Ultra-Orthodoxy and Organ Donation
After learning the results of an experiment involving a decapitated sheep, Rabbi Shlomo Zalman Auerbach decided to permit organ donations.
If given no alternative, some transplant surgeons would accept Auerbach’s requirement for a 30-second waiting period after removal from the respirator. Others insist that it is irrelevant in determining brain death and significantly reduces the chances of a donor heart functioning well in the recipient.
Some years ago, the Chief Rabbinate approved the principle of brain-stem death. The chief rabbis have formally approved heart transplants under rabbinical supervision at Jerusalem’s Hadassah-University Hospital, and more than a dozen Israelis owe their lives to such surgery. But the Chief Rabbinate has not issued a halakhic ruling on liver transplants because doctors here have less experience with that surgery. Nevertheless, half a dozen such transplants have been performed successfully in the past year without the chief rabbis objecting.
Rabbi Dr. Moshe Tendler, a biologist at New York’s Yeshiva University and chairman of the bioethics commission of the (Orthodox) Rabbinical Council of America, said he helped persuade Auerbach to recognize the validity of brain- stem death and the permissibility of organ transplants.
Since decapitation is regarded by the Talmud as the only applicable model for brain death, Tendler and Hadassah-University Hospital medical ethicist Rabbi Yigal Shafran arranged for an $8,000 experiment a few months ago. A pregnant sheep, close to giving birth, was decapitated and organ viability was maintained with a respirator. The decapitated sheep was kept on a respirator for several hours with heart action and blood pressure remaining within normal limits. A live lamb was delivered by cesarean section.
That, Tendler said, proves that neither a beating heart nor a live fetus is a sign of life when an animal is on respiratory support. Auerbach modified his view after being notified of the results of this experiment. But a potential donor’s heart must not continue beating on its own after being taken off a respirator for 30 seconds, he ruled. “I had thought that this was impossible. I had thought that a heart cannot beat in a dead person, but the experiment proved that it can beat,” Auerbach decided.
Tendler said that waiting 30 seconds does not affect the success of a lung or liver transplant, but most doctors believe it lowers the chances of success in a heart transplant. The heart must be removed from the brain-stem-dead donor while it is still beating via the respirator.
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