Organ Transplants

Here is a copy of my sermon delivered this past Shabbat. My Chairman quipped that I really murdered this one. Read on to find out why.

The Jewish Chronicle sometimes makes my blood boil.

Last week was no exception. It decided to use its front columns to report on The Beth Din’s decision in relation to Organ Donor Cards and Organ transplantation.

I have no problem with that.

It must be emphasised that this is not an easy subject. The RCA- The Rabbinical Council of America, which is a body representing 1000 mainstream Orthodox Shuls in America recently held an investigation into what is the Halacha in relation to Organ Transplants. After producing a 110 page document and bringing all the various viewpoints on this subject, they came to the conclusion that for their Rabbinate it was better that each individual rabbi use his own discretion to rule in the way he seemed fit in Halacha.

However our Beth Din are more forthright in their opinions: They issued a ruling that whereas Organ donation is permitted in many instances according to the Torah especially in connection with a live donor and even after death, for example kidney or cornea donation, and not only that, but it is a good and upright thing to do. However, when it comes to people carrying blanket donor Cards to be used after death , this was against the Halacha.

The JC in an editorial took a rather emotive and irreverent stand on this issue. They showed complete ignorance of the issues- they could not understand why the Chief Rabbi and the Beth Din do not come in line with Israel and other countries who already allow Organ Donor Cards and could not understand why they do not classify brain stem death as death as if there was an international three line whip on the issue.

This morning we read from the Decalogue, commonly known as the Ten Commandments.

Every body knows that the Ten Commandments are divided into two parts. The first five speak about the Mitzvot Bein Adam LeMakom, the Mitzvot that are between man and G-d and the second five speak about those Mitzvot that are interpersonal-between man and his neighbour.

We all know that and I haven’t said anything new.

But the question is that if you look at the Aseret Hadibrot there appears to be two separate elements. There are those mitzvot that are fundamental to being Jewish like "I am the Lord Your G-d" which speaks about Belief in G-d and "Remember the Shabbat day to keep it holy". These are the Mitzvot that are high, reaching up towards the heavens- if you know what I mean.

And then there are those Mitzvot that if the Torah hadn’t told us about them you would have known about them anyway for example: Lo Tirtzach – Thou Shalt not murder. After all it makes sense for any civilised society that if people are going to live with one another, that the first rule of thumb ought to be that you would not murder one another.

It’s a matter of human survival.

So we need to understand if Lo Tirtzach-Thou shalt not murder is self understood and self explanatory and makes sense, why include this commandment in the Top Ten?

There were before and after the Torah had been given, societies, who had as the main framework of their rule book the law that murder is against the law.

Let’s just look at how the Ten Commandments are written on the Two tablets of stone.

You have five on one side and five on the other. The mitzvah of Anochi Hashem Elokecha- I am the Lord Your G-d- belief in Him is placed next to the Mitzvah of Lo Tirzach – Thou Shalt not murder. Why is that so?

Because there might be an occasion where you or I in our finite limited minds will rationalise and say

You know the Torah says You shall not murder- So in the blatant truth of it all of course it is against everything we believe. But maybe there is a sort of grey area where it’s not so easy to make a decision. Perhaps in certain instances it is muttar, you can rationalise forfeiting life- for example a case when somebody is in the last stages of life. They are about to die anyway- why not hasten the experience? In Switzerland there is the Dignitas clinic where people can elect to go and die in a humane fashion before they have to go through the suffering.

It makes sense- end the life a little bit earlier and make it easier why not make it law over here?

However let me just paraphrase the words of Chief Rabbi Lord Jacobovitz Z’l on this very issue.

A parable.

Imagine a person is about to jump off the Empire State building in an attempt to commit suicide. He takes the plunge and on his way down a person with a shotgun shoots and kills him.

So you say- he was going to die anyway?

However according to Jewish law even though he had only twenty seconds to live before he hits the ground nevertheless the person who shoots him is a murderer. But- you say- he was going to die anyway-and his life was very limited- Yet the gunman is a murderer.

Why? Because human life is human life and is sacrosanct- and it makes no difference the quality or the quantity of that life. The Torah says Lo Tirzach- Thou shalt not murder and next to it are the words – Anochi Hashem Elokecha- it is not for us to decide when a person should or should not die- It is in the hands of G-d and He ultimately makes the decision.

So now we come back to the view of Beth Din in relation to Brain Stem death. It’s very easy to become emotive on this issue but it’s a matter of debate: when is a person dead? Now that is a very simple question to answer. When the Neshama-soul departs the body?

But can somebody tell me exactly when that is? How can you tell that a person is dead? When you don’t see signs of neshimah – of breathing? When the heart has stopped? When a person is brain or brain stem dead- yet those organs are still functioning with the help of a ventilator? It’s a grey area- it’s difficult to know- and there are Poskim on both sides of the view.

Rabbi Moshe Feinstein, Rabbi Moshe Tendler. Rabbi Nachum Rabinowitch are amongst those that accept brain stem death as being true death.

Yet there are Rabbis like Rabbi Eliashiv, Rabbi Shlomo Zalman Auerbach and others who say that Brain Stem death is not necessarily death.

And it makes a difference when it comes to Heart Transplantation. The heart can only be taken from the donor for transplantation when it is still beating. But the question is – is the person alive or dead?

If he/she is still technically alive, to take out the heart would be tantamount to murder according to those authorities. And it’s not just Rabbis but some secular ethicists as well hold this view.

And this is from where the London Beth Din are coming.

I deliberately left out all the sources to this debate.

It’s important to know because when it comes to Lo Tirtzach –it’s no laughing matter.