Thursday, October 18, 2018

What Does Judaism Say About Organ Donation?

What Does Judaism Say About Organ Donation?

June 12, 2013 in 2006 March-April, Ask the Rabbis
0 Comments

Secular Humanism

For Humanistic Jews, there is no greater value than the sanctity of life. We honor the traditional notion of pikuah nefesh, the concept that one must act to save a life even at the expense of transgressing other prohibitions, not because this is halachically mandated but because it’s the right thing to do, independent of any religious system.

It is beyond dispute that organ and tissue transplants save and extend the quality of lives. The ultimate act of altruism is for a living donor to make the gift of an organ to a spouse, a sibling or a friend. And there is no greater legacy for the deceased than to serve as a life giver to others. Rather than deepen our pain at the time of our loved one’s death, this ultimate act of generosity may actually soften our loss and uplift us. This was certainly the case in Israel when the organs of a young Jewish woman, killed in a terrorist attack—and those of a teenage Arab boy killed by Israeli soldiers—were donated indiscriminately to Jews and Arabs alike, creating what has been called a bridge to peace.

Rabbi Peter H. Schweitzer
Association of Humanistic Rabbis New York, NY

Jewish Renewal

Organ transplantation and donation were once prohibited by Jewish law and tradition because they were experimental and endangered life. Today organ donation and transplantation are essential, highly successful medical procedures. Accordingly, rabbis and scholars across the spectrum of Jewish life have upgraded organ donation from a corpse to the status of a mitzvah chiyuvit, an obligatory mitzvah, that fulfills the mitzvah of pikuah nefesh, that of “saving a life.” Organ donation from a living donor, so long as it will not significantly risk the donor’s life, is a mitzvah kiyumit, a praiseworthy but not obligatory mitzvah, since with all surgery there is some danger and distress to the donor.

There can be significant emotional and spiritual blocks to fulfilling a mitzvah such as organ donation. It is important to ask God, a rabbi, friend or counselor to listen and help you to work through such obstacles as fear and attachment to your own physicality. Also, be sure everyone in your family is aware of your plans to fulfill this uniquely post-mortem mitzvah. Many people still remember the former Jewish position against organ donation; this sometimes leads family members to block their deceased loved one’s organ donation out of emotional discomfort or misplaced devotion.

May you be blessed to take the time to honor and overcome any inner fears to fulfilling the mitzvah of organ donation. Remember, “whoever saves one life is considered as if [s]he had saved the entire world.” [Mishnah Sanhedrin 4:6].

Rabbi Goldie Milgram
Aleph Ordination Program
Philadelphia, PA

Reconstructionist

It’s hard to accept that someone’s life and soul are gone when brain death is declared. We still see our beloved in front of us, warm, breathing, pulse going as fast as ever. It takes great love for the world to say “since the person I knew is gone, please take their organs, so that others may enjoy the life my loved one is now losing.” For those of us who find meaning in traditional rituals like tahara (ritual washing of the body), it’s harder still.

But we cannot let fear or denial prevent a life-affirming choice. Tradition may once have equivocated on this question, but today the commandment of “not standing idly by the blood of your neighbor” includes the hundreds of millions of ‘neighbors’ within a five hour flight, whose sight or happiness or hope can be restored only by letting your newly deceased loved one give a final and great gift.

A favorite bumper sticker reads, “Don’t take your organs to heaven—heaven knows we need them here!” Organ donation needs to be seen as a true mitzvah, a commandment, a ‘must.’ If you fear that upon the Messiah’s return that you will be resurrected without a vital organ, remember that a God who can raise the dead can make you a new cornea or kidney.

May you live a long healthy life and die peacefully at 120. But in case you don’t: Have a heart. Sign up now to give yours so that, if need be, someone else can have a true (lev chadash), a new heart. God and the thousands of precious souls on transplant waiting lists demand no less.

Rabbi Fred Scherlinder Dobb
Adat Shalom Reconstructionist Congregation
Bethesda, MD

Reform

The Reform movement’s position is to permit transplantation of organs or body parts from a corpse for any legitimate medical purpose. Some authorities claim that the procedure violates the traditional prohibitions against deriving benefit from the dead (hanah’ah mehamet), treating the corpse in a disrespectful manner (nivul hamet), and unnecessarily delaying the burial of the corpse in its entirety (halanat hamet). We argue that none of these prohibitions applies in this case and that they cannot prevent us from fulfilling the overriding mitzvah to save life (pikuah nefesh) and to heal the sick (refu’ah). To be agents of life and healing after our deaths is to render honor and respect to our bodies. It is not an act of desecration or mutilation.

Then there are organ donations made by living persons. Here, too, the Reform halachic tradition considers it praiseworthy for a healthy individual to donate an organ in order to heal the sick. The most obvious objection against this is our tradition’s teaching that we are not to expose our lives to unnecessary danger. Through the ages, some rabbis have interpreted this prohibition strictly: we should never subject ourselves even to a limited degree of risk, even in order to save the life of another. A competing interpretation, however, would permit and even require us to accept a limited degree of risk to save a fellow human being from mortal danger.

We must also consider the transplantation of such vital organs as the heart and the liver. These must be functioning in order to be of benefit to the recipient, yet to remove them from the donor would result in the latter’s death. Reform Judaism accepts the standard of brain death as a sufficient indicator. Thus, when clinical tests reveal that the donor is brain dead and that the function of his or her vital organs is being maintained solely through artificial means, then those organs may be used for transplantation.

