Summer 2014: Organ and Tissue Donation

Rabbi Dr. Geoffrey HaberWhatever you heard, whatever you thought, and whatever you read about the prohibition against donating organs and tissues, put it aside. In truth, Jewish law does, in fact, permit organ donation for immediate life-saving and therapeutic use! Only donating one’s body for scientific research or anatomical study is questionable. Jewish law permits us to sign our donor cards and, when someone we love dies, to use their body to save other lives. Indeed, some authorities even say it is an obligation.

So why, then, is there a persistent misperception that Jewish law opposes organ donation? Well, there are four legal concerns and one eschatological argument Judaism confronts when determining whether or not to permit organ and tissue donation. At first glance, each may appear to be a roadblock preventing the permissibility of organ and tissue donation. This is probably why so many of us conclude that we cannot sign donor cards. But follow the discussions to their conclusions and you will understand that among all Jewish sects (except the Haredim regarding heart and lung donations), organ donation is permissible.

  1. Honoring the dead: The first area of legal concern is how we treat the body of someone who died. Judaism views human beings in life as created b’tzelem Elohim, “in the image of God” (Genesis 1:27) and, therefore, must be treated with utmost respect and without defilement. Would not, then, making incisions in the human body after a person died desecrate the image of God in which we are created? The Talmud makes it clear (TB, Hullin 11b) that to do so unnecessarily and for no good purpose would violate the principle of k’vod ha’met, honoring the dead. But if such a post-mortem examination might save a life, the Talmud teaches us that we should indeed examine that body by all means available.

  2. Burying the entire body: The second area of legal concern entails our responsibility for burying a person’s entire body. This area constitutes the traditionally observant community’s primary concern regarding both autopsy and organ donation. Traditional authorities discuss the burial of a person’s entire body as a means to prevent the ritual contamination of kohanim, members of the Jewish community’s priestly class, the group that in Temple times was in charge of all the sacred rituals. In the twelfth century, the great rabbinic authority, Rabbi Moses Maimonides, differentiated between parts of the body that render the kohen impure, and parts of the body that do not (Mishneh Torah, Hilkhot Tumat Hamet 2.3). Maimonides determined that internal organs do not transmit ritual impurity, and therefore, while we should not frivolously remove any internal organs, we have no obligation to bury them with the body. Thus, it follows that when a surgeon takes an organ and puts it into a living body, it becomes part of that living body. Its status as part of the dead which needs to be buried is void and the kohen need not worry about contamination.

  3. Resurrection of the dead: The one eschatological argument against organ and tissue donation comes from the concept of the resurrection of the dead and relates to burying the entire body of the deceased. There are only two biblical references to the resurrection of the dead and biblical scholars hold that both passages owe something to Persian influence. The first is from the Book of Isaiah (26:19): "Your dead shall live, my dead bodies shall arise, awake and sing, you that dwell in the dust, for your dew is as the dew of light, and the earth shall bring to life the shades;” and the second, from the Book of Daniel (12:2): "And many of them that sleep in the dust of the earth shall awake, some to everlasting life, and some to reproaches and everlasting abhorrence.” From these two passages arose the belief that after the restoration of the Jewish people to its homeland in the days of the Messiah, the resurrection of the dead would take place. However, if the dead are missing vital body parts, how could they be resurrected? The answer to this challenge comes from the opening verse of the Torah (Genesis 1:1): “In the beginning God created heaven and earth.” Surely, the God who created the universe ex nihilo, from nothing, can restore the dead to life and create anew those limbs and body parts that the dead might be missing. After all, our tradition teaches in the prayer book: “Who is like You, mighty One! And who can be compared to You, Sovereign, who brings death and restores life, and causes deliverance to spring forth!”

  4. Not benefiting from the dead: The third area of legal concern is a general principle that we may not use the body of the dead for the benefit (hana’ah) of the living (TB, Sanhedrin 47b). It would certainly seem clear to us that organ donation would be in direct violation of such a principle! Removing part of a body from someone who died and giving it to someone who is still living surely appears to be for the benefit of the living! However, when we take a closer look at the Talmud’s teaching, we learn that the word hana’ah, “benefit,” in this context refers to cannibalism, which Judaism clearly forbids, but not to organ donation. Thus, all Jewish authorities agree that saving a human life by way of surgical transplantation does not fall into this category.

  5. The moment of death: The final area of legal concern is defining the precise moment of death. This is an important issue in Jewish tradition because it requires us to bury our dead as quickly as possible. For thousands of years, Jewish law has understood the moment of death as being cardio-pulmonary, that is, when breathing and heartbeat stop (M. Yoma 8.5; Mishneh Torah, Hilkhot Shabbat 2.19; Shulhan Arukh, Orah Hayim 329.4). These are understandable criteria for past generations who, in the absence of modern technology, were limited in the resources available to them for determining when death had occurred. Today however, in an age when bodies continue to breathe and hearts continue to beat because of artificial respirators, an additional criterion for determining death is cessation of all brain activity. Only the Haredim do not accept brain death as a criterion for determining death, which is why they do not permit transplanting hearts or lungs. They nevertheless, permit other types of organ and tissue donations.

BLUF (Bottom Line Up Front): Jewish legal tradition never opposed organ donation for immediate life-saving or therapeutic use. For nearly 2,000 years, Judaism laid the groundwork in favor of such actions. In other words: sign your donor card and let your family know about it.

Rabbi Dr. Geoffrey Haber, MA, DMin
Director, Spiritual Care
Baycrest Health Sciences