Stem cells: definition, ruling on setting up stem cell banks and using them for medical purposes

1.

The cells referred to in the question, stem cells, are
extracted from the umbilical cord after birth. These cells that are taken
from it play a role in rebuilding blood cells and strengthening the immune
system of patients with blood diseases such as leukaemia (blood cancer) and
anaemia. They may also be used to treat neurological diseases such as brain
paralysis, Alzheimer’s and so on. These cells are not attacked by the immune
system, because they quickly develop into a neutral state. The umbilical
cord looks somewhat like a rope; it connects the foetus in the uterus to the
placenta. It contains two arteries and one vein. The arteries take blood
carrying waste material from the foetus to the placenta, and the vein takes
blood carrying oxygen and nutrients from the mother’s blood to the foetus. 

Al-Mawsoo‘ah al-‘Arabiyyah al-‘Aalamiyyah. 

2.

There are three sources for stem cells: 

(a)Stem cells taken from human
embryos between the ages of 5 days and two weeks.

(b)Stem cells taken from adults,
which are collected in two ways:

(i)

From bone marrow, i.e. from the bone itself, such as from the
bones of the pelvis or chest. The problem with this method is that it is
regarded as painful and requires a general anaesthetic; it also takes a long
time, in addition to the fact that the amount of stem cells collected in
this manner is very small.  

(ii) 

From blood. This requires a large amount of blood to be
taken, then filtered, but in the end only a very small amount of stem cells
is obtained. 

(c)The last and most important
source of stem cells is the umbilical cord, which is a rich source of these
cells; it may contain as many as 200 million stem cells!

3.

Hence the idea developed of keeping these cells in “banks”.
In Dubai there are public and private stem cell banks, and in Jeddah there
is a private company that stores cells for those who want that, in return
for a fee. These banks implement measures to guarantee that the cells will
not be tampered with; the owner can also follow up and check on them just as
he can check on the money in his bank account. 

Some doctors have stated that it is possible to preserve
these cells for up to 25 years, and some doctors say that it is possible to
store them for life. 

4.

These cells are useful not only for their owner who may be
affected by diseases in which he can benefit from them; rather he can also
donate them to others. Stem cells have indeed been used to treat cases of
sickness and they have been a successful alternative to the risky procedure
of transplanting bone marrow. From a medical point of view, stem cells are
regarded as an alternative to organ donation, as it is possible to
regenerate the patient’s damaged cells. 

For their owner, they are a perfect match for his cells, and
he is the only one who has a perfect match. Among members of the same
family, the likelihood of a match varies between 25% to 40%. All of this, of
course, applies so long as the mother does not have any communicable
diseases such as hepatitis or AIDS. Hence it is essential to carry out tests
on the mother’s blood before collecting the stem cells.  

Based on that, if an individual keeps them for himself, there
should be no difference of opinion that it is permissible. 

5.

Because of these benefits in the cells that are taken from
the umbilical cord, some of those who do not fear Allah hastened to obtain
umbilical cords by means of deliberate abortion. We are sorry to say that
some of those whom people trusted with their lives did that. Hence there was
a clear statement by the Islamic Fiqh Council that it is haraam to carry out
deliberate abortions for the purpose of using the embryo’s organs –
including stem cells, of course. There follows the text of the statement: 

In the session of the Islamic Fiqh Council, held during its
sixth conference in Jeddah, KSA, 17-23 Sha‘baan 1410 AH (14-20 March 1990
CE), after studying the research and recommendations on this subject – which
was entitled Using Foetuses as a Source for Organ Transplants – which was
also one of the topics of the sixth Medical Fiqh conference held in Kuwait,
23-26 Rabee‘ al-Awwal 1410 AH (23-26 October 1990 CE) – in cooperation
between this Council and the Islamic Medical Sciences Organization, the
following was determined: 

(i)

It is not permissible to use foetuses as a source for organs
that are needed for transplant into another individual except in some cases
that are subject to conditions that must be met: 

(a)It is not permissible to
deliberately induce abortion for the purpose of using the foetus in order to
transplant organs into another individual. Rather abortion should be limited
to that which is natural and spontaneous (i.e., miscarriage) and not
deliberate, or abortion that is carried out for a legitimate shar‘i reason.
Surgery should not be resorted to in order to extract the foetus except
where that is necessary in order to save the mother’s life.