Rabbi Mark Washofsky
Hebrew Union College
Jewish Institute of Religion
Cincinnati, OH

Conservative

Jewish law and tradition endorse the principle of k’vod ha-Met, (honoring the deceased), including prompt burial and respectful treatment of remains. At the same time, Judaism affirms the centrality of the mitzvah of pikuah nefesh, (saving lives).

Members of The Committee on Jewish Law and Standards of the Conservative movement (CJLS) have long grappled with the tension between k’vod ha-Met and pikuah nefesh, asking whether it is possible for pikuah nefesh to override the concern with k’vod ha-Met. Their answer is that not only is it okay for a Jew to donate organs, and not only is it an act of hesed (loving kindness), it is a mitzvah, a positive command.

“Saving a person’s life is so sacred a value in Judaism that if a person’s organ can be used to save someone else’s life, it is actually an honor for the deceased,” says Rabbi Elliot Dorff, a member of the CJLS and rector of the University of Judaism.

The Conservative movement provides two forms for people to sign. One is a legal document to be signed by the donor and two witnesses. The other document to be signed asks family members to act as partners in in the mitzvah of pikuah.

Rabbi Avis D. Miller
Adas Israel Congregation
Washington, DC

Modern Orthodox

Judaism’s fundamental value is the primacy and dignity of all life. Human life is godlike—created in the image of God—and is to be treated as infinitely valuable, equal and unique.

Respect does not end with the death of a beloved. The dead body is the shell of a living image of God, but Jewish tradition confirms human dignity in life by calling on us to treat the corpse with reverence. Cleansing, purifying and escorting the dead to the final resting place, burying, mourning and remembering—all are done out of hesed shel emet (true loving kindness). They are the paradigm of pure goodness because the dead person cannot repay the kindness.

The prohibition against use of a body is an expression of the principle that respect and love transcend economic considerations. Thus, it is a tradition not to use the deceased’s belongings but to give them away to the poor. This concept is also the source of the strong tradition of protecting graves (and not moving bodies needlessly) as well as opposition among the most traditional Jews to autopsies and even organ donation.

Now, however, modern science has changed the halachic attitude by changing the dynamics of lifesaving. When early modern medicine showed that an autopsy could save a life by establishing causes of death and the pattern of mortality, Rabbi Yehezkel Landau (1713-1793) ruled that when there is an ill person whose life can be saved by performing an autopsy on a recently deceased individual, then the mitzvah of lifesaving overrules the prohibition of use from a dead body. The halachic authorities then followed with permission to donate organs with family approval. Rabbi Moshe Feinstein widened this permission to corneal transplants, arguing that blindness is a form of death: the handicap so reduces the quality of life that restoring sight is equivalent to lifesaving.

Heart transplants then became the cutting-edge issue. The classic, halachic definition of death was cessation of breathing. Following this principle meant that when death came, the deteriorated heart would not be usable. Doctors then showed that brain death can occur while breathing and a heart beat continues. However, the early survival rate of heart transplant patients was so low that Rabbi Feinstein ruled that those who performed heart transplants were guilty of double murder—removing the heart from a halachically alive person and dooming the recipient as well.

Happily, medicine continued to improve and heart transplants survival rates soared. Rabbi Feinstein finally ruled that brain death is a legitimate criterion for establishing death and that donating a heart fulfilled the mitzvah of lifesaving and constituted permitted use of a dead person’s body.

Organ donation is the highest mitzvah and the most religious person should perform it. The ultimate respect for the dead is to enable them to save a life; giving life is the highest form of respect for life.

Rabbi Yitz Greenberg,
Jewish Life/Steinhardt Foundation
New York, NY

Lubavitch Hasidism

Jewish law distinguishes between organ donation during your lifetime and organ donation after death. While you are alive, to donate an organ that you can live without in order to save another life is one of the greatest acts you could do. “To save a life is to save an entire universe,” our sages have declared.

After death too, organ donation is permitted—and constitutes an awesome mitzvah—in the case when an organ is needed for a specific, immediate transplant.

Yet, a few considerations need to be addressed.

In Jewish tradition, the body, during life and after death, possesses profound sanctity and its desecration, even in the slightest form, is prohibited. If the organ is being used to save a specific life, there is no greater honor one can bestow upon the body. But when you sign a consent form to have your organs removed, the doctors will remove them whether or not they are needed for an immediate transplant. They may use them for research, store them for future transplantation or even throw them out. Therefore, unless there is an actual person who immediately needs the organ, it is improper to tamper with a corpse.

Even when there is a specific, immediate transplant, there is need for caution, because often times in order to obtain organs as fresh as possible, a doctor will remove the organ before the patient is actually “dead” according to Jewish law.

The bottom line is that each case is different. Many considerations in Jewish law and spirituality must be reviewed. So before going ahead with any procedure, I’d consult with a rabbi well versed in Talmud and Jewish law. It is not as simple as blankly signing an organ donation card.

When dealing with questions so fundamental and far-reaching as life and death, the responsibility is huge. Sentiment and feelings can be dangerous judges. I wouldn’t want to have to decide what is right and wrong based on my own subjective opinion. Thank G-d we have the Torah to guide us.

Rabbi Yosef Y. Jacobson
Rabbinical College Chovevei Torah
Brooklyn, NY

No Comments

Post A Comment