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Introduction
General Info about Organ Donation
Group Exercises
Ideas for Writing a Paper
Other Resources

Dear Student,

This page will give you some background information about medical and halachic issues concerning organ donation and will offer you a few ideas to write a paper or create a project for your high school.

Introduction
First, it is important to understand what the Halachic Organ Donor (HOD) Society does. The HOD Society is an educational organization whose mission is to save lives by encouraging organ donation from Jews to the general population. HODS accomplishes this mission by educating Jews about the halachic and medical issues involved in organ donation and providing a unique organ donor card which enables people to donate their organs in accordance with their own halahic belief. 

People of any age can obtain our organ donor card (you do not have to be 18).  If you decide to register for an organ donor card, it is important to share this decision with your family members, as ultimately they will have an impact on the decision and your decision will have impact on them.

General Info about Organ Donation
There are two types of organ donation: removal of organs from a person who has recently died (deceased donor), or from a living donor. In the first case, a deceased donation, allows 8 life-saving organs to be transplanted: the heart, lungs (2), kidneys (2), liver (split in 2) and pancreas. This can save 8 lives.

In cases of a living donor, a person will voluntarily opt to donate one of their kidneys.  Everybody is born with two kidneys yet only needs one to live.

HODS can match individuals who wish to donate a kidney while alive with recipients in the Jewish/Israeli community. 

In the United States there are 96,000 people on the transplant waiting list and about 17 people die every day waiting for an organ.  In Israel, there are 1,000 on the waiting list, and 100 die every year. Unlike other disease from which people die because there is no known remedy, medicine has a cure for organ failure: organ transplants. Unfortunately not enough people agree to donate their organs and as result many lives are unnecessarily lost. 

This issue is particularly important to the Jewish community since Jews have a significantly lower rate of organ donation.  In Israel 8% of the population has elected to be organ donors compared to 35% of the United States population.  

Group Exercise to Discuss Organ Allocation
If you were in charge of deciding to whom you would give a life-saving organ, how would you go about doing it? There are many ethical considerations that arise in the process of allocating scarce resources. Should you use emotional guidelines, or an objective and systematic approach?

We recommend that students break up in to small groups and read aloud the following scenarios. Discuss how you would make the decision.  What halachic considerations would come into play? Once you have gone through these scenarios try to create a set of guidelines based on the scenario outcomes.

Do not read the scenarios all at once. Read one, then discuss, then move on to the next one.

Scenario #1
A kidney is available for transplant. Many people are waiting for kidneys but only a few are available. Not everyone will get one, and many will die.  A computerized search indicates that the kidney that is available matches medically with two people. The first is a 30 year-old mother with 3 children. The second is a 65 year-old man, father to 3 and grandfather of 7.  Who should receive this kidney? Don’t be afraid to say that there is other information you would need to know before you make your decision, but state clearly what that information is and why you would need to know it.

Note: Consider that while there is no age limit to receiving organs from both medical and legal perspective, the Ethics Committee at the Organ Procurement and Transplantation Network (OPTN) state that “transplantation should be carefully considered if the candidate’s reasonable life expectancy is significantly shorter than the reasonably expected ‘life span’ of the transplanted organ.” 

Scenario #2
A world-renowned scientist who made great advances in the cure for cancer needs a liver.  Should he be moved to the top of the list to receive a liver even though other people have been on the waiting list for a long time.

Scenario #3

A world-renowned scientist who has made great advances in the cure for cancer needs a liver.  The research he is currently working on is not yet finished and has the potential to save thousands of lives.  Should he be moved to the top of the list to receive a liver even though other people have been on the line for a long time before him.

Scenario #4
A heart becomes available for transplant.  The two potential matches are a 25 year-old male serving a 10 year prison sentence for assault that crippled another man and a 65 year-old school teacher.  Who should receive the organ?

Note that the Ethics Committee at the Organ Procurement and Transplantation Network (OPTN) states “…convicted criminals have been sentenced only to a specific punishment and have not been sentenced by society to an additional punishment of an inability to receive consideration for medical services.”

Scenario #5
South Carolina is currently considering a law which would allow prisoners to donate a kidney in exchange for 180 day reduction in their prison sentence.  Is this ethical?

Other questions to consider:

  • Should the purchase of organs, from living people, be made legal?

  • Should those who have agreed to become organ donors get preferential treatment if they need an organ?

  • Should families donating a loved-ones organs be allowed to dictate the religion of the recipient   

Ideas for Writing a Paper
Much of the debate surrounding organ donation in the Orthodox Community stems from the question of when death occurs in Jewish law. Most organs are taken from people who are brain-dead. Many Rabbis believe that since the heart is artificially kept alive then the person is alive, even though the brain is not functioning. They forbid organ donation in this case because they think it would be “killing” the donor.

Other Rabbis think that a brain dead person is dead even though the heart is still beating. You can learn more about this issue throughout the regular website and below we have recommended a few articles and videos. Use them to write a paper on the debate surrounding brain-death.

  1. Brain Death Controversy in Jewish Law, The
    Download: English
    Author: Breitowitz, Rabbi Yitzchak
    Publication: Jewish Action
    Year: 1992, Spring 5752
    HOD Comment: A clear overview and important responses from R. Tendler and R. Breitowitz

  2. All Take and No Give
    Download: English
    Author: Berkowitz, Adena K.
    Publication: Moment
    Year: 1995, August

  3. Video of Rav Dovid Feinstein
    http://www.hods.org/English/videoE.shtml

Other Resources
www.hods.org

http://www.pbs.org/wgbh/nova/eheart/transplant.html - Conduct a heart transplant online!

http://www.donatelife.net/index.php

http://www.organtransplants.org/

http://www.transweb.org/

HOD Self Test

Questions and comments can be directed to admin@hods.org or 212-213-5087