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Therapeutic abortion in Islam: contemporary views of Muslim Shiite scholars and effect of recent Iranian legislation


full article,here:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2563289/

Abortion is forbidden under normal circumstances by nearly all the major world religions. Traditionally, abortion was not deemed permissible by Muslim scholars. Shiite scholars considered it forbidden after implantation of the fertilised ovum. However, Sunni scholars have held various opinions on the matter, but all agreed that after 4 months gestation abortion was not permitted. In addition, classical Islamic scholarship had only considered threats to maternal health as a reason for therapeutic abortion. Recently, scholars have begun to consider the effect of severe fetal deformities on the mother, the families and society. This has led some scholars to reconsider the prohibition on abortion in limited circumstances. This article reviews the Islamic basis for the prohibition of abortion and the reasons for its justification. Contemporary rulings from leading Shiite scholars and from the Sunni school of thought are presented and reviewed. The status of abortion in Muslim countries is reviewed, with special emphasis on the therapeutic abortion law passed by the Iranian Parliament in 2003. This law approved therapeutic abortion before 16 weeks of gestation under limited circumstances, including medical conditions related to fetal and maternal health. Recent measures in Iran provide an opportunity for the Muslim scholars in other countries to review their traditional stance on abortion.

All the major world religions consider life to be sacred, beginning with conception and ending with death. Islam is no exception in this matter. Traditionally, abortion has been considered to be absolutely forbidden or to be treated with strong disdain and limited to certain circumstances. The Catholic church does not allow abortion under any circumstances. However, abortion is not considered to be morally objectionable when the treatment given to save the life of the mother results in an abortion.1 The Protestant viewpoint is heterogeneous with evangelical sects opposing abortion and more liberal ones allowing it.2 Buddhists also oppose abortion, although there is no official stance but rather a general opposition to harming any life.3 Judaism allows abortion when the life of the mother is threatened,4 but otherwise considers it to be forbidden.5Islam is unique among world religions in that the embryological development of humans has been extensively discussed and described in the divine scripture, the Quran, and commented on in detail by Prophet Muhammad and the Imams, exemplary teachers who are descendents of Prophet Muhammad. Islam is a codified religion, the basis of which is derived from the Quran and the records of Prophet Muhammad's sayings (hadith) and rulings (fatwas) as judge and head of the city‐state of Medina, in the Arabian Peninsula. Muslim jurisprudents continued, throughout the ages, to derive rules and methods of deducing new rulings as new issues arose. This allowed Islamic law to be flexible in its application and accommodating towards certain local customs and needs. The issue of non‐therapeutic and therapeutic abortion is no exception.The prevalent and widespread practice of abortion in nearly all industrialised countries and many developing countries has been equated with the “culture of death”.6 The estimated rates of abortion in the industrialised world include Russia (58.2%), China (27.1%), Sweden (25.7%), New Zealand (24.8%), the US (24.3%), Canada (24.2%), Japan (22.2%), Australia (22.5%), the UK (21.8%), France (21.3%) and Italy (19.1%).7 Additionally, in Vietnam and Cuba, abortions occur at nearly 2–3 times the world average rate of abortion for every 1000 women of child‐bearing age.8 Asia accounts for 50% of the world's population, but 60% of all abortions.7,9In developing countries, undeniable pressures owing to limited economies and burgeoning populations have contributed considerably to the wanton taking of human life. Along with this are the increased social services, housing and healthcare needs, employment needs and, finally, social security and retirement needs. Abortion has become a reality, often carried out in unsanitary conditions, with great risk to the life of the mother and without the knowledge of the immediate family members or consent of the father of the child.This article presents an overview of the concept of abortion in Islam by examining the source material of Quranic verses and hadithes, mainly from the Shiite point of view. It presents contemporary rulings of Shiite jurisprudents on abortion and concludes with a case study of the recent parliamentary laws passed in the Islamic Republic of Iran, which allow therapeutic as well as non‐therapeutic abortions during the first 4 months of gestation, under certain circumstances. Iran is the only Islamic Republic whose legal system is founded solely on Shiite Islamic law or shari'a, but which also allows democratic representation. This article also considers some of the reasons behind recent changes in Iran's legal system with regard to abortion. For the sake of definition, therapeutic abortions are defined as “those recommended by the healthcare provider to protect the mother's physical or mental health”.10

