Misgivings and Misconceptions

Though most rabbinic authorities allow organ transplants, the Jewish community has a poor track record when it comes to donations.

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Reprinted with permission from The Jewish Journal of Greater Los Angeles.

While halachic [Jewish legal] debate still surrounds the donation of some organs, there is growing consensus that donating organs is not only permissible within Jewish law, but fulfills the positive imperative to save a life.

 

Several new educational initiatives have emerged in the Jewish community to spread that idea and to counter a very disturbing fact: The Jewish community has one of the lowest rates of organ donation among ethnic groups. For despite rabbinic decisions, at a grassroots level, there persists in all segments of the Jewish community—traditional and liberal—a reluctance to discuss the topic, and an assumption that Judaism forbids organ donation.

Twelve people die every day waiting for an organ. There are currently about 68,500 people on the waiting list of the United Network of Organ Sharing, and that number is expected to quadruple in the next few years, according to the Division of Transplantation of the federal government’s Department of Health and Human Services. In 1998, about 5,800 people who died donated organs and tissue—about a third of the number of potential donors. An additional 4,300 people were living donors, mostly of kidneys. One cadaver can supply a heart, kidneys, pancreas, lungs, liver, intestines, cornea, skin, bone marrow and connective tissue. Some of those on the waiting list can survive for several years without a transplant. Many will die waiting.

The situation has been particularly dire in Israel, where donation was chronically low, and Israel was consistently a net drain on the European organ sharing network, endangering the Jewish state’s status in the network. Israelis have often had to travel abroad to procure organs. The situation has recently taken a turn for the better, as several major rabbis, most recently Shas leader Rabbi Ovadia Yosef, declared it not only permissible but a mitzvah to make your organs available. Still, Israel’s remains among the lowest rates of organ donation in developed countries.

Given the high stakes, what is holding the Jewish community back?

Partially, the same things that keep the number of organ donors so low in the general population.

“Part of it is people don’t want to contemplate death altogether, and part of it is when they do contemplate death, they have trouble thinking of themselves minus some organs,” says Rabbi Elliot Dorff, a bioethicist who is rector and professor of philosophy at the University of Judaism and chair of the Committee on Jewish law and Standards of the Conservative movement. About five years ago, Dorff participated in an inter-religious project that looked at the psychological, folkloric and literary issues that prevent people from making their organs available. He said aside from a general aversion to death, what also came into play were people’s fears of surgery and notions about resurrection.

According to many doctors and educators who deal with the issue, Jewish audiences—of whatever denomination—consistently bring up the idea that in order to be resurrected, one needs to have all her body parts. Rabbi Eddie Reichman, a physician and professor at Yeshiva University’s Albert Einstein College of Medicine in New York, says the idea stems from some obscure references in midrashic sources. But he points out that if one believes in resurrection, that must come with a belief that God will restore decomposed bodies.

At a panel on end-of-life issues at B’nai David-Judea Congregation [in Los Angeles] a few months ago, Reichman countered with another midrashic idea.

“There is a rabbinic tradition that there is one bone called the luz bone from which resurrection will take place,” he said, “so we will have a connection to the original body in which we lived. Rabbi Aryeh Kaplan has translated this midrash into contemporary understanding, saying one simply needs one strand of DNA.”

But there is also more solid ground for the perception that Judaism would frown upon organ donation: the very real halachic concept of kavod hamet, preserving the dignity of the body that housed the departed soul. Cadavers are treated with honor, so that modesty is retained even during the ritual washing. The body is never left alone, and it is buried as soon as possible. Every effort is usually made to bury a person with all her body parts, even amputated limbs or spilled blood. It is no surprise, then, that harvesting organs would seem to violate these precepts.

But everyone involved in the halachic debate surrounding organ donation agrees that all those laws must be overridden if it is a matter of pikuach nefesh, saving a life—considered one of the greatest mitzvot in Judaism, surpassing most other commandments.

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Julie G. Fax

Julie Gruenbaum Fax is religion editor at The Jewish Journal of Greater Los Angeles.