INTRODUCTION
One of the scientific developments regarding
biotechnology research that is interesting to study is the use of stem cells.
At the current world level, stem cells are one of the main focuses in biotechnology
research, especially in relation to cell therapy and regenerative medicine.
Prior to the use of stem cells, disease treatment was carried out
conventionally by administering drugs containing chemical substances (McArdle et al., 2014). Development is a
systematic and continuous effort made to realize something that is aspired.
Development is a change towards improvement. Changes towards improvement
require the mobilization of all human resources and reason to realize what is
aspired. In addition, development is also very dependent on the availability of
natural resource wealth. The availability of natural resources is one of the
keys to economic growth in an area (Shah et al., 2020).
Stem cell technology is now increasingly becoming a
trend that is considered to be able to help treatment in the medical field (Ogliari et al., 2014). In Indonesia, the
development of stem cell therapy is directed at degenerative and hereditary
diseases that are widely found in the community. Advances in science and
technology in all fields, increasing people's living standards, increasing
attention to the fulfillment of human rights and increasing public awareness of
the importance of healthy living have led to increased public demand for
quality health services. Stem cell technology needs to be developed as an
alternative to disease therapy for the benefit of patients and affordable by
the community. Stem cells have great potential in the medical world to be used
as cell therapy for various� degenerative
diseases and cancers that are difficult to cure, including diabetes, heart
infarction, stroke, Parkinson's, and so on (Ojeh et al., 2015). �
Kalthoff in Analysis of Biological Development
explained that Stem cell therapy is not only useful for overcoming various
degenerative diseases that have been incurable and incurable, but also very
useful for Reverse Aging (returning young), beautiful, attractive, passionate,
fit and energetic (Kalthoff, 2001). Its ability to
replace dead cells with new, young and healthy cells is needed for anyone who
wants to stay beautiful and healthy, away from illness caused by decreased
function or damage to organs.�
Although it is still relatively expensive, it is undeniable
that this stem cell is a new hope in the field of medicine. The important role
of embryonic stem cells is for therapy and treatment to reduce the number of
sufferers of degenerative diseases, such as neurological, heart and liver
diseases (Lo & Parham, 2009). �Utilization of stem cells is now not only
limited to health, but also beauty. In accordance with the nature of these
cells to repair damaged tissue, various skin problems due to aging are also
claimed to be treated with stem cells. Some of these health clinics are
suspected of practicing illegal medicine. The practice is injecting illegal
stem cells into patients.
The perpetrators have carried out the practice of
buying and selling stem cells to their victims for USD 16,000 or the equivalent
of Rp. 230 million. Stem Cell Serum imported from Japan. The serum was brought
to the clinic for immediate injection into the patient. For now, the three
arrested people may be subject to Article 204 paragraph (1) of the Criminal
Code and or Article 263 of the Criminal Code and or Article 75 paragraph (1),
Article 76 of Law No. 29 of 2004 concerning Medical Practice, and/or Article
201 in conjunction with Article 198 in conjunction with Article 108 of the
Republic of Indonesia Law no. 36 of 2009 concerning Health and/or Article 8
paragraph (1) letter a of RI Law no. 8 of 1999 concerning Consumer Protection
in conjunction with Article 55 and Article 56 of the Criminal Code�
What is considered controversial is the process of
destroying human embryos when isolating the stem cells so that it becomes a
conflict because it causes problems with the human code of ethics and also
violations of religious law. To obtain the nature of stem cells that have the
ability to develop into all body cells (pluripotency), cells must be taken from
the embryo in the blastocyst phase (5-7 days after fertilization) before the
implantation process occurs in the uterus (Rendon & Sch�kel, 2019). The procedure for
taking stem cells is considered as destruction in the early stages of human
life. Many argue that like humans who have been born, the embryo has the right to
live and develop.�
According to the thought that develops among
Muhammadiyah scholars, the embryo is formed after conception, meaning that
there is already life there. So taking it is the same as having an abortion,
Nahdlatul Ulama also believes that embryonic stem cell therapy can only be done
when there is no other way to save humans (Wijaya, 2019). Even if the
application of embryonic stem cell therapy to humans is carried out, they must
be very careful with regard to their impact on humans, the action must be
carried out according to the objectives of Islamic law, namely the preservation
of religion, soul, honor, lineage and human property.
