Blood Transfusions and Donations: A Detailed Explanation

We are a local newspaper based in Blackburn targeting the Asian communities in Lancashire and Greater Manchester. We have worked with the National Blood Service in promoting the donating of blood and as you will be aware there are misgivings within the Muslim community on this particular action. We would like you to provide us the Islamic view on this issue so we can try to tackle this topic through editorial and informative articles. 

In the name of Allah, Most Compassionate, Most Merciful, 

It is a well known principle of Shariah that all the organs and parts of a human body whether one is a Muslim or a non-Muslim are sacred and must not be tampered with. To take benefit from any part of a human without a need is unlawful (haram). This also includes blood, for it is an integral part of a human. There are two reasons for the impermissibility of taking benefit from another person’s blood. Firstly, it is sacred like all other parts of a human.

Allah Most High says:

“And verily we have honoured the children of Adam” (Surah al-Isra, V.70).
Secondly, blood (when taken out) is impure and to derive benefit from something that is impure is unlawful.
 
Allah Most High says: 

“Say: “I find not in the message received by me by inspiration any (meat) forbidden to be eaten by one who wishes to eat it, unless it be dead meat, or blood poured forth, or the flesh of swine, for it is impure” (Surah al-An’am, 145). 

Sayyiduna Imam Shafi’i (Allah have mercy on him) states: 

“If one infused blood under the skin and skin grew on it, it will become obligatory to extract that blood and repeat all the prayers that were performed after infusion”. (al-Umm, 1/54). 

Due to the above two reasons, under normal circumstances it will be impermissible to transfuse the blood of one person in to the body of another. Sanctity of human parts demands this, as well as the impure element in blood. 

  The Exception, However 

However, Islam is a religion of mercy and caters for all the problems faced by humanity. It acknowledges the needs of people, thus gives concessions and dispensations wherever needed. 

Allah Most High says: 

“On no soul does Allah place a burden greater than it can bear”. (al-Baqarah, 286). 

The famous principle of Fiqh states: 

“Necessity makes prohibition lawful” (See: Ibn Nujaym, al-Ashbah wa al-Naza’ir, P. 85 ). 

Due to this, classical scholars gave a dispensation in that the milk of a female may be used for the purpose of medication. It is stated in the famous Hanafi Fiqh reference, al-Fatawa al-Hindiyya: 

“There is no harm in injecting a woman’s milk in a man or to drink it for medical purposes”. (al-Fatawa al-Hindiyya, 5/355). [f: This is conditioned by what is mentioned below in the same text] 

It is also stated in the same book: 

“It is permissible for a (severely) sick person to drink blood and urine, or consume the meat of a dead animal for the purpose of medication if an experienced Muslim medical expert stipulates that this is the only cure, and that one does not find an alternative. If the medical expert states that by using unlawful substances you will be cured earlier, then there are two opinions of the scholars”. (al-Fatwa al-Hindiyya, 5/355). 

Imam al-Haskafi (Allah have Mercy on him) says: 

“The Scholars differed regarding the usage of haram medication. The apparent opinion in the (Hanafi) school is that it is haram. However it is said that it will be permissible when the medicine is known to be effective and there is no other alternative, just as there is a dispensation in drinking alcohol for a person dying of thirst, and the fatwa is given on this opinion.” (Radd al-Muhtar ala al-Durr al-Mukhtar, 1/210). 

The Messenger of Allah (Allah bless him & give him peace) advised the people of Urayna to consume the urine and milk of camels due to them being affected by the climate of Madina. (See: Sahih al-Bukhari, no. 231). 

Moreover, two reasons were mentioned for the impermissibility of using human blood, one the aspect of sanctity and the other, its impurity. 

As far as the first reason is concerned, it must be remarked that although blood is a component part of a human body yet the manner of its transfusion does not require any surgical procedures in the body, rather it is drawn and transfused by means of injection, thus it is akin to human milk that is extracted without any surgical procedures. 

In appreciation of a child’s need, Islam regarded this milk a means of nourishment for it, and the mother is obliged to feed the baby this very milk. Even for adults, women’s milk has been made lawful for medical purposes, as stated in the text of al-Fatawa al-Hindiyya quoted earlier. 

The Ruling 

Hence, it can be said that blood transfusion is lawful as a necessity just as Islamic law has permitted women’s milk for infants out of necessity, despite it being part of a human body. 

