When religion collides with organ donation, what does Islam say?

Abdul-Kareem Salahuddin had gotten used to the pitying looks from family and friends. He had suffered from hepatitis C for more than 20 years. By 2012, his skin color had darkened, his hair had fallen out, his limbs were swelling, his liver was shot.

“You’re going to need a transplant, or you’re going to die,” his doctor told him.

Amid fears about his declining health, the threat of death, and the prospect of waiting years for a transplant, Salahuddin also had this to ponder: What did his religion say about the procedure? Would Islam, the faith that had given him so much peace and fulfillment, permit him to receive a transplant? Does it allow Muslims to donate their organs?

Uncertain what Islam has to say on the matter, Muslims often err on the side of caution. Like others across the spectrum of faith traditions, some not only lack information about organ donation but may mistrust institutionalized medicine. A scholarly minority views it as a desecration of the body, but defenders say its medical benefits outweigh religious considerations.

It is a concern that counselors for the Gift of Life Donor Program repeatedly hear from Muslim families during the heartbreaking moments in a hospital when a loved one is declared brain dead, and the question of organ donation is broached — moments that will increasingly arise as the region’s Muslim population, which community leaders estimate at more than 200,000, continues to grow.

That has prompted the Philadelphia-based nonprofit to begin a series of eight public information seminars to answer questions about Islamic texts and offer scholars' interpretations. Gift of Life, which facilitates organ donation in Eastern Pennsylvania, South Jersey and Delaware, has partnered with diversity and inclusion consultant Aliya Khabir, who has enlisted Tahir Wyatt, education director at Philadelphia’s United Muslim Masjid and a scholar of Islam who earned his Ph.D. in theology at the Islamic University of Madinah in Saudi Arabia.

At the first — and so far, the only scheduled — session this month at Masjidullah, a mosque in West Oak Lane, Wyatt told an audience of more than 200 that he wasn’t there to persuade them to become organ donors but to clarify Muslim principles so they could make informed decisions.

“You won’t find a book in the Quran and a verse that talks about donating a liver, kidney, or pancreas,” Wyatt said. However, most Muslim scholars agree that organ donation is “permissible with certain criteria.” In Islam, “the person who saves a life, it’s as if he has saved the lives of mankind.”

In the Philadelphia area, about 5,200 people are waiting for organ transplants. Of those, an estimated 350 will die before a donor can be found, said Howard Nathan, Gift of Life president and CEO. About 4,700 on the regional list are in need of a kidney, and of that group, half are African American. Kidney failure is three times as prevalent in the black community because of higher incidences of diabetes and high blood pressure.

One of those waiting is Philadelphia rapper Freeway, born Leslie Pridgen, a Muslim who was diagnosed with kidney failure in 2015 and who chronicled his medical journey in the documentary Think Free, scheduled for release next year. Now 40, he lived with high blood pressure and diabetes for years, but never took care of himself, he said. “I was traveling on tour. My diet was crazy. I would eat cheeseburgers at 2:30 a.m. in the morning in the studio — just ripping and running.”

The rapper, recently on tour with Jay-Z and Beyoncé, wound up on dialysis three times a week. Wherever he travels, he must find a center for the arduous treatment. He said he has turned to Allah for comfort and remembers this Islamic principle: “With every struggle comes ease.” He is praying that will come with a transplant.

Muslim Americans are less likely than Caucasian Americans to be organ donors, and the perceived lack of support from Islam is a factor, said Ruba K. Azzam, medical director of the pediatric liver transplantation program at the University of Chicago and co-author of a 2014 study examining the issue.

But also clouding the issue is a suspicion of institutional medicine, Wyatt said. For many African Americans, it is rooted in historical infamy, in the use of black people as research subjects in cases such as the government-sponsored Tuskegee Syphilis Study, in which hundreds of Alabama sharecroppers were not told they had the disease and were not they treated for it.

Stephanie Drewitt-Jerman of West Oak Lane, who is Christian, donated the corneas and tissue of her son, Cornell Dreuitt, a Muslim, when the 38-year-old father of four was shot and killed in 2014. Dreuitt had decided to become an organ donor before his death, though he wasn’t certain of what Islam said about it, Drewitt-Jerman said.

The family decided together that “if anything happened, we would help save someone,” she said. “Somebody took his life, and we gave life back.”

If the donor is living, Islamic principles say the person must have reached the age of puberty, must be mentally competent,is able to donate the organ without detrimentally affecting his own quality of life, and should not profit financially from it, Wyatt said.

The organ that is donated must be used for the preservation of life or to preserve the quality of life, he added. For that reason, Muslims cannot give their bodies to science for research.

In cases in which the hospitalized person is brain dead but on life support — making organs eligible for harvesting — there are “gray areas,” Wyatt said.

“I don’t think we can categorically say that brain death is not death, or that brain death is death,” Wyatt said. In Islam, if three doctors determine that a person is brain dead irreversibly, that can be considered death. Only after that can the organs possibly be donated, he added.

That happened on Aug. 19, 2014, when Ryan Shaw, 20, of Philadelphia, was rushed to Temple University Hospital after suffering a severe epileptic seizure. Within days, he would be brain dead. His mother, Carol McCloud, made the decision to donate his organs.

His liver went to Abdul-Kareem Salahuddin.

“None of us understands the depth of Allah’s wisdom,” said Salahuddin, who has become friends with McCloud. “In my time of need, the Muslim community took care of me. And I’m here today because another family in their time of grief thought about saving someone else — and I thank Allah for that.”