Human Stem cells are beneficial for humans, but the
lack of clarity on regulations, especially those that regulate them at the
research stage and their use, opens the possibility of misuse of Human Stem
cells (Liras, 2010). Human stem cells
originating from the human body are not a commodity that is prepared for a
certain selling value which incidentally only benefits the interests of certain
parties. Human stem cells are a wealth of human civilization that should be
protected for the sake of human life itself.�
The use of stem cell therapy invites many pros and
cons, for degenerative diseases it is permitted because it brings the principle
of benefit that comes first, it can help human life, but for beauty, fitness
and energy, this is what needs to be regulated because the process of taking
stem cells is still debated by religious experts (Jensen & Parmar, 2006). �
Based on the above background, the problem that will
be studied in this research is about the perspective of Islamic law on the use
of stem cells for beauty.
METHOD
This research is qualitative research that is library
research which uses books, journals and other literatures as the main object (Creswell & Poth, 2016). The type of
research used is qualitative, namely research that produces information in the
form of notes and descriptive data contained in the text under study (Sugiyono, 2018). With qualitative
research, it is necessary to do descriptive analysis. The descriptive analysis
method provides a clear, objective, systematic, analytical and critical
description and explanation of the values in Islamic law. The qualitative
approach is based on the initial steps taken by collecting the required data,
then classification and description are carried out.
RESULTS AND DISCUSSION
1. Stem Cells (embryonic stem
cells)
Embryonic�� are stem cells obtained when an individual's
development is still in the embryonic stage. More precisely, these stem cells
are the inner cell mass contained within the blastocyst. Inner cell mass is
formed when the new embryo is 3 to 5 days old. The time at which the blastocyst
forms, and will implant itself into the uterine wall. Embryonic stem cells are
the origin of all types of cells in the human body. Embryonic stem cells are
classified as pluripotent stem cells. This is the specialty of embryonic stem
cells, which are difficult to compete with other types of stem cells. Based on
its pluripotent nature, logically there is no single degenerative disease that
cannot be treated. The drawbacks of using embryonic stem cells, both in the
field of research and in the field of clinical trials on the human body, are
related to the ethical value of using embryos as a source of obtaining these
cells. Because of this, research around embryonic stem cells generally uses animal
embryos, which of course gives results that cannot be compared to human
embryos. To carry out human embryonic stem cell research, researchers have
tried various methods or methods that are considered not contrary to ethical
values, of course including therapeutic cloning. contrary to the prevailing
ethical values.�
2. Adult stem cells
Adult� stem cells are stem cells that are found
among other differentiated cells in a mature tissue. Adult stem cells are a
group of undifferentiated cells, sometimes even found in an 'inactive' state in
a tissue that already has a specific function in the individual's body. The
existence of these stem cells is thought to aim to maintain homeostasis of the
tissue in which they are located. Based on the available scientific evidence,
the ability to differentiate today's stem cells is classified as multipotent.
So today's stem cells have a lower ability to differentiate, when compared to
embryonic stem cells, only being able to differentiate into several types of
cells, generally belonging to a group. Meanwhile, the drawback of today's stem
cells is that their concentrations are relatively much lower when compared to
differentiated cells in adult tissues. It was found that, it turns out that
almost all tissues and organs in the body that have matured, proved to contain
adult stem cells. Thus, today's stem cell classification is carried out based
on the organ and or cell group that will be the path of differentiation, such
as hematopoietic stem cells, heart stem cells, neural stem cells, mesenchymal
stem cells, skin stem cells, and so on. It has been mentioned previously that
the differentiation potential of adult stem cells is classified as having only
multipotency, but scientific journals in recent years have found evidence that there
is transdifferentiation, namely the differentiation of adult stem cells into
adult stem cells outside the usual differentiation pathway.
