April 2, 2026
In light of recent public discussions on the X platform regarding the use of porcine-derived heparin in clinical settings, Muslim physicians and medical ethicists from Al-Amin Ethics Institute wish to offer clarity on the intersection between Islamic law, medical necessity, and patient autonomy. We express our firm support for clinicians who advocate for transparent, ethical care—specifically regarding the disclosure of porcine-derived pharmaceuticals.
To briefly summarize, a Hematology/Oncology Clinical Fellow at the Dana-Farber Cancer Institute/Mass General Brigham posted the following on X:
"Today my co-fellow @SR_DeshpandeMD taught me that since all heparin products are porcine-derived, all Muslim patients should be asked about/informed about heparin products prior to their use! Make sure you ask before starting that dvt prophylaxis!"
A number of commenters, including Muslims, responded with rejection or disagreement. A few of those responses are shared below.
"Muslims are allowed to use pork or pork related products as life saving measures while informing is the best path to go i fear it might lead to uninformed people making a worse call with regard to their health."
"Muslims are allowed to use porcine products for medicinal purposes. Even medications that contain alcohol are allowed. The prohibition is in consumption of pork (which is full of germs as the pig eats its own shit). You do not need to ask before starting it."
"It's an unnecessary concern as pork eating is prohibited in different faiths including Judaism, Islam, Sikhism and Hinduism (all animal eating is prohibited), but using as life saving medicine is not. By this logic Hindu patients will be left with only mechanical cardiac valves and in emergent situations will still need heparin products. No need to complicate things more than they already are."
"There's no ambiguity. All the Quran stated was that pork should not be eaten. That doesn't extend to pig being used for other than food."
"Using heparin is OK and not a concern. We use it everyday in muslim countries. Please dont confuse the patients and doctors. You may actually harm the simple patient. Sorry but this post is terrible. You could have done some homework. Regards."
In the Islamic legal and ethical tradition, it is paramount to consider whether or not an action is in line with Allah's Divine command. This extends from matters as mundane as what we eat and drink to major life decisions such as marriage. Likewise, a Muslim believes that this Divine jurisdiction also extends to what happens in the clinical setting.
As a general principle, Muslims are encouraged to seek the means of treatment for their medical problems from qualified experts. However, in some cases, a treatment may offer some potential medical benefit while utilizing materials or methods which violate Islamic law. It is for this reason that Shaykh Amin Kholwadia has reframed the conventional medical maxim of "first, do no harm" as "first, do no sin."1
As he has said, "We have to ensure that we are in line with the maqāṣid (objectives), but, at the same time, that we are also in line with the ʾĀkhirah (Hereafter). Because we cannot detach the ʾĀkhirah when you talk about Islam."1
As Dr. Fitzgerald's post correctly identifies, heparin is a primary example of the possible tension that arises between purported medical benefit and Islamic law. While its efficacy in venous thromboembolism prophylaxis is well-established, the medical literature also notes the potential for over-utilization such as in scenarios where the clinical benefit is marginal compared to mechanical prophylaxis.2,3,4 Furthermore, non-porcine alternatives—such as fondaparinux—are frequently overlooked because many clinicians are unaware of the porcine origin of heparin or the synthetic nature of the alternatives.
Dr. Fitzgerald's post fulfills several vital functions:
It may be easy to downplay the significance of this incident on the basis that it is simply an isolated interaction on the Internet. However, we understand that the Internet is a powerful tool of both information and disinformation, and the attitude expressed by Muslim physicians is consistent with the perspectives that we, the authors, have run into from our Muslim colleagues in the clinical setting.
We were dismayed to see the number of comments that undercut the importance of the commentary that the author made. While we respect a healthy engagement with academic difference of opinion, it is plainly true that Muslims do not use porcine products and the doctor has a moral responsibility to inform the patient. In the specific case of heparin, the muftī (qualified Muslim jurisconsult) may give an individual dispensation (rukhṣah) for its use (and other interventions which are by default prohibited) based on a comprehensive understanding of the circumstance. It is nonetheless clear that using porcine-derived products is not the ideal for the Muslim.
We contend it is irresponsible and unethical for any physician (Muslim or otherwise) to take it upon themselves to withhold this information from a patient and make the ethico-legal determination on their own. The sentiment shared by some online that disclosing details about heparin would only serve to confuse Muslim patients is also in contravention of the contemporary medical understanding of patient autonomy, and we strictly denounce this form of deception and coercion in the medical workplace. The default assumption should always be patient competence, never inability.
In many of our experiences as Muslim physicians, it is common for us to witness Muslims forgoing interventions that are Islamically questionable during health crises when spiritual sensitivities tend to be understandably very high. We welcome this understanding of patient autonomy from our colleagues in medicine and we firmly believe that the physician should always provide the patient with the opportunity to make such decisions.
With respect to Muslims in healthcare, it is paramount to understand that a medical degree and being a Muslim do not qualify a person to make Islamic legal determinations for a patient. Elsewhere, this act of leveraging one's privileged qualifications in domains outside one's field of specialization has been termed epistemic trespassing.5 While a medical degree qualifies a person to make commentary on the medical elements of a patient case (and even then they may have gaps in knowledge or research), it is only through a sound understanding of Islamic law (typically by way of a muftī) that a comprehensive understanding of a matter is achieved for both the dunya and ʾĀkhirah.
We encourage physicians, both Muslim and otherwise, to bring their expertise in collaboration with the expertise of sound Islamic scholarship in order to bring about the best outcome for their Muslim patients both in this life and in the next. We likewise encourage Muslims to be proactive in their understanding and application of Islamic values within the medical context.
"We need to do more than just say 'concede to the status quo' and then let people live their lives assuming there is no alternative and there is no ḥalāl solution. For that, confidence in Islamic knowledge and tradition is a must. And so too is the belief that ḥalāl for healing is best for all people universally."
— Shaykh Amin Kholwadia