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Views on Sterilization

The four sources of legislation in Islam are: (1) The Qoran, (2) The Hadith or sayings of the Prophet, (3) analogy and (4) the unanimous opinion of Muslim scholars. The second two apply only to issues not mentioned by Qoran or Hadith, and their use should revolve around the legalistic dictum of ensuring "public welfare". Since sterilization is not mentioned by Qoran or Hadith, and assuming there is no unanimity of opinion about it, it can therefore be judged by analogy, an intellectual process of reasoning and matching with comparable issues mentioned by Qoran or Hadith.

We are here discussing permanent sterilization be it male orfemale. The temporary or reversible procedures belong in the domain of contraception, which Islam clearly permits for a wide spectrum of indications, varying from medical urgency through socio-economic reasons to the preservation of a beautiful physique. Sometimes ethical limitations have to be posed on this freedom to contraception, in response to national or domestic needs. Using the term 'contraception' we do not include abortion, which is prohibtied by Islam except for a medical indication.

The writings of some contemporary scholars on sterilization are largely vitiated by misconception of surgical anatomy and physiology. Some equated it with castration, an old practice denounced by Islam, but resorted to for providing male eunochs for safe employment in sultans' harems. Its concept was one of sexual disarmament quite unrelated to our topic, in which sexual features and powers remain intact.

To oppose sterilization, some scholars even quoted the Qoranic report of Satan's argument with God about the sons of Adam, saying: 'and I will command them so that they shall alter the creation of God.; in this instance by surgical operation. This view is hardly worthy of regard.. for it is equally applicable to appendicectomy, tonsillectomy or other surgery, or even to beard shaving and nail trimming.

Sterilization is therefore merely a surgical operation, and per se cannot be described as 'haram' (prohibited) or 'halal' (unprohibited). It is upon the application of this procedure that such verdict may be reached.

When it is therefore done to obviate the transmission of genetic disease to the offspring, sterilization is not only pennissible but mandatory. So also it is when further pregnancy is hazardous to the mother with an uncorrectable health deficit and for whom ordinary contraceptive methods are unadvisable or uncomfortable. This seems to be the enlightened Islamic consensus as it complies with the Islamic dictum of "'repelling harm", and this was voiced by such authorities as Sheikh Ahmad Ibrahim, Sheikh Mahmood Shaltoot and others.

When practised for nonmedical indications, however, a rule of thumb does not exist, and careful balance should be held between pros and cons. By analogy, it can be said that permission to contraception by Islam is not bound by a time limit, and that a couple's right to practise contraception permanently is the same right to adopt p ~rmanent contracep- tion which is sterilization.

In answer to the thesis that sterilization contradicts the need of the Muslem nation to grow, we believe that a couple who have attained the family size commensurate with the desired population growth rate, can claim to have fulfilled their duty in this respect. The hazards of high parity are becoming known to more and more people, who cannot be denied to avoid them without a lifelong ordeal of contracep- tive practice.

But permission to sterilization is not absolute, and must be guarded with certain constraints which as the case with many medical procedures -belong to the subtle area of ethics rather than the circumspect specifications of jurisprudence. It is more likely therefore that a decision complies with religion if the decision-maker has belief in religion and total faith in its moral code as well as legal system.

Specific situations will be encountered. The general guidelines influencing the decision of the Muslem doctor and we believe also doctors of other scriptural religions include:

(1)   Sterilization should be the outcome of voluntary , enlightened and free consent of both spouses. People should not be pressured into sterilization. Procreation is a. basic individual right and racial, political or social considerations should not mar it.

(2) Sterilization is usually a final irreversible procedure. A thorough.. preassessmentof the psychological stamina even of our consentinr; patient may avert a sad psychologic and or psycflosomatic atermath in the case of subsequent change of mood.

(3)   With the possibility of loss of children by accidents of fate, or the possibility of the youngish spouse remarrying after divorce or widowhood the exercise of reason and precaution offers reversible contraception as the method of choice for family limitation. The availability of reliable contraraception should make sterilization superfluous in the majority of cases.

(4)   Wholesale sterilization should be avoided, whether to control population growth or to experiment with new techniques. Individualisation is absolutely necessary , and sterilization is but one among a full armamentarium of methods, to be used only when best but not when second best. Responsible parenthood is an expression of education and when some people exceed their optimal parity, the proper answer to the situation is more education.

(5)   Because "Religion is advice" as the Prophet said, it is the duty of the doctor to fully inform the candidates of the implications of the operation and let him or her decide in free will. The choice of the patient should not be binding to the doctor; and occasion will arise when the doctor refuses to do the operation if not convinced that it is for the best interests of the patient as in cases of too young an age or too small a family.

In conclusion, we believe that steriliz, tion is "halal" when judiciously used, and "haram" when at used, according to the guidelines we forwarded, and only when these are observed in good Islamic faith...

For the wind that bloweth the sail is the mind,
But the faith in the heart is the compass to guide,
And what is eyesight if the heart is blind?
All of us look so good. ..but what is inside?
Who is right Who is wrong?.. Only God will decide."