האם מותר לתרום איברים ביהדות

Jewish law—which is the halakha accepted by Orthodox Judaism—establishes that saving a life (piquah nefesh) pushes aside all the prohibitions found in the Torah except for idolatry, adultery, and murder.

The following is excerpted from Professor Abraham S. Abraham’s book, The Comprehensive Guide to Medical Halacha (p. 187, 37:1-7). Dr. Halperin’s comments are indicated in square brackets.

1. One may offer part of one’s body for transplantation into a seriously ill patient (see Chapter 1, paragraph 1) provided that according to expert medical opinion the donor will not thereby suffer permanent harm, and this is regarded as a most meritorious act. Thus a kidney transplant from a live, healthy donor is permissible if, according to expert medical opinion, it carries only a small risk for the donor. (Competent halachic authority must first be consulted.)

2. Bone-marrow transplantation carries only a minimal risk for the donor and is, likewise, permitted; indeed, it is praiseworthy. (Competent halachic authority must first be consulted.)

3. Transplantation of skin from a corpse in order to save the life of a badly burned patient is permitted under certain circumstances. (Competent halachic authority must first be consulted.)

4. The cornea removed from a corpse may be transplanted into a blind person. (Competent halachic authority must first be consulted.)

5. The kidneys may be removed from a corpse, under certain circumstances, for transplantation into seriously ill patients (see Chapter 1, paragraph 1 [below]). (Competent halachic authority must first be consulted.)

6. It is not permissible to remove any organ from a dying person for transplantation, even if the recipient’s life might thereby be saved.

7. A patient who has been pronounced to be clinically brain dead (brain-stem dead) [there is a disagreement among halachic authorities on whether or not brain death is halachically considered to be death] is considered halachically to be in the category of a possible gosses [moribund person]. No organ may be removed for transplantation [before cardiovascular death is determined]. In the Diaspora, one may be the recipient of an organ from such a donor.

Following is ch. 1, para. 1, of Prof. Abraham’s book:

1. The seriously ill or dangerously ill (holeh she-yesh bo sakkana): that is, the patient suffering from a potentially fatal condition.

a. A person who himself senses that he is seriously ill, or whom a physician or anyone with some knowledge of medicine considers to be so.

b. One who, though not in immediate danger, may deteriorate into such a state unless given treatment in time; for example, an insulin-dependent diabetic patient who has run out of insulin.

c. Patients with certain conditions held by the Talmud to be states of danger, even if contrary to current medical opinion; for example, a woman within seven days of childbirth.

Once such a potentially fatal condition has been diagnosed, one of two practical applications ensues:

— If actual or possible danger to life is imminent, everything necessary to save the patient’s life must be done as speedily as possible, exactly as one would were it not the Sabbath. In such a situation, one who delays treatment in order to seek a halachic decision is considered to have “shed blood,” since the delay may result in a loss of life.

— If, however, it is certain that there is no imminent danger to life in taking the time to consult competent halachic authority, this should be done in order to be properly guided as to when and how to set aside the Sabbath regulations.

Danger to a Limb But Not to a Life

In almost all situations in which there is danger to a limb the patient is held to be seriously ill and must be treated as such. For details, see Nishmat Avraham [by Prof. A. S. Abraham]).

[For more details please see ‘hashtalat eivarim’ in Encyclopedia Hilchatit Refuit by Prof. Avraham Steinberg.]

Regarding the Reform approach, it is difficult to find clear legal rules in the literature.