(b)If the foetus is viable (i.e.,
could survive), then medical treatment should focus on saving and preserving
its life, and it should not be used for organ transplants. If the foetus is
not viable, it is not permissible to use it except after its death, subject
to conditions mentioned in statement no. 1 of the fourth conference of this
Council, which discusses one human benefiting from the organs of another
human, living or dead.

(ii)

It is not permissible to use the process of organ transplant
for commercial gain under any circumstances. 

(iii)

It is essential to delegate responsibility for supervision of
organ transplants to a committee of specialist and trustworthy individuals.
End quote. 

6.

It seems – and Allah knows best – that it is permissible to
make use of the cells found in the umbilical cord, especially when the cord
is usually discarded. 

The Fiqh Council of the Organization of the Islamic
Conference issued a statement concerning this matter during its session that
was held on 18 Jumada al-Aakhirah 1408 AH (6 February 1988 CE). The text of
this statement follows: 

Firstly: it is permissible to transplant an organ from its
place in a person’s body to elsewhere in his body, whilst making sure that
the expected benefit from this procedure outweighs any potential harm, and
on condition that this is done for the purpose of replacing a missing organ
or reshaping it, or changing its function, or correcting a defect or
removing a deformity that is causing psychological or physical pain. End
quote. 

Shaykh Ibraaheem al-Fayyoomi – Secretary General of the
Islamic Research Council in Egypt – said: 

The Council found that generating and growing tissues and
cells in order to benefit from them in treating humans is done by using
stems cells, and there is nothing wrong with that. This is based on what was
mentioned by Professor Dr. Ibraaheem Badraan – a member of the Council and
former Minister of Health. 

And he said: 

Islam does not prevent science that is beneficial to man. The
Council is following with interest everything that is new in this important
branch of science, and acknowledges that growing stem cells opens a new door
to treatment that will reduce dependency on organ transplants from deceased
persons or donors. It will give a greater opportunity to help patients whose
sickness is incurable, especially in cases of liver, kidney and heart
disease. 

And he said: 

There is no shar‘i reason to disallow setting up banks to
store stem cells, so long as they are used for treating humans. End quote. 

7.

We should point out that it is not permissible for anyone to
donate sperm or eggs for the purpose of producing zygotes (fertilised eggs)
which will then develop into the foetus with the aim of obtaining the stem
cells from it. It is also not permissible to use cloning in order to obtain
foetal stem cells. Rather permission is limited to obtaining stem cells from
umbilical cords. 

A statement was issued by the Islamic Fiqh Council, no. 54
(6/5) on the topic of transplanting brain cells and nerve cells, the text of
which is as follows: 

The session of the Islamic Fiqh Council that was held during
the sixth conference in Jeddah, KSA, 17-23 Sha‘baan 1410 AH (14-20 March
1990 CE), after studying the research and recommendations on this topic that
was one of the topics of the sixth Medical Fiqh conference held in Kuwait,
23-26 Rabee‘ al-Awwal 1410 AH (23-26 October 1990 CE) – in cooperation
between this Council and the Islamic Medical Sciences Organization, and in
light of the conclusions reached by the conference referred to, and knowing
that this does not mean transplanting the brain of one person to another
person; rather the aim of this transplant is to treat a defect in specific
cells in the brain that are not able to excrete sufficient chemical or
hormone substances, so they are supplemented with similar cells from another
source; or it is done to treat gaps in the nervous system that result from
some injuries, the Council determined the following: 

Firstly: if the source of the tissue is the adrenal gland of
the patient himself, and there is an advantage in that because it will not
be rejected by his immune system as the cells are from the same body, there
is nothing wrong with that from a shar‘i point of view. 

Secondly: if the source is an animal foetus, there is nothing
wrong with this method if it can be successful and there are no shar‘i
reservations. Doctors have stated that this method has been successful in
different kinds of animals and it is hoped that it will be successful whilst
taking the necessary medical precautions to avoid rejection by the immune
system. 

Thirdly: if the source of tissues is living cells from the
brain of an early embryo – as old as ten to eleven weeks – the ruling varies
according to the following: 

(a)The first method: taking the
tissue directly from a human foetus in the mother’s uterus by opening the
uterus surgically; this method results in death of the embryo as soon as the
brain cells are taken, and it is haraam unless it happens after spontaneous
abortion (miscarriage) or an abortion that is permitted in sharee‘ah in
order to save the mother’s life, and after ascertaining that the foetus has
died, whilst paying attention to the conditions which will be mentioned on
the topic of using embryos in statement no. 59 (6/8) of this session.

