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Bioethics in Malaysia

By:
Salilah Saidun
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.

Bioethics in Malaysia

Malaysia is a pluralistic country where Islam is both the majority religion and is recognized as the official religion by the government. The Constitution of the Federation of Malaya (today known as the Constitution of the Federation of Malaysia), which came into force when Malaysia gained its independence in 1957, gives each state the legislative authority in regulating Islamic affairs within its borders, including determination of Islamic law and punishment of Muslims for religious offenses. Each state has its own State Islamic Council, mufti (religious leader), fatwā committee and Sharīʿah Court. The first bioethics fatwā was issued by the Fatwa Committee of the State of Perlis in 1965 on corneal transplant. In 1970 the Fatwa Committee of the National Council for Islamic Affairs (FCNCIA)—currently under the Department of Islamic Development (JAKIM)—was established, which issued its first fatwā on heart and lung transplants in the first year of its establishment. The founding of two other government agencies, the Institute of Islamic Understanding Malaysia (IKIM) in 1992 and the National Bioethics Council (NBC) in 2010, adds to the history of bioethical policies in Malaysia. This article will give an overview of Islamic bioethics in Malaysia in terms of deliberation, legislation, and education.

The process of deliberation depends on the institution. For FCNCIA, the fatwā deliberation process begins with either a directive from JAKIM, or the receipt of queries submitted by individuals, government agencies, non-government organizations, or private agencies on specific issues. Then, the Research Unit of JAKIM will search for existing fatāwā on the issue. If none exists, a period of research begins, starting with the identification of relevant experts (academics, researchers, or practitioners) for the issue. Sometimes, international experts are also involved, such as during the fatwā deliberation process for the issue of stem cell research. The experts will then contribute by conducting research on the issue (including scientific experiments when necessary) and presenting the findings to a panel through a series of meetings to help them understand the scientific and social aspects related to the issue, including the materials involved (such as pharmaceuticals) and the common practices surrounding the issue. In order to help them understand the issue from a scientific and social perspective, experts use various means such as video presentation, animation, model, and oral presentation. If the issues involve food (such as the deliberation on genetically modified food), JAKIM’s Halal Hub Division will be involved. Based on the input presented by the experts, paperwork is prepared by the Research Unit of JAKIM and forwarded to the FCNCIA for deliberation through ijtihād jamāʿī (collective ijtihād), involving all fourteen State Muftis and a Muslim law advisor, along with experts in theology, Islamic jurisprudence, biomedicine, and finance. The four primary sources of law in Islam—Qurʾān, ḥadīth, ijmāʿ (consensus) and qiyās (analogical reasoning)—are typically cited during these fatwā deliberations. Qawl al-ṣaḥābī (opinions of the Prophet’s Companions), qawl al-tābiʿīn (opinions of the Companions’ followers), opinions of past and present prominent Muslim scholars and fatāwā issued by other fatwā institutions (e.g., Majmaʿ al-Fiqh al-Islāmī) are also taken into consideration. Since the majority of Malaysian Muslims follow the Shāfiʿī madhhab (school of thought), the opinions of Shāfiʿī scholars on fiqh issues and their particular method of ijtihād are predominantly used in Malaysia, except in the state of Perlis. There typically is no madhhab preference during fatwā deliberation in Perlis, though the scholarly activities fall under the Sunnī tradition. In the other thirteen states, the stance of three other main madhhabs in the Sunnī stream are also considered and may be used in specific cases when any of them provides a stronger basis for the benefit of the society or the nation. All fatāwā are intended to be in line with the Maqāṣid al-Shariʿah (objectives of Sharīʿah), with prioritization of al-ḍarūriyyāt (the essential necessities of life) over al-ḥājiyyāt (the complementary) and al-taḥsīniyyāt (the embellishment). Besides Sharīʿah, other factors are also taken into consideration, such as the current social and economic state in Malaysia and the local and global implications of the issue. This may require scholars and jurists to learn more about the secular bioethical stance with the help of industry experts involved in the deliberation process. Weighing the beneficial and detrimental effects of biomedical technology from the religious, scientific, and social aspect in the local and global context is a challenging task. Since the fatwā deliberation involves the cooperation of various institutions including universities, research institutions, relevant government agencies (such as Ministry of Health and Ministry of Agriculture), and industries, the process requires substantial duration. Deciding what to disclose to the public is also a dilemma as the issue may be confidential, or the technical Sharīʿah aspects may lead to mass confusion. As of 2019, seventy-eight fatāwā on bioethical issues have been issued. After fatāwā are issued, there may be amendments upon request from any party if there is new information on the issue (Department of Islamic Development Malaysia, 2017; Muhammad, 2011). For example, the FCNCIA has issued two fatāwā regarding the use of Menomune Meningococcal vaccine in 2002 and 2014. The first fatwā declared the impermissibility of using the vaccine but after reconsidering the latest formulation and production, the second fatwā revoked the former fatwā and affirmed that the vaccine is permissible.

