of a doctor extend beyond the mere distribution of these remedies. They also encompass social, psychological, and religious dimensions of life, along with offering advice on behavioural modifications for disease prevention. From an Islamic standpoint, a proficient doctor should exemplify adherence to Sharia rulings, thereby providing appropriate guidance to patients for their overall well-being.
3. Doctor-Patient Interaction
In the practice of their profession, it is imperative for Muslim medical practitioners to be well-versed in all pertinent religious rulings issued by religious authorities. It is understood that the ultimate remedy for any ailment resides solely within the power of the Almighty. The Fiqh Academy of Makkah, during its 8th session held from the 19th to the 28th of January 1985, decreed that a Muslim woman is prohibited from fully undressing in the presence of a man with whom she is forbidden to engage in sexual intercourse, except for legitimate purposes recognized by Sharia. Such legitimate purposes include cases where a woman requires medical treatment or care.
The privacy and modesty of the patient, known as awra, must be safeguarded to the greatest extent possible, with the doctor examining only those areas deemed necessary. Ideally, female patients should be attended to by female doctors. The seclusion (khalwa) of a male doctor with a female patient, or vice versa, within a closed room, is forbidden, and the presence of a third person, such as the patient's spouse, should be ensured with the consent of the patient. In situations where extended confidential consultations between the doctor and patient are unavoidable, such as in psychiatry, it is recommended that the psychiatrist be a devout Muslim.
4. Contraception
The stance among Muslim jurists regarding contraception varies, with the majority tolerating temporary methods if the wife consents and it is a result of free choice. However, "permanent" contraception, such as surgical sterilization or sterilization implants, is generally deemed impermissible.
Regarding specific methods, the overwhelming majority of jurists permit the use of intra-uterine devices (IUDs) as a contraceptive, as they do not consider the fertilized ovum to hold sanctity (hurma) as long as it has not implanted in the uterus. While the fertilized ovum may possess dignity (ihtirm), it is not regarded as sanctified.
The seminar on "Human Reproduction in Islam" held by the Islamic Organization for Medical Sciences (IOMS) in Kuwait in 1983 accepted surgical contraception (sterilization) on an individual level in cases of necessity.
Resolution no. 39 (1/5) of the Council of the Academy of Muslim Law (Fiqh) of Jeddah, during its Fifth Session in Kuwait City from 10 to 15 December 1988, states:
1. "General laws" that restrict the procreative freedom of spouses are deemed unlawful.
2. Depriving a human being of the capacity to procreate (sterilization) is prohibited except in cases of necessity approved by Sharia.
3. Temporarily controlling procreation to space out or interrupt periods of pregnancy is lawful in cases of necessity recognized by Sharia. However, this should be decided by the married couple based on mutual agreement and after consulting on the lawfulness of the methods.
Sharia reasons cited for allowing temporary contraception methods include:
1. The need to space out births to safeguard the mother's health.
2. Prevention of transmitting hereditary and infectious diseases.
3. Protection of an already ill woman from the risks associated with pregnancy.
4. Avoidance of economic hardship.
5. Protection of the breastfed baby from potential negative impacts on the quality of milk caused by a new pregnancy.
5. Abortion
Abortion rulings involve several key considerations:
1. The commencement of human life.
2. The moment of ensoulment of the unborn child.
3. The stage at which the embryo/foetus assumes the characteristic form of a human being.
4. Consent of the husband for the abortion procedure.
5. Risks to the mother's health/life from continuing the pregnancy.
The inquiry into when human life begins is pivotal in abortion discourse, yet a definitive consensus is absent due to varying interpretations of scriptural texts. Islamic scholars and Muslim scientists hold divergent viewpoints:
1. Human life begins at fertilisation of the female ovum by the sperm.
2. Human life begins at the implantation of the zygote into the endometrium of the uterus.
3. Human life commences at ensoulment.
The prevailing perspective favours the third viewpoint.
The Qurʾān does not explicitly delineate the timing of ensoulment, understood as the transition from biological life to human life. Evidence for ensoulment is drawn from interpretations of hadith literature, which propose different durations. The majority of jurists posit ensoulment occurring 120 days after fertilisation, while alternative views suggest durations ranging from 40 to 45 nights. Some medical practitioners contend that ensoulment aligns with brain development, supported by modern medical imaging techniques.
