New York – Does Jewish Law Permit Donating a Kidney? What About Selling One?

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    New York – With the recent media attention of the arrest of a Brooklyn man who is accused of trafficking kidneys, one might wonder does the Jewish law permit selling and donating organs.

    Renowned doctor and expert in medical law according to the Halacah, has written below article on this subject, and is posted on Aish.com

    The Organ Shortage

    There is a severe shortage of organs for transplantation throughout the world, including in the most scientifically advanced countries. The U.S. Government reports that each day, about 74 people receive an organ transplant. However, another 18 people die each day waiting for transplants that can’t take place because of the shortage of donated organs. (www.organdonor.gov)

    While organ transplantation has offered a new life to those whose native organs have failed, it has raised a myriad of ethical questions. Although the issues raised in live and cadaveric donation are different, all organ transplantation questions have three ethical issues that must be clarified: with respect to the donor, the recipient, and society at large.

    The Donor

    As our discussion focuses on donors who are alive, the issues of desecration of the dead body and prolonging the burial do not apply. The issues that do arise are whether the donor is allowed to wound himself to donate the organ, and whether the harvesting is acceptably safe. In most cases, the prohibition of wounding oneself may be superceded by other considerations, such as medical necessity, or as in this case, saving the life of another.

    The consensus of modern poskim 1 (rabbinic legal decisors) is that one may undergo a small risk to save someone else from certain danger or death (see SARS and Self-Endangerment) Nevertheless, one may never obligate or coerce someone to donate an organ, even to save the life of another. Additionally, one may not significantly risk one’s own health to save the life of another, and one who does is called a “pious fool. 2

    Donating a Kidney

    With respect to kidney donation, the issue is whether the surgery poses a significant risk to the donor and whether living with only one kidney is an unacceptable risk.

    Rabbi Moshe Feinstein, 3 among other Rabbinic authorities, 4 permitted, but did not require, the donation of a kidney to very ill person, considering the act to be a pious one.

    Rabbi Shlomo Zalman Auerbach, arguably the preeminent decisor of Jewish law in Israel during the latter part of the 20th century, ruled that “if the seriously ill patient is present (and known to him…) it is certainly permissible for a person to even undergo much suffering, for example, by donating his kidney, to save the life of the patient.” 5

    The 12 grown children argued over who would have the privilege of donating a kidney to their father.

    Rabbi Yosef Shalom Elyashiv, a leading decisor in Israel, also rules that live organ donation of kidneys is permissible and appropriate, while not an obligation. Rabbi Elyashiv became personally involved in the case of well-known Knesset member Rabbi Avraham Ravitz, who required a kidney transplant. Rabbi Ravitz’s 12 grown children argued over who would have the privilege of donating a kidney to their father. In the end, with the guidance of Rabbi Elyashiv, the choice was narrowed down to two sons, with the final decision being made by means of a lottery. 6

    Dr. Avraham Steinberg, author of the Encyclopedia of Jewish Medical Ethics, encapsulates the four requirements necessary for ethical live organ donation. 7 He asserts that:

    1. surgery to remove the organ must not be dangerous
    2. the donor must be able to continue his life normally after the donation
    3. the donor must not require prolonged and chronic medical care, and
    4. the success rate in the recipient must be high

    Some decisors have expressed hesitation to allow live organ donation, concerned that the risk may be too great to the donor. However, as the risk of complication has been greatly lowered, even these opinions might permit live kidney donation. For the sake of thoroughness, we present here the few circumspect opinions:

    Rabbi Yitzchak Weiss 8 was very concerned about both the danger associated with the donor’s surgery and the risk of living with only one kidney. As a result, he was inclined to forbid such a transplant, but suggested that kidney donation may be permissible if the donor will definitely save the life of the recipient by his donation. Even in such a case, he remained circumspect.

