“Don’t Take Your Organs to Heaven; Heaven Knows We Need Them Here”: A Jewish Idea?

Organ Donation "on one foot":

Organ donation, both for living and deceased donors, is strongly supported by Judaism. This source sheet looks at some of the texts explaining why. See here for an article on the topic: https://www.myjewishlearning.com/article/organ-donation-and-judaism/

Pikuach Nefesh - Saving a Life

Context: This is from the Biblical Book of Leviticus, where G-d is telling the Israelites to follow G-d's rules and not the rules of the Egyptians.

What meaning can you derive from the phrase "a person should do them and live"?

Context: This is from the Babylonian Talmud, Masechet (Tractate) Sanhedrin, which is about court cases. This comes from a discussion about which rules can be broken in extenuating circumstances, such as when a life is at risk. This text is one of the sources of "pikuach nefesh", breaking almost any rule in Judaism to save a life, and the rule bases itself (elsewhere) on Lev. 18:5 (the previous text in this sheet).

If you can break almost any rule in Judaism to save a life, what would this text say is more important - being buried with all of your body parts, or donating after you die in order to save somebody else's life?

Context: This is from the Biblical Book of Leviticus, from "the Holiness Code" in Chapter 19. Chapter 19 of Leviticus lays out a variety of ways to live a holy life.

How might "do not stand idly by the blood of your fellow" be relevant today?

Context: This is from Maimonides's Mishneh Torah, where he reorganized the Talmud and just cut to the chase on each situation.

If this text could talk, would it encourage you to donate organs after you die? What about while you're alive?

Context: This is also from the Babylonian Talmud, Masechet (Tractate) Sanhedrin, this time from a discussion about the obligations of bystanders. The text plays with the vowels in a Biblical word to make the claim that if you can restore a person's health to them you are obligated to do so.

If this text could talk, would it encourage you to donate organs after you die? What about while you're alive?

Context: This is from the Mishnah, Masechet (Tractate) Sanhedrin. It's from a section about how the witnesses are warned in capital punishment cases to prevent them from condemning innocent people with their words.

If this text could talk, would it encourage you to donate organs after you die? What about while you're alive?

Are there Limits to Pikuach Nefesh?

Context: This is from Pirkei Avot, a part of the Mishnah containing quotes from the rabbis who lived between 200 BCE and 200 CE. This saying is by Hillel, who lived around the year 1 BCE (and CE).

If this text could talk, would it encourage you to donate organs after you die? What about while you're alive?

Context: This is from the Babylonian Talmud, Masechet (Tractate) Bava Metzia, which is about torts and property law. Right before this section the Talmud is discussing the matter of charging interest, and one rabbi cites a verse from Leviticus which says "Your brother shall live with you" (Lev. 25:36). Rabbi Yochanan interprets that verse differently, and this text lays out how he applies that verse.

If this text could talk, would it encourage you to donate organs after you die? What about while you're alive?

Context: This is from Rabbi David ben Solomon ibn Zimra, known by the acronym "the Radbaz" for short. The Radbaz was 13 when his family was forced to leave Spain in the Expulsion of 1492. He lived in the Land of Israel and Egypt. The Radbaz received many letters about how to live Jewishly; his answers, known as Teshuvot, were widely known and respected. This text refers to something Maimonides (the Rambam) said -- Anybody who is able to help somebody and doesn't violates the mitzvah of "Don't stand idly by the blood of your neighbor".

The Radbaz lays out 5 situations to clarify what the Rambam said: 1. There's no danger to the rescuer -- you have to make the rescue 2. There might be a potential small risk to the rescuer (safek sakanah) -- you have to try to help (or spend your money to help). 3. There's definitely a risk to the rescuer (safek vadai) -- you don't have to help 4. There a 50-50 percent likelihood of risk (safek muchra, or safek hashakul) -- you don't have to help. 5. There's less than a 50% likelihood of risk (safek eino muchra) -- you have to help.

If this text could talk, would it encourage you to donate organs after you die? What about while you're alive?

Donating Organs While Still Alive and Well

Context: This is from Maimonides' Mishneh Torah.

If this text could talk, would it encourage you to donate organs after you die? What about while you're alive?

Rabbi Ovadiah Yosef, Yechaveh Da’at 3:84 (1980)

The truth is, that we have been informed by God fearing medical experts that the degree of danger in the removal of a kidney is minimal and that roughly 99 percent of kidney donors recuperate fully. Accordingly, all the authorities who prohibited one from putting himself at risk, were referring to a “balanced risk” (safek hashakul) which is not the case here, for it is definitely a mitzvah to donate in order to save his companion from certain death...and therefore it seems that according to the halakhah it is permissable, and even a mitzvah to donate one of his kidneys to save the life of a Jew whose life is endangered from kidney disease. And this worthy mitzvah will protect the donor as a thousand shields.

