Organ Transplantation Laws in Saudi Arabia (Controversial Essay)
Should the Organ Donors in Saudi Arabia Have the Right to Reject Donate Their Organs?
The paper focuses on the controversial issue of organ transplantation in Saudi Arabia. The problem of whether to be or not to be a donor is the personal right of every individual. The world is suffering from the lack of donors, and many people are dying every year, waiting for the transplantation surgery, which can save their life. Sharia does not prohibit the transplantation, as it stands for the compassion and overall support inside the communities. However, the question remains of whether an individual has the right to reject being a donor in Saudi Arabia. The work consists of three parts. The first one states that every individual should be a donor. The second part forms a counter-argument, and argues that everyone in Saudi Arabia has the right not to choose to be a donor. The last section provides the reflection of the investigation.
The modern world is now sorely lacking donor organs. Medicine is developing, and such advancement is constant. Today, organ transplantation is widely and loudly discussed and promoted. It happens very often that operational transplant organs from a deceased person saves the life of a patient, for whom such a surgery represents the only chance to live on. Half a century had passed since the time when a little-known doctor Christiaan Barnard performed the first heart transplant operation in the world (Gutkind. Although transplantation has since become a recognized trend in medicine, the debate about what can and cannot be done during the removal of organs, do not cease, and erupt with a renewed vigor (Jensen). From a medical point of view, as soon as the transplantation of organs started to take first steps, appeared the problems, which has no direct connection to the medical science. From the point of view of ethics, it is hard to receive a consent to organ removal of the person or his relatives, the right to receive the body of the dying and the opinion of the family of the donor. The final responses and indisputable solutions to all of these new questions have various interpretations (Jensen). However, taking into account the cultural and religious differences, each region is forming an opinion about the transplant. In Saudi Arabia, people are always wondering whether they have a freedom to refuse the organ donation process. It is not prohibited in the Saudi Arabia, and, according to the laws, any individual can rightfully refuse to becoming a donor. Despite that, the paper states that an individual has no ethical possibility to refuse to be a donor, as according to the values of the Sharia every person should be compassionate and provide overall support for individuals who really needs it.
Cultural and Religious Attitudes in Favor of the Organ Donation
The transplantation of human organs and tissues is a process of replacing the missing or in any way damaged part of the patient’s body, based on the harvesting of the needed organs and tissues from a donor or a human corpse (Gutkind). It can be done only in cases when the conservation and storage have been done through a surgery (Gutkind). One should borne in mind that the human organs and tissues are anatomical structures, and do not define the distinctive traits. Donor organs and tissues come from an individual who voluntarily provides his or her anatomical structures for transplanting them to sick people (Gutkind). The recipient is a person to whom therapeutic purposes transplanted organs or human tissues (Kirk).
The range of therapeutic interventions or the medical technology has expanded incredibly and, of course, increased their efficiency in the treatment of various conditions. However, there is the possibility of an elevated increased risk. A doctor himself can often be beyond the power to solve the age-old and very responsible and difficult problem of “benefit – risk” (Gutkind). Currently, the transplantation process goes to the level of physical preventing of the human death. There are fundamental socio-cultural problems, and ethics in transplantation represent one of the most important areas of bioethics and public health practice.
The origins of the organ transplantation date back to ancient times, when the skin grafting was performed in ancient Egypt (Gutkind). However, only in in the modern world, unsuccessful attempts to transplant vital organs and tissues of the human body took their place. The first successful kidney transplant took place in 1954, the first successful heart transplant occurred in 1967. In the future, organ transplantation can become a method, not content with the symptomatic therapy, but liquidating the very source of the disease. Therefore, the possible widespread of it is causing enthusiasm in the world.
The reason for such a euphoria lies not just in the obvious benefits of transplantation. It is also caused by the fact that it touches the dream of modern man to achieve earthly immortality (Miller & Truog). Therefore, it is no exaggeration to say that the emerged hype lies in the danger of human distraction from the ultimate goal of its existence and of its most important tasks. Therefore, it is even more evident that the transplantation can hardly be regarded as a panacea for the salvation of humanity. An excessive belief in organ transplants of human interest focuses only on his or her physical health, at the same time giving the illusion of earthly immortality (Miller & Truog). However, the majority of Muslim scholars consider it permissible to sacrifice the body, provided that there is a need for doctors, and medical indications do not preclude the transplantation, donor, or the recipient (Ebrahim).