Shiite scholars and sources of Islamic rulings
The Shiites, unlike the Sunni Muslims, have a series of scholars, Ayatollahs, who are the most senior jurists qualified to make new rulings on issues of contention when they attain the level of “ijtihad”. For issuing new rulings based on the Quran, hadithes and logic, they go through a standard and rigorous training lasting more than 30 years and receive letters of attestation from other Ayatollahs on their qualifications for issuing new rulings. Qualified scholars are regarded as independent and differ from their contemporaries in individual rulings. To follow Islamic injunctions in day‐to‐day matters, a Muslim who is not trained in Islamic law may pose a question to an Ayatollah and receive an appropriate response. The rulings noted later were in response to specific questions asked by people, but may be generalised to the general populace.

Pregnancy and stages of fetal development according to Islamic sources
Pregnancy, according to Shi'i Islamic teachings from the seventh century onwards, begins when the fertilised ovum (nutfah) settles in the uterus, and not before it. This view was elaborated on in the classical fiqh (jurisprudence) by the author of Shahr al‐Lum'a, and in contemporary times by Ayatollahs Khomeini and Khu'i.11,12 Five distinct stages of embryonic development are discussed in the Quran :

And certainly We created man of an extract of clay, then We made him a small seed (nutfah) in a firm resting‐place (the uterine wall), then We made the seed a clot (‘alaqah), then We made the clot a lump of flesh (mudhghah), then We made (in) the lump of flesh bones (‘idham), then We clothed the bones with flesh (lahim) …” (23:12–14).

In the science of hadith and jurisprudence, the term “nutfah” refers to both the male sperm and the fertilised embryo and is distinguished from the context of its use. Thus the first stage, nutfah starts with conception and ends 40 days after implantation. Each stage lasts 40 days (see below). Thus, at 200 days of age, or at 28 weeks of gestation, a fetus has human proportions. The lungs have matured enough so that it can conceivably survive outside the womb without technological assistance.13At the end of the third period of development—that is, the mudhghah phase, at 4 months (120 days) of gestation—the human “spirit” (ruh) enters the body, termed “wuluj” according to Islamic metaphysics. At this point, the fetus is referred to as “another creation” (23:14):

Then [God] made [man] of an extract, of water held in light estimation. Then He made him complete and breathed into him of His spirit (32:8–9).

It is at this point and after it that abortion is absolutely forbidden unless the life of the mother is threatened by the continuation of pregnancy. There are hadithes in which Prophet Muhammad ruled on paying tort for the death of a fetus that had passed more than 4 months of gestation by induced abortion.14 The amount of tort depends on the sex of the fetus and its degree of development. Regardless of the amount of tort, all the people participating in the abortion are encouraged to seek forgiveness for their deeds according to Islamic ethics. There are other quotations from Prophet Muhammad in which it is said that the angels come to the nutfah at 40 days of gestation to determine its fate.15As abortion is an act that terminates a pregnancy, accordingly, non‐therapeutic or elective abortion can be regarded as the termination of pregnancy for non‐life‐threatening reasons, which is generally not permitted in Islam. This is consistent with the following explanation by Imam Ali Zaynul Abideen, the great grandson of Prophet Mohammad. When asked about when an intentional miscarriage would be considered to be an abortion, he replied, “after the stage of nutfah”, explaining, “A nutfah is a substance which, when placed in the womb, settles down in it for forty days.”16 Regardless, the Islamic ethos of respecting life does not encourage non‐therapeutic abortion at any time.

