General Topics

Organ Donor

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“ Is it true that if I donate an organ to another person I will not be allowed to be buried and go to heaven?” When I recovered from the shock of being asked this question after a Shabbat morning service, I asked the young person, a student at one of the best Orthodox Jewish Day schools in New York, where such a crazy idea had come from. It was a Jewish studies teacher at school.

A few weeks later I bumped into the  Rabbi in charge of the school and asked him if that was school policy. He replied that he was not able to control everything all his teachers were saying and proceeded to take out his donor card as proof of his commitment to donate his organs. And I noticed it was a State Donor Card. Not one issued by an Orthodox organization. When I asked why he replied that it was in the interests of equity and good relations. If we Jews were happy to accept organs from non-Jews, why should we not be prepared to give our organs to a non-Jew in need if we could save a non-Jewish life? I was impressed by this humanitarian attitude. 

There are many urban myths about Jewish attitudes and laws. And many different customs and attitudes amongst the groups that make up what is called Charedi or Orthodox society. Jewish law has always been open to different opinions. What position should a traditional Jew take on this issue?

 As a general rule, one should donate one’s organs either to save a life, restore sight, or to give blood and tissue to help the living. It is an obligation to help preserve human life. The human body is regarded as holy, in the sense that it must be treated with enormous respect. At death, the body is washed, purified, and watched over until burial and all parts of the body should be buried. However, as with most commands in the Torah, there is a greater command to save lives. 

The idea that if human parts are not buried together, somehow it is going to impact the body or soul in the afterlife, is an example of irrational superstition. It would mean that all the millions of Jewish martyrs whose bodies were mutilated, burnt, and destroyed, should in whatever way suffer spiritually. It not only makes no sense, but it insults their memory. 

While one is alive, there is no question about donating an organ or parts that one can live without, like a kidney, bone marrow, or blood, to save or improve another life. It is one of the greatest acts of kindness a person can do. However, when it comes to removing an organ from a dying person there are some qualifications as to when and how. The most significant one is how to define death. In Jewish law no matter how likely or imminent death is, one may do nothing to hasten the moment of actual death. But harvesting organs often needs to be done as soon as possible. And there is a fear that doctors might try to advance death to get hold of an organ as quickly as possible.

 For thousands of years, death was defined in terms of the cessation of heartbeat and breath. About fifty years ago the debate began in halachic circles over the issue of brain death even while the heart might still be beating whether artificially or otherwise. Initially, those who supported considering brain death, such as the American Rabbi and medical doctor Moshe Tendler, were excoriated. All new ideas initially face resistance. Only when he was joined by the late Rabbi Moshe Feinstein, his father-in-law, and a universally accepted halachic giant did brain death come to be considered positively. 

One of the reasons for resistance goes back to the issue of autopsies and organ removal in the 1950s when the Ministry of Health in Israel was run by left-wing secular Jews who made fun of what they saw as the primitive taboos of both the Orthodox and the oriental Jews, concerning the human body after death. They were happy to use corpses for medical practice, to perform autopsies as training. Too often human remains ended up in trash cans. The Alder Hay Hospital baby organ scandal in Liverpool, in 1999, shows how common it was for hospitals to take body parts without consent, and illegally, for all kinds of purposes. https://www.theguardian.com/uk/1999/dec/05/anthonybrowne.theobserver  

And similar cases have been revealed in the United States in recent years. Initially, the ultra-Orthodox position was that all autopsies are forbidden but, in the end, a compromise was reached that autopsies were permitted for both medical and legal criminal reasons. Although some Charedi rabbis oppose the removal of organs when the person is classified as “brain-dead,” many Charedi communities have recently issued organ-donor cards which are intended to ensure that organs are not removed from the bearer after brain death or brain stem death.  Charedi Jews both in Israel and the Diaspora have a high rate of live organ donations. In 2014, 17% of all live kidney donations to strangers in the United States were donated by Charedi Jews, even though they are only 0.2% of the US population. https://en.wikipedia.org/wiki/Organ_donation_in_Jewish_law

So that in the end it depends on who your rabbinic authority is or who you ask, not whether organ donation is permitted, but just what precautions will be taken to preserve the sanctity of the body after death.  I admire the humanitarianism of those rabbis who have decided to sign up for State issued donor cards. And I do accept brain death and trust doctors not to make too hasty or premature decisions over one’s death. However, I do want my body to be treated with respect, and any parts removed and not used to help other immediate human beings should also be treated with respect. And this is why I strongly recommend joining one of the Jewish donor card organizations that exist such as The Halachic Organ Donor Society H.O.D.S., that guarantees that Torah law and values will be applied to both donor and receiver. It has branches around the world. I have signed up for it and I urge you to. It’s on the internet at hods.org!