The Iranian government's efforts to facilitate foundation-led kidney donation align with the Maqāsid al-Sharī'ah

The issue of kidney transplantation, particularly through compensated living-unrelated donors, represents a complex intersection of medical necessity, ethical debate, and international governance. Iran is unique in legally regulating compensated kidney donation, aiming to address the chronic shortage of transplantable organs while providing structured financial incentives to donors. This study analyzes Iran’s kidney donation system through the lens of maqāsid al-sharī’ah, emphasizing the objective of hifz al-nafs (preservation of life), to evaluate both the ethical legitimacy and life-saving effectiveness of the policy. Employing a qualitative-descriptive approach, the research synthesizes empirical evidence on donor demographics, motivations, compensation mechanisms, and clinical outcomes, alongside normative Islamic ethical considerations and international standards such as the WHO Guiding Principles and the Declaration of Istanbul. Findings reveal that while Iran’s system significantly enhances patient survival and fulfills the core goal of hifz al-nafs, donor participation is heavily influenced by economic necessity, raising ethical concerns about voluntariness, long-term welfare, and equitable access. Moreover, the system’s interaction with foreign patients highlights challenges in cross-border governance and the potential for transplant tourism. The study contributes academically by integrating empirical outcomes with Islamic normative ethics, and practically by offering insights for policymakers, religious authorities, and international health organizations on navigating the tension between life preservation, ethical legitimacy, and socioeconomic realities. The research underscores that while the Iranian model demonstrates pragmatic life-saving benefits, ethical safeguards for donors must remain central to uphold the objectives of maqāsid al-sharī’ah.