Contemporary Islamic rulings on abortion
All scholars, from the four Sunni and the Shiite schools of thought, agree that after the fourth month of gestation an abortion cannot be performed unless it is to save the mother's life. This is true, according to classical jurisprudence17 and contemporary scholarship.18,19 The disagreements are related to the status of the fetus before 4 months of gestation.Traditionally, Shiite scholars did not allow abortion before 4 months either. Among contemporary Sunni scholars, there is still disagreement on when an abortion is permissible without payment of tort, and after which point it is no longer allowed, with exceptions as noted earlier. There is a range of opinions on whether it is even a sin to abort a fetus before, at the very least, 40 days. Nearly all jurists agree that wanton abortion is to be discouraged, and that there should be a good reason for an abortion—namely, the mother's health—even before 4 months of gestation.20 The contemporary Shiite Ayatollahs are nearly unanimous in their rulings on abortion before 4 months of gestation, and this is discussed in detail later.

Abortion before 4 months of gestation
Wanton, non‐therapeutic abortion
Contemporary Shiite jurists consider pregnancy to begin with the implantation of the fertilised embryo in the uterus.21 Ayatollah Khomeini22 stated, “Termination of pregnancy even at the earliest possible stage under normal circumstances without any reason is not allowed.” Ayatollah Khamene'i23 wrote, “The shari'a does not permit the abortion of a fetus. In the consideration of the honorable shari'a, there is no difference between a fetus less than or greater than four months gestation with regard to this matter.” This holds true among all the other contemporary Shiite scholars.

Non‐therapeutic abortion for non‐medical reasons
Traditionally, the prohibition of abortion among the Shiite scholars included non‐medical social situations. For example, again, Ayatollah Khomeini24 ruled, “Termination of pregnancy is not allowed for economic reasons, even if that puts a family into hardship, or the old age of mother or having many children.” Ayatollah Khamene'i25 has not allowed it when the mother has a diagnosed mental illness. However, as of late, certain social aspects have been considered. Ayatollah Sane'i,26 who is considered to be progressive, ruled, “Any fetal or maternal condition that brings extreme difficulties (‘usr va haraj) for the mother or the family allows for abortion.” This is a singular ruling and there is no consensus on this matter.

Therapeutic abortion for medical reasons relating to the health of the mother
Therapeutic abortion has received special consideration among the contemporary scholars when it relates to the health of the mother. Again, Ayatollah Khomeini 27,28 ruled:

Abortion before 4 months of pregnancy when it leads to a fatal condition for mother is allowed, and, abortion is allowed before 4 months of pregnancy in cases where the mother has an advanced disease as such that her life is threatened by the continuation of pregnancy provided that a specialist physician confirms it.

Therapeutic abortion for medical reasons relating to the health of the fetus
A series of fatal congenital deformities may occur during embryonic development. Contemporary scholars have not generally allowed for an abortion for this reason. However, as we have noted above, one Ayatollah has allowed it in cases of “extreme difficulty”. For example, Ayatollah Makarim‐Shirazi29 stated, “It's problematic to abort the fetus (in cases of deformity), particularly because you cannot be absolutely certain that the deformities are not compatible with life.” Ayatollah Fazel‐Lankarani30 has allowed the fetus to be aborted before 4 months of development if it is dying from a maternal illness. Ayatollah Khamene'i31 initially did not approve of therapeutic abortions based on probability of deformity:

The likelihood of bearing a deformed fetus does not allow for it to be aborted. However, if a trustworthy physician attests that there is a concern that the life of the mother is in danger, the fetus may be aborted before the spirit is breathed into it (i.e. four months gestation).

He has, however, allowed the abortion of a deformed fetus under limited circumstances. A questioner wrote, “Is it permissible for a woman to abort a deformed fetus when she requires special assistance in delivering it, especially granted that she had a similar experience with past pregnancies?” In reply he wrote, “To the degree necessary, such a procedure, with the husband's consent, is not forbidden, but you must avoid any impermissible action that may result from undergoing the abortion.”32

Therapeutic abortion after 4 months of gestation
we have noted, abortion is not allowed after 4 months of gestation unless the mother's life is in danger. Ayatollah Fazel‐Lankarani33 says,

Aborting a fetus is not allowed under any circumstances after the spirit has been breathed into the fetus, and before this time it is not allowed unless the mother's life is in danger.