    Rabbi Eliezer Yehuda Waldenberg 9 is also hesitant to allow live donation, but writes that while it is not a mitzvah, if the expert doctors are sure that there will be no danger to the donor, he may donate a kidney to one who is seriously ill. Dr. Avraham Avraham describes Rabbi Waldenberg as meaning that certainty does not mean “there is no possibility of harm,” but rather that “there is a good possibility he will not come to harm.” 10

    Rabbi Ovadiah Yosef evaluates the objections of both Rabbi Weiss and Rabbi Waldenberg, but asserts that since the true risk of kidney donation is so low, there is a great mitzvah to donate a kidney. 11 He even suggests the possibility that donating a kidney to save a life might be required by the Torah’s command “not to stand idly by as your neighbor’s blood is shed.” 12 Rabbi Yosef ends his responsa with the words: “Thus it appears that the standard rule is that it is permitted and also a mitzvah to donate one of his kidneys to save the life of a fellow Jew who suffers from renal failure.” 13
    Donating Blood and Bone Marrow

    Donation of blood and bone marrow are much easier to halachically justify. Blood and marrow are quickly renewable, and while the donation process is somewhat painful for bone marrow donation (sometimes requiring general anesthesia); both forms of donation are very safe, presenting minimal risk to the donor. For these reasons, these types of live donation are permitted by all.

    Rabbi Shlomo Zalman Auerbach felt that it is a mitzvah to be a bone marrow donor to save a Jewish life. 14 Both Rabbi Auerbach and Rabbi Moshe Feinstein ruled that one is permitted to donate blood to a blood bank even without knowing that it will go to save a life. 15 Interestingly, Rabbi Auerbach ruled that a competent minor may agree to donate bone marrow and the parents of an incompetent minor may consent for him. 16

    If the potential donor does not wish to donate his blood or marrow, there is a difference of opinion. Some rabbinic authorities feel that one cannot be compelled to donate, even at the cost of the potential recipient’s life, while others feel that coercion is permitted to save a life. 17

    By contrast, donations of other solid organs which present a significantly higher risk (such as liver lobes and lung lobes) are more difficult to justify.

    The Recipient

    The perspective of the recipient is straightforward. So long as the donor is permitted to donate the organ, and there is a medical indication for the transplant, the recipient is permitted to accept it, so long as there is no other viable, less dangerous medical treatment available.

    The recipient must be capable of following the post-transplant medical regimen.

    The recipient must understand the risks associated with transplant, including the need for life-long immunosuppressive therapy, and must be capable of following the necessary post-transplant medical regimen, including being able to afford the anti-rejection drugs.

    Judaism has no intrinsic objection to accepting an organ donation per se, but only insists that no prohibitions be transgressed in the process of donation.

    Society

    Societal issues also come into play with respect to live organ donation, the most sensitive being payment for organs. While society wants to provide incentives to increase the donor pool, incentives that are too persuasive may unduly influence a potential donor to undertake a course of action that is not prudent. Donors are routinely reimbursed for expenses related to donating their organ, but such payment is not usually considered to undermine the purely altruistic motivation of the donor.

    Selling Organs

    Actual payment for organs themselves is a very controversial topic. Most experts in the field of transplantation, including surgeons and ethicists, have expressed opposition to payment for organs. In the United States, federal law prohibits the sale or trade of organs. The motivation behind the ban is a concern for exploitation of people who would not donate except for the monetary incentive, as is already the case in India. Additionally, there is a fear that the creation of a market in human organs will create an inequity between rich and poor. Those who can afford organs would be able to obtain them, while those who could not afford them would be left without options.

    The best solution for society might be a national registry of people who are willing to donate for compensation.

    Nevertheless, there are benefits to allowing direct payment for live organ donation. Obviously, it might increase the supply of organs, saving more lives, even if it does skew the distribution of the organs. While allowing compensation for organs would surely encourage only the poor to donate, causing a degree of inequity, in the current situation it is only the rich who currently can afford to buy a kidney on the black market anyway. Hence, the best solution for society might be a national registry of people who are willing to donate for compensation, with the kidneys allocated by the national registry in the same way that is currently done for cadaveric organs. This would hopefully lead to equal distributions to all recipients, including the poor. 18

    Advocates of organ sales point out that society does not object to the many people who undertake dangerous forms of employment for monetary compensation (such as miners, soldiers, firefighters and policemen). 19

    Another justification of payment for organs is that it would bring an end to the thriving international black-market in human organs, which now currently functions unregulated, with most of the profits going to middle-men, not the poor people selling their organs. 20

    For society, increasing the organ supply makes fiscal sense. The cost of kidney surgery is far less than the cost of dialysis, which runs about $50,000 per year. Even paying large sums of money to donors would save money in the long run.

