Heparins are a vital and life-saving medicine for many people in the Australian community. To better inform the Australian Muslim community, we have contacted Eli-Lilly, a multinational medicines corporation and a major supplier of heparin-based medicines in Australia. We have also conducted preliminary research into the origins of heparin, the Islamic literature on heparin, other societies’ positions, and the Australian heparins market.
Nearly all heparins are derived from animal tissues.1 To make heparin, the animal tissue is sent through multiple steps to remove impurities. The final product is rigorously tested to ensure quality and reliability. In addition, the final product has had any other harmful proteins and DNA removed.1, 2
Please note that beef and sheep are not used commonly because of the threat of prion related diseases such as Creutzfeldt-Jakob Encephalopathy.
Whilst it would be ideal to have a completely artificial product, presently, this is not possible in Australia. If people miss out on this medicine, the consequences are grave; they may die because they have not treated their pulmonary embolus, brain clot, or heart clot.
The Australian Islamic Medical Association would advise that if you as a health practitioner discuss this with your patients, you inform them that heparins are an essential medicine and place this in the context of their medical issues.
It would also be advised that we inform patients that scholars agree on animal-derived heparins’ use when prescribed by a doctor, and an alternative is not available.3
In a similar stance, the Islamic Medical Association of North America’s ethics committee states that the use of animal-derived or porcine heparin is permitted for Muslim patients based on the following circumstances4:
- Necessity makes that which is prohibited lawful.
- If there are two evils, then you use the lesser one. In this case, the bigger evil is that not using the available heparin could lead to significant morbidity or mortality.
- As long as there’s some modification of the original porcine product, then it’s appropriate to use.
- Taylor, S. L., Hogwood, J., Guo, W., Yates, E. A. & Turnbull, J. E. By-Products of Heparin Production Provide a Diverse Source of Heparin-like and Heparan Sulfate Glycosaminoglycans. Sci. Rep. 9, 2679 (2019).
- Van der Meer, J.-Y., Kellenbach, E. & van den Bos, L. J. From Farm to Pharma: An Overview of Industrial Heparin Manufacturing Methods. Mol. J. Synth. Chem. Nat. Prod. Chem. 22, 1025 (2017).
- Zarif MMM, Murad AHA, Fahmi Md Yusof A. The Use of Forbidden Materials in Medicinal Products: An Islamic Perspective. 2013;6.
- IMANA Brochure: Use of Heparin | IMANA. https://imana.org/resources/imanabrochure-use-of-heparin/.