According to Imam Khomeini,34 abortion for saving the life of the mother is allowed, whereas abortion is not allowed in the case of a mentally retarded mother if her life is not endangered.35

Abortion in Islamic countries
In all, there are 57 members in the Organization of Islamic Conference—an organisation of countries with Muslim majorities or pluralities.36 Most Muslim countries have restrictive abortion laws that permit abortions only when the life of the mother is threatened.37 Twelve members of the Organization of Islamic Conference allow unrestricted access to abortion. With the exception of Turkey and Tunisia, they are mainly former Soviet Bloc states. Bahrain, a politically and socially conservative Muslim state, is the 12th among these countries to permit unrestricted access to abortion. Among socially conservative Muslim countries, seven countries permit abortion in the first 4 months of gestation for fetal deformities, four countries in subSaharan Africa (Benin, Burkina Faso, Chad and Guinea) and three in the Middle East (Kuwait, Qatar and, now, Iran).

Contemporary abortion policies in the Islamic Republic of Iran
Iran is the first Islamic country in contemporary times that has attempted to combine principles of theocracy and religious law with representative, parliamentary democracy. People vote for representatives to the unicameral legislative body, the Majlis‐e Shura. They debate and pass laws independent of the executive and judiciary branches. The laws passed must, however, go before a special body, Majlis‐e Negahban, the Guardian council. This council, comprising six jurists, chosen by the supreme religious leader, and six lawyers, chosen by the parliament, examines laws for conformity to contemporary religious rulings, according to Articles 71 and 96 of the Iranian Constitution.38 If a part of the bill violates Islamic rulings, it is sent back for amendment before ratification. If the impasse still cannot be resolved, it may be sent to the Expediency Council (Majma' Tashkhis‐e Maslahat‐e Nezam), a mediating body, for further deliberations before final approval or rejection.

According to an official notification from the head of the judiciary, dated Winter 1383 (December 2003–March 2004), to the National Legal Medicine Organization (Sazman‐e Pezeshki‐e Qanooni‐e Keshvar), therapeutic abortion may be performed under 51 medical conditions (see boxes 1, 2). This notification was forwarded by the National Medical Council (Nizam‐e Pezeshki), legally allowing doctors to practise abortion in conditions mentioned in the notification.39 The Majlis‐e Shura‐e Islami (Islamic Consultative Assembly or Parliament), in July 2004, also legislated a bill regarding therapeutic abortion in which approval of three specialists is mandatory for the justification of therapeutic abortion. The bill was initially rejected twice on technical grounds by the Guardian's Council. The parliament amended it as per the recommendations of the Guardian's Council on 21 June 2005.

The final bill40 states:

Therapeutic abortions may be performed under the following conditions. First, the fetus must be less than four months of age, that is, before the spirit is breathed into it. Second, the fetus must be suffering from profound developmental delay or profound deformations or malformations. Third, these fetal problems must be causing extreme suffering or hardship for the mother or the fetus. Fourth, the life of the mother should be in danger. Fifth, both the mother and the father give their consent to the procedure. The physician performing the abortion shall not be penalized for the performance of these services.


Conclusion
In conclusion, abortion is a generally forbidden act according to Islamic teachings. It is permissible under certain circumstances if carried out before ensoulment at 4 months of gestation and after that to save the life of mother. Traditionally, the well‐being of the mother was the sole consideration for abortion. Currently, some Islamic countries, including Iran, and several Sunni and Shiite scholars, have permitted abortions when the fetus has congenital disorders that are profoundly debilitating or not compatible with life, or when there are serious social or economical hardships entailed in carrying a child to term. The therapeutic abortion legislation in the Parliament of the Islamic Republic of Iran is a step towards crafting a legal mechanism for abortion in accordance with the laws of Islamic Shari'a. It is of utmost importance that safeguards against misusing this provision are scrupulously observed to maintain the spirit of Islam's emphasis on respect for life, while recognising the emphasis on not making religion a burden on people.

more on abortion and contraceptives in Islam:

http://www.al-islam.org/m_morals/chap4.htm

All sins outside Shirk are forgiveable by God. If the person is truly repentant. Forgiveness is very much possible.

Say: O My servants who have transgressed against their own souls, despair not of the mercy of Allah. [b]Indeed, Allah forgives all sins. [/b]Truly, He is Most Forgiving, Most Merciful. (Surah az-Zumar 39:53)