Ematai: Saving Lives Every Day

While organ donation is clearly not a topic that most high school students give much thought, it is vital for high school students to begin learning about this life-saving topic so that informed Torah attitudes and perspectives can be formed early in life.

Two weeks ago, many of our Posnack high school students had the opportunity to learn about the life-saving work performed by those who join and support Ematai, formerly known as HODS, Halachic Organ Donor Society. About 60 students had an interactive session and discussion with the current CEO and director of Ematai, Rabbi Dr. Shlomo Brody.

Before the seminar turned to the medical and Torah considerations of organ transplant/donation, Rabbi Dr. Brody addressed four major areas where misinformation improperly informs, and unfortunately, molds and guides the attitudes held by many Jews, left, right and center. He used the acronym SETH to enumerate these four categories. SETH stands for superstition, emotions, timing, and halacha. He explored with the students 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. good fortune after finding a four-leaf clover, or harm from walking under a ladder or a black cat crossing your path, etc.) To paraphrase the Rambam: “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. That is like saying a person cuts his/her life shorter by purchasing life insurance. Clearly, our great Torah scholars did not subscribe to this view. Having a “ketubah,” marriage document, is a requirement for a Jewish marriage. Yet the “ketubah” clearly outlines the monetary obligations of the husband to the wife should a divorce ensue, or he predeceases her.

Related to superstition is the question of resurrection. It is brought as an obstacle by those who oppose organ donation. 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 at resurrection, each organ will have to be regenerated. If God created the universe, He could certainly restore a body whole and complete. 

Human emotions are very powerful and run very deep in our psyche. 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 from a protracted decline, as is the case of a person suffering with a slow but progressive terminal illness, or in the case of a sudden and tragic death. At the time of death certain feelings and 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 our emotional pain, do 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, the procedure can often times 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 halacha, Jewish law. We are forbidden to desecrate a dead body. How does this Jewish issue impact the mitzvah of פיקוח נפש, saving a life. At this point in his presentation, Rabbi Dr. Brody showed how Jewish law is dynamic and in line with modern science and medical knowledge. All Torah scholars agree that one may not hasten the death of any person. However, the question becomes when does death 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 confirmed by an injection of radioactive dye. This procedure clearly shows whether or not there is a complete cessation of brain activity. When the cessation of complete brain activity has been verified, this condition is halachicly 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. In such a case these Torah giants rule that the ventilator should be removed immediately. The person is dead and the 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 serviced, there are still parts of the body that may be salvaged for future transplant. 

In his closing remarks, Rabbi Dr. Brody shared recent poignant cases of organ donations made by our brave IDF soldiers recently killed in defense of Israel. He mentioned that from 9 soldiers, whose wishes were to be organ donors, 35 people were given lifesaving transplants. The soldiers’ lifesaving acts brought great comfort to their families as well.

Let me conclude my summary by urging us 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. Except for three cardinal commands (not to worship idols, not to murder, not to engage in forbidden sexual relations) which can never be violated even to save your life, every other mitzvah in the Torah is set aside to save a life. Every other consideration, then, is set aside when a lifesaving opportunity presents itself. Such is the case with the question of organ donation. פיקוח נפש, “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 not only supporting Ematai financially but, if possible, with your body as well. Become a member of Ematai today. I have been a member since 2007. Find out more about what Ematai does and its services by visiting their website ematai.org. Please just do not take my word for it. Listen to the recorded words and read scholarly articles by some of today’s foremost Torah authorities, Ashkenaz and Sefard. 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