    But from a philosophical point of view, there is another reason to consider allowing the sale of organs. It may be a misplaced sense of paternalism that leads us to prevent the sale of organs by the poor. While other less traumatic means of helping the underprivileged would be far better, the reality of the world situation today is that there are millions of people who might welcome the chance to alleviate their poverty by selling an organ.

    Society must also protect potential donors from coercive tactics or from being preyed upon due to donor ignorance. Informed consent is an absolute requirement of live organ donation. For this reason, mentally incompetent people who cannot consent to donate in a meaningful way are usually barred from becoming live donors. A particularly interesting question raised by Dr. Steinberg is the case of an incompetent potential living donor whose primary caregiver is a relative in need of the transplant. The potential donor may suffer more from not donating if the caregiver will die for lack of a donor organ!

    May Jews Sell Organs?

    Taking all this into account, we must ask whether selling one’s organs is permitted from a Jewish legal perspective. In the final analysis, there is no intrinsic halachic objection to selling organs, per se. Rabbi Yaakov Weiner, Dean of the Jerusalem Center for Research, integrates the issues that we have discussed (the problem of injuring oneself, the degree of acceptable risk, and the motivations that might drive someone to sell an organ) when he rules: 21

    One may sell his organs to save a life, if it causes no halachic risk to the donor’s life. This would not be subject to the prohibition of injuring oneself, because selling the organ is seen as a great need to save life and also because saving a life is a mitzvah which suspends all others. If however a lifesaving situation does not obtain, for example, selling organs to a bank or for research purposes, then doing so is prohibited. But if the motivation for his selling the organ could be defined as a great need (e.g., avoiding bankruptcy with its accompanying legal and social repercussions), it would be permitted.

    This ruling may seem novel, but in reality is very logical. There is no particular reason why receiving compensation for an action which involves risk should necessarily be forbidden either morally or halachically. While most secular experts remain opposed to payment for organs, there is a growing support for the idea. In an excellent article in the British medical journal Lancet, 22 the authors make several cogent arguments for why payment for organs should be revisited, raising each objection and explaining how it might be solved. A review article in the Israel Medical Association Journal 23 also supported permitting payment for organs under tightly controlled guidelines.

    The fact that one is being rewarded for an act, does not take away from the ethical value of that act.

    From a Jewish legal point of view, the mere fact that one is being rewarded for an act, does not take away from the ethical value of that act. In fact, Rabbi Shlomo Zalman Auerbach ruled that “even if the person selling his kidney is poor (and needs the money for himself) or to pay off his debts, since he obtains this money by saving the life of another Jew, he will certainly be doing a mitzvah. This is true even if he would not have donated his kidney only to save life.” 24

    If we put aside the issue of live organ donation itself, there is a precedent in Jewish law for the selling of organs. Rabbi Moshe Feinstein ruled 25 that one may sell one’s blood to a blood bank, as mentioned above. While blood is a renewable resource and blood donation causes no long-term disability in the donor, if the donation process for solid organs such as kidneys were to present no other halachic impediments, then the selling of blood and the selling of organs are similar issues.

    Simply put, if donating an organ were to be permitted in a given situation, then there is no intrinsic reason why selling it should be forbidden. It is only external societal concerns and fear of exploiting the donor that might persuade us to forbid the selling of organs.

    Conclusion

    The consensus of Jewish legal experts is that live organ donation is a permissible and noble act, but is not an obligation. Those who are hesitant to allow live organ donation do not object to the concept, but feel that the risk may be too great to the donor. Since the risk of mortality or serious complication from live kidney donation is now so low, even those poskim who had discouraged live organ donation might consider it safe enough to be permitted.

