Religious beliefs play an important role in organ donation. Health care professionals are often unaware of religious beliefs and tend to avoid this in sensitive issue in discussions with family regarding organ donation. The major religions in the subcontinent are Hinduism, Sikhism and Islam.

Hinduism is the major religion in the sub-continent with more than one billion followers. It has no founder and no universal authority. Hinduism believes in transmigration of the soul and reincarnation where the deeds of an individual in this life will determine his fate in his next life. An important tenet of Hinduism is daan or selfless giving to help someone who is suffering.

The physical integrity of the dead body is not seen as crucial to reincarnation. “As a person puts on new garments, giving up the old ones the soul similarly accepts new material bodies giving up the old and useless ones”

In fact one of the earliest depictions of xenotransplantation is the case of Ganesha, the head of an elephant on a human body and is one of the best known and most widely worshipped deities in Hinduism.

Various Hindu scholars have endorsed organ donation publicly. Hasmukh Velji Shah of the World Council of Hindus stated that “The important issue for a Hindu is that which sustains life should be accepted and promoted as Dharma (righteous living). Organ donation is an integral part of our living.”

Sikhism: is a monotheistic religion founded in 15th century India by Guru Nanak Dev Ji.. Sikhs think religion should be practiced by living in the world and coping with life’s everyday problems. Sikhism also stresses the importance of doing good actions. Sikhs believe in life after death, and a continuous cycle of rebirth. All Sikhs, apart from stillborn babies and infants dying within a few days of birth, are cremated. In Sikhism, the physical body is not crucial to the cycle of rebirth, as the soul of a person is eternal while the body is simply flesh.

Islam: Altruism is also an important principle of Islam, and saving a life is placed very highly in the Qur’an—‘Whosoever saves the life of one person it would be as if he saved the life of all mankind . The Islamic Jurisprudence Assembly Council in Saudi Arabia approved deceased and live donation in a landmark decision in 1988. Similar formal rulings are in place in India as well.

Religious concerns may be an under-reported obstacle to deceased and live donation and/or the willingness to accept a transplant. Transplant teams, donation coordinators, intensivists and nephrologists need to be more aware, and strategies to increase donation should take into account religious concerns, although a proactive approach must be balanced against the patient’s right to keep this issue confidential.