Civil and criminal law in Malaysia are under the federal government’s legislative authority while Islamic affairs are under the regulation of the state governments. Fatāwā in Malaysia are subdivided into gazetted (published) fatāwā, official non-gazetted fatāwā, and fatāwā in forms of questions and answers. Only gazetted fatāwā are legally binding on all Muslim residents in the specific state in which the fatāwā are announced—except in the state of Pahang where all official fatāwā are legally binding. Although FCNCIA regularly issues fatāwā, they are not legally binding and it is not mandatory for the states to accept the fatāwā. For example, the FCNCIA’s 2009 fatwā stated that female circumcision is compulsory but should be avoided if it is harmful to the individual. On the contrary, the Fatwa Committee of the State of Johor decided in 2012 that female circumcision is permissible while the Fatwa Committee of the State of Perlis in 2017 affirmed that it is not compulsory but is permissible if it is advised by medical specialists. It is also up to each state to gazette the fatāwā of FCNCIA with or without amendments, with the assent of the state rulers who act as the states’ religious leaders. Hence, the law and the punishment for religious offenses differ between states. Defying, disobeying, or disputing a gazetted fatwā, or disseminating any opinion contrary to the gazetted fatwā, is considered a religious offense which may lead to prosecution (Chiroma et al., 2014; Kasnan, 2006). Despite the divorce between state Sharīʿah Courts for trials of religious offenses and Civil Court for trials of other offenses, there have been rare instances where Civil Courts request the opinions of muftis or state fatwā committees (Nasohah, 2005). At the national level, FCNCIA fatāwā may be incorporated in national legislation. For example, the FCNCIA fatwā on stem cell research in 2005 has been incorporated in the Guideline on Stem Cell Research issued by the Ministry of Health Malaysia in 2006 and the revised guideline in 2009. The guideline regulates stem cell research in Malaysia in the form of a non-legally binding “soft law” (Foong, 2012). For the issue of organ transplantation, besides having the national Human Tissue Act of 1974 following the issuance of the fatwā on organ transplants in 1970, the states of Sarawak and Penang also gazetted fatāwā on organ transplants in 1996 and 2010, respectively. Sarawak’s gazetted fatwā focused only on kidney transplants. Penang’s gazetted fatwā stated that transplantation between a Muslim and a non-Muslim (as a donor or recipient) is permissible, except in the case of a Muslim donating his or her organ to a kāfir ḥarbī (non-Muslim who wages war on Muslims). The states of Perlis, Selangor, and Johor issued official fatāwā on organ transplantation in 1965, 2000, and 2001 respectively, but they are not gazetted (Saifuddeen et al., 2011). The Ministry of Health issued the National Organ, Tissue and Cell Transplantation Policy 2007, which involved JAKIM during the development. The Policy outlines the following:

  • 1. The National Transplantation Program is governed by the National Transplantation Council (NTC), which consists of, among others, one representative from JAKIM or IKIM.
  • 2. The National Transplantation Unit (NTU) coordinates the implementation of the National Transplantation Program.
  • 3. The National Transplantation Technical Committee advises NTC regarding policy and advises NTU regarding implementation. It consists of a number of experts in the field of law and ethics.
  • 4. Transplants involving unrelated living donors must obtain prior authorization from the Unrelated Transplant Approval Committee.
  • 5. The Transplantation Procurement Management Unit coordinates organ and tissue procurement from cadaveric donors.
  • 6. All patients eligible to receive organs or tissues are listed in the National Transplantation Waiting List.
  • 7. All centers performing transplantation shall report to the National Transplant Registry.
  • 8. Potential donors for bone marrow and umbilical cord blood are listed in the National Marrow Donor Registry and the National Cord Blood Registry.