Context: This is from Rabbi Ovadiah Yosef (1920-2013), the former Chief Sefardic Rabbi of the State of Israel. He is referring to the Radbaz's categories of whether donating a kidney is putting the "rescuer" at risk these days.

If this text could talk, would it encourage you to donate organs after you die? What about while you're alive?

Context: This is an ELI Talk (Jewish TED Talks), given by Rabbi Shmuly Yanklowitz in 2016. In it he lays out why he donated his kidney, along the way explaining reasons why Jews don't donate organs and why Jewish law actually favors organ donation. You can watch it here: https://www.youtube.com/watch?v=Vdfd8uc7J4Q.

Donating Organs After You Die

Issue #1: When is Death?

Context: This is from the Babylonian Talmud, Masechet (Tractate) Yoma, which is about Yom Kippur. It is explaining a mishnah (Yoma 8:6-7) which says that if somebody has a life-threatening situation on Yom Kippur you give them food, even if it is not kosher. The mishnah goes on to say that this is just like if somebody is trapped under a fallen building you move the debris on Shabbat to rescue them, and you keep doing this up to the point where you realize that they are dead. The Gemara questions how you know if they are dead, and whether it's based on their breathing or their heartbeat. It settles on the breathing test, and this is confirmed by the Shulchan Aruch (O.C. 329:4).

The reason this is important is that when a person dies and they want their organs donated to people who need them, the organs do much better if they are taken out after brain death but before the heart has stopped (a ventilator is used to make this happen). Orthodox, Conservative, and Reform rabbinical groups have all confirmed that this counts as "halachic death", as has Rabbi Moshe Feinstein (https://www.sefaria.org/Care_of_the_Critically_Ill%2C_Responsa_of_Rav_Moshe_Feinstein%2C_Iggeros_Moshe%2C_Yoreh_De'ah_III_132.5?lang=bi).

Does this explanation satisfy any concern you might have had about post-mortem organ donation happening after a person is "halachicly dead"?

Issue #2: Body Integrity

Context: This is from the Babylonian Talmud, Masechet (Tractate) Bava Metzia, which is about property law. This text comes from a discussion about deeds of sale. It discusses the question: If a sale was made, and then the seller died and was buried, and now you think the seller might have been too young to legally make the sale, can you dig them up and poke at them to figure out if they were indeed a minor? (Answer: No) This text is the source of the Jewish value "kavod haMeit", the dignity of the dead.

While some are under the impression that this source precludes removing organs from somebody who has died in order to help others live, experts say that is not so because of the following:

A. This text is only about monetary claims.

B. There is not actually a value that the body be buried entirely intact.

C. Terror victims in Israel still get Jewish funerals, even without all their body parts.

D. People voluntarily donate organs (through surgery) while they are alive, so this is not a desecration of the body.

E. Pikuach Nefesh, saving a life, overrides almost everything, including "the honor of the dead"

F. Assuming the deceased was a kind person, it would not be a disgrace to them to continue to help others (and this is why you should have these discussions with people in your life before you or they die).

Do any of these reasons work for you as to why "bodily integrity" is not a Jewish deterrent to donating organs after you die?

Issue #3: Expedient Burial

Context: This is from Mishnah Sanhedrin, from a discussion about burying executed criminals on the day they died so as to treat even them with dignity. It's based on a statement to that effect in Deuteronomy (Deut. 21:23).

This is relevant to post-mortem organ donation because that process delays burial. However, according to this text, you can delay burial for the sake of the deceased honor, and certainly if somebody wanted to donate organs in order to save other lives that would be honoring their wishes. Jewish funerals are often delayed by a few days for the sake of the living, like letting relatives arrive. Again, saving a life trumps the value of expeditious burials.

On the subject of burials, some people are worried that organ donation will interfere with Taharah, the Jewish process of preparing a body for burial. However, Jews who die during or shortly after surgery still get Taharah, and this is no different.

Some people are also worried that donating their organs after they die will prevent them from being buried in a Jewish cemetery, on grounds that they don't have a whole body. This is false - accident victims, terror victims, and soldiers sometimes don't have their entire body, and they get buried in Jewish cemeteries like everybody else.

