

Wednesday, June 2, 2010


Be a Mensch – Become an Organ Donor

If only I had a heart. Become an organ donor.
If only I had a heart. Picture from BarryNapierWriting.wordpress.com

By Rivqa Berger

I know an organ recipient who believes that organ donation is halachically prohibited. Generally I consider myself a fairly tolerant person, but if I saw him in the street I wouldn’t even say hello. That should make my position on the topic fairly clear, but let me spell it out anyway: I think that everyone should be signed up as a organ donor, and if they’re not, they shouldn’t be on a transplant list.

One donor can save up to 10 lives, as well as providing non-essential (but life-changing) tissue, such as corneas to cure blindness. The Jewish community (and other communities that are based on moral systems) should be leading the way, but Jews remain an ethnic group with one of the lowest rates of organ donation. Israel was expelled from the European Union Organ Donor Network because it took organs for transplant but didn’t donate.

From a halachic perspective, the first issue that many people think of when objecting to organ donation is “kavod hamet”, respecting a Jewish person’s corpse. This principle is derived from three biblical laws, which prohibit delay of burial and needless mutilation or derivation of benefit from a corpse. These laws are negated by the more important principle of “pikuach nefesh”, saving a life. “Kavod hamet” is such a weak excuse not to donate organs, it can only be ascribed to superstition, squeamishness or laziness.

Others oppose organ donation by Jews because the organs will most likely be transplanted into non-Jewish recipients. But any Jews on a transplant list will progress up the list if a non-Jew higher on the list receives an organ – or the next person on the list could be Jewish (admittedly unlikely in Australia, but still possible). Either way, Jewish people can benefit – and even if there were no Jews on the transplant list, presenting the racist attitude of Jews only helping themselves does nothing to lessen anti-Jewish sentiment.

However, it gets more complicated. Today, a person’s heart can stop beating but be jolted back into functionality; a damaged brain stem, conversely, can not be repaired, although breathing can be maintained artificially using a respirator. Most organs for life-saving transplantation are taken from donors who are “brain dead” (whose brain stems have stopped working), but whose bodies continue to function because they are on a respirator. This ensures that the organs are in usable condition, as organ quality degrades rapidly once oxygen is no longer provided.

As with so many other issues, the halacha (and equally, or more importantly, Jewish public sentiment) regarding organ donation has been playing catch-up with technology since the first successful organ transplant from a deceased donor, over 50 years ago. The original source of the debate is the Talmud, written long before respirators and defibrillators were invented. It centres around a discussion about whether death is defined as cessation of heart beat or breathing. If death is defined in this way, then given that breathing is controlled by the brain stem, organ donation is halachically acceptable as the donor is dead. If it’s not, the donor is still alive, and harvesting his or her organs is murder.

Organs can be obtained from donors whose hearts have stopped, but this is a developing technique. And it opens another can of worms, as in some cases it’s only a viable option if doctors give potential donors certain medications before they die. There are issues about consenting to such procedures, and possibly halachic issues as well.

Donation following brain stem death remains the more useful and prevalent technique. Those in search of a halachic opinion to support it are in good company: Rabbi Moshe Tendler, Rabbi Yosef Dov Soleveitchik, Rabbi Shlomo Zalman Auerbach, and the the Chief Rabbinate of Israel, among others. As far as I am aware, Reform and Conservative authorities encourage organ donation under either circumstance.

HODS (the Halachic Organ Donor Society) offers a donor card where you can choose which halachic opinion you follow; it’s succinctly worded in a way that any doctor could understand. They also provide more detailed halachic discussions; the information here is really just a summary.

It can be uncomfortable to make plans about your body after death, and of course it’s highly unlikely that you will become an organ donor. But that’s precisely why it’s so important to have more potential organ donors willing and registered. It can also be helpful to consider registering for the Bone Marrow Registerand donating blood regularly; in the context of these living donations, the focus is taken off donation after death.

According to Australia’s Organ and Tissue Authority, fewer than one in five Australians have discussed their wishes regarding donation with their families. This is why donation rates are so low: people don’t know their loved one’s wishes and err on the side of refusal. The message is pretty clear: register as an organ donor and talk about it with your family. If the halacha is important to you, discuss that as well. It might save a life – or several – one day.

Rivqa Berger likes to have the best of both worlds, so she followed her Bachelor of Science with a Masters of Arts. She appreciates critical thinking and campaigns against irrationality. She blogs atEnoughsnark.blogspot.com.

Source: Galus Australis: Jewish Life in the Antipodes

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