Qatar Foundation ethicist sheds light on the Islamic perspective of genomics

Most, if not all of us, have heard of the possibility of a future that will consist of genetic report cards. It will state how likely a person is to suffer from a disease based on the mutations present in their genome. Grades for diseases will be assigned based on genetic disposition, for example, an “A” in colon cancer will indicate that the person is highly likely to develop it.

“It is true that genomics has opened doors to knowledge that our ancestors never had,” says Dr. Mohamed Ghaly, Professor of Islam and Biomedical Ethics at the Research Center for Islamic Legislation & Ethics (CILE) at Qatar Foundation’s Hamad Bin Khalifa University (HBKU).

Genomics is poised to launch a monumental leap in healthcare. Its ability to read the so-called ‘book of life’ and alert people to possible future health issues may at first sight look like fortune-telling or infringing upon the unseen (al-ghayb), a practice which is in principle discouraged by various Muslim scholars.

“The scope of seen and unseen is not fixed in Islam. With technological advances over time, what was once unseen can become seen. For example, hundreds of years ago, it was not possible to see an embryo grow using ultrasounds during pregnancy, and people would not find out the sex until the baby was born. This knowledge which was unseen hundreds of years ago is commonly found knowledge today.”

The other question is, we can, but should we find out beforehand? Would it be right to interfere with something that was destined for us by God?

“The Holy Quran and sunnah mandate us to explore, ‘Don’t you contemplate over your own self’, (Quran, 51:21). This verse can be interpreted in many ways, the mandate to contemplate here can be achieved by understanding our psychology and behavior, and it can be through biomedical sciences.

“Genomics offers us a peak into human biology like never before. The more we explore it, the more we are left in awe of our creator and His creations. Its ability to explore diseases at a molecular level will greatly support the medical community in tackling grave diseases. Therefore, genomics has been deemed to be a collective duty by key religious institutions in the Muslim world, including the International Islamic Fiqh Academy based in Jeddah, Saudi Arabia, and the Islamic Organization for Medical Sciences based in Kuwait.”

Dr. Ghaly says, another thing to remember is, while Islam requires us to place our trust in Allah, it also requires us to simultaneously use the means available to solve our problems. ‘Trust in Allah, but tie your camel’, this hadith clearly portrays that we must not sit back and leave our affairs to God, rather we should actively work towards finding solutions.

Another issue that has been the topic of debate for as long as genomics has existed is the ethical management of Incidental Findings (IF). These are findings that are coincidentally discovered during sequencing one’s genome. The debate is whether or not (some of) these findings should be disclosed to the person if they have chosen the right to not know. For example, if a young woman is participating in a genomics research and IFs reveal that she carries BRCA genes 1 and 2, which have correlation with ovarian and breast cancer. What should be done in such cases?

“If the person has chosen the right to not know, their choice will be respected unless the finding is life-threatening and the treatment for it is available. In which case, it is morally and religiously obligatory to reveal the information to them, because saving life is not an option but an obligation,” says Dr. Ghaly.

He explains: “Some IFs should be revealed, others like misattributed paternity shouldn’t, and then there is a third category which considers IFs on a case-by-case basis. For example, if a person is found to be susceptible to a grave disease but a cure for the condition does not exist, the IF may or may not be revealed depending on various factors related to the person, his or her family, social and financial status, etc.”

“Islam and Muslims are no strangers to scientific research and medical innovation. Prophet Muhammad (PBUH) once said, ‘Make use of medical treatment, for Allah has not made a disease without appointing a remedy for it, with the exception of one disease: old age.’ This is evidence that we must keep exploring, any disease is incurable only until a cure is found for it.”