In terms education, numerous parties contribute to the development and dissemination of Islamic bioethics in Malaysia. These include several government agencies, non-governmental organizations, research institutions, and universities, including the ones mentioned above.

Government Agencies

National Bioethics Council (NBC)

The NBC discusses and disseminates information, as well as advises and assists the government, researchers, academics, practitioners, and members of the lay public regarding bioethical issues. The NBC comprises three working committees: Information and Education Committee, Research and Development Committee, and Legal and Social Committee. Since its establishment, NBC conducted various activities to promote bioethics, including:

  • 1. Organization of various bioethics seminars, conferences, and forums
  • 2. Review of the Malaysian Code of Practice for the Care and Use of Animals for Scientific Purposes, the Malaysian Code of Responsible Conduct of Research, the Guidelines on the use of human biological samples for research, and the Code of Conduct for Biosecurity in the framework of Biological Weapons Convention
  • 3. Compilation of bioethics references, including a database of bioethics experts

In addition to this, starting in the 2010s NBC has been researching and planning for the establishment of a national Bioethics Act in Malaysia.

Department of Islamic Development Malaysia (JAKIM)

JAKIM was established to become a regulatory body of Islamic affairs in Malaysia. Currently, JAKIM serves three main functions: standardization of Islamic law, coordination of Islamic administration, and coordination and development of Islamic education. Aside from its significant role in Islamic bioethics through FCNCIA and Halal Hub Division, JAKIM works to increase Islamic knowledge among the masses through various means, such as publications and public lectures.

Institute of Islamic Understanding Malaysia (IKIM)

IKIM was founded as a research institute that intends to promote a better understanding of Islam among Muslims and non-Muslims. As one of its main areas of common concern, bioethics is an area that IKIM addresses through research, publications, seminars, and conferences in collaboration with other institutions. Research on bioethical issues is carried out by the Centre for Science and Environmental Studies at IKIM. To date, IKIM has produced numerous types of publications (e.g., newspaper articles, bulletin articles, online articles, proceedings, journals, monographs, and books) on various bioethical issues. IKIM also uses its radio service, IKIM FM, to promote awareness of bioethics in Malaysia through its weekly thirty-minute Islam and Science slot.

Non-governmental Organizations (NGOs)

The following NGOs organize various events that aim to promote greater understanding of Islamic bioethics for the lay public and healthcare professionals.

  • 1. Islamic Medical Association of Malaysia (IMAM)
  • 2. Malaysian Ibnu Sina Medical Charity Organization (PAPISMA)
  • 3. Islamic Hospital Consortium of Malaysia (IHCM)
  • 4. Muslim Medical and Healthcare Practitioners League Malaysia (I-Medik)
  • 5. Multaqaʾ Asatizah wa Duʾat (MURSHID)

Academic and Research Institutions

At institutions of higher learning, Islamic perspectives on related biomedical issues are taught to undergraduate students at the following institutions, either formally in the subject syllabi or informally in compulsory seminars or ḥalaqah (religious study circle):

  • 1. Kuliyyah (Faculty) of Medicine, Kuliyyah of Allied Health Sciences, Kuliyyah of Dentistry and the Kuliyyah of Nursing, International Islamic University Malaysia
  • 2. Faculty of Medicine and Health Sciences and Faculty of Dentistry, Islamic Science University of Malaysia
  • 3. Faculty of Medicine and Faculty of Dentistry, MARA University of Technology
  • 4. Faculty of Medicine, Cyberjaya University College of Medical Sciences
  • 5. Faculty of Nursing and Allied Health Sciences, Selangor International Islamic University College
  • 6. School of Medical Sciences, PUSRAWI International College of Medical Sciences
  • 7. Department of Science and Technology Studies and Academy of Islamic Studies (Applied Sciences with Islamic Studies Program), University of Malaya

In other academic institutions of medical, dentistry, nursing, biomedical, and health sciences, where the Islamic input on bioethics is not formally taught, students may still be exposed to the subject through internal seminars organized by respective student representative bodies and national or international seminars organized by other universities or NGOs. Moreover, Islamic perspectives on bioethical issues may be discussed informally during lectures and tutorials. Fiqh of science and technology is also taught to Islamic studies students in many Islamic studies faculties. Research on Islamic bioethics also takes place at a few research and academic institutions in Malaysia. The International Institute of Advanced Islamic Studies (IAIS)—an independent non-profit research institute—conducts research and disseminates its findings through numerous publications, public lectures, and conferences. One of its research units focuses on science, technology, environment, and ethics. Postgraduate research degree programs on bioethics are offered at the School of Health Sciences at the Science University of Malaysia, the Centre for General Studies at the National University of Malaysia, and the Department of Science and Technology Studies at the University of Malaya. Besides that, one can pursue a postgraduate research degree on the fiqh of science and technology or bioethics legislation at academic institutions focusing on Islamic studies or law, respectively.

