Transplant Query

Ynews presented this article, at http://www.ynetnews.com/articles/0,7340,L-3663653,00.html, regarding the comments of the father of an 8yr. old Charedi girl, in Israel, who received a heart and lung transplant. The father stated that while it was permitted for the family to accept an organ transplant, they would never donate one of their organs as that would be in contravention of Halacha. The article then quoted the comments of one of the doctors involved in the transplant who found this position to be unethical. The question is how to respond to such a challenge?

There were actually many variant issues addressed in the article, some introduced, I believe, to attempt to embarrass the Charedi world. I actually found myself quite impressed with many of the presented statements of the father who had to deal with many questions which were attempted assaults on his belief. For example, there was an attempt to make an issue out of the fact that the organs came from an 8yr. old Arab boy and how the father and family may feel about the daughter now having Arab organs. The father dealt with that, in my opinion, in a very proper way, making a point of his sympathy for the loss of the Arab family, sending them a note to express his thanks but also his condolences on their terrible loss. Yet, there was still the issue of the transplant itself. In stating that he would accept an organ transplant but not donate an organ, the father opened himself, and the Torah world, to potential criticism for being takers and not givers, for not being, essentially, fair.

To be honest, I found much confusion in the article. There is a distinction between heart transplants and other organ transplants and this distinction was not clear in the article. While there is still some controversy regarding general organ transplants, there is a more intense debate regarding heart transplants as the halachic definition of death, a matter of great controversy, is at the centre of this issue. The article seemed to treat the entire issue of transplants within the confines, though, of this latter issue. Thus, one is left unsure whether this family was specifically talking about heart transplants or whether they were also, effectively, saying that they would follow the stringent opinion in regard to all organ donations. This, though, would a matter of interest to one knowledgeable of the halachic issues. The real question is, though: how to deal with this in the face of a public that would look upon it in negative terms?

Concepts such as chilul Hashem or m'pnei eiva immediately come to mind. What is permissible in the deviation of the prima facie halachic position due to these broader halachic constructs? To what extent should we be concerned with the view of non-Jews or non-halachic Jews when their viewpoint is not technically cognisant with the position of Halacha? Rav Moshe makes a distinction between a value that a non-Jew broadly perceives to be part of Torah and one that arises simply from the non-Jew's personal value system. We are not concerned that the non-Jew doesn't like our values; we are concerned that the non-Jew believes that we are not abiding by a value that they believe is in Torah. This parameter would seem to apply in this case. How much do we consider how others will look at us in cases such as these? How much weight would this consideration have in the halachic decision-making that would surround such a case?

One thing did hit me though? In situations where there is a recognized disagreement, machloket, in the Torah Law, these types of concerns may be a factor in considering the use of a more lenient position albeit that the normative decision follows the more stringent opinion. If this is true, whether we see the disagreement over death as a machloket in Halacha or whether one side views the other side as outside the pale could have a great significance in approaching this issue. Let us postulate a rule that one who has had a close family member receive a transplant should accept a lenient view and become a donor in order to avoid the possibility of a chilul Hashem. This would avoid a condemnation such as in this case. The application of such a rule, though, would depend on whether one sees the divergent opinions as a machloket within Torah or simply as the presentation of the proper view while others present an incorrect view.

The application of the concept of eiva to these type of cases may also be of interest. If Shabbat is affected by this concept, then what would be the affect of this concept in this type of case. The fact that this may concern retzicha, murder, though, in the case of heart transplants abiding by the view that cessation of heart beat is the only determinant of death, may make the application of this concept here, albeit its application concerning Shabbat, most difficult. It should also be noted that, even regarding Shabbat, there is some controversy regarding this concept. See, for example, the Mishna Brura on the subject.

Rabbi Ben Hecht