For many patients, organ transplantation is the only way to return back to normal lifestyles. Besides, such surgeries show really effective results. For example, there are two methods of treatment of chronic renal failure: dialysis or a kidney transplant. The survival rate of patients with dialysis is about 34.8%, and in kidney transplantation, the figure amounts to 90 percent (Gutkind). The person could become a donor only when it is a voluntary fulfillment and as a kind of donation. From a medical viewpoint, organ transplant from one person to another is permitted if the expected benefit from the transplantation surpasses the possible damage (Jensen). Furthermore, the surgery must be held because the patient will be able to obtain a new healthy body, or his or her body is given a chance to restore its function, or acquire normal appearance. Moreover, transplantation is allowed to correct physical defects or deformities that cause psychological or physical suffering (Gutkind).
Permission is granted to organ transplant from one person to another provided that they have the ability to regenerate, for example, blood, tissues or skin. Possible organ transplant from a living dead man is possible only if the deceased during his lifetime gave permission, or relatives of a deceased individual gave consent (Jensen). In Saudi Arabia, there is a possibility to receive the necessary organ from the living dead man with the consent of the Muslim leader in case the deceased has no close family or is not recognized (Ebrahim). Transplantation is authorized and should provide the confirmation that does not involve trade and financial gain (Ebrahim). Cases that are not addressed in the above paragraphs require an individual approach and a decision in each matter, after the careful study of the medical and Islamic point of view has been carried out (Ebrahim).
In Saudi Arabia, the authorities do not see anything wrong in transplantation (Ebrahim). Moreover, it is worth noting that it is one of the countries which employs the best surgeons in transplantation. Importantly, the state is sponsoring medical projects in this professional field, which has already brought up outstanding results (Ebrahim). The cornerstone of the abovementioned issue is health and the patient’s life saved. Sharia focuses on everything that is good for an individual and society, while at the same time harmonizes their interests (Ebrahim). It calls for Muslims to cooperate, as well as promotes compassion and charity (Ebrahim). Therefore, a person cannot radically refuse to become an organ donor, since it is Muslims’ obligation to be responsible to the problems of the other humans.
Legislation in Support of the Organ Donation
The legal problems of the organ donation decision are only based on the ethical and moral standards. There is no doubt that the formation of a positive public opinion is the responsibility of highly professional specialists working in all phases of transplant service: from examining the donor to the patient’s rehabilitation (Shaheen). Organ transplantation is permitted in Islam, given that it is performed within the limits outlined by the Sharia (Shaheen). The scientists have stipulated the following conditions for the donation. Conditions for a living donor and a person who gives his or her body for transplantation after the death significantly vary (Shaheen).
Thus, a living donor must be of a sound mind and should be able to take the responsibility of his or her actions. Such a person should be an adult, ideally older than 21 years (Ebrahim). A future donor has to make the decision on his or her personal conviction and not under duress. When talking about a deceased donor, it is allowed to do transplantation only after obtaining the consent of a given donor before his/her death (Ebrahim). If the donor’s concession was not obtained prior to death, it could be done with the approval of the next of kin of a deceased one, who is authorized to make decisions on behalf of the aforementioned individual (Ebrahim). It should be an organ or a tissue that is medically kept, and can maintain the life of another person. The authority should be withdrawn from the dead immediately after his/her death (Ebrahim). Agencies can withdraw road accidents victims, whose identity has not been established, but it can be done only with the permission of court (Ebrahim).
It is significant to note that people are only allowed a free donation of human organs, but not to sell them. The sale of human organs violates people’s right to dignity and honor, and, therefore, is a forbidden action (Jensen). Some scientists believe that people, though, become too materialistic, selfish, and calculating. At the same time, it has to be impossible for the authorities to purchase organs, and the Muslims are prohibited committing such crime (Ebrahim).
Ethical Theories in Support of the Organ Donation
An important ethical document regulating the transplantation is the “Declaration on Human Organ Transplantation”, adopted by the 39th World Medical Assembly (Madrid, 1987), and the “Regulation on the transplantation of fetal tissue”, adopted by the 41th World Medical Assembly (Hong Kong, 1989) (Gutkind). Both regulate transplantation, including neurotransplantation using fetal tissues. The scripts also state that the transplantation of organs from one person to another is one of the greatest achievements of the modern medicine.
