Organ Donation

The halachah is clear that the mitzvah of pikuach nefesh (the saving of a life) supersedes all other mitzvot, other than a few exception. These are murder, illicit sexual relations, and idol worship. (Sanhedrin 74a-b)

A person is not required by law to donate an organ of his body if it would cause him danger for the organ to be moved, he is forbidden to risk his life.--Tsitz Eliezer 9:45

The traditional definitions of kevod hamet and nivul hamet came into being long before medical science developed the technologies of organ transplantation. Now that physicians and surgeons can save many lives through these procedures, they have become an integral feature of the legitimate practice of medicine. In this new scientific reality, the operative rule is the dictum that "any and all measures, with the exception of idolatry, sexual immorality, and murder, may be utilized for the sake of healing." (BT Avodah Zarah 25a; Yad, Yesodey Hatorah 5:6; Shulchan Aruch Yore De'ah 155:2.) Cadaveric organ donation is included in these measures. It is a mitzvah, and it must not in any way be associated with the acts that our tradition condemns as disgraceful treatment of the dead. (CCAR Responsa Committee. 5763.2: Live Liver Transplantation.)

We feel that the desire to help a fellow human being, especially in these dire circumstances of piquah nefesh is of primary significance. From our liberal understanding of the halakhah, this is the decisive factor. The act of donating organs does honor to the deceased; many of those about to die would gladly forego any other honor and donate organs for this purpose (Kid. 32; Shulhan Arukh Yoreh Deah 364.1, 368.1; Isserles Responsa #327). As the donation of an organ will help to save the life of another human being, storage until the time of proper use presents no problem. Progress in the future may raise new issues of use and lead us to reexamine this matter. At the present time we should insist that storage and handling be done with appropriate respect and that the disposal organs which are not used be done with reverence.

CCAR RESPONSA

Contemporary American Reform Responsa

Cadaveric Organ Donation. As of this writing, nearly eighty percent of all organs transplanted in the United States are taken from deceased donors.[2] Given the large number of potential organ recipients who currently await transplantation[3] and the efforts by governments and other institutions to encourage individuals to become organ donors upon death,[4]it is clear that cadaveric organ donation is a critically important resource in the struggle against disease. For this reason, we might suppose that Jewish law, which places such great emphasis upon the mitzvah of healing, would raise no objections to this practice. Yet it is far from obvious that this is so. The harvesting of organs from deceased persons might well conflict with another central Judaic value, that of kevod hamet, the obligation to respect the dignity of the dead. This respect entails that human remains are to be quickly and properly buried; we are not to utilize or manipulate them for our own purposes, even for the fulfillment of the mitzvah of refu’ah.[5] “The dead,” it has been noted, “are not obligated to fulfill the commandments…and we are (therefore) not empowered to deny them the honor that is their due.”[6] In particular, the use of cadaver organs for transplantation would seem to conflict with three separate ritual prohibitions:[7] the ban against deriving benefit or profit from the dead (isur hana’ah min hamet),[8] the disrespectful treatment of the corpse (nivul hamet),[9] and the delay in burial of the remains (meni`at hakevurah).[10]

Halakhic authorities, however, have come to recognize organ donation as an exception to each of these prohibitions. For example, Rabbi Isser Yehudah Unterman, a former chief rabbi of Israel, rules that the positive duty to preserve human life (pikuach nefesh) outweighs the prohibition against deriving benefit from the dead. As additional support, he offers the novel argument that the prohibition ceases to apply “when these organs are ‘resurrected’ [i.e., through the process of transplantation]” and can be considered “alive” rather than “dead.”[11] Various poskim waive the proscription against “disrespectful treatment” when the otherwise forbidden act is undertaken for a good and appropriate reason.[12] And once an organ has been transplanted into the body of the recipient, it is no longer part of the body of the deceased and thus no longer subject to the requirement of burial.[13]

Reform Jewish tradition concurs with this permissive view. Indeed, we teach our people that organ donation is a mitzvah,[14] and we are not so concerned in this regard with the various prohibitions concerning the handling of the remains of the deceased. This is not to say that we do not believe that the dead deserve respectful treatment, but simply that the traditional definitions of kevod hamet and nivul hamet came into being long before medical science developed the technologies of organ transplantation. Now that physicians and surgeons can save many lives through these procedures, they have become an integral feature of the legitimate practice of medicine. In this new scientific reality, the operative rule is the dictum that “any and all measures, with the exception of idolatry, sexual immorality, and murder, may be utilized for the sake of healing.”[15] Cadaveric organ donation is included in these measures. It is a mitzvah, and it must not in any way be associated with the acts that our tradition condemns as disgraceful treatment of the dead.