    Regarding the sale of organs, while the thought may be distasteful (and we pray for a society that would make donating one’s organs for money unnecessary), we are a long way from such a world. If allowing payment for organs with proper safeguards would increase the number of lives saved, then Jewish law would sanction such an approach.

    Dr. Daniel Eisenberg is with the Department of Radiology at the Albert Einstein Medical Center in Philadelphia, PA and an Assistant Professor of Diagnostic Imaging at Thomas Jefferson University School of Medicine.

    Dr. Eisenberg continues to lecture around North America and now writes medical ethics articles for Jlaw.com and Aish.com.

    Footnotes:

    1 Responsa Igros Moshe, Yoreh Deah II 174:4
    2 Responsa Radvaz, Volume 3:627 (1052)
    3 Responsa Igros Moshe, Yoreh Deah II 174:4
    4 See Hershler, Rabbi Moshe, “Where Organ Donors are Considered Mentally Incompetent by the Halacha,” Halacha U’Refuah, vol. 2:122-128, Regensberg Institute, 198; Zilberstein, Rabbi Yitzchak, “May Parents Give Permission to Donate the Kidney of a Child to a Sibling,” Halacha U’Refuah, vol. 4:156-57, Regensberg Institute, 1985; Halevi, Rabbi Chaim Dovid. “Donating Organs from Living Donors and Cadavers in Jewish Law,” Assia vol. 4:251-259, Machon Schlesinger, 1983.
    5 Nishmat Avraham, ibid
    6 Personal communication with Dr. Avraham Steinberg. Rav Elyashiv used the gorel of the GR”A, a traditional means of deciding complex questions. See also the Shaare Zedek Medical Center website, http://www.szmc.org.il/index.asp?id=110&top=2&page_id=985
    7 Steinberg, Dr. Avraham. Encyclopedia of Jewish Medical Ethics; pp. 1095; Feldheim: New York, 2003
    8 Responsa Minchas Yitzchak, 6:103
    9 Responsa Tzitz Eliezer, X:25:7
    10 Avraham, Dr. Avraham. Nishmat Avraham, Yoreh Deah, p. 347 (English version)
    11 The risk of mortality from live kidney donation is now estimated at .03% with a low rate of serious complications. See Surman, O.S., “Perspective: The Ethics of Partial-Liver Donation,” New England Journal of Medicine, 346:1038 (Number 14, April 4, 2002)
    12 Leviticus 19:16
    13 Responsa Yechava Da’at, III 84
    14 Avraham, Dr. Avraham. Nishmat Avraham, Yoreh Deah (Vol. 2), p. 346 (English version).
    15 Responsa Igros Moshe, Choshen Mishpat 1:103
    16 See Encyclopedia of Jewish Medical Ethics, page 1096 for a full discussion of blood and bone marrow donation.
    17 ibid.
    18 Suggested in personal communication with Dr. Avraham Steinberg
    19 The true danger of some of these professions was brought into stark relief with the events of September 11, 2001, when hundreds of firefighters and policemen perished in the Twin Towers of lower Manhattan.
    20 Finkel, Michael, “This Little Kidney Went to Market,” New York Times Magazine, May 27, 2001.
    21 Weiner, Rabbi Yaakov, Ye Shall Surely Heal, p. 155, Jerusalem Center for Research, 1995. Also see Rabbi Weiner’s extensive chapter entitled “Transplants from Live Donors.”
    22 Radcliffe-Richards, J et al, “The Case For Allowing Kidney Sales,” The Lancet, 351:9120, June 27, 1998 p. 1950-1952
    23 Rapoport, J., “Legalization of Rewarded Unrelated Living Donor Kidney Transplantation: Suggested Guidelines,” Israel Medical Association Journal, 346:1038 (2002)
    24 Avraham, Dr. Avraham. Nishmat Avraham, Even Ha’Ezer and Choshen Mishpat (Vol. 3), p. 347 (English version)
    25 Responsa Igros Moshe, Choshen Mishpat 1:103

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    84 COMMENTS

    1. Well done research. However, I find myself asking more questions now. I know there is some kind of organ donation society that claims to be within the confines of halocho…. but I’m not sure how.