Classical positions of the madhāhib are as follows:
- Ḥanafī jurists: Permit abortion before ensoulment, with or without justification.
- Shāfiʿī jurists: Allow abortion within 40 or 42 days with parental consent, though it remains legally detestable (makruh).
- Mālikī jurists: The majority prohibit abortion even within the first 40 days.
- Ẓāhirī jurists: Deem abortion unlawful both before and after ensoulment.
In February 1987, Resolution no. 140 of the Saudi Committee of Senior Ulama proscribed abortion at any stage except in specific cases permitted by Sharia. Within the first 40 days, abortion is lawful if it serves a legitimate benefit. Between the 40th and 120th day, abortion is impermissible unless pregnancy poses a threat to the woman's health and life. After 120 days, abortion is prohibited except when the pregnancy endangers the mother's life.
The 2004 Islamic Code for Medical Ethics of the IOMS allows abortion if the mother's health and life are at risk, provided it occurs before the 120-day period. The recommendation for abortion must be confirmed by at least three doctors, and written consent from the husband and wife (or guardian) is mandatory.
The Islamic Medical Association of North America (IMANA) Ethics Committee asserts that abortion is permissible within the first 120 days to safeguard the mother's life and/or health from severe psycho-physical harm. Additionally, abortion is sanctioned in cases of lethal foetal malformations with medical expert consent, as well as in instances of rape, incest, and war crimes.
An additional note: Following ensoulment, the diyya (full blood price) is payable if the foetus is aborted alive and subsequently dies, while the ghurra (equivalent to 1/10-1/20 of diyya) is applicable if the foetus is aborted dead.
6. Artificial Reproductive Techniques
6a. Third-party involvement in reproduction
Artificial reproductive techniques are considered initially permissible in Islam if they exclusively involve the married couple, where both the sperm and eggs originate from the couple within the bounds of a valid marriage. Involvement of third parties is prohibited.
6b. Cryopreservation
The cryopreservation of the wife's ova, husband's sperm, or fertilised ova is deemed permissible by many Islamic scholars, provided they are utilised in subsequent cycles for the same couple within the duration of their marriage. It's notable that the marriage contract ceases upon divorce or the death of a spouse, rendering it impermissible to impregnate a woman with stored sperm from her former husband or fertilised ova.
6c. Surrogacy
Various forms of surrogacy exist:
1. Traditional surrogacy involves natural or artificial insemination of a surrogate. If the intended father's sperm is used, the resulting child is genetically related to both the intended father and the surrogate. If donor sperm is used, the child is not genetically related to the intended parent(s) but is genetically related to the surrogate.
2. Gestational surrogacy occurs when an embryo created by in vitro fertilisation (IVF) is implanted in a surrogate, known as a gestational carrier. Regardless of the method, the resulting child is genetically unrelated to the surrogate.
Surrogacy, whether partial or complete, and surrogate maternity in polygamous marriages are prohibited. The consensus among Muslim scholars asserts that the birth mother holds the primary maternal status.
6d. Gender selection
The application of preimplantation genetic diagnosis (PGD) or sperm sorting techniques for sex selection is generally discouraged. Gender selection is permitted solely for medical reasons, such as the predisposition to severe genetic conditions like Duchenne muscular dystrophy, haemophilia, and fragile X syndrome.
In 1983, the Islamic Organization for Medical Sciences (IOMS) seminar stated that foetal sex selection is unlawful at a national level but may be permissible on an individual basis with the consent of a married couple. Subsequent resolutions and conferences have reiterated prohibitions on certain practices, including surrogate maternity and the donation and commerce of reproductive materials, while permitting stem cell therapy under specified conditions. Furthermore, gender selection for social reasons is prohibited, while allowance is made for medical purposes only.
7. Organ Transplantation
In 1996, the Indonesian Council of Ulama, in conjunction with the Indonesian Forum for Islamic Medical Studies and the Federation of the Islamic Medical Association (FIMA), unanimously declared in the final resolution of the International Seminar on Organ Transplantation that while organs belong to Allah, they were created for the benefit of humankind, thus permitting the use of organs for the benefit of the community.
In 1988, in Jeddah, resolution no. 26 (1/4) by the Council of the Academy of Islamic Law outlined several principles:
(1) The recipient of a transplant must lead an honest life according to Sharia.