Transplantation of organs from living donors is not less ethically problematic than with the case of a deceased person becoming a donor (Jensen). The humane purpose of extending the life and salvation of the recipient loses the status of humanity as a means of achieving, if it is harming the life and health of a donor. Equally dramatic is the deficit of donor organs. Regarding the problem of choosing between recipients of donor organs specialists took two general rules. Firstly, organ allocation, as the priority should not be determined by identifying the benefits of certain groups and special financing. Secondly, the donor organs must be transplanted to the patient that is the most appropriate exclusively in terms of medical immunological indicators.
A certain guarantee of fairness in the allocation of donor organs is used to enrolling recipients into the transplant program, which is formed based on the waiting list at the regional or interregional level (Gutkind). Recipients have equal rights to their corresponding donor within such programs, which are also provided for the exchange of donor transplants between transplant organizations. The provision of just rights is implemented through the mechanism of selection in terms of pure medical reasons, the severity receiving patients’ condition, or immunologic parameters of the genotype donor characteristics (Jensen). Assessing the underlying organ allocation system as a guarantee against all kinds of abuse, the recommendation to create a donor organ system at the regional or national level should be seen as one of the common ethical rules.
The ethical theory of utilitarianism is the one that supports the values of the transportation (Shafer-Landau). From a standpoint of utilitarianism, the action is morally justified, even to the extent that it leads to an increase in extra-moral good (Shafer-Landau). Hence, as human activities in areas such as medicine, art, science, are not aimed at solving moral problems, they are morally important or subject to moral evaluation (Jensen). The utilitarian theory recognizes only one major benefit. It maintains that human beings must always act in such a way as to achieve the best possible relations between the positive and negative consequences of their actions, or the smallest of the total damage, if the repercussions known to be negative (Shafer-Landau). As such, even in Saudi Arabia, the ethical theory is of a significant value.
The liberal position is to justify the promotion of transplantation as a new direction in medicine. The modern transplant does not create utopian concepts, but aspires to be aligned with the ethical rules and regulations of its activities (Gutkind). Various guidelines and standards that take-transplant specialists within the boundaries of the liberal position have as their fundamental basis the two principles of anthropocentrism. The first concerns natural and pragmatic understanding of a man, the second one corresponds to the ultimate life and the denial of the immortality of a human soul.
The success of the transplantation is possible only under conditions of justification and fostering of transplantation as a new direction in medicine, recognition of human values in terms of all issues with the practice of organ transplantation (Miller & Truog). Among unconditional humanistic values, the major ones are – voluntariness, altruism, and independence (Gutkind). A special place in liberal bioethics takes the concept of anatomical gifts. It is worth noting that liberal bioethics have the aim to overcome and eliminate possible economic motives of this act (Shaheen). The inclusion of any form of economic calculation indicates the loss of values and a meaningful, moral status donation.
Transplantation enables to ensure the right of every person to live. Such a statement serves as a concrete proof in terms of the moral value of the organ donation. The idea of protection of life and health is highly moral. Transplantation is recognized as an effective form of treatment of irreversible diseases and human injuries. Numerous doctors around the world support such thesis as their major aims include serving people and protect their lives and health. The argument in favor of transplantation is based on the appeal to those situations, where the method in question is the only one possible way to preserve the life of an individual. Nevertheless, the given approach is not acceptable when there are other methods of treatment and there is the possibility of the patient to recover with the help of medical support and medicine. Organ transplantation is only possible when for a given person it constitutes a single chance to survive.
Transplantation is the process of transferring the living material within the same organism or another recipient. There is currently a great need for donor organs. Opinion polls consistently show that, even though people are aware of such shortage, they are reluctant to use the transplant of their own bodies or the bodies of their relatives (Jensen). Organ transplant operations can be of varying degrees of complexity. Semi-legal clinics specializing organ transplantation focus mainly on relatively simple kidney transplants. According to the World Health Organization, more than 66 thousands of such operations were carried out in the world (Kirk). Approximately, 10 percent of them used paid donor agencies from developing countries. Saudi Arabia is against the practice of selling organs, as it is prohibited by the values of Sharia (Ebrahim). Moreover, the human being has the grounds to reject being a donor of organs according to individual moral beliefs. This argument can be proved by the base of particular prescriptions in Sharia, and the values of the ethical theories. The counter-argument of the work is based on the fact that an individual has the right to reject the philosophy of being an organ donor, since, in accordance with the nature rules and ethical theories, every person should commit no harm for his or her own body and has the right to treat it in every possible way, which is accepted by the individual.
