Mohammad Ali Jinnah: His Vision and Legacy

Eighty years ago, when Mohammad Ali Jinnah started his address to the 1938 Session of the All-India Muslim League, he spoke in Urdu: Jab hum Patna ka tariki shahr mein aya. Immediately the public started shouting: “English! English!” and the Quaid-i-Azam resumed his address: “When I came to this historic city of Patna…”. What was the reason behind the public’s odd demand? At that time it was clearly understood that Independence had to be taken from the British. The Muslims knew that they needed a leader who could speak to the colonial masters in their own language. That is why, though only a fraction of the gathering could speak or understand the language, they wished their leader to speak in English

Assisted Reproductive Technology Art As a Treatment of Infertility in the Light of Islamic Shariah

Infertility is the failure to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse. It affects one among every four couples in developing countries. In Pakistan, about 22% of couples face infertility. It may be of two kinds: Primary and secondary infertility. If the couple never had a live birth of a child, it is known as primary infertility, but if they had a previous live birth, it is known as secondary infertility. The cause may be found in female, male or both. Female factors are more common, and usually involve problems in ovulation and in the Fallopian tubes. Male factors usually include poor quantity and/or quality of sperm. Infertility in 10% of couples might have no clinical pathology (unexplained infertility). In the Islamic viewpoint, infertility is only a disease inflicted on some people as a decree of Allāh Almighty. Like any other disease, it will also affect the marital relationship of the couple. The marriage comes under stress, and the couple experiences a diverse range of feelings and emotions- grief, self-blame, depression, anxiety, irritability, thought of being useless and social isolation. It is one of the reasons to dissolve a marriage. But not all couples want a divorce. A few might be loving enough to spend a life, even at the cost of their childlessness. The assisted reproductive technology (ART) is meant for them- for those who are not thinking of a divorce or a second marriage or adoption. They want a child in their own relationship. The techniques of assisted reproduction are a biomedical manifestation of a procreative ease (taysīr). They are seen as a cure for infertility and may be used by a married couple who is facing fertility issues. These may be practiced by an infertile Muslim couple, within the limits of Sharī‘ah, in order to remove hardship and difficulty of their life. In the light of Islamic Law, the main justification for their use is based on the objective of preservation of progeny and genealogy (hifz al-nasl wa ’l-nasab). Therefore, the donation of gametes or embryos is strictly prohibited. By definition, assisted reproductive technology (ART) includes all treatments or procedures that include the in vitro handling of both human oocytes and sperm, or embryos, for the purpose of establishing a pregnancy. One of such technologies is artificial insemination (AI) whose most common form is intrauterine insemination (IUI). It involves the deposition of a washed sample of sperm in the uterine cavity around the predicted time of ovulation, so that fertilization takes place within the body of a woman. If AI does not work, the procedure of choice is in vitro fertilization (IVF) that is an ART procedure that involves extracorporeal fertilization. This technique involves the following steps: The anterior pituitary is suppressed to prevent the LH surge which triggers ovulation in a normal cycle. Then, the ovaries are stimulated with drugs for multiple follicular development. When ova are mature, ovulation is triggered and they are retrieved. The ova and sperms are fertilized in the laboratory. The zygote is allowed to divide and the pre-embryo is transferred to the uterus at 4 cell stage. The progesterone is given to support and maintain pregnancy. There are two further variants of IVF that are no longer widely used due to poor success and increased risks of ectopic pregnancy. One procedure is gamete intrafallopian transfer (GIFT) in which the ova collected after superovulation and prepared motile sperm are transferred to the Fallopian tube to allow fertilization to occur in vivo. The other procedure is zygote intrafallopian transfer (ZIFT) in which fertilization is allowed to take place in vitro, and the zygote is transferred to the Fallopian tube. IVF may be used with another technique in which an immobilized sperm can be injected directly into the cytoplasm of ovum. This technique is known as intracytoplasmic sperm injection (ICSI). It can be used in male with sperm concentration less than 5 million/ml. The sperm can be retrieved directly by micro-surgical procedures that include testicular sperm extraction (TESE) or microsurgical epididymal sperm aspiration (MESA) or percutaneous epididymalsperm aspiration (PESA). The technique of cryopreservation of gametes and embryos has expanded the scope of ART. It includes a method of freezing human semen in liquid nitrogen vapour at -196 °C. This technique permits long-term storage of gametes and embryos. Preimplantation genetic diagnosis (PGD) is another technique that is used to test oocyte or embryo made by IVF for a known genetic abnormality carried by one or both parents to determine whether it carries that disease or not. Then, the embryos that are the carriers of the disease are not transferred to the woman. Another technique is gender choice by which IVF is achieved by selective gametes with which embryos of only favourable gender are formed. These techniques are of two kinds: Firstly, preconception methods that are sperm sorting techniques, based on the separation of X-bearing sperm from Y-bearing sperm. Then, achieve IVF with Y-bearing sperm. Secondly, preimplantation methods that are gender-oriented preimplanation genetic diagnosis (PGD) techniques. Surrogacy is a practice that involves IVF and embryo transfer. It is defined as the practice whereby one woman (the surrogate mother) carries a child for the infertile couple (the commissioning couple) as the result of an agreement prior to conception that the child should be handed over to that couple after birth. One of its kind is called traditional surrogacy whereby conception usually occurs by artificial insemination of the surrogate using the commissioning father''s sperm, hence, the surrogate mother is also the genetic mother of the child. In another kind, an embryo created by gametes of the commissioning couple is transferred to the uterus of the surrogate mother. Hence, the role of the surrogate mother is purely gestational and the child is genetically related to the intended parents. This is called gestational surrogacy. The last on the list ishuman reproductive