(2) Transplanting an organ within one's body is permissible if it serves to replace a lost organ, restore its regular function, or correct a fault causing psychological or physical harm, provided the benefits outweigh potential harms.
(3) Transplanting self-renewing organs like blood and skin from one person to another is permissible, provided the donor meets Sharia conditions.
(4) Using organs from a person with a sickness, like taking a cornea from a diseased eye, is permissible.
(5) Transplanting an organ essential for life, like the heart, from a living person to another is prohibited.
(6) It's prohibited to transplant an organ that, although not vital, would cause an essential function to cease, like taking corneas from both eyes, unless the person will still retain partial function.
(7) Transplanting an organ from a deceased person to a living one is permissible if consent was given before death or by the heirs after death or by Muslim authorities if the identity of the deceased is unknown.
(8) Organ transplantation is conditional upon not involving the sale of organs, though expenditure for obtaining necessary organs, offering compensation, or honoring the donor is subject to further deliberation.
(9) Further research and discussion are warranted on all matters related to organ transplantation.
In 1990, resolution no. 6/8/59 of the Academy of Islamic Law in Jeddah prohibited the transplantation of genital organs (ovaries and testicles) and external genital parts or most shameful parts (awrât mughallaza), though the uterus was not included in this prohibition.
In 1989, the Islamic Fiqh Academy of New Delhi stated that:
(1) Transplantation of organs from halal animals is permissible.
(2) Organs from haram animals are permissible if there are no alternatives and if life is at risk.
(3) Organs from a pig can only be used if there is a serious danger to life.
(4) Donation of organs in a will is non-binding.
In 1989, the Islamic Organization for Medical Sciences (IOMS) in Kuwait, together with the Islamic Fiqh Academy of Jeddah, recommended:
(1) Licit transplant of nerve tissues if derived from the marrow of the suprarenal glands of the subject.
(2) Use of organs from an anencephalic for transplantation only after the brain stem death of the fetus.
(3) Transplanting of sexual organs is prohibited.
In 1996, in Jakarta, the Indonesian Resolution on “Organ Transplantation from the Islamic Perspective” permitted the transplantation of organs from halal animals and from animals that are haram or ritually impure (najis) if they represent the only cure.
In 2002, Sheikh Yusuf al-Qaradawi issued a fatwa stating that it was unlawful for a Muslim to donate organs to a non-Muslim that attacks Islam or to an apostate.
Rulings on death, brain death, and organ retrieval from brain-dead subjects have been discussed extensively.
7b. Blood Transfusion
Blood transfusion is generally allowed from non-Muslims based on the necessity criterion according to various schools of fiqh.
7c. Autotransplantation
Autotransplantation, transferring tissues or organs within the same person's body, is permissible if the benefits outweigh the harms and the purpose is legitimate.
7d. Allotransplantation
Allotransplantation, transplanting tissues or organs from one person to another, is permissible under specific conditions, including the regeneration of the donated organ and removal for medical reasons.
7e. Cadaveric Transplantation
Cadaveric transplantation, from a deceased person to a living one, is subject to controversy, particularly concerning the concept of death itself and brain death.
7f. Transplantation of Organs of the Reproductive System
Transferring testicles or ova is forbidden, but transplanting other reproductive organs that do not transfer genetic characteristics is permissible.
7g. Transplantation of Brain Cells and Nervous Tissue
Transplanting these tissues is permissible if obtained from the patient's adrenal gland.
7h. Transplanting or Obtaining Cells/Tissue from a Human Fetus
Permissible only after a legal abortion or natural miscarriage.
7i. Prominent Fataawa on Brain Death
Various fatwas have been issued regarding brain death, with differing perspectives on its equivalence to Islamic death.
7j. Recipient Prioritization/Prohibition
Recipient prioritization based on religious affiliation is suggested in certain scenarios, though legal considerations in non-Muslim countries may override this.
7k. Organ Donation as Part of Will, Donor Card, and Opt-Out Organ Donation
There are diverging opinions on the validity and binding nature of organ donation in a will, through a donor card, and in an opt-out organ donation system, with various scholars offering different interpretations.
8. Burying of Limbs/ Placenta etc.
(i) Hanafi fiqh ruling as mentioned in Fatawa al-Hindiyya, Vol. 5, P. 438, Darul Kutub Ilmiyya, and Badaai' al-Sanaai', Vol. 4, P. 316, Darul Kitab Deoband, regarding separated limbs, placenta etc., is that one should endeavour to bury them but it is not necessary to bury them in a designated graveyard.