The second reason was the impurity of blood. This has been discussed earlier in that impure and unlawful things become permissible in cases of need and necessity. 

In light of the foregoing, it would be permitted to donate and transfuse blood under the following conditions: 

a) The donor is mature and sane, 
b) The donor willingly donates his blood. If he is compelled to do so, it will not be permissible, 
c) There is no apparent risk to the life or health of the donor 
d) There is absolute necessity in donating blood in that there is a definite risk to the life of a patient, and in the opinion of the medical expert, there is no other way in saving his/her life, 
e) There is a need for it, that is, there is no risk to the life, but in the opinion of the experts, restoration of health may not be possible without it, 
f) There is no reasonable alternative 
g) It is not for the sake of beatification or any other additional benefit, 
h) Transfusion of blood must not be carried out by way of buying and selling, for trading in human parts is never permissible. However, if one is in need of blood desperately and the only means to obtain the blood is to purchase it, then only will it be permissible to pay for the blood. This is discussed further in the following section 
 
Buying and selling blood 

As mentioned in the last part of the conditions, that it is unlawful to buy and sell blood for the purpose of transfusion. Classical Hanafi Jurists (fuqaha) have explicitly stipulated that to trade in any part of a human is unlawful, and especially blood for the impure element found therein. 

Imam al-Kasani (Allah have mercy on him) states: 

“The sale of a woman’s milk put in a bowl is invalid for two reasons: 
Firstly, milk is not considered wealth, thus it is impermissible to sell it. 
Secondly, it is part of a human body and all parts of a human are sacred, thus it is contrary to its honour and respect to disgrace it by trading in it”. (al-Kasani, Bada’i al-Sana’i, 5/145). 

Some classical scholars (from the Shafi’i, Maliki & Hanbali schools) consider purity a pre-requisite for a valid sale (See: Nawawi, Radhat al-Talibin, 3/ 348, Ahmad Darder, Sharh al-Sagir, 3/22 & al-Bahuti, Sharh Muntaha al-Iradat, 2/143). Blood is considered impure with the consensus of all the scholars, thus preventing it from being an article of trade. 

However, in case of necessity, if one is unable to obtain blood except by purchasing it, then it will be permissible to purchase it, but the provider will still be sinful. (Durr al-Mukhtar, 4/113). 

This ruling also serves as prevention to the evil of trading in blood found in many places, where for the sake of a small amount of money; poor and desperate people sell their blood. Some go the extent where they put themselves in danger, and as mentioned earlier, it will only be permissible to donate or give blood if the donor’s life or health is not affected. 
 
Transfusion of a non-Muslim’s blood into a Muslim’s body 

In principle, there is no difference between the transfusion of Muslim’s and a non-Muslim’s blood, thus both are permissible. 

However, scholars recommend that one should abstain from the blood of unbelievers, transgressors and sinners, when reasonably possible, for there is a risk that the evil effects found in such people may affect the one in whom the blood is transfused. 

Classical scholars also disliked the breastfeeding of a child by a sinning and transgressing woman. 
 
Blood transfusion between family members and relatives 

Blood transfusion can not be considered in any way to be a cause of creating blood relationship between the two people involved, thus it is perfectly lawful to transfuse the blood of the husband into the wife or vice versa, and this will not effect their marriage in any way. Similarly, there will be no relationship between the one who donated the blood and the one in whom it was transfused, thus marriage between the two will be permissible, for they are regarded as strangers. 

The reason for this is that, Islam has restricts relationship and the impermissibility to marry with lineage and fosterage, thus it is inappropriate and not permissible to exceed these two. 

Conclusion 

From all of the foregoing, we learn that donating and transfusing blood will be permissible in cases of need and necessity (along with the other conditions stipulated above). It will not be permissible to use it for the purpose of beatification or merely gaining strength. It is also impermissible to buy and sell blood. 

Today we see the establishment of blood banks where the blood of different people is stored and used whenever needed. The advantage of these banks is that it gives them an opportunity to store the different types of blood and then match it with the blood of the one in need. 

From a Shariah perspective, it will not be permissible for one to sell his/her blood to the bank; rather it must be donated freely. Also, one must determine that his/her blood (and the blood in that particular bank) is only used in cases of need and necessity, and not for beatification purposes. 

And Allah knows best 

Muhammad ibn Adam al-Kawthari,
Darul Iftaa, Leicester, UK