Religious and Cultural Aspects on the Possibility of the Organ Donation
Transplanting organs from one person to another, provided that it is done on a volunteering basis and is not harmful to the authority which transplanted it, is allowed, according to the Sharia. However, the transplantation is possible only in cases when the doctor believes that the surgery would benefit the patient. Such meaning is beyond the scope of the hadith. It is necessary to admit that the donors-to-be are thinking about the influence of the committed sin on their soul (Jensen). When an organ is transplanted to another patient, he/she gets his body and is no longer associated with the previous owner. When a person commits a sin by his or her body, the demand for the sin will be with the one who uses this authority because of sin and worship of God are closely connected with the mind, the thoughts and will of a man. Nonetheless, they belong to the perpetrators of these processes. The body is only a tool, and any decision with regards to it is solely dependent on the owner.
It is worth noting that in Islam there is a belief that honor to the dead person should be the same as to the living one, but when necessary and there is no possibility to cure the patient in any other way, organ transplants are allowed (Shaheen). At the same time, it is necessary to ensure the calm death of whose bodies taken away. Death should not be clinical, but one that is considered to be based on the laws of Sharia (Ebrahim). The death set by the Sharia stops all the organs of the body, cooling it, blood clotting, halting all extremities (Ebrahim). Islam does not allow a euthanasia, so the doctor who will conduct it, commits murder, and it is said so in the Qur’an (Ebrahim).
There is a yet another problem with certain types of transplantation. A possibility exists that the surgery can lead to the loss of moral, psychological, and spiritual integrity of a human being, especially in transplant marrow and gonads. Transplantation of the brain is linked to the problem of personal identity. After all, brain is the concentration of the individual’s identity (Gutkind). During the transplantation procedure, the brain has to be alive, but then the donor has to be alive as well. Hence, when the human body is extremely mutilated and the skull remained intact, it is a whole body transplant. It is worth noting the prematurity of such surgeries as they are at the stage of a research project.
A weighty argument against the organ donation is the risk of adverse effects taking place, and the extreme complexity this sort of surgical manipulation. Some transplant operations have to be enhanced, for instance a heart transplant surgery. Other types of transplantations are still at experimental stages. Quite common is the rejection of the donor tissue, which can lead to death. Next complication is associated with the transplantation of heart. This type of operation requires the donor to be clinically dead. There is a clear moral requirement: the heart can be transplanted without the ethical warnings only when the donor is clearly dead. Failure to comply with this requirement leads to the issue when during a heart transplant is a donor killing (Kirk). This problem is rather complicated because it involves a state of death, about which no ambiguous criteria on today.
Modern medicine outlines the following death criteria: heart and its beating rate, breathing, reflexes, and brain activity (Jensen). An important method of determining these criteria is the electroencephalogram. There is a debate around the issue of brain death. The concept of the brain death is due to a change in the traditional worldview installation that existed before that time (Jensen). After all, for centuries, it has been recognized cardiac, cerebral and not the criteria for death. In addition to the heavy ideological reorientation associated with breaking stereotypes, there are many other problems associated with the brain death. Legal aspects of this process still do not have clear answers. Even the task of recording brain death moment is practically an impossible one (Shaheen). Normally, it is believed that there is a certain time when the patient signs of declining brain function first appear. Sometimes, lawyers familiar with the court’s records see the cause of death during surgery for the removal of organs, but not in the brain injuries (Gutkind). In addition, it might lead to the prosecution of a murderer of the transplant patient (Gutkind).
There is also an additional claim against the problem of transplantation, as there exists the risk of abuse in connection to the commercialization of modern medicine. Nowadays, the world is gaining popularity of the organ sales. One may obtain bodies in a fraudulent or criminal way, from defenseless people. Moreover, trading bodies business is developing very fast today. The world community, in the face of all sorts of organizations, is struggling to prevent such destructive mechanisms and wrongdoings. In particular, the World Assembly in 1985 called upon the governments of all countries to prevent commercial use of human organs (Gutkind). Therefore, this is the key argument for the rejection of being the donor, as there is always the threat that the donated organ would be sold for the benefit of criminals.