B. Uses of Stem� �
Cells The stem cells in
your baby's umbilical cord blood have the potential to be used in the treatment
of many diseases today. Stem cells can be used to treat hematopoietic and
genetic disorders. In cord blood transplantation, stem cells are infused into
the patient's bloodstream where they work - healing and repairing damaged cells
and tissues. After successful stem cell engraftment, the patient's blood and
immune system will regenerate.
Alongside a number of
conditions that are now treatable, the potential for stem cell treatment is of
great interest as research continues to uncover new possibilities. The
potential and efficacy of stem cells in medicine are real. While Stem Cell
Therapy is a very effective therapy to treat degenerative diseases such as
Alzheimer's, Parkinson's, stroke, diabetes mellitus, especially Insulin
Dependent Diabetes Mellitus (IDDM), atherosclerosis, myocardial infarction and
many other degenerative diseases as well as AutoImmune such as Lupus and
others.��
C. Clinical Aesthetic Uses of Stem Cells��
As previously explained,
stem cells therapeutic option versatile, so they can also be used in the world
of beauty. The world of beauty in medicine is a specialty of
dermatovenereologist (doctors of skin and venereal diseases). The skin is an
organ that is very important for survival, as a protection and prevention of
dehydration, as a sensory and thermoregulatory organ, as well as being an
active site of vitamin D synthesis and immune cell control.�
When the skin is injured,
it has a coordinated and organized healing system, which results in healing of
the integrity and function of the skin tissue. This process can be inhibited by
special conditions which will then lead to chronic (continuous) wounds that do
not heal. Conditions that can cause this are arterial and venous insufficiency,
diabetes, kidney disease, trauma, old age, and prolonged pressure on an area of
the body. Local factors such as tissue hypoxia (lack of oxygen), ischemia
(obstructed blood flow), the presence of foreign bodies, tissue maceration,
exudates, infection, impaired regulation of the inflammatory process, and
systemic factors such as poor nutritional and immune status, can contribute to
the development of the immune system. hinder the healing process of the skin.
In this modern era, the number of people with non-communicable diseases is
increasing, which in turn can also increase the incidence of chronic wounds
like this.� stem cell therapy is an
option that is becoming more common in skin cases. In general, stem cells are
usually taken from organs that have significant cell regeneration, such as bone
marrow and skin. Hematopoietic stem cells (HSE), or stem cells that function in
blood cell differentiation, usually have high concentrations in bone marrow,
umbilical cord, and placental blood. Bone marrow, fat tissue, skin (dermis),
and umbilical cord tissue are very rich in stem cells mesenchymal (adult)In
addition, the umbilical cord has a low risk of infection and immunogenicity,
with a high regeneration power, so it is very beneficial. However, as of today,
only HSE from bone marrow and cord blood is allowed for medical use. Usually,
HSE is used for blood diseases, genetic and acquired, or tumors that often
affect children such as neuroblastoma, neuroblastoma, Wilms tumor, and
osteosarcoma.�
The definition of
'aesthetic' in the medical world has a broader scope than 'beauty'. According
to the KBBI, aesthetics is about beauty, concerning the appreciation of beauty,
or having an assessment of beauty. In a recent journal compiled by Ahmadi-Ashtiani
et al. (2020), stem cells have many
benefits in the field of skin diseases. One of them is congenital skin disease
from birth which, although not life-threatening, interferes with aesthetics,
namely vitiligo and psoriasis.��
Vitiligo is a skin disease
caused by the destruction of melanocytes (cells that color the skin) by
abnormally functioning immune cells, called cytotoxic T cells. This causes the
area of skin where the melanocytes are damaged to be lighter in color than the
surrounding area. This disease is closely related to the quality of life and
the patient's self-confidence is very low.�
While psoriasis is an inflammatory skin disease that is also caused by
genetics and immune cells. Psoriasis is also closely related to a very low
quality of life, because the symptoms interfere with the patient's life. Not
only does it have an aesthetic impact, psoriasis also causes pain, itching, and
bleeding.� therapy stem cell, it is hoped
that the patient's quality of life can improve, in terms of symptoms to
aesthetics.