Bioethics in Malaysia has gone through various challenges since the country’s independence. Despite significant institutional breakthroughs, it still has a long way to go. As biomedical technology evolves, Islamic reflection on bioethical questions in Malaysia, and elsewhere, need to constantly keep abreast with rapidly progressing scientific developments.

Bibliography

  • Baharuddin, Azizan. “The Role of the Institute of Islamic Understanding (IKIM) in Malaysian Bioethical Discourse.” In Conference Proceedings of the International Conference: Health Related Issues and Islamic Normativity, edited by J. Schreiber, T. Eich, and M. Clarke, pp. 191–206. Halle: Universitäts- und Landesbibliothek Sachsen-Anhalt, 2013.
  • Chiroma, M., et al. “The concept of fatwa (Islamic verdict) in Malaysia and the constitutional dilemma: a legislation or legal opinion?” International Journal of Business, Economics and Law 4, no. 3 (2014): 11–20.
  • Department of Islamic Development Malaysia. www.islam.gov.my.
  • Department of Islamic Development Malaysia. Guideline on fatwa issuance in Malaysia. Kuala Lumpur, Department of Islamic Development Malaysia, 2017.
  • e-SMAF: Fatwa Information Portal. e-smaf.islam.gov.my/e-smaf.
  • Foong, P. C. K. “The regulatory regime for human embryonic stem cell (HESC) research in Malaysia: a critique.” Malaysian Journal of Law and Society 16 (2012): 55–68.
  • I-Medik. www.imedik.org.
  • Institute of Islamic Understanding Malaysia. www.ikim.gov.my.
  • International Institute of Advance Islamic Studies. https://www.iais.org.my.
  • Islamic Hospital Consortium of Malaysia. www.ihcmalaysia.my.
  • Islamic Medical Association of Malaysia. www.imamalaysia.org.
  • Kasnan, H. “Prosedur mengeluar dan menguatkuasa fatwa di Semenanjung Malaysia” (Procedure for the issuance and enforcement of fatwa in Peninsular Malaysia). Malaysian Journal of Law and Society 10 (2006):1–19.
  • Malaysian Ibnu Sina Medical Charity Organization. https://www.papisma.org.
  • Medical Development Division, Ministry of Health Malaysia. National organ, tissue and cell transplantation policy. Putrajaya: Ministry of Health, 2007.
  • Muhammad, R. M. “Peranan institusi keagamaan dan institusi pengajian tinggi awam (IPTA) dalam menganalisis isu bioetika: Ke arah pembentukan panduan kepada pengguna bioteknologi di Malaysia” (The Role of Religious Institutions and the Public Institutions of Higher Education in Analyzing Bioethical Issues: Toward Formulation of Guidelines for Consumer of Biotechnology in Malaysia). Master’s thesis, University of Malaya, Kuala Lumpur, 2011.
  • MURSHID: “Multaqa Asatizah & Duʾat.” www.murshid.my.
  • National Bioethics Council of Malaysia. www.bioetika.gov.my.
  • Nasohah, Z. “Undang-undang penguatkuasaan fatwa di Malaysia” (Fatwa Enforcement Law in Malaysia). Islamiyyat 27, no. 1 (2005): 25–44.
  • Saifuddeen, S. M, et al. Organ Transplantation from the Islamic Perspective. Putrajaya: Transplantation Unit, Ministry of Health Malaysia, 2011.
  • Zainal, Nor Safina. “The Department of Islamic Development Malaysia (JAKIM) and its relation to bioethical issues.” In Conference Proceedings of the International Conference: Health Related Issues and Islamic Normativity, edited by J. Schreiber, T. Eich, and M. Clarke, pp. 176–190. Halle: Universitäts- und Landesbibliothek Sachsen-Anhalt, 2013.
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