By Maxine Dovere
The Rabbi stood before a mixed congregation – some were already actively involved in organ donation, some had come to learn. “Why,” he asked, “is organ donation even a question? It is an opportunity to save a life.”
“How does a Jew become part of the prophetic scene?” continued Rabbi Neil Zuckerman, Associate Rabbi of the Park Avenue Synagogue in Manhattan. Noting that Jewish tradition aspires to bury a body as whole and complete as possible, he acknowledged that “there can be a collision of values: the value of saving a life versus the value of following halachic tradition.”
In Judaism, almost all acts are permissible to save a life. If a living donor will suffer no appreciable detriment to her health, she may, and, in fact, is obligated to save a life. The Conservative and Reform movements sanction the act of living donation if the donor’s life is not endangered. Organ donation, Zuckerman suggested, is “behaving in a G-d-like way, giving the gift of life.”
In both Orthodox and non-Orthodox Judaism, to save a life,cadaver donation is permitted. Irreversible cardiac rhythm cessation is the widespread definition of death. Defining “death” however, is complex: removing a life-sustaining organ from a still living person could, under some interpretations, be considered murder.
How else is death defined? Establishing the moment of death has become increasingly complicated. When the heart is kept beating artificially – a necessary condition since most organs must be removed for transplant while there is heart function – modern medicine relies on the concept of brain or brain stem death. Rabbinic acceptance of “brain death” or irreversible coma, is based on criteria established by a Harvard committee in 1968. Growing numbers of Orthodox authorities now accept brain stem death with various contingencies. Organ donation laws, established in 2008, supported by the Chief Rabbinate of Israel, and organizations such as the Halachic Organ Donor Society (HODS), encourage and support donation.
Throughout the transplant process, Jewish law requires respect of the body. The principle of preservation of life – pikuach nefesh – overrides the restriction against mutilation of the dead, allows a brief postponement of burial, and outweighs Torah prohibition against “benefiting” from the dead. There are specific admonitions for each organ transplant Heart transplants are the most controversial. Liver transplants must be done while there’s still circulation. The use of artificial organs including artificial heart valves (not artificial hearts, however), bone parts, joints, blood, marrow, and use of dialysis poses no halachic issue.
While Jewish law has no conflict with transplants from live donors as long as the prospects for success are greater than the risks, questions remain. When is a person obligated to endanger his own life to save the life of a critically ill person? With a live kidney donation, the donor can live with one kidney. Although some rabbis prohibit live kidney donation, others say it as an act of piety, and believe it is an obligation – “Thou shall not stand idly by the blood of thy fellow man.” (Leviticus 19:16)
Some Hasidim vehemently oppose organ donations and consider post mortem organ removal a desecration. Haredim in Israel have issued an anti-organ-donor “life” card, forbidding organ removal. Haredim do, however, participate in live organ donations. In 2014, Haredi Jews donated 17% of all live kidney donations to strangers in the United States.
Michael Tobman, New York Jewish Life’s publisher, is a kidney donor. Speaking about his experience, Tobman relayed the following:
“In 2015, a friend needed a kidney. Testing showed I was a match. After consulting with my family, there was no question, no real issue: I would donate a kidney.
The care I received throughout was superb. Although recovery took a bit longer than envisioned, the donation has had no impact on my health. I’m actually in better shape now than before, and more thoughtful about exercise and nutrition.
Among all the well wishers who reached out, it was my Orthodox and Hasidic friends who were most supportive and affectionate.”
Chabad, the Jewish outreach organization says “donating an organ to save a life is one of the highest act of virtue.”
The humanity of organ transplant was starkly displayed when the beneficiary of a heart transplant offered her story. She is a breast cancer survivor who in 2016 learned she would need a heart transplant. Her wait began with placement on a list at Columbia Presbyterian Hospital, but no New York heart was available. A journey to Cedar Sinai in Los Angeles, which does about 130 heart transplants a year, was next. Her donor heart came from from a brain dead 31 year old woman. The heart, she noted, “is the last organ given….The heart never misses a beat. It is taken from a dead person and placed into a living person.”
“It’s amazing,” said the recipient. ”I was walking in two days and out of the hospital in a week.” You don’t know what the donor family goes through…you don’t know what the recipient’s family goes through.”
Donation, said Rabbi Zuckerman, is part of the end of life conversation. Intentions should be made clear. ge is less important than donor and recipient health. In the United States, transplants for money are not allowed.
“It is the obligation of every Jew to save the life of another human being,” concluded Rabbi Zuckerman. “The ability to save lives is a divine act.”