Do these explanations assuage any concerns about organ donation that you might have on grounds of burial issues?

Issue #4: Resurrection

Sa'adia Gaon, Book of Doctrines and Beliefs

We know of no Jew who opposes this doctrine, or finds it difficult from the perspective of reason that God could revive the dead, since it is already clear to him that God created the world ex nihilo. He can, therefore, find no difficulty in believing that God should, by a second act, create something from something disintegrated and dissolved.

Context: This is from Sa'adia Gaon, who lived in the 900s in Babylonia and Baghdad. He wrote a book about what Jews should believe, including this part about the Resurrection of the Dead when the Messiah comes.

There are those who are concerned that when the Messiah comes they will not be fully resurrected if they were buried without an organ. However, as we see from this text, if G-d can bring the dead back to life then G-d can cause a person to grow a new version of whatever they donated. Besides, all of the organs disintegrate anyway unless you died very shortly before the resurrection. And your organs will be buried - they'll just get another round of life before they get buried, helping you literally live on after your death.

Does this address any resurrection concerns you might have had about organ donation?

For More Resources:

- HODS: Halachic Organ Donor Society: https://hods.org (now integrated into Ematai - https://www.ematai.org)

- Renewal: Jewish Kidney Donor Organization: https://www.renewal.org

- LiveOnNY: New York Organ Donor Society - Jewish perspectives: https://www.liveonny.org/judaism/

- Other religious views: https://www.organdonor.gov/about/donors/religion.html

With appreciation to Rabbi Ari Perl from LiveOnNY (whose PowerPoint provided the structure and many sources for this source sheet - www.liveonny.org/judaism), Sarah Gorbatov, Melton, and HODS

Appendix: The Views of Denominations

Orthodox

Rabbinical Council of America, 2011

While debate continues over the issue of brain stem death, much greater consensus exists concerning the issue of organ donation. Almost all authorities maintain that organ donation, under halachically permitted circumstances, is not only allowed, but a Mitzva- when such donations are applied towards saving the life of another. It should be noted, however, that those who do not accept brain stem death as meeting the halachic criteria for the determination of death will consequently be more limited in the cases of allowed organ donation.

Live organ donations, such as kidney donation, are halachically permitted and praiseworthy, as life-saving measures presenting only minimal risk to the donor. Most authorities also encourage post-mortem corneal transplants, based upon the principle that saving someone’s sight is akin to saving their life.

https://rabbis.org/brain-stem-death-and-jewish-law-rca-clarifies-its-stance-regarding-brain-stem-death-and-jewish-law/

Conservative

Rabbinical Assembly Resolution on Organ Donation

Resolution on Organ Donations

WHEREAS the Rabbinical Assembly passed a resolution "On Educating Conservative Jews Regarding Organ Donations" at its May 1996 convention; and

WHEREAS every day as many as 200 people in the United States join the list of those awaiting organ transplants, with a death occurring every three hours as a result of a severe organ shortage; and

WHEREAS Jews do not constitute a proportional share of organ donors, possibly due to the misapprehension that Judaism prohibits organ transplants; and

WHEREAS the Committee on Jewish Law and Standards has concluded that organ donation is not only permissible, but a mitzvah. (https://www.rabbinicalassembly.org/story/mitzvah-organ-donation; https://responsafortoday.com/en/organ-transplants-and-donor-cards/)

THEREFORE BE IT RESOLVED that the Rabbinical Assembly re-affirm its 1996 resolution calling for each Conservative synagogue to encourage organ donations among its members through an educational program and campaign, the goal of which is to have an increasing number of people sign organ donor cards and to inform family members of their desire to be organ donors.

Passed by the Rabbinical Assembly Plenum, March, 2000

https://www.rabbinicalassembly.org/resolution-organ-donations

Reform

CCAR Responsa Committee 5763.2 (2003)

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.

