In a recent column, we looked at organ transplantation in Israel and the struggle to respect Judaism’s values of preserving life and the ability to harvest organs without hastening the death of the donor. Today, how various streams of Judaism are grappling with this issue.
The Halachic Organ Donor Society greets you with its mission statement: “To save lives by encouraging organ donation from Jews to the general population (including gentiles) by educating them about the halachic and medical issues concerning organ donation.” The trilingual site (English, Hebrew, Spanish) includes testimonial videos from rabbis, including one from a rabbi who died while waiting for a kidney. There is information about conducting one-day seminars, and emergency phone numbers. “If you need to immediately consult with a rabbi before making a decision concerning an actual case of organ donation, then this is considered a medical emergency because you can save eight lives.”
The Toronto Board of Rabbis has produced a brochure with 19 smiling faces below the headline, “We’ve signed our organ donor cards. Have you?” The text continues, “We believe in the Divine mandate to save life – an obligation first expressed in the Torah itself: ‘You shall not stand idly by the blood of your neighbour.’ (Leviticus 19:16) We see organ donation as a new means to fulfil an ancient, eternal religious duty.”
That theme is echoed in a brochure put out by the Union for Reform Judaism where you can find both background on the issue and an Organ/Tissue Donation Card. “Jewish tradition teaches that we are partners with God in continuing and sustaining the daily miracles of creation. Organ and tissue donations are an extension of this partnership. Through donation, you have the unique and holy opportunity to bestow the gift of life and wellness from one of God’s creations – you – to another. With your gift, you are responding Hineini (Here I am!) to God’s call.”
The Rabbinical Assembly’s 16-page Jewish Medical Directives for Health Care includes two forms that deal with end-of-life issues. In regard to organ donation, four alternatives are presented ranging from: “when I die any or all of my vital organs and other body parts be donated for the purpose of transplantation” to: “I do not wish that any part of my body be used for purpose of transplantation.” For more on the Conservative movement’s views on organ donation, Rabbi Joel Roth’s responsum examines the use of artificial limbs, animal organs, and human blood, bone marrow and kidney donations.
In “Life, Death and Halacha,” Rabbi Avi Shafran of the Agudath Israel of America explains that a divergence in the definition of death between contemporary medicine and Halachah poses a serious challenge to transplantation when life ends. Internal organs are most successfully transplanted when “harvested” from a ventilated “brain dead” patient, whose blood remains oxygenated and circulating. While a diagnosis of brain death may satisfy medicine’s definition of death, “in the judgment of a majority of major decisors [halachic authorities], ‘brain-dead’ human beings whose hearts are still beating must be maintained on life support” and cannot provide organs for transplantation. (The above page links to several other thought-provoking articles on the Ethics of Brain Death and Organ Donation.)
To underline the difficulty and sensitivity of this issue, in 2010, the Rabbinical Council of America published a 110-page internal document that seemed to forbid donation by Jews who are brain dead, yet allow Jews to be recipients of such organs. The following January, the Council was forced to clarify its stance and released the following statement: “The RCA takes no official position as an organization on the issue of whether or not brain stem death meets the halachic criteria of death.”
Rabbi Moshe Tendler, a professor of medical ethics and biology at Yeshiva University, is not ambivalent. He says the cessation of brain stem activity does satisfy the halachic definition of death. “The often repeated query, ‘Is it really permissible to desecrate the dead by removing their organs?’ is answered by the undisputed affirmation that the saving of a life takes precedence over all other ritual concerns. … In truth, it is not a desecration! No greater honour can be bestowed on an individual than that of being a savior of as many as eight lives through donation of heart, liver, kidneys, pancreas, lungs and small intestines.”
Unlike most other organs, a kidney transplant can take place thanks to the generosity of a live donor (which bypasses the debate over the halachic definition of death). The ultimate goal of the Renewal organization “is that no one in need of a kidney transplant should wait longer than six months to find a donor.” Their U.S. site has numerous rabbinical endorsements as well as an explanation of kidney disease and the transplantation procedure. The related Renewal Toronto site has links to stories from The CJN and elsewhere about the incredible people who have donated a kidney and the lives they have saved.
A look at the importance of organ donation wouldn’t be complete without acknowledging its impact on individual lives. “On Sept. 29, 2005, just after her birthday, at the start of the Jewish year, my mom received the gift of life, a second birthday in the form of a kidney transplant. She had been sick for some time and had begun dialysis six months prior. On a fateful September day, while at a dialysis treatment she was informed that a kidney donor had been found. We were shocked and overjoyed. The kidney and blood type were a perfect match. We were told by the transplant co-ordinator that this was like winning the lottery… On Sept. 24, 2006, my mother, Sara, turned 60 years old. This website has been up since then to wish her a happy birthday and raise awareness about organ donation.” The name of the site: HappyBirthdaySara.org.