The use of stem cells in
other clinical aesthetic cases is in anti-aging age-related dysfunction. During
the aging process, DNA is damaged and accumulates, causing damage to protein
homeostasis, cell function and communication, and normal organ physiology.
Another sign of aging is dysregulation or exhaustion of the stem cell in the
body, which leads to decreased homeostatic function and repair of damaged
tissues. Aging is very closely tied to stem cells;biology stem cell and regenerative
medicine is how to use stem cells to reverse aging and the dysfunctions
associated with it.�
Aging of the skin is caused
by damage from ultraviolet (UV) rays, environmental factors, inflammation, and
an increase in oxidative stress species compared to antioxidants. Typically,
stem cells used are multipotent cells, which are capable of proliferating and
reprogramming in the epidermal layer, then creating stem cells in the basal
cells, and finally, new keratinocytes.��
Stem cells in the field of beauty
are indeed very promising, but are often misused. The problem that arises from
stem cells in the field of beauty is that stem cells are often advertised
misleadingly, because people's knowledge is still not good about stem cells.
Drug companies have strategies that are often unfounded, and often exaggerate
claims, thereby putting patients at risk.�
The use of stem cells in fighting aging is also often misused by being
promoted as a facelift. The term �stem cell facelift� is also often used, which
is a non-surgical procedure that is actually intended for skin tightening and
cannot be compared to a facelift. What is usually advertised and promoted as a
new and original technique of �stem cell facelifting� is usually only
lipofilling enriched with stem cells.�
The use of stem cells can
be given through several routes, namely systemically via oral and systemic
injection, or locally, via local and topical injection. Systemic administration
has drawbacks as many cells are affected, not just the target organ (in this
context, the skin). Local injection usually has complications related to
administration risk and patient compliance, so topical administration is often
preferred to stem cells for the skin. Topical administration is an easy route,
specific, and has a high probability of patient compliance, without any
systemic side effects. Administration of topical medications is easy so that
patients can do it themselves;efficacy of stem cells will increase due to low
total daily dose by continuous drug input. Topical medications can also be
discontinued immediately when needed, for example if side effects occur.�
D. The Application of Stem Cells in the Field of Cosmetic Medicine
The Aspect of Islamic Law
Medical expertise in the
problem of rejuvenation known as Stem Cell Therapy is a blessing from Allah SWT
to mankind to return to the nature of its most beautiful creation which should
be grateful for by using it in its place and not misused to fulfill ungrateful
human desires. Therefore, Islam highly glorifies the science of health and
medicine as a means of caring for life with the permission of Allah SWT.
There are 2 clear reasons
for rejuvenation treatment with stem cell therapy methods, namely for
aesthetics and function. Rejuvenation can not only improve skin health, but in
certain cases can also have a major impact on a person's environment and career
development. In addition, better physical health can lead to a better standard
of living. The main goal of rejuvenation with stem cell therapy is to carry out
early detection, prevention, treatment, and repair to the original state of
various dysfunctions, disorders and diseases associated with aging, as well as
its ability to replace dead cells with new, young cells that aim to prolong
live in good health.�
Body treatment or aging by
using stem cell therapy according to Islamic law is permitted, provided that it
is in a 'conditional condition', namely: 1. Intention to seek treatment, 2.
