Articles

Below you will find articles by rabbis, doctors and scholars about the halachic and medical issues surrounding brain-stem death and organ donation. Some articles are pro organ donation and some are con. We believe by showing all positions, we can allow the public to judge for themselves where they stand on these issues.

136. Title: Kaddish for J.J. Greenberg
     

     Author: Mark, Jonathan
     Publication: Jewish Week Blog
     Year: 2008
     Download: English

     HOD Comments:
     The Jewish Week Blog

      

137. Title: Expanding the Donor Pool: Effect on Graft Outcome
     

     Author: Ramos, E., S. Aoun, W.E. Hermon
     Publication: Journal of the American Society of Nephrology
     Year: 2002
     Download: English

     HOD Comments:
     The American Society of Nephrology

      

138. Title: Methods and Principles in biomedical Ethics
     

     Author: Beauchamp, T.L.
     Publication: J. Med. Ethics
     Year: 2003~~
     Download: English

     HOD Comments:

      

139. Title: Ethical Incentives– Not Payment– For Organ Donation
     

     Author: Delmonico, Francis L., MD; Robert Arnold MD; Nancy Scheper-Hughes PhD; Laura A. Siminoff PhD; Jeffrey Kahn PhD, MPH; Stuart J. Youngner MD
     Publication: The New England Journal of Medicine
     Year: 2002
     Download: English

     HOD Comments:
     Massachusetts Medical Society

      

140. Title: Brain Death
     

     Author: Elliot, J.M.
     Publication: Trauma
     Year: 2003
     Download: English

     HOD Comments:
     Dr. Elliot writes a paper describing the British brain death criteria and compares it to other countries’ standards. Most brain death standards, such as the US’, use a ‘whole brain’ approach while the UK system recognizes ‘brain-stem’ death instead. The British define brain-stem death as the “irreversible loss of the capacity for consciousness, combined with irreversible loss of the capacity to breathe,” all functions attributed to the brain stem. The ‘whole brain’ approach widens the definition to greater brain function. Because both definitions are ultimately dependent on the brain-stem, many of the same tests are used to diagnose both definitions of brain death. Some countries require further confirmatory tests, such as EEG, for whole brain death. Since EEG measures higher brain functioning, it is excluded in the British definition. Disputes over the validity of minimal activity findings in EEG have called its use into question. Both ‘whole brain’ and ‘brain-stem,’ has gained widespread acceptance globally. There is room for greater standardization amongst bodies of criteria. Previous criteria required exclusion of illnesses that could mimic brain death; they apply here as well. Elliot relies heavily on Wijdick’s “Brain Death Worldwide” paper; for more information, please see this entry in our listing.~~

      

141. Title: An ethical market in human organs
     

     Author: Erin, Charles and John Harris
     Publication: Journal of Medical Ethics
     Year: 2003
     Download: English

     HOD Comments:
     This paper includes a discussion opener by ethicists Harris and Erin followed by additional articles by Savulescu and Richards on the regulated organ sales debate. Harris and Erin argue that the solution to the organ shortage crisis is an ethical market of organ sales. Their plan would allow a single governing geopolitical area (the UK or EU) to create a single-payer distribution network that would both distribute organs and ensure that no misconduct occurred. Distribution would be assigned according to an established formula of priority. Participants (both vendors and donors) would be resident citizens of the governing area preventing exploitation of citizens from poorer countries. Sellers in this system “would know they had saved a life and would be reasonably compensated for their risk, time, and altruism, which would be undiminished by sale.”Savulescu argues that people should have the right to decide for themselves whether or not to sell a body part. When this right is denied, it constrains anindividual’s autonomy. He feels this is a “double injustice” for those escaping poverty, as if society is saying, “You can’t have what most other people have and we are not going to let you do what you want to have those things.” In contrast, Richards calls for a clarification on the types of arguments against a regulated system for organ sales. She believes that the anti-organ sales camp has failed to distinguish between those who believe that organ sales are immoral and those who anticipate potential harm to be too great when the system is put into practice.~~

      

