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Human reproduction

By:
Noor Munirah Isa
Source:
The Encyclopedia of Islamic Bioethics What is This? A comprehensive reference work covering the major issues in Islamic bioethics, including medicine, clinical practice, genetics, theology, and Islamic law.

Human reproduction

By nature, humans reproduce sexually. Following sexual intercourse between a male and a female, a male’s sperm fertilizes a female’s ovum and the fertilized ovum later grows in a uterus within the female’s body. Most humans normally have an earnest desire to bear their own children, which can also be seen as a means to strengthen the marital relationship. In the Islamic tradition, a child is regarded as important not only to preserve the family legacy but also to earn more blessings and to improve the quality of life for the family.

Given the importance that many cultures and religions place on traditional parenthood, the issue of infertility has been a major concern. Thanks to the advancement in science and technology, new applications such as in vitro fertilization (IVF) have been developed to overcome this condition. Today couples may have a higher chance than before not only to have a child, but for that child to be healthier, and even to have certain desired traits, including gender. They can even procreate without having sexual intercourse, or postpone the conception by freezing the sperm or the egg, or cultivate the fertilized egg to term outside the body (Delaunay, 2015). The development of these applications may bring a great hope to infertile couples, but at the same time it has raised complex ethical questions.

The Islamic tradition anticipates that people will find difficulties in solving ethical questions. For that reason, people are in need of divine revelation, known as Shariʿah, to guide them. Shariʿah generally aims to prevent harm from being inflicted both in this world and in the hereafter (al-Sulamī, 2010). Some actions have clear reference in the Qurʾān and Sunnah. Those actions that do not have clear reference, such as modern reproductive technologies, require a profound investigation of the Qurʾān, the Sunnah, and other sources of Shariʿah. This investigation, typically performed by trained Islamic scholars, is known as ijtihād and its end product is fatwa (juristic legal opinion).

This article is divided into two sections. The first section explains the basic ethical guidelines related to human reproduction that can be found in the Qurʾān and Sunnah, while the second section highlights several key Islamic ethical principles that can be derived from fatwas and scholarly writings of Muslim scholars regarding ethical issues in human reproduction.

Human Reproduction in the Qurʾān and Sunnah

Islam acknowledges the innate nature of humans to find mates and reproduce. The Qurʾān (3:14) states that children are among the things that humans naturally covet: “Fair in the eyes of men is the love of things they covet: women and sons; heaped-up hoards of gold and silver; horses branded (for blood and excellence); and (wealth of) cattle and well-tilled land. Such are the possessions of this world’s life; but in nearness to Allah is the best of the goals (to return to)” (Ali, 2007).

As the main references in Islam, both the Qurʾān and Sunnah provide basic ethical guidelines regarding human reproduction. The most important and the most frequently mentioned aspect of the Islamic worldview is that it is God who creates humans and the universe and knows everything about His creations. For example, the Qurʾān (23:12–14) describes phases in human creation from clay: “Man We did create from a quintessence (of clay); Then We placed him as (a drop of) sperm in a place of rest, firmly fixed; Then We made the sperm into a clot of congealed blood; then of that clot We made a (foetus) lump; then We made out of that lump bones and clothed the bones with flesh; then We developed out of it another creature. So blessed be Allah, the Best to create!” (Ali, 2007).

Another important aspect of the Islamic worldview relating to human reproduction is the connection between the creation of human beings and God’s will. For example the Qurʾān (13:8) explains that divine knowledge encompasses the development of the fetus and that not all fetuses would develop into complete human beings: “Allah does know what every female (womb) does bear, by how much the wombs fall short (of their time or number) or do exceed. Every single thing is before His sight, in (due) proportion” (Ali, 2007).

According to the Islamic tradition, humans are noble creatures who are blessed with special characteristics that other creatures do not have (Qurʾān 17:70; al-Zuḥaylī, 2009). In order to preserve human dignity, procreation is to be pursued only through marriage. Adultery, as stated in the Qurʾān (17:32), is prohibited. It is regarded as a shameful act that will cause significant types of harm such as confusion in human lineage (al-Qurṭubī, 1993). Several Qurʾānic verses mention spouses prior to offspring or pregnancy, which indicate the precedence of marriage to procreation. For example, the Qurʾān (16:72) states that: “And Allah has made for you mates (and companions) of your own nature, and made for you, out of them, sons and daughters and grandchildren, and provided for you sustenance of the best…” (Ali, 2007).

