Note: However beneficial stem cells are for treating diseases and extending human lifespan, they bring about numerous jurisprudential challenges to the same extent. These challenges arise in the harvesting of stem cells, in organ transplantation or utilizing these cells for regeneration, and generally in matters such as mahramiyat between donor and recipient of stem cells. Hujjat al-Islam wal-Muslimeen Dr. Mohammad Bol-Hasani, who, in addition to teaching advanced levels in the Islamic Seminary of Qom, holds a doctorate in Criminal Jurisprudence, has been researching this field for years. We conversed with him regarding the jurisprudential challenges of using stem cells. He considers the most crucial jurisprudential challenge in stem cells to be the “source of cell harvesting.” The detailed exclusive interview of Contemporary Jurisprudence with this professor and researcher of medical jurisprudence is presented below:

Contemporary Jurisprudence: What is the ruling on using stem cells for treatment? Can it be deemed unlawful through titles such as “altering the creation of Allah”?

Bol-Hasani: From the perspective of Shia jurists, the primary principle (al-asl al-awwali) regarding all things and actions is permissibility (ibahah), unless a specific Sharia proof exists establishing its prohibition. Regarding the treatment of diseases, not only is there no prohibition, but preserving life (hifz al-nafs) and bodily health is among the mandatory Sharia and rational duties. Arguing with the noble verse “and I will command them so they will change the creation of Allah” (Surah An-Nisa, Verse 119) to prohibit stem cell therapy is incorrect; because “altering Allah’s creation” promised by Satan means altering the monotheistic innate nature (fitrah), mutilating animals’ bodies, or irrational and unlawful modifications, not restoring health. Treatment via stem cells is in fact an effort to restore the body to its natural state and the “best stature” (ahsani taqwim) created by God, not creating a new nature opposed to creation. Just as kidney transplantation or heart surgery is not considered altering creation, cell injection to repair damaged tissue is likewise not an instance of unlawful alteration. Therefore, this therapeutic method is permissible per se, and in cases where saving a patient’s life depends on it, it becomes a collective (kifa’i) or individual (‘ayni) obligation upon physicians and the patient.

Contemporary Jurisprudence: What jurisprudential challenges does the use of stem cells entail?

Bol-Hasani: Utilizing this technology bears several jurisprudential challenges, the most crucial of which is the “source of cell harvesting.” If the cell source is a “human embryo,” the discussion of abortion prohibition and the timing of spirit ensoulment (ta’alluq al-ruh) is raised: Is destroying a blastocyst (a few-day-old embryo) to extract cells an instance of homicide or destroying potential life? The second challenge is the issue of “ownership and commerce”: Is a person the owner of cells separated from his body? Does a stem cell possess “property value” (maliyyah), allowing it to be sold, or is there only the right of free transfer? The third challenge relates to “cloning”: If these cells are used to produce a human similar to the donor, complex discussions regarding lineage, inheritance, and mahramiyat arise. Furthermore, the issue of “genetic intervention” and potential modifications in the human genome that might transfer to future generations has raised concerns under the rule of “No Harm” (La Darar) and preservation of lineage, requiring precise jurisprudential deductions.

Contemporary Jurisprudence: Given the view of most jurists that “man is not the owner of his body,” does the use of stem cells require the permission of the cell owner or the guardian of the cell owner?

Bol-Hasani: Yes, permission is definitely required. Although true ownership of man and the universe belongs to God and man lacks absolute ownership over his existence, in jurisprudence, man possesses a “right of authority” (haqq al-saltanah) and “right of exclusivity” (haqq al-ikhtisas) over his body. Based on the jurisprudential rule “people have authority over themselves” (al-nasu musallatuna ‘ala anfusihim), any disposal of a living person’s body without his consent is unlawful and entails liability (daman, in terms of blood money or retribution). Therefore, harvesting stem cells from a mature and sane individual definitely and religiously requires his “informed consent,” and no physician has the right to sample without permission. Regarding children or sources like umbilical cord blood belonging to an infant, decision-making rests upon the “Sharia guardian” (wali shar’i, the father or paternal grandfather). The guardian is likewise obligated to decide based on the child’s “welfare and interest” (ghibta wa maslahah); that is, if cell donation causes no harm to the child and carries a rational benefit (such as storage for the child’s own future), the guardian has permission; otherwise, his guardianship falls.