(ii) The opinion of Shaikh bin Baz as mentioned in kitaab Majmoo’ Fataawa wa Maqaalaat Mutanawwi’ah li Samaahat al-Shaykh al-‘Allaamah ibn Baaz , vol. 9, p. 436, is that the matter is open although it is good and preferable to bury amputated limbs in the ground.
9. Cloning
1997 in Jeddah, International Islāmic Fiqh Academy (IIFA), prohibited both types of human cloning, reproductive and twinning, and any other type that might lead to human procreation. Cloning in the botanical and zoological fields is permissible.
10. Stem Cell Research and Genetic Engineering
Introduction of a healthy gene into somatic cells, if performed for therapeutic reasons, is permissible; some experts deem this technique equivalent to a transplant at the molecular level and is accepted by those in favour of organ transplants (the majority of jurists).
The modification of an organ through a gene for therapeutic purposes is acceptable according to some; however, the modification of an entire
the organism is formally prohibited.
1998 in Kuwait, 11th Seminar on “Genetics, Genetic Engineering, the Human Genes and Genetic Treatment – An Islāmic Perspective,” organised by the International Islāmic Fiqh Academy of Jeddah, the WHO Regional Office, Alexandria (Egypt), and the Islāmic Education, Science and Culture Organisation (ISESCO), recommendations:
(1) Islām promotes knowledge and does not obstacle any “constructive” scientific research; for these reasons, Islām must move to the fore
in genetic research. Recourse to genetics to cure hereditary or acquired pathologies does not contradict the acceptance of divine will. Genetic research must never have priority over the rules of the Sharīʿa and respect for human rights.
(2) Mapping of human genes is permissible as an effort aiming at the knowledge of the human being and comprehension of the mechanisms of some hereditary pathologies.
(3) Genetic engineering on germinal cells is prohibited by the Sharīʿa. Genetic engineering should not be used with offensive purposes or crossing genes of different species to improve the human race or to tamper with the personality of an individual (eugenic purposes).
(4) Muslim law has no objections to the use of genetic engineering in agriculture and for animals but calls for an evaluation of the long-term risks on humans, animals and the environment.
(5) Genetic consulting should be available to citizens but without any obligation; consulting must remain confidential; recourse to consulting must be encouraged by the health institutions, the mass media and in the masājid.
11. The Utilization of Unlawful or Judicially Unclean Substances in Food, Medicines, and Vaccines
In May 1995, the 8th seminar organized by the Islamic Organization for Medical Sciences (IOMS) took place from the 22nd to the 24th, with participants including the University of Al-Azhar, the Fiqh Academy in Jeddah, the World Health Organization's regional office in Alexandria, Egypt, and the Ministry of Health, State of Kuwait. This seminar brought together leading specialists in Islamic law (fuqaha), modern medicine, pharmaceuticals, and scholars from other disciplines in Human Sciences. The second day of the seminar focused extensively on the topic of "The use of unlawful and judicially unclean materials/substances in foodstuffs and medicine."
The following recommendations were issued on the third day of the seminar:
Firstly: Skin Grafting
1. Recognizing the inherent dignity of human beings, whether Muslim or not, and the importance of protecting human life according to Shariah, skin grafting operations are deemed permissible. This process aligns with the overarching goals of Shariah, though certain conditions must be met, as discussed subsequently.
2. Skin, being an organ like any other, is subject to the general recommendations regarding organ transplantation outlined in previous symposia.
3. Skin transplantation from human sources is endorsed by Shariah as a necessity, subject to the general Shariah principles of "necessity."
4. Human-to-human skin transplantation is permissible, provided certain conditions are fulfilled, including being the only effective treatment method and ensuring minimal harm to the donor.
5. Conditions for permissible human-to-human skin transplantation include the absence of coercion in obtaining the skin and ensuring volunteerism whenever possible.
6. Skin grafts from permissible animals slaughtered according to Islamic specifications are permissible.
7. Grafts from non-slaughtered animals or living animals are deemed unclean and impermissible except in cases of necessity.
8. Pigskin grafts are impermissible except in cases of dire necessity and when no lawful alternative is available.
9. Establishing a human skin bank is permissible under specific stipulations, including state control and appropriate disposal of surplus skin.