142. Title: Why We Should Develop a Regulated System of Kidney Sales: A Call for Action!
     

     Author: Matas, Arthur J.
     Publication: The American Society of Nephrology
     Year: 2006
     Download: English

     HOD Comments:
     Continuing the discussion for a regulated kidney sales system, Dr. Arthur Matas (Professor of Surgery at University of Minnesota) outlines what the system and its oversights would look like once the 1984 Congressional Ban on organ incentives was lifted. Working within the existing government-regulated organ donor networks, Dr. Matas proposes that regionalized organ procurement organizations (OPOs) would evaluate potential kidney donors, submit the evaluation for regional crossmatch according to the national registry (UNOS) for a matching score, and then offer the organ to the highest ranking candidate in the registry. Upon acceptance, a detailed donor evaluation would be sent to the center. All bills for donor evaluation, surgery, and follow-up would be sent to the OPO, which would then bill the center for its services. Inherent in this system would be certain incentives for the donor. One proposal would offer a fixed sum, term life insurance, long-term health insurance, travel expense and time out of work reimbursements, and/or a tax deduction. Incentives have often been thought of as the morally inferior perspective, though Matas argues, “the moral high ground is to eliminate the ban on financial incentives so that we can increase the number of transplants, significantly decrease or eliminate wait-list deaths, and improve the overall survival rate and quality of life for patients with ESRD [end stage renal disease].” For earlier entries by the same author, see “The Case for Living Kidney Sales: Rationale, Objections, and Concerns.”~~

      

143. Title: Retrospective Follow-Up of Transplantation of Kidneys from ‘Marginal’ Donors
     

     Author: Dahmane, D., et al.
     Publication: Kidney International
     Year: 2006
     Download: English

     HOD Comments:
     International Society of Nephrology~~

      

144. Title: Sephardic Ruling on Brain-Stem Death
     

     Author: Amar, Rabbi S. M.
     Publication:
     Year: 2008~~
     Download: English Hebrew

     HOD Comments:

      

145. Title: An Equitable Distribution of Human Organs for Transplantation: Sale of Organs from a Living Donor for Transplant: Motivation and Decision Making
     

     Author: Rappoport, Rabbi Shabtai
     Publication: Greene Fund for Equity Studies
     Year: 2006~~
     Download: English

     HOD Comments:

      

146. Title: People v. Eulo
     

     Author:
     Publication: Court of Appealls of New York
     Year: 1984
     Download: English

     HOD Comments:
     In two separate criminal cases, defendants had been convicted of manslaughter in the shooting deaths of victims whose families had donated their organs for transplantation after they had been declared brain dead. The New York Court of Appeals affirmed both lower court decisions, holding that the term “death” as used in state statutes encompasses cessation of functioning of the entire brain even if the heartbeat and breathing are being sustained by artificial means and that, if victims are properly diagnosed as dead, no subsequent medical procedure such as organ removal can be deemed a cause of death.~~

      

147. Title: Nostrils, Navel or Heart?
     

     Author: Tal, Rabbi Alex Ph.D.
     Publication: –
     Year: 2007
     Download: English

     HOD Comments:
     This article evaluates the textual variations of Talmud Yoma 85a concerning the sign of life and death. While the standard printed edition of the Talmud, records the debate as between checking the nostrils (respiration) and the heart (for heartbeat) most manuscripts including, the Talmud Yerushalmi, record the debate as between the nostrils and the navel.~~

      

148. Title: Enough: The Failure Of The Living Will
     

     Author: Fagerlin, Angela and Carl E. Schneider
     Publication: Hastings Center Report
     Year: 2004~~
     Download: English

     HOD Comments:

      

149. Title: Organ Transplants from Living Donors (Kidneys)
     

     Author: Kedem-Dror, Ronit
     Publication: Knesset Library
     Year: 2003~~
     Download: English

     HOD Comments:

      

150. Title: Musar Kliyot (in Hebrew)
     

     Author: Jennifer Skokin
     Publication: Din v’Chesbone
     Year: 2006
     Download: Hebrew

     HOD Comments:
     Article about Moshiko.~~