With regard to one’s capability to secure financial resources to satisfy the needs of children, the Qurʾān (17:31) explains that God is the one who provides sustenance. Therefore, parents should not regard their children as burdensome and kill them for fear of poverty (ʿAbd al-Bāqī, 1995). The Qurʾān does not give any preference to a male offspring over a female as mentioned in the Qurʾān (16:58–59) in which God denounces attitudes of the pagan Arabs who used to feel insulted by the birth of their daughters (Ibn al-Qayyim, 1986). In response to their attitudes, Islam raised the status of women and has promised heavenly rewards to parents who take care of their daughters. This has been mentioned in several Prophetic reports, one of them narrated by Abū Saʿīd al-Khudrī. According to him, the Prophet said, “There is not one of you with three daughters or three sisters, or two daughters or two sisters, fearing God regarding them and treating them in the best manner, except that he will enter Paradise.” (Ibn Ḥanbal, ḥadīth 11404: 1998).

Islam encourages Muslims not only to have offspring but also to ensure that they develop certain qualities that would enhance their happiness in this life and in the hereafter. This may begin with finding a suitable spouse with certain favorable traits such as kindness and fertility (al-Sijistānī, ḥadīth 2050, n.d.). Muslims are encouraged to pray in order to be blessed with good children following the example of Prophet Zakariyyā (al-Qurṭubī, 1993). They are also encouraged to raise righteous and pious children who will benefit them even after their death. In one example, the Prophet had prayed for his companion Anas Ibn Mālik to be blessed with many children, which can be translated as follows: “O Allah increase his wealth and offspring and bless him in what you have provided for him” (al-Qurṭubī, 1993).

Islam recognizes infertility as one of the difficulties faced by humans (Fadel, 2002). Nevertheless being infertile does not make one a lesser man or woman. This is because a human status is not determined by the number of children one has, but rather by one’s taqwā (righteousness). One should also bear in mind that fertility can fluctuate over a person’s lifetime due to a number of factors. According to the Islamic tradition, this is because it is God who decides whether one would have a child or not, as stated in the Qurʾān (42:49–50: “To Allah belongs the dominion of the heavens and the earth. He creates what He wills (and plans). He bestows (children) male and female according to His Will (and Plan). Or He bestows both males and females, and He leaves barren whom He will: for He is Full of Knowledge and Power” (Ali, 2007).

Confirming absolute divine omnipotence, the Qurʾān (11:72–73) tells the story of Prophet Abraham and his wife who were granted a child in their old age. The verses can be translated as follows: “And his wife was standing (there), and she laughed: but we gave her Glad tidings of Isaac, and after him, of Jacob. She said: “Alas for me! Shall I bear a child, seeing I am an old woman, and my husband here is an old man? That would indeed be very strange!” They said: “Do you wonder at Allah’s decree? The grace of Allah and His blessings on you, O you people of the house! For He is indeed worthy of all praise, full of all glory!” (Ali, 2007).

Several Prophetic reports have directly mentioned ʿazl (coitus interruptus), which was practiced by the Arabs long before Islam. The majority of Muslim scholars opine that ʿazl is permissible. This is because it had been approved by the Prophet in several occasions (Omran, 1992; Al-Qaradāghī and al-Muḥammadī, 2006). One of the reports narrated by Abū Saʿīd al-Khudrī states that the Prophet was queried about ʿazl. He answered, “Not out of all the semen a child is formed, and if Allah willed to create something nothing would stop him from doing it” (al-Nawawī, ḥadīth 133, Chapter on Marriage, 1996). In another ḥadīth reported by the same narrator, a man told the Prophet about his practice of ʿazl and a claim made by the Jews that it was a minor infanticide. The Prophet said that was a lie and added that “if Allah intends to create it, you cannot turn it away” (al-Sijistānī, ḥadīth 2171, n.d). On the other hand, few scholars argue that ʿazl is prohibited. Their arguments rely heavily on a ḥadīth narrated by Judāmah bint Wahb who stated that the Prophet replied that ʿazl is a “hidden” infanticide when he was asked about it (al-Nawawī, ḥadīth 141, Chapter on Marriage, 1996). According to some scholars, who consider ʿazl permissible, this ḥadīth actually does not imply prohibition. This is because hidden infanticide is different from minor infanticide whereby the latter denotes the actual murder but the former does not. In the attempts to reconcile the reports about ʿazl, some Muslim scholars consider the practice permissible yet unfavorable (Omran, 1992).