Secondly: The Use of Unlawful or Juridically Unclean Substances in Food and Medicine
General principles:
1. Muslims are obligated to adhere to the rulings of Islamic Shariah, particularly in matters of food and medicine, which contribute to a healthy lifestyle. Concessions are granted in cases of necessity or ordinary need recognized by Shariah.
2. Alcohol is not deemed judicially unclean, as its impurity is considered ideational rather than physical. Therefore, its use as an antiseptic or disinfectant is permissible.
3. Despite alcohol being forbidden due to its intoxicating nature, its use in medicines containing small amounts for preservation or dissolution purposes is permissible until alcohol-free alternatives are available.
4. Foods containing even small amounts of wine are prohibited, and the rule of exceptional permissibility does not apply.
5. Foods containing tiny amounts of alcohol for dissolving materials insoluble in water are permissible due to necessity.
6. Foods containing pig fat that remains unaltered, such as certain cheeses and creams, are prohibited.
7. Treatment of diabetes with insulin from a pig source is permissible due to necessity, provided Shariah principles are observed.
8. Transformation processes can render unclean substances permissible, such as gelatin from animal bones, skin, and tendons, or soap made from pig fat.
9. Narcotic drugs are generally prohibited, except for specific medical treatments determined by physicians. Nutmeg is permissible for use as an aromatic in food, provided it does not lead to sedation or narcosis.
In summary, the scholars reaffirmed the consensus that pigs are judicially unclean but allowed for the use of pig components in medicine where transformation has occurred.
In 1997, during the 9th seminar organized by the Islamic Organization for Medical Sciences (IOMS), the Islamic Educational, Scientific, and Cultural Organization (ISESCO) joined the participants from the 1995 seminar. Islamic scholars reaffirmed the permissibility of using porcine gelatine, citing the Islamic ethico-legal construct of istiḥāla. Additionally, they approved the use of pig enzymes in medicine production through the construct of istihlāk.
In 1998, the Islamic Fiqh Academy (IFA) of Jeddah stated that it is permissible to use gelatine extracted from lawful materials and from animals slaughtered in accordance with the rulings of Islamic Sharīʿa. However, the use of gelatine extracted from prohibited animals or materials, such as pigskin and bone, is not permissible.
In 2008, the council of Indonesian ulema (MUI) issued a fatwa declaring the meningitis vaccine produced by GlaxoSmithKline as harām due to the use of pig enzymes in its manufacture. However, the Saudi government required Hajj pilgrims to be vaccinated against meningitis, prompting the MUI to allow the use of the vaccine based on the principle of necessity, as no alternative was available. In 2010, when halāl meningitis vaccines became available, the permissibility to use the GlaxoSmithKline vaccine was withdrawn.
While Muslim jurists generally agree on the principle of transformation (istiḥāla), differences in phraseology exist among them. It is noteworthy that Shafii jurists, whose official fiqh Indonesia follows, do not generally accept the applicability of istiḥāla to porcine products. Hanafi and Maliki jurists hold the view that istiḥāla can purify porcine products, although some Hanafi scholars argue otherwise. The dominant opinion among Hanbali jurists leans towards the belief that porcine products are not covered by istiḥāla, although scholars like Ibn Taymiyyah and Ibn Qayyim al-Jawziyyah held the opposite view.
The inquiry into the permissibility of utilizing medication containing harām substances prompts a discussion of classical Hanafi jurisprudence. Imām Abū Ḥanīfa held the view that employing anything deemed unlawful, even for medical purposes, is impermissible. In contrast, his prominent student, imām Abu Yusuf, deemed it permissible. The authoritative Hanafi text states: "The Scholars differed regarding the usage of harām medication. The apparent opinion in the (Hanafi) school is that it is harām. However, it is said that it will be permissible when the medicine is known to be effective and there is no other alternative, just as there is a dispensation in drinking alcohol for a person dying of thirst, and the fatwa is given on this opinion." (Durr al-Mukhtar, 1/210)
According to the Hanafi perspective, the use of medicines containing impure or unlawful substances is permissible under specific conditions:
1) The effectiveness and necessity of the medicine are reasonably established;
2) No permissible alternative is reasonably available;
3) The endorsement comes from an expert Muslim doctor who exhibits at least outward righteousness and piety.