Kidneys and Controversies in the Islamic Republic of Iran: The Case of Organ Sale

Abstract

Iran is the only official Shia Islamic country with Ithna-Ashari or Twelver Shiism as the dominant form. For various reasons in part due to the interpretive approach to jurisprudence in Ithna-Ashari Shiism but also due to other aspects of Iranian culture the Iranian approach to medical science and technology is dramatically different from that in most other Islamic countries. In Iran what is and is not considered Islamically acceptable is constantly being renegotiated depending upon social political economic and technological conditions. This kind of flexibility and often pragmatic approach to social problems has major positive and progressive implications for health policy on numerous levels. However the drive to embrace new technologies and capabilities can also precede or override ethical deliberations. Drawing on fundamental religious and ethical debates within the country as well as interviews and observations in an Iranian transplant center this article investigates Islamic discourse perceptions of life death and the body and the case of organ sale/donation in Iran. This article is based on a qualitative pilot investigation conducted in 2002 in Shiraz Iran. Interviews were conducted with health professionals working in transplant centers with recipients of donated organs from living related (LR) and living unrelated (LU) donors and with living commercial donors themselves using a semi-structured open-ended format. Observation was also conducted at Shiraz University of Medical Sciences in the Namazi Hospital Organ Transplant Ward. This ward is arguably the largest and most successful kidney transplant ward in Iran and in 2002 was the only center which also conducted liver transplants. Iran is of particular interest in the transplant world because it is the only country where there is an official state-sponsored system of financial remuneration for kidneys and liver portions from living unrelated donors. (excerpt)