Muslims and Modern Developments in Human Reproduction

Since the late twentieth century, Muslim scholars have addressed ethical issues in human reproduction, as evidenced in fatwas and other types of scholarly writings. These scholarly discourses highlight several key principles as guidelines for humankind in solving ethical questions regarding human reproduction. The summary that follows is based on a review of fatwas and academic writings of the Muslim scholars about ethical issues pertaining to abortion, family planning, artificial insemination, in vitro fertilization, sperm and ovum donation, sex selection, surrogacy, reproductive cloning, and gene therapy, as well as reproductive organ transplantation. The fatwas that serve as case studies here are issued by the International Islamic Fiqh Academy of the Organization of the Islamic Cooperation (IIFA-OIC), the Islamic Fiqh Council of the Muslim World League (IFC-MWL), Dār al-Iftāʾ al-Miṣriyah of Egypt (Dār al-Iftāʾ) as well as the Fatwa Committee of the National Council for Islamic Affairs of Malaysia.

Preservation of Human Nature

The creation of a person is regarded as one of the signs of the Creator. Along with their diverse physical traits and capabilities, humans also have variations in tribes and languages. Humans should preserve the beautiful nature of the creation because violation of this nature may result in physical as well as spiritual harm. Hence any technological interventions that violate human nature are not allowed in Islam.

Based on this principle, birth control in an Islamic context is typically allowed only at an individual basis, whereby a couple can decide to do so if there is a specific need, such as protecting the mother’s health. However, permanent prevention of conception such as via hysterectomy and vasectomy is typically forbidden unless there is necessity to do so (see fatwas on family planning or birth control by IIFA-OIC, IFC-MWL, and Dār al-Iftāʾ; JAKIM, 2015). Likewise, gender selection of an offspring is allowed only at an individual level, whereby the parents can practice traditional techniques such as taking certain nutritional supplements. However, selection through modern genetic intervention, such as preimplantation genetic diagnosis, is not allowed unless there is necessity to prevent transmission of genetic diseases (see fatwa on gender selection by IFC-MWL; U. al-Ashqar et al., 2001). Dār al-Iftāʾ, however, has declared that all practices of gender selection are allowed at an individual level with the exception of practices deemed harmful by the specialists (see fatwa on gender selection by Dār al-Iftāʾ).

A government authority is not allowed to issue a legal command to restrict married couple from reproducing, or from reproducing a certain gender. Such a restriction violates the right of the married couples to reproduce, and may cause imbalance in human population (see fatwa on birth control or family planning by IIFA-OIC and IFC-MWL and fatwa on gender selection by Dār al-Iftāʾ).

According to the Fatwa Committee of the National Council for Islamic Affairs of Malaysia, reproductive cloning via somatic cell nuclear transfer (SCNT) is unlawful despite its high potential to help infertile couples to beget a child. This decision was made because a clone is produced without fertilization of an egg by a sperm, which is clearly against human nature (JAKIM, 2015; Zawawi, 2001). The clone would be genetically similar to the host, which could eventually reduce diversity in human population (Fadel, 2002).

According to the Qurʾān, humans are created in the best form and in accord with what God wills. It is God who determines traits for each human and blesses them with different capabilities. Therefore the use of any genetic intervention such as germline gene therapy solely to enhance traits of an individual or a race is considered unlawful according to most Muslim scholars (see, for example, the fatwa on genetic engineering by IIFA-OIC and IFC-MWL; Serour, 2008; U. al-Ashqar et al., 2001).

Preservation of Human Lineage

The preservation of human lineage is regarded as one of the five objectives of Shariʿah. Accordingly, reproduction is allowed only between couples with a marital bond so that each child will have an assigned guardianship. The child should be ascribed to his legitimate father, who is linked to his grandfather, his great-grandfather and so on. Having a clear lineage is important as basis for preserving the child’s dignity so that he or she will be well accepted in the society (Clarke, 2009). It is also important to avoid confusion in human interpersonal relations as well as preserving the well-being of the society. For a Muslim a clear lineage is crucial because it will determine other rulings including custody, inheritance, and marriage (Būruqʿah, 2007).

Therefore infertility treatment in Islam is allowed only between legitimate couples (see, for example, fatwas on IVF by IIFA-OIC, IFC-MWL, and Dār al-Iftāʾ; JAKIM, 2015). Such treatment must be conducted carefully to avoid mixing of the samples (see fatwa on artificial insemination and IVF by IFC-MWL). Conception cannot be done before marriage, nor after the marriage ends due to divorce or death of the spouse (JAKIM, 2015; Serour, 2008). If conception occurs, the resulting offspring cannot be ascribed to the owner of the sperm, and the decree in this case is similar to offspring of the unmarried couple (al-Qaradāghī and al-Muḥammadī, 2006).