Within a certain period, 3. With a certain capacity or dose, 4. Does not use
embryonic stem cell types, 5. Its use is conscious (not addicted). Reproduction
The use of stem cell therapy for reproduction using in vitro fertilization
(IVF), according to Islamic religious law, is allowed on the following
conditions: 1. Under conditions of necessity (emergency), 2. Fertilization
between sperm and ovum comes from a legal husband and wife pair, also called
Artificial Insemination Husband (AIH).�
Regarding the rejuvenation
method used in stem cell therapy, there are still differences of opinion.
Moreover, saying that this is an act that is not in accordance with the
Shari'ah. Based on the way of taking it, it is clear that stem cells are very
contrary to morals and ethics because to take them must damage and kill the
embryo in embryonic stem cells. Therefore, this action is an act of murder as
described in Al-Maidah: 32 and AlIsra: 33.
The concept of stem cell
therapy is categorized as an act that changes Allah's creation, because getting
old is an absolute thing that has been ordained. Moreover, it is reinforced by
the hadith of the Prophet SAW which clearly prohibits making changes back young
for beauty. This is in accordance with the hadith of Rasulullah SAW narrated by
Al Bukhari� and Muslim.�
In the practice of
rejuvenation, neither the patient nor the doctor should hesitate in carrying
out this treatment. So if any doubts are found in practice, then the youth
process must be canceled for good. This goal becomes a necessity for someone if
the condition really needs treatment. It aims to normalize or correct
abnormalities in the function of the skin or body that cause premature aging so
that it can function optimally so that it can bring benefits and keep away
harm.�
Before doing this stem cell
treatment, one must consider the benefits and risks. These considerations
include considerations in terms of physical, psychological and financial
benefits. Like the type of treatment in stem cell therapy, it will certainly
bring side effects, as well as the type of stem cell therapy treatment. Because
the treatment given for bone marrow and stem cell transplantation may be
exactly the same as the drugs given for chemotherapy but with higher doses, the
side effects that occur may be more severe. This stem cell therapy method is
used, although now it is using the oral or capsule method which is
cheaper.�
Hence with these various
risks, do not let the rejuvenation treatment actually create more serious harm,
even though it is considered necessary at the beginning. "The law of
everything that is harmful is haram." This rule is the opposite of the
first rule. The law for medical treatment using goods that are dangerous and
harmful to the law is haram. Including haraam treatment with dirty and unclean
items such as khamr and blood.�
Yusuf Al Qardhawi emphasized
the fiqhiyah rule which states that harm (dharar), including danger,
destitution, misery and misery, should be eliminated as much as possible (Qardhawi,
1995). However, in the case of
eliminating the dharar, it is not permissible to use a larger or equivalent
dharar. Minimally removed with a lighter.
Dharar Rejuvenation with
the use of embryonic cells for any purpose is not allowed except when the
therapy is the only solution for the good of mankind (Negredo
et al., 2020). In addition, even if the
application of embryonic stem cell therapy in humans is carried out, it must be
very careful with regard to its impact on humans. Returning for beauty purposes
in the absence of a more important purpose should be avoided. None other than
to avoid actions that are prohibited by the Shari'ah so as not to bear sins.
CONCLUSION
The application of stem cells is viewed from an Islamic
point of view as the utilization of stem cells in a manner that is more
beneficial, does not contradict norms, ethics, or religion, does not result in
damage, and respects creation and The Creator. According to Islamic law, the
treatment of the body or the slowing of the aging process through the use of
stem cell therapy is permitted, provided that it meets certain
"conditional conditions." These conditions are as follows: 1.
Intention to seek treatment; 2. Within a specific period of time; 3. With a
certain capacity or dose; 4. Does not apply embryonic stem cells; 5. Its use is
conscious (not addicted).
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Copyright holder:
Rizka, Septarina Budiwati (2022)
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First publication right:
Journal of Social Science
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This article is licensed under:
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THE APPLICATION OF STEM CELLS IN
THE FIELD OF COSMETIC MEDICINE THE ASPECT OF ISLAMIC LAW