(b)The second method: this is the
method which may be brought about in the near future, which involves growing
brain cells in “farms” in order to make use of them. There is nothing wrong
with this from a shar‘i point of view, if the source of the cells is
legitimate and they were obtained in a manner that is Islamically
permissible. End quote.

8.

All countries must oppose the abortion of foetuses in order
to obtain their organs and cells, and it is not permissible to benefit from
that which has been taken in unlawful ways to take part in setting up their
banks. Trustworthy organisations should be in charge of this matter and
these cells should be collected in ways that are Islamically acceptable, in
order to treat those who need transplant of cells. 

9.

After writing the above, we came across a statement of the
Islamic Fiqh Council attached to the Muslim World League on the topic of
stem cells, which agrees with what we have stated above. We will post it
here to summarise what is stated above and to give it precedence over other
statements, because it is the opinion of virtuous scholars who are
specialised in medicine and sharee‘ah. 

The statement of the Islamic Fiqh Council: 

The Islamic Fiqh Council of the Muslim World League, in its
seventeenth conference in Makkah al-Mukarramah, 2003 CE, discussed the topic
of transplanting stem cells on the basis of the sources of these cells, in
accordance with the recommendations of the organisation in its sixth
conference in 1989 CE, as mentioned above. In the third statement of the
Islamic Fiqh Council, dated 17/12/2003 CE, it says the following: 

Stem cells, which are the original cells from which the
embryo is created, have the ability – by Allah’s leave – to develop into
different types of cells in the human body. Scientists have recently been
able to find out about these cells and to isolate them and grow them with
the aim of using them for medical treatment and various scientific
experiments. Hence they can be used to treat disease and they are expected
to have a great impact in the future in treating many diseases and physical
deformities, including some types of cancer, diabetes, kidney and liver
failure, and so on. 

These cells can be obtained from numerous sources, including
the following: 

(i)The embryo at the blastula
stage, where it forms a sphere of cells from which the various cells of the
body will grow. Zygotes (fertilized eggs) produced in attempts at in-vitro
fertilisation are regarded as the main source. It is also possible to
deliberately fertilise an egg from a donor with sperm from a donor in order
to obtain zygotes, and grow them until they reach the blastula stage, then
extract the stem cells from them.

(ii)Aborted foetuses at any stage
of pregnancy.

(iii)The placenta or umbilical cord

(iv)Children and adults

(v)Cloning, which is done by
taking a cell from an adult human, then extracting its nucleus and inserting
it into an egg from which the nucleus has been removed, with the aim of
reaching the blastula stage, then obtaining stem cells from it.

After listening to the research presented on this topic and
the opinions of members, experts and specialists, and finding out about this
type of cells and their sources, and the ways in which they may be used, the
Council took the following decision: 

Firstly: it is permissible to obtain stem cells and grow
them, and use them for medical treatment or permissible scientific research,
if the sources are permissible. That includes, for example, the following
sources: 

(i)Adults if they have given
permission and that will not cause any harm.

(ii)Children, if their guardians
have given permission, if it is done for a legitimate purpose and without
harming them.

(iii)Placentas and umbilical cords,
with the permission of the parents.

(iv)Spontaneously aborted foetuses
(i.e., miscarriage) or foetuses from abortions that were carried out for
medical reasons permitted by sharee‘ah, with the permission of the parents.

We should also be reminded of the seventh resolution of the
twelfth session, about cases in which it is permissible to abort a
pregnancy.

(v)Spare fertilised eggs (zygotes)
from attempts at in-vitro fertilisation, if there are any and they have been
donated by the parents; it should be noted that it is not permissible to use
them for an illegitimate pregnancy.

 Secondly: it is not permissible to obtain stem cells and use
them if their source is haraam, such as the following, for example: 

(i)Foetuses that have been aborted
deliberately without any medical reason that would make that permissible
according to sharee‘ah.

(ii)Zygotes that result from
fertilisation of donor eggs with donor sperm.

(iii)Cloning. End quote.

And Allah knows best.