Contemporary Jurisprudence: Given that mere “breastfeeding” (rida’) establishes mahramiyat, can it be said, a fortiori, that using one person’s stem cells for the opposite sex establishes mahramiyat?

Bol-Hasani: No, this argument is rejected in Shia jurisprudence; because analogy (qiyas—extending the ruling of one subject to another without definitive proof) is invalid in the Imami school. Mahramiyat resulting from “breastfeeding” (rida’) is a devotional and specific ruling (hukm ta’abbudi) established by the Sacred Lawgiver with very precise conditions (such as 15 consecutive nursings, from a woman’s pure milk, causing growth of flesh and bones). However, in organ transplantation, blood transfusion, or stem cell injection, although a person’s body tissue enters another person’s body, there is no textual Sharia proof (verse or narration) indicating the establishment of mahramiyat in these cases. Stem cells are merely living tissue possessing a regenerative function and do not alter the identity or lineage of the recipient to create a kin relationship. Therefore, receiving cells from a sister, brother, or stranger carries no declaratory effect (athar wad’i) in establishing mahramiyat or altering marriage rulings.

Contemporary Jurisprudence: What jurisprudential restrictions and limitations govern the use of stem cells?

Bol-Hasani: The use of this technology is not absolute or unrestricted, but is bound by important Sharia qualifications. The first and most crucial restriction is the rule of “No Harm and No Harassment” (La Darar wa La Dirar); meaning that the cell extraction process must not cause life-threatening harm or irreversible complications for the donor (such as severe damage to bone marrow). The second restriction is the “prohibition of mutilation” (hurmat al-muthlah); tissue harvesting must not cause hideousness or gross visible physical defect in the donor. The third limitation concerns “embryonic sources”: using embryos into which the spirit has been breathed to extract cells is unlawful and incurs full blood money (diyah). Even in stages prior to ensoulment, destroying an embryo is impermissible except under conditions of emergency (idtirar) where a human life (e.g., the mother or another patient) depends on it and no other way exists. The fourth qualification is observing ethical standards in “commerce”: buying and selling cells must not lead to exploiting humans or converting the human body into a commercial commodity, although receiving compensation for the sacrifice and act of donation (not selling the organ) is permissible according to many jurists.

• Observing the No Harm Rule: The donor must not suffer significant harm (e.g., if extracting bone marrow poses a life risk to the donor, it is unlawful).

• Prohibition of Harming the Embryo: If cell extraction entails destroying an embryo possessing a spirit (and based on precaution, even before ensoulment), it is impermissible, except under specific emergency conditions where the mother’s life is at risk (depending on the authority’s fatwa).

• Informed Consent: The consent of the cell owner is a condition.

• Rulings on Ritual Impurity (Najasah): If the cell is taken from an essentially impure animal (najis al-‘ayn, such as a dog or pig) or a disbeliever (kafir), specific operational rulings for ritual purity in prayer may arise (although if transformed into a part of the recipient’s body, it is considered pure).

Contemporary Jurisprudence: Do disbelief, illegitimacy (walad al-zina), hypocrisy, and other titles of the stem cell donor or recipient create limitations on its use?

Bol-Hasani: In this area, there is no scientific material proving spiritual effects, and from biological and ontological perspectives, cells are tools of life and do not carry the beliefs, sins, or moral traits of their owner; therefore, the cell of a disbeliever or an illegitimate child has precisely the same biological performance as the cell of a believer. From a jurisprudential perspective, treating and saving a human life (whether Muslim or non-Muslim, except a belligerent disbeliever (kafir harbi) at war with Muslims) is valuable and permissible. In the discussion of “ritual impurity” (najasah), the body of a non-scriptural disbeliever is considered ritually impure; however, in the treatment and transplantation process, the rule of “transmutation” (istihalah) or “transformation” (inqilab—change of nature) or “becoming part of the body” applies. When a disbeliever’s stem cell is transplanted into a Muslim’s body and gains life, it is considered part of the Muslim’s body and becomes ritually pure (tahir). Therefore, there is no jurisprudential restriction on receiving cells from individuals with differing beliefs or birth statuses, and these titles are not obstacles to treatment, unless specific security or ethical concerns (outside the topic of the cell’s nature) are raised.