cloning that is an assisted reproductive technology, which involves a process of ‘cloning’ a human being with or without the assistance of a partner. The first part of this technique is somatic cell nuclear transfer (SCNT) in which the nucleus of an egg cell is removed, which is then replaced with the nucleus of a somatic cell taken from the body of an adult. The somatic cell donor may be the same person or another, whether a male or a female. The human blastocyst thus formed may be used to prepare embryonic stem cells (ESCs) for further clinical and research purposes. This process is known as “therapeutic cloning” or “non-reproductive cloning”. The other course is that it may be transferred to the uterus of the same woman whose enucleated ovum has been used, or in the uterus of another woman. This is called “reproductive cloning.” In the light of Islamic Sharī‘ah, the procedure of artificial insemination may be done using the semen of the husband (AIH). The employment of procreation without conjugation is an essential principle of these techniques. This not equal to going against the Will of Allah and His Creative processes because it is done as a need, in order to remove the hardship of infertility. As a general rule, the act of conjugation is not essential in the Islamic law to prove the genealogy of the child since nasab has been established even to a majbūb husband. Therefore, as an act of istiḥsān, the husband gametes can be inseminated in his wife. However, the procedure should be done by a female doctor preferably. The Sharī‘ah’s viewpoint about in vitro fertilization (IVF) overlaps with its view about AI. Both are allowed for an infertile married couple within the span of their lives. In the procedure of IVF, the ova can be retrieved from a woman and fertilized in the laboratory due to istiḥsān based on ḍarūrah. The hardship can be removed by employing ova retrieval and getting fertilization outside woman’s body because there is silence (sukūt) about the exact site of fertilization in the text. As ḥifẓ al- nasl is a necessary objective, it may be preserved by using ḥīlahḥasanah of taking ova out of a woman’s body because she has difficulty in getting in vivo fertilization. This ḥīlah provides a legitimate heir to the couple and blocks the door of adultery for a child or the need of donated sperm. The surplus embryos of IVF can be cryopreserved for future use with the consent of the couple; however, they cannot be used in future if anyone of the couple dies. If they are not needed, they can be destroyed by leaving them as such in the laboratory. The Sharī‘ah supports the procedure of intra-cytoplasmic sperm injection (ICSI) as it is beneficial for those males who have poor semen parameters. The procedure is an extension of IVF and assists in the success rate of IVF. Moreover, the micro-surgical procedures of sperm retrieval are allowed along with ICSI for the benefit they provide to infertile men and remove the possibility of donor sperms. However, the procedures, such as gamete intra-fallopian transfer (GIFT) and zygote intra-fallopian transfer (ZIFT) and assisted hatching (AH) are not recommended. These procedures do not give any additional benefit to IVF and ICSI, whereas they increase the risk of side effects. Pre implantation genetic diagnosis (PGD), including HLA typing for the birth of saviour sibling, is permissible to diagnose or to cure or alleviate human suffering. The Islamic viewpoint asks for a thorough assessment of the benefits and risks involved in the procedure. The genetic engineering is permissible to obtain large quantities of the secretions of genes to be used treatment of diseases. However, it is prohibited to perform such procedures for the purpose of eugenics, scientific wonders, such as chimera, etc. The determination of sex of the embryo by a gender choice technique is allowed for medical reasons. For instance, the X-linked recessive diseases can be detected to avoid transfer of such embryos. However, the most suitable and cost-effective technique shall be used after an informed consent of the couple to whom the embryo belongs. However, the gender selection for non-medical reasons, such as for discrimination against female embryos, family balancing, and equalization of the male to female ratio, is prohibited. In the Islamic viewpoint, the necessary objectives of the Sharī‘ah include ḥifẓ al-nasl wa ’l-nasab, and not ḥifẓ al-jins (preservation of gender). Although it is not equal to homicide, but the social evils involved in it are obvious. It will support or encourage the prohibited practice of gendericide. There is a general prohibition of any form of surrogacy as per the rulings of Muslim jurists. However, if there is an extreme necessity (ḍarūrah), such as the woman has no uterus or her uterus has been removed surgically, an exemption (rukhṣah) may be made as an exceptional case for the surrogate who is also the second wife of the male. Now, the procedure may be performed in conformity with certain conditions: There shall be no harm to anyone involved in the process (la ḍarar wa la ḍirār). The informed consent of all, the first wife, the second wife and the husband, is essential. The husband shall provide mahar, nafaqah and suknā to the second wife. The second wife shall get the first child for herself, then perform surrogacy after two years of suckling. If she agrees to give this child to the first wife, she shall be delegated the right to divorce. Both wives shall live happily like any other polygamous relationship. The child belongs to the birthgiver, but she is adopted by the ovum donor, who is also the genetic mother. With an agreement, both will become mothers and shall visit the child. However, if a conflict occurs, the surrogate mother shall be preferred. The cloning may be therapeutic (non-reproductive) or reproductive. The nonreproductive (therapeutic) cloning is permissible in necessity for the purpose of therapy. Human reproductive cloning may occur by embryo splitting or SCNT. Both of them are forbidden; embryo splitting is forbidden due to the risks and complications implicated in it and SCNT is an absolute rejection of human nature and a departure from the established way of Allāh. The regulatory situation in Muslim countries is disappointing. The regulatory mechanism is weak and detail laws do not exist. The regulation is usually done by orders, or decrees and the guidelines of bioethical committees. The difference from the Western legislation exist with regard to the permission for donation of gametes and embryo, which is strictly forbidden in Muslim countries but permitted in most Western countries. In Pakistan, there is a regulatory body the National Bioethics Committee (NBC) that provides guidelines for bioethical research. Moreover, the rulings of the Federal Sharī‘ah court and the recommendations of the Council of Islamic Ideology also provide a regulation." xml:lang="en_US