      Is there an existing live organ donor program out there for yidden? Is there somewhere that we can be tested and registered such that if a need arises we can be contacted?

      If anyone knows more information about LEGAL organ donation, I would love to find out more.

    2. 1) There is far too much learning and too many halachic sources for our simple minds. In 2009 we need a Kol Koreah or a Daas Torah to tell us yea or nay. Too much thinking here for our robotic brains. (This comment is meant to be sarcastic.)
      2) Besides the issue of בכלל selling organs, another question is whether you can buy a kidney for $10,000 and sell it for $160,000. (This comment is not meant to be sarcastic.)

        • The “market” wasn’t willing to pay for it. There weren’t numerous suppliers and consumers, rather one (that we’re aware of) supplier and many desperate consumers who would pay whatever they were charged to save their lives. That’s extortion, not maximization of profits.

          • You can make the same argument against any medical treatment. If organs were available on the open market, the market would dictate the price (as it always does). If you don’t believe that, note that organ transplants in, say, China, where there is an open market, are much less costly than here in the US where we have to wait for a donation. Also, some of the non-market “cures” are worse than the disease. the fix being discussed thes days for the shortage of donated organs is to change the donor registration on the drivers licences. Currently potential donors opt into the donor pool by checking the organ donor consent box on their drivers license application. The change would be to automatically make all drivers organ donors unless they specifically opt out of the program. Do you think that’s better than free trade in organs?

        • i am not a rabbi, but my sense is yes.
          ask your rabbi if you can charge a desperate sick person $160,000 to procure a kidney for you in an act that is illegal under federal law while paying a desperate poor donor $10,000.. this does not cover any of the medical or surgical expenses for either the donor or recepient. at the end of the day your rabbi will either say allowed or forbidden to act as such as a middleman.. in my community we wouldnt have the chutzpah to even ask such a question.

            • you are absolutely wrong, i hope a sick person can recover and regain health (but you already knew that) so let me be crystal clear now..
              i would rather people (such as yourself) altruistically donate a kidney (that for mitzvah not profit) or if $10,000 is the cost to the donor then the receipient should pay $10,200 to cover the administrative costs of acting as an honest, open, and transparent organization involved in these kinds of chesed.
              do you now get it?
              if not tell me how i can articulate my position in a more clear manner

            • What I was trying to say is that you have a desperately sick person waiting for relief. Unfortunately, the only person offering help is doing it in a distasteful and illegal manner. I believe saving the life overrides the distaste.

              I think the laws against selling organs are too strict and misguided. The only objection to allowing it should be that people might be forced into donating or unscrupulous people would kill people to make them donors.

              There should be some outlet for the crying need for more organs and some rules and oversight should be applied to let those that can afford it, pay to save their lives. Not everyone needs to be thrown into the bottomless general pool.

              Allowing the sale will increase the overall availability of organs and will not stop the general donor supply.

              I don’t believe that 160,000 is out of scope for such a service. I also believe that it should be up to the poor people who need the money to decide if they want to participate since according to most medical opinions, there is not a great risk to the donor.

            • it seems we have an honest difference of opinion
              since you talk price i beleive paying a donor $10,000 and charging the recepient $160,000 is not only out of scope but is both predatory and profiteering..paying $150,000 to the “shadcan” in these cases is outrageous to me, however i do respect your right to an opinion and we obviously differ. if donors knew the going price was $160,000 i don’t think too many would donate at the $10,000 level.
              do you agree that their should be transparancy and the donor be aware of the markup? if they knew the truth very few would sell at the $10,000 number in my opinion. ofcourse you have the right to disagree

            • The main issue is the availability of organs to those that need it.

              I personally don’t believe that with the complications involved and all the arrangements necessary that 150,000 is out of scope. However, currently this is a necessary evil. If the legal sale of organs were organized, the competition would drop the price down.

              However, what is the purpose of making it more expensive to get organs by letting the donors in on the possible profits? If they are satisfied with 10k, why enable them to ask for more? 10k is a substantial sum where they come from.

              If any delay or complication were introduced into the process by making the donors aware, we would be trading off a “fairer” payment to the donor against the expedited availability of organs. This is a bad trade off.

