Halakhic Questions about Organ Transplants

What are the Jewish legal issues with organ transplantation?

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In regard to the physician or medical team performing the organ transplant there are two major halakhic issues. Does an organ transplant constitute standard medical therapy or human experimentation but with therapeutic intent? Corneal and kidney transplants can be considered standard medical therapy, whereas heart, lung, and liver transplants should still be viewed as experimental. Physicians are obliged to heal the sick using all standard therapies available. Human experimentation is permissible in Jewish law under specific restricted conditions. The more difficult issue is the establishment of criteria for determining whether a prospective donor is dead, for if the donor is still alive when the physician performing an organ transplantation removed one or more of his organs, the physician would be guilty of murder. In relation to heart transplantation, the question of “killing” the recipient is also raised by several rabbis. When the recipient’s diseased heart is removed prior to the implantation of a new heart, the patient is without a heart. Is the patient halakhically dead? If so, are the physicians guilty of murder? Obviously not!

There are numerous Jewish legal questions concerning the organ donor. I have already mentioned the most important of all; namely, the establishment of the death of the donor before any organ is removed for transplantation. In addition, there is a biblical prohibition of desecrating or mutilating the dead. How can one remove an organ for transplantation without desecrating the body? There is also a biblical prohibition of deriving benefit from the dead. The recipient of an organ from a deceased person certainly derives benefit from the dead! Furthermore, there is a biblical prohibition of delaying the burial of the dead and the positive commandment of burying the dead. Another halakhic consideration is that of ritual defilement for priests in the same room with either the donor or only the donor’s organ or organs. Do such organs transmit ritual defilement? Finally, in Jewish law is permission necessary either from the deceased prior to his demise or from the next of kin? Is one “robbing the dead” if one fails to obtain consent? Does the deceased have total rights over his body, or does it belong to God, who gave it to him on loan for the duration of his life?

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Dr. Fred Rosner

Dr. Fred Rosner is Director of the Department of Medicine of the Mount Sinai Services at the Queens Hospital Center and Professor of Medicine at New York's Mount Sinai School of Medicine. He is a diplomat of the American Board of Internal Medicine and a Fellow of the American College of Physicians.