Attendees Included:

Ms. Amna Farooq, Dr. Sarosh Saleem, Ms. Wajiha Aijaz, Dr Malik Ali Hassan Sajid, Dr. Muhammad Hassaan Ali, Dr. Raja Sajjad Asghar, Ms. Huma, Dr. Fareeha Farooq, Dr. Hafeeza Naz, Dr. Qamar Uz Zaman, Dr. Muhammad Waseem, Dr. Huda Ashraf, Dr. Jamshed Akhtar.

Agenda:

• Amna Farooq from Lahore, discussed “The use of pig organs for human transplants.”
• Hafeeza Naz from SiDER, Shalamar Hospital, Lahore, presented on “A case of hypogonadism.”

New business:

Case 1: Ms. Amna Farooq presented on the topic “The use of pig organs for human transplants”. Xenotransplantation, or the use of pig organs in human transplants, is proposed as a solution to the global organ shortage.

Case 2: Dr. Hafeeza Naz presented a case of primary Amenorrhea on “A case of hypogonadism.” A 26-year-old female presents with the chief complaint of primary amenorrhea, expressing concern about the absence of menstrual cycles. She is scheduled to marry next week and seeks guidance regarding her future health and fertility.

Discussion & Suggestions:

Case 1: Ms. Amna Farooq discussed the controversial topic of xenotransplantation, focusing on organ transplants from pigs to humans. From an Islamic perspective, some scholars argue that it is permissible in life-threatening situations based on the principle of “necessities allow prohibitions,” while others oppose it due to the religious prohibition on pigs, citing Quranic verse that deems pigs impure. “Indeed, He has only forbidden to you dead animals, blood, the flesh of swine, and that which has been dedicated to other than Allah. But whoever is forced [by necessity], neither desiring [it] nor transgressing [its limit], there is no sin upon him. Indeed, Allah is Forgiving and Merciful.” (Surah Al-Baqarah: 173). Scholar Sheikh Mohammed Tarawneh argues that pig organ transplants are forbidden unless no alternative exists.

Ms. Amna concluded by stressing that xenotransplantation should not move forward until the risks of zoonotic diseases are better understood and mitigated. She also emphasized the importance of Muslim scientists to engaging in biomedical research and alternatives that align with Islamic principles.

The discussion revolved around the use of animal parts and the possibility of better acceptance if halal animals were used for this purpose. Some surgeons in the discussion shared their experiences of using porcine sutures because they are often cheaper than other options available. Similarly, some experiences were narrated where patients refused pig organs even though they were associated with a better clinical outcome. The discussion concluded on the note that religious and spiritual beliefs are extremely important for many people. Respecting values and beliefs are essential. Patients have a right to know the details of procedures, especially the ones that may be sensitive to cultural and religious beliefs. Cultural sensitivity and humility are essential for healthcare providers.

Case 2: Dr. Hafeeza Naz presented a case of primary amenorrhea in a 26-year-old female, sharing the patient’s history, clinical findings, and diagnosis, she was diagnosed as a case of Hypogonadism, and she was started on oral contraceptives/hormonal replacement therapy. The patient showed tanner stage 3 breast development with otherwise normal secondary sexual characteristics. FSH and LH levels were low, indicating central hypogonadism and her karyotype results were normal. The diagnosis was central hypogonadism with underdeveloped secondary sexual characteristics.

The patient’s mother asked whether her daughter could marry as she was hesitant to disclose the condition to her future in-laws. Dr. Hafeeza questioned how to sensitively disclose the diagnosis to the patient, particularly with a poor chance of giving birth to a child, and whether it would be appropriate to involve her spouse in the discussions.

The discussion revolved around the rights of the spouse and the responsibilities of the clinicians. The importance of communication with the patient and her family as well as the Hospital Ethics Committee was discussed at large. An important point regarding the importance of support groups was also shared and appreciated. The experiences of patients must be acknowledged and are central to clinical ethics. Clinical issues cannot be isolated from social and cultural pressures that the patients and families face, however, we must analyse all aspects and facilitate the patient in making ethically justifiable choices.  The role of multidisciplinary teams involving psychological support was discussed along with honest communication and risks of giving false hope were discussed among the participants.

Final statement from PBG:

Case 1: The use of pig organs in transplants presents a potential solution to the organ shortage crisis, but it is fraught with scientific, ethical, and safety challenges. While the opinions of Islamic scholars differ on the permissibility of pig organ transplants, there is a possibility of being acceptable in life-threatening situations in the future, provided that the risks are managed, and alternatives are not available. However, the ethical and religious challenges of using pig organs remain significant, and careful consideration is needed for each case. Dialogue between religious scholars, scientists, bioethicists, and patient representatives must be encouraged.

Case 2: The case of Hypogonadism highlights the complexity of managing sensitive medical conditions, particularly in a cultural context where issues related to fertility and marriage carry significant social and emotional weight. In such cases, sensitivity to the patient’s emotional well-being, offering support groups, and counseling can play an important role. Overall, a supportive environment that provides clear, fact-based information and realistic expectations should be practiced so the patient and her family can make an informed decision about her future.

Adjournment:
The meeting was adjourned by the moderator Dr. Sarosh Saleem with thanks to all attendees for their support, encouragement, and valuable contributions. The next meeting is scheduled for March 07, 2025, at 09:30 AM.