Resolution against the Organ Donation
Commercialization of organ transplantation, transplant tourism, and trafficking of donor organs have been acknowledged and convicted by the resolution of the Assembly of the World Health Organization on 22 May 2002 (Miller & Truog). Under the auspices of the WHO International Summit on transplant tourism and organ trafficking in the Istanbul, was adopted the Declaration, which contains a number of specific requirements for Governments, in one role or another involved in the international exchange of the transplant services (Miller & Truog). In particular, Governments are called for to put in place a ban on paid organ donation and serious criminal charges for all kinds of illegal or forced organ transplantation. Developed countries are strongly recommended to encourage in vivo, and post-mortem donation among its own citizens (Miller & Truog). According to the Islamic law, it is not allowed to turn over a vital organ of one person to another, if it entails the imminent death of the donor (Ebrahim).
Transplantation is prohibited in case after the operation the donor loses the function of a transplanted organ, although it continues to live. An example could be the surgery for the corneal transplant of both eyes. Logically then, a partial loss of function of the transplanted organ occurs, the donation should be considered on an individual basis, because there is no consensus among scientists. Moreover, it is significant to remember that any doctor cannot take for transplanting organs and tissues in people under 18 years (Ebrahim). Adult donation is valid only under circumstance of a consent, written the constraint, in the presence of two witnesses, in a clear memory and sanity (Ebrahim). Alternatively, the resolution can be expressed verbally provided utterance of two witnesses, and information recorded by a third party verification as a lawyer and a doctor.
It is forbidden to transplant the organ or tissue under the threat of a living person’s health (Kirk). As such, all of it is put in place so as to prevent bodies from becoming a commodity which can be traded. The death of a donor must be certified by the joint opinion of the cardiologist, neurologist, specialists in anesthesiology, and rescuer. The doctors, who are busy organ harvesting, storage, grafting, and transplantation, have no right to be among the witnesses to death (Miller & Truog). For violation of the conditions of the donation, as well as for the sale of organs or brokering their sale provides criminal penalties in many countries around the world. Patients in a coma are not considered dead, and the taking of organs is prohibited, because the known cases of miraculous recovery (Kirk). Although, it is significant to understand that there have been no cases on the medical practice when patients with a diagnosis of brain death did not come back to life. They died from heart failure or lung, as well as at the request of relatives, after which the body was disconnected from the apparatus of artificial feeding.
Ethical Theory against the Organ Donation
The controversy around the use of human organs for transplantation represents the need to balance the benefit of transplantation and evil organ harvesting. It applies to the bodies being viewed as dead and living donors, although the ethical issues related to these two situations are different (Miller & Truog). In the first case, the emphasis is put on the human tragedy of death, in the second one – on the risks associated with the process of donation (Miller & Truog). The nature of the required informed consent in these two cases is also different, but in both of them there is an aspect of moral complicity (Jensen). Organ transplant from a living donor is associated with causing harm to his health. The transplant ethical principle of “do no harm” if the donor at hand is alive, is practically impossible (Jensen). An average doctor has to face the contradiction between the moral principles of “do no harm” and “do well” (Jensen). On the one hand, an organ transplant is lifesaving an individual. On the other though, the living donor of the organ’s health is severely impaired, which violates the principle of “do no harm”. Thus, in case of a individual’s living donation it is always a question of the degree of benefit and the degree of harm, and always applies – the benefit itself should be greater than the harm caused.
The theory of moral obligation by Ross refers to the advantage of a pluralistic approach is that it is closer to our everyday moral experience (Shafer-Landau). It argues that human beings usually do not follow a single principle or rule, but rather take into account different rules (Shafer-Landau). Although these principles may conflict with each other. The ethical theory in question supports the idea that not everyone should be the donor of organs, even if this issue is supported by the Sharia. In this approach, which can be called correlative, an individual does not refuse any matter in order to follow the principles and rules of any order to fully take into account the uniqueness of concrete situations (Shafer-Landau). The essence of the correlative approach lies in the obligations arising from the principle, though not denied, may be violated (Shafer-Landau). Each of the principles of the approach in question retains its importance, and one is not talking about how to find the overriding principles and subordinate to it. However, everyone should be respected not in all cases, but only as long as it does not come into conflict with others in a particular situation.
