1 Journal of the British Islamic Medical Association Re-examination of the Fatawa on Organ Donation in Light of Current Medical Research Introduction Muslims in the UK face discord due to the clash of opinions on the ‘opt-out’ system to be introduced in April 2020. In this article, I share my opinion on how a careful re-examination of the fatawa that contribute to the prohibition of organ donation may provide a fresh perspective on how to advise on the new opt-out system. Re-examination of the Fatawa on Organ Donation Te fatawa on organ donation have been re-examined over the decades as mufis became more informed of medical research. Te earliest known discussion on organ donation was by the Saudi Quranic exegete Sa’di in 1925 [1]. Te discussion encourages organ donation as a viable option for Muslims who seek an organ transplant. Tis discussion occurred two decades afer the frst corneal transplant was performed in 1906. Te permissibility of blood transfusion and corneal transplants were ofcially given a permissibility status by the grand mufi of Egypt Sheikh Mamoon in 1959 [2]. Perhaps, the period of time that elapsed before the fatwa was released may surprise some, however, a number of developments occurred between Sa’di’s discussion and Mamoon’s fatwa on permissibility. Tese developments included the approval of Safar’s ABC technique for resuscitation which became the basis for mass training of CPR. Te frst successful kidney transplant was performed between fraternal twins in 1959 [3]. Tese developments would have infuenced the process of issuing the fatwa on the permissibility of organ donation, especially since the aforementioned developments contributed to the success of life-saving transplants. A fatwa that precedes scientifc discoveries requires re- examination. Further discussions on organ transplantation saw a number of diferent arguments from a theological perspective on the question of who owns the body and whether humans have any right to donate organs in life or upon dying. While such theological or philosophical Mufti Usman Maravia. Correspondence: u.maravia@lancaster.ac.uk Keywords: Organ Donation, Fatwa, Islam, Medical ethics Vol. 2 - No. 1 | August 2019 | www.jbima.com Ethics questions are not answerable by medical research, such questions have warranted much attention over the past few decades, questions to which science may provide insights. Medical science can help determine the point when an individual could be considered dead; or whether organ donation is the best treatment on a practical level, rather than the process being experimental. Neurological criteria for death, which revolutionised how end of life was determined, was adopted by the Harvard Ad Hoc committee in 1968 [4]. Tis year is signifcant as only a year earlier, the late grand mufi of Pakistan Muhammad Shaf issued a fatwa on the prohibition of organ donation [5]. Te same year saw the frst successful heart transplant in South Africa [6] followed by another in the United States [7]. Te frst successful liver transplant also occurred in the same year. Whether Shaf was aware of these successful transplants remains unknown. Nevertheless, these medical breakthroughs have lead contemporary jurists to the re-examination of the arguments made by Shaf, whose fatwa could no longer be viewed as timeless. Furthermore, re-examination of fatawa should be researched-based and in light of the latest medical developments. In the UK, organ donation has resulted in a diference of opinion involving the majority of Islamic jurists of south Asian afliation being inclined to the mentioned fatwa by Shaf. On the other hand, other jurists of the same afliation have considered the medical research which followed Shaf’s fatwa. Te numerous international conferences that have taken place in the past few decades in Egypt (1979) [8], Kuwait (1979) [9], Saudi Arabia (1985) [10], and in Europe (1995) [11] all agreed on the permissibility of organ transplantation for life-saving purposes as well as for increasing the quality of life, from both living and deceased donors. Consequently, jurists in the Indian sub-continent were also divided over the issue in light of this new research. Qadhi Mujahidul Islam Qasmi [12] and Khalid Saifullah