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Halakhic Organ Donation

Two weeks ago, many of our Posnack high school students had the opportunity to learn about the lifesaving work performed by those who join and support the Halachic Organ Donor Society, HODS. About 60 students had an interactive session and discussion with the founder and director of HODS, Mr. Robby Berman. It was clearly a topic that most of the students had not given much thought, particularly to Jewish thinking and opinions on the subject.

Robby Berman addressed four major areas where misinformation improperly informs, molds and guides the attitudes held by many of the adherents to Judaism. He used the acronym SETH do enumerate these four categories. SETH stand for superstition, emotions, timing, and Halacha. Let’s look at each one of these areas individually.

In the Laws of Idol Worship 11:17, the Rambam rails against any Jewish person that allows any form of superstition to influence his or her life. (E.g. finding a four leaf clover, walking or not walking under a ladder, a black cat crosses your path, etc.) To paraphrase what he writes: “It is not fitting for Jews, whose entire approach to reality is through wisdom, to follow these nonsensical actions or to let these ideas enter their hearts to think they are true, helpful or beneficial.” In this regard, some people believe that if they make the commitment to become an organ donor, some awful tragedy will befall them. Robby Berman quickly points out a glaring contradiction. These same people have car, home, and life insurance! Having a ketubah, marriage document, is a requirement for a Jewish marriage yet it clearly outlines monetary obligations of the husband to the wife should a divorce later ensue.

Related to superstition is the question of resurrection. It too is raised as an obstacle by those who oppose organ donation. After all, if a person donates his corneas for example, when resurrection occurs, how will he see?! Of course, such a person fails to consider that in death, every part of the human body disintegrates and will have to be regenerated. If God created the universe, He can certainly restore a body whole and complete.

Human emotions are very powerful and run very deep. This is no more apparent than when we must confront the death of a loved one. Understandably, we do not want to let go of the person be it a protracted decline, as is the case of a person suffering from a slow but progressive terminal illness, or in the case of a sudden and tragic death. At a time of death, our emotions rise to the fore. The thought of dismembering and/or disfiguring the body of a loved one is a very painful thought. The question very simply is notwithstanding the pain, can we let these feelings override a potentially lifesaving intervention for another person in need of an organ right now?

“Timing,” as the expression goes, “is everything.” So too and true is this factor in organ donation and transplantation. This issue is no doubt crucial to the survival of the recipient. Harvested organs have a very short shelf-life. Yet there is a halachic concern. If the donor is living, as is often the case with many liver and kidney transplants, often times the procedure can be scheduled. However, the demand for livers and kidneys far exceeds the supply. Most livers and kidneys become readily available upon death. The catch here becomes the exact definition of death according to Jewish law.

The issue of timing leads directly into the “H” of the acronym, “SETH.” All Torah scholars agree that one may not hasten the death of any person. However, the question becomes when does death actually occur? Does death occur with the cessation of autonomous breathing or does death also occur when the brain stem no longer sends blood to the brain? The leading Torah scholars of this generation hold that death occurs when the brain stem dies. This death is verified by an injection of radioactive dye. This procedure clearly shows whether or not there is the complete cessation of brain activity. When the cessation of complete brain activity has been verified, this condition is halakhically synonymous with the Talmudic case of decapitation. Even if the person is on a ventilator and his heart and lungs are working, these functions are merely the mechanical result of the ventilator being plugged in. In such a case these Torah giants rule that the ventilator should be removed immediately. The person is dead and critical time for harvesting organs may be lost through any further delay of the transplantation procedures. However, even if you maintain the other definition of death and wait until the ventilator must be turned off, many parts of the body may still be salvaged for future transplant.

Finally, it is important to keep in mind the command of our Torah. In Vayikra 18:5, God states, “You shall observe My decrees and My laws, which man shall carry out and by which he shall live, I am Hashem.” Our Sages derive from the expression “by which he shall live,” that the commandments were given for the sake of life, not death. The need to preserve life, therefore, supersedes the observance of Shabbat, Yom Kippur or the laws of Kashrut for example. Hence, with the exception of 3 cardinal commands which can never be violated even to save your life (idol worship, murder, and forbidden sexual relations) every other mitzvah in the Torah is set aside to save a life. Clearly then, every other consideration is set aside when a lifesaving opportunity presents itself. Such is the case with the question of organ donation. Saving a life is so valuable that it is considered by Judaism as if you saved the entire world.

Please, I urge you to consider, with your financial support but if possible with your body as well, membership in the Halachic Organ Donor Society, HODS. Please just don’t take my word for it. Sometime after Shabbos, please take the time to visit their website: hods.org and listen to the recorded words today’s foremost Torah scholars, among them Rabbi Moshe Tendler, Rosh Yeshiva and Dean of Yeshiva University, a medical and halachic expert, who testified on brain death before a Congressional subcommittee; Rabbi Dovid Feinstein, son of the late Gadol HaDor, Rabbi Moshe Feinstein, and Rabbi Amar, Chief Sephardic Rabbi of Israel. Spend time reading some of the many articles that appear on hods.org that address the latest medical breakthroughs and their application to halachic issues. Their words, spoken and written, will enlighten and inspire you with the depth and breadth of Jewish law. At the same time, their words will give you comfort and peace of mind when confronting these most difficult decisions to be made in life and in death.

Shabbat Shalom,

Rabbi Robert Kaplan