There is a number of ethical and psychological dilemmas, arising when one attempts to obtain the consent of an individual or his family for donation of organs (Jensen). Getting the permission of the person who is in a terminal state is practically impossible due to ethical and medical reasons, as people in such state cannot come up with voluntary, responsible decisions based on the complete and accurate information presented in the accessible form. The process of communication with the relatives of the dead or dying individuals is rather complex and virtually unattainable without the use of ethical theories and psychological support (Jensen).
Thus, despite the great potential in the field of medical care for people, transplantation remains largely a research and experimentation. The issue at hand is rather complicated due to the fact that there are many ethical and psychological problems, which arise during the communication with donor and his family. Summing up the consideration of the ethical aspects of the transplantation, it should be mentioned that this method is an efficient and effective means of treatment.
Transplantation of organs and tissues quite often saves a man’s life, it continues in the new positive qualities. At the same time, it should be remembered that transplantation outcomes depend on thorough implementation of all stages. According to the experts, the selection of recipients, donor software, surgical equipment, and postoperative care requires coordination together with professionalism. Moreover, there is another important element – the moral humanistic installation. According to the values of the ethical theory and the provisions of the Sharia, every person could refuse to be the donor of organs if it harms the health and moral stability. Moreover, in situation when the death of the donor cannot be confirmed, it is of a crucial contributor for the refusal of the relatives of the donor to provide organs for transplantation.
Each species carries a donation of risk, both to the donor and the recipient. In addition, around donation and hovering many myths on this day. In the beginning of the paper, the author stated that the individuals should not reject the Organ Donation in Saudi Arabia. As the norms and values of the Sharia claim, each individual shall commit the act of ultimate generosity. Perhaps the greatest benefit of the organ donation is the recognition of the fact that you save someone’s life. It can be the life of a spouse, a child, a parent, a close friend, or even a stranger, who would then be eternally grateful to the donor.
Organ donation is a major surgery. All operations are accompanied by certain risks such as bleeding, infection blood clots, allergic reactions or damage to surrounding tissues and organs. While you will be carried out anesthesia during surgery as a living donor, you may feel pain during the recovery period. Pain and discomfort will vary depending on the type of operation. After the surgery, one might be left visible scars. One’s body will need some time to recover from the surgery. An individual undergoing such type of surgery may have to be absent from work all the time it will take to complete healing. While insurance payments may cover the costs of the operation itself, any medical problems that may arise in the future, will not be refunded.
Notably, there is no objection about the organ transplantations as such. Most of the questions surrounding the removal of organs. The issue of recording the moment of death, allowing making the removal of organs became more than a regular medical problem, causing a variety of different opinions in the society. The development of bioethics is going in different directions. Among them is the main legislative regulation of biomedical research, the definition of the moment of death, beyond the maintenance treatment of terminally ill patients, and so on.
The human body is designed so that nothing unnecessary in it, but some of my organs can be divided in the event of an emergency. In any case, the lifetime of the donation is not decreasing. However, the donor must be much more careful with respect to treating his or her body and pay much more attention to the health problems. All the world’s major religions approve of donation and consider that decision to be or not to be a donor – a matter of personal choice of the person. Therefore, in Saudi Arabia, there are no mandatory restrictions on the donation. At the same time, no one can force an individual to become a donor after his death. The legislation of most countries prohibits the purchase and sale of organs. The violation of law is a criminal offense. According to the provisions of Sharia, it is prohibited to sell the organs, which is a yet another rationale behind an individual rejecting to become the organ donor.
Perhaps, a system of measures aimed at improving transplant image in the eyes of the population would help me to change the opinion. It is necessary to carry out a broad information campaign, to talk about the social significance and the value of the donation because the help of the donor is always someone’s life saved. However, there is the possibility that the paper is capable of changing the public mind about donation. While the author himself is not willing to become a donor due to the existence of the black markets. It is also caused by the fear that the organs will not go to the benefit of a real person, but would help other people earn fraudulent money. Altogether, the issue of the Organ Donation is controversial. According to research, Islam does not prohibit the donation of organs; however, it adjusts the right of every person to reject this possibility. Therefore, it is the decision of each person of whether to become the donor or not, and in Saudi Arabia, everyone has the right to refuse to give the organs on the donation if it does not meet the personal beliefs and rules.