Q&A: Organ Donation
Organ Donation
Question
Hello Rabbi Michael, in the past I signed an Adi card. My question is whether this is permitted according to Jewish law, or whether I should cancel it. From an initial reading online, I saw that Rabbi Ovadia opposed Adi for halakhic reasons. I would be glad to hear your opinion on the matter.
Also, when my late father passed away a little over a year ago, we donated his corneas. My question is whether that is forbidden because of desecration of the dead? Or perhaps for other reasons?
Answer
In my personal opinion there is no prohibition whatsoever, and it is a great commandment to sign. I’ll explain briefly.
The problem is usually made to hinge on the question of what the moment of death is: brain death or cardiac death. If it is cardiac death, then even if the donor’s brain is dead but his heart is still beating—in which case doctors take the view that this person is considered dead and pronounce him dead (with great audacity, since this is not within their authority. This is not a medical question but a value question, and they have no relevant expertise to determine it)—then according to Jewish law he is alive, and taking organs from him is murder. But if the moment of death is brain death, then there is no problem, since he is indeed considered dead according to Jewish law as well.
But a few comments should be made here. First, with an Adi card there is an option to condition the donation on rabbinic approval. Second, even if there is a prohibition of murder, the prohibition is on the doctor (who holds that it is permitted), not on the donor. Third, my own approach (published in an article in Techumin) is that the dispute about the moment of death (brain death or cardiac death) is not relevant to the discussion of organ donation. Even if the donor is not considered halakhically dead, it is still permitted to take organs from him in order to save a life, since his blood is less red than the recipient’s blood. This is of course contrary to the opinion of virtually all halakhic decisors. But that is my view, and if you ask me, I not only permit it—I would even obligate it. Especially in light of the previous comments.
As for cornea donation, it seems obvious to me that it is permitted, since he is already dead. Is saving a person’s eyesight not worth overriding desecration of the dead? Danger to an eye is considered life-threatening enough that one desecrates the Sabbath for it. So how could one not override the prohibition of desecration of the dead for it—a prohibition far lighter than the Sabbath?! And halakhic decisors also wrote that when the cornea is transplanted into another person it is alive, and therefore there is no obligation to bury it. So there is neither desecration here nor failure to bury.
Discussion on Answer
I would appreciate an exact reference to your article in Techumin. Thank you.
This is the article in Techumin https://mikyab.net/%d7%9e%d7%90%d7%9e%d7%a8%d7%99%d7%9d/%d7%aa%d7%a8%d7%95%d7%9e%d7%aa-%d7%90%d7%99%d7%91%d7%a8%d7%99%d7%9d1/
Rabbi,
1. You wrote: “Even if the donor is not considered halakhically dead, it is still permitted to take organs from him in order to save a life, since his blood is less red than the recipient’s blood. This is of course contrary to the opinion of virtually all halakhic decisors. But that is my view, and if you ask me, I not only permit it—I would even obligate it.”
In a case like this, where you permit organ donation from a person such that regardless of his medical condition his heart is taken from him, and clearly the donor will die from it, and clearly the recipient will live because of it—where did we get the authority to decide who will live?
2. You wrote: “Even if there is a prohibition of murder, the prohibition is on the doctor (who holds that it is permitted) and not on the donor.”
You claim that the murderer is the doctor. That does not make sense, because suppose I hired a contract killer to murder so-and-so. The murderer succeeded in murdering so-and-so and was caught and interrogated, and it was proven that someone hired his services to murder so-and-so. What would they do to the murderer, and what would they do to the one who hired the murderer?
In my opinion the murderer is like the doctor, because he gets paid for his work, but in actuality the real murderer is the one who hired the murderer, and justice should be carried out against him and not against the hired killer. Do you understand?
3. There is a concept in Jewish law that if a person stole something while risking his life and succeeded in stealing it, then what he stole is his. And it cannot be taken from him because he risked his life. My question is: can’t one argue that the contract killer “stole” the murdered person’s life at risk to his own life, so he should be exempt under that same rule?
Where is my mistake here?
1. As I understand it, that is the halakhic determination. If you think Jewish law has no authority—don’t obey it.
2. I understood and did not agree. The words of the rabbi and the words of the student—which words do we heed? (True, there is discussion about someone who gets paid, as in one who hires false witnesses to testify, but this is not the place.)
3. I am not familiar with such an idea in Jewish law. I am familiar with an exemption from paying for broken vessels under the rule that one receives only the greater punishment. As for your question, he also stole the Torah, because he violated it—and therefore he is exempt. That is empty pilpul.
Questioner:
You wrote: “Even if there is a prohibition of murder, the prohibition is on the doctor (who holds that it is permitted) and not on the donor.” The question is whether the donor is not considered aiding a transgression בכך by enabling the doctor to do it. If the patient had not signed the card, the doctor would not have carried out the murder.
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Rabbi:
There is more here than merely aiding a transgression. This is “do not place a stumbling block.” But it is still a lighter transgression than murder. This is another branch of leniency.
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Questioner:
So if I understood you correctly, even though there is “do not place a stumbling block” here, since there is life-saving on the recipient’s side, that overrides “do not place a stumbling block”?
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Rabbi:
Indeed.
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Questioner: Recently I learned of a new card called “Bilvavi” (details at the link: http://bilvavi.co.il/Home/About). In your opinion, is it preferable to sign such a card? Or perhaps there is not much difference?
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Rabbi: In my personal opinion there is no difference, and even with Adi there is no need to require rabbinic approval as a condition for donation. In the opinion of many rabbis, that one is preferable.