1. The data, covering the period from January 1, 1988 – March 31, 2003, are collected by The Organ Procurement and Transplantation Network, the unified transplant network established by the United States Congress under the National Organ Transplant Act (NOTA) of 1984. (These figures deal with the following organs: kidney, liver, pancreas, heart, lung, and intestine. Other donations (for example, corneal tissue) are not included.
2. As of this writing, more than 82,000 persons are currently on waiting lists for organ transplantation in the United States, while 6,279 transplantation were performed in the United States during the first three months of 2003. See the data collected by UNOS ( ), the non-profit, scientific, and educational organization that administers the Organ Procurement and Transplantation Network.
3. Resources and information may be found at the website , sponsored by the United States Department of Health and Human Services. Among the many organizations that actively promote organ donation are the American Medical Association ( ) and the Coalition on Donation, an alliance of for-profit and not-for-profit organizations ( ).
4. Yechiel M. Tucazinsky (20^th cent. Eretz Yisrael) entitles the fifth chapter of his Gesher Hachayim, a treatise on the Jewish law of mourning and burial, “kevod hamet.” The chapter begins with a one-sentence paragraph: “whosoever takes part in the preparation and burial of a human corpse must bear in mind that he is dealing with a holy thing.”
5. Yitzchak Ya`akov Weiss (20^th-cent. England and Israel), Resp. Minchat Yitzchak 5:8.
6. See R. A. S. Avraham, Nishmat Avraham (Jerusalem, 1982), Yore De`ah 349:3, pp. 261-264. On all the following, we are indebted to our colleague, Rabbi Moshe Zemer, for his article “Terumat eivarim vehahalakhah,” in R. Cohen-Almagor, ed., Dilemot be-etikah refu’it (Jerusalem: Van Leer Institute/Hakibbutz Hameuchad, 2002), 265-282.
7. BT Sanhedrin 47b; Yad, Avel 14:21; Shulchan Arukh Yore De`ah 349:1.
8. The phrase nivul hamet is not found in the classical rabbinic sources. Indeed, the word nivul as “disgraceful treatment” is applied twice by R. Yehudah b. Ilai to activities with respect to living persons: a form of cosmetics ( Mo`ed Katan 1:7) and a form of execution (M. Sanhedrin 7:3).On the other hand, the concept of nivul is used with respect to the dead in various places, including BT Arakhin 7a, Mo`ed Katan 27b-28a, and Bava Batra 154a.
9. The mitzvah to bury the dead in the ground is derived from Deuteronomy 21:23; see BT Sanhedrin The prohibition against unnecessary delay in burial is found in M. Sanhedrin 6:5, Yad, Avel 4:8, and Shulchan Arukh Yore De`ah 357:1.
10. Rabbi I. Y. Unterman, Shevet Mi’hudah (Jerusalem: Mosad Harav Kook, 1955), 54-55. Rabbi Unterman, who admits that his chidush (novel legal argument) is at first glance somewhat “strange” (muzar), compares organ transplantation to famous instances of resurrection (techiyat hametim) in the Bible (g., Ezekiel 37; II Kings 4): just as there is never a question of forbidden hana’ah in those Biblical cases, so there should be no similar issue with respect to transplantation. Like many chidushim, Unterman’s is forced and, we think, ultimately unpersuasive. Kidneys, corneal tissue and other organs retrieved from corpses are in fact “dead,” not “living,” at the time of the transplantation. Techiyat hametim, moreover, pertains not to the realm of human science but to the miracles traditionally associated with the end of days. The argument that pikuach nefesh takes precedence over the prohibition against deriving benefit from the dead is more than sufficient to permit this medical procedure. Still, Rabbi Unterman’s suggestion is an important example of the power of creative thinking in halakhah–a trait not restricted to liberal rabbis–and of the readiness of a leading posek to find a way to transcend the existing conceptual structure of Jewish law in a situation where it is vital to forge an affirmative response.
11. Ovadyah Yosef (20th-21st cent. Israel), Resp. Yabi`a Omer 3, Yore De`ah, no. 23. The classic precedent is provided by R. Yechezkel Landau (18^th cent. Bohemia), Resp. Noda Bi’hudah 2, Yore De`ah 210, who permits autopsies when the procedure is needed to uncover information to save the lives of persons “in our presence,” despite the fact that autopsy was generally regarded as an instance of nivul hamet. See as well R. Shaul Natanson (19^th cent. Galicia), Resp. Sho’el Umeshiv I, 1:231, who permitted the exhumation and examination of a corpse in order to determine its identity and to permit the deceased’s wife to remarry; nivul hamet applies only when the “desecration” is committed for no valid purpose, and sparing a woman from the fate of the agunah is indeed a valid purpose.
12. Yabi`a Omer 3, Yore De`ah, no. 22. R. Yosef cites the opinion of Rabbi Unterman (see at note 11) in this context.
13. For example, the “Matan Chaim” program of the Union of American Hebrew Congregations ( ) actively encourages organ donation.
14. BT Avodah Zarah 25a; Yad, Yesodey Hatorah 5:6; Shulchan Arukh Yore De`ah 155:2.

https://www.ccarnet.org/ccar-responsa/nyp-no-5763-2/