Third party involvement, either through sperm, egg, or embryo donation, as well as surrogacy, is strictly prohibited because it compromises the lineage (see, for example, fatwa on IVF by IIFA-OIC, IFC-MWL and Dār al-Iftāʾ; JAKIM, 2015). Likewise, applications such as germline gene therapy that may cause confusion are not allowed (see fatwa on genetic engineering and human genome by IIFA-OIC; al-Aqeel, 2007). Transplantation of genital organs such as the ovary, which carries genetic traits from the donor, is also impermissible (see fatwa on transplant of genital organs by IIFA-OIC).

Additionally, some Shīʿī scholars see temporary marriage known as mutʿah as a way to resolve the issue of third party involvement and to avoid reproducing out-of-wedlock babies. Therefore they allow egg donation from a single or widowed woman to a man whom she temporarily marries. The marriage should last at least until the whole process (from egg retrieval to embryo transfer) takes place. Married women, however, cannot use mutʿah to get sperm donation because Islam does not allow polyandry (Abbasi-Shavazi et al., 2008).

Since reproductive cloning via SCNT does not involve sperm, the clone is not directly ascribed to a legitimate father. This may cause great hardship because there is no specific party who bears responsibility for taking care of the child. It is also unclear how the relationship between the clone and the host as well as the cell donor (and their relatives) will be determined. This, in turn, would raise several problems concerning many issues such as marriage and inheritance, which explains why human cloning is not allowed in Islam (M. al-Ashqar, 2001; Sachedina, 2009).

Prevention of Harm

Islam dictates that harm must be eliminated. Like other modern technologies, reproductive technologies have the potential to bring both harm and benefit to humankind. Islamic principles of priority, which are developed based on the Qurʾān and Sunnah, can be applied to assess whether such technologies are allowed in Islam. The utmost priority is to obey Shariʿah, which is revealed to prevent harms from being inflicted upon humans both in this world and in the hereafter (Isa and Man, 2014).

Muslim scholars have identified five human basic necessities, namely religion, life, intellect, property, and lineage that have been preserved by Shariʿah. Therefore, actions or applications that may cause harm to these necessities are considered impermissible. With regard to human reproduction, concerns have been raised mostly on the prevention of harm from being inflicted upon life and lineage. Preservation of the mother’s life is considered one of the main conditions that must be met in reproductive technologies. Therefore, pregnancy should be discontinued if it has been confirmed by physicians that it may harm the mother’s life. This is agreed by most scholars from both Sunni and Shīʿī communities (see fatwa on abortion by IFC-MWL; Hedayat et al., 2006; JAKIM, 2015). Likewise, family planning is allowed at an individual level to prevent harm, including harm to the mother’s life (see fatwa on birth control or family planning by IIFA-OIC, IFC-MWL, and Dār al-Iftāʾ; JAKIM, 2015). The use of harmful infertility treatment that may harm the couples is not allowed. If all available options are harmful, couples should choose the least harmful treatment.

Premarital genetic screening, prenatal diagnosis, and preimplantation genetic diagnosis are allowed if they are necessary to prevent genetic diseases such as thalassemia (see fatwa on genetic engineering and human genome by IIFA-OIC; Al-Aqeel, 2010). People may face some difficulties when undergoing these procedures, including financial hardship, but these difficulties often do not outweigh the benefits that they may receive, especially the possibility of preventing transmission of genetic diseases to the offspring.

Similarly, germline gene therapy is allowed if there is necessity to prevent inheritance of genetic diseases that can bring a great harm to the offspring, to the extent that it would not cause confusion to the lineage (see fatwa on genetic engineering and human genome by IIFA-OIC). In this case the greatest harm that must be avoided would be confusion to the lineage, which would not only cause hardship to the child but also the society as a whole. Justification for allowing the therapy must be based on confirmation by experts on the possibility of occurrence of such diseases, average rate of success, no greater harm involved, and no other way to prevent such diseases (U. al-Ashqar et al., 2001).

Obligation to Shariʿah Takes Priority over Rights

The advancement of reproductive technologies has invoked debate about reproductive rights whereby a person has been said to have the right to decide whether to reproduce, to terminate pregnancy, or to use any reproductive services available. In the name of these rights, some applications, such as reproductive cloning as well as postmenopausal and posthumous conception, which have been declared impermissible by most Muslim scholars, are considered permissible to the scholars who believe in reproductive rights (see, for example, Banh et al., 2010, on postmenopausal reproduction). Muslim scholars typically do not share this perspective on reproductive rights. By contrast, more emphasis is placed on the duty of Muslims to abide by Shariʿah than achieving their reproductive rights. There is no absolute freedom in Islam because such freedom is subject to what has been prescribed by Shariʿah (Nasr, 2010). That is to say in a case where reproductive rights conflict with the obligation, the latter takes priority (Kamali, 2002).

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