              The truth is that there should probably be chesed organizations developed that arrange for people that desperately need an organ transplant to be sent to countries that consider it legal that have adequate medical facilities to carry out the transfer safely. There should be a fee assessed on those that can afford it to maintain the organization.

            • you keep missing the point
              if you believe $150,000 profit to the middleman “shadchan” is in scope thats fine.. you and I have a very fundamental diference of opinion

              i am referring to transparancy.. would you sell your kidney for $10,00 knowing there is a $150,000 profit on the other end? ofcourse you would it is obvious from your posting (sell me the brooklyn bridge too)
              regarding your next point, i think higher payments to donors will make more organs available .. why not pay them $1000,000 and the middleman can then make $250,000 for a total cost of $350,000 (brooklyn would love that) maybe you are seeing my point now ( i suspect not really)
              i hope you are never in the position that you need to purchase a kidney for $160,000
              your last paragraph has some value.. why not lobby to have the laws here in the USA changed too.

      • Selling an organ for $160,000 is actualy not a lot when you take into consideration docor fees hospital fees surgery airplane tickets for the donor and rehabilitation, for all I know he could of done it leshem mitzva. Al tudin es chaveirchu at shetagia limkomo.

      • During a very bad economic year, it might be conceivable to buy the organ for $160,000 and sell it for $10,000, reflecting the overall decrease in the DJIA.

      • keep in mind your insurance company wont pay for you to take out a kidney, someone has to pay for it privately, so yes at the end of the day the donor gets 10k, doctor, nurses, hospitals, tests, and transport all cost money

    3. I am involved in the medical care of transplant patients in a major metropolitan medical center and see daily, the risks and benefits of organ donation and transplantaion.
      First of all, a correction. Bone marrow donation can now be accomplished through filtering the cells (similar to donation of platlets) without a surgical procedure or general anesthesia, thereby greatly lowering the risk and discomfort.
      Secondly, the arguements here are very similar to the reasons given for justifying legalization of drug use with strict controls, it will reduce crime, poor people won’t be forced to make a dishonest living, etc. Those arguements have been dismissed with cocaine, heroin, and marijuanna use and should likewise be dismissed with organ transplants.
      The only way to equalize treatment across all social and economic boundaries is to allocate organs to those who need them most. The only way to jump to the head of the line is to have a family member or friend agree to donate altruistically with the only compensation being for medical expenses and time missed from work for the procedure and a period of recuperation.
      Imagine if compensation were allowed. Many poor people, desperate in these economic times, would bid low for the right to donate. Not only would they suffer the risks and potential complications, but the financial compensation at the end may not be enough to pay for their needs if down the road they develop kidney disease and end up requiring dialysis or a transplant themselves. The whole idea which is now looked upon as a high, morally admirable, and an act of love and caring would degenerate to a cold for profit endeavor. Let’s keep the gift of life as it should be, a gift, not a business transaction or worse.

      • untill you or ur loved one are in need of a kidney…then you will be talking differently. people are dying every day waiting for a kidney. if the sale of organs are leagal it will help reduce the waitingtime as well as reducing trafficking, since the mob and chazeirim will be out of the picture

        • My mother died of lung cancer. They weren’t starting lung transplants yet. I believe those are cadaver donations still. However in searching for the source of the metastisis to her skull which was found first, they discovered an atrophied kidney. I was asked if she were to need a transplant, would I donate. I had a 3 year old at the time and said absolutely not. Everyone was shocked but you know what? My daughter was spared total kidney failure but due to “silent” bladder infections she actually lost part of one by age six. It is chutzpah to allow our emotions dictate such matters. Hashem KNEW my daughter would lose part of a kidney and that my mom would die before we discovered it. My daughter didn’t need a transplant B”H because she underwent major surgery at that tender age to correct the defect that caused the loss but Hashem have mercy on those who think transplants are chesed and that we have the RIGHT to decide who gets what. WE live, we die. That’s the way HKBH arranged it. Accept tha tHE’s in charge not you and not our Rabbis.

      • See the editorial in today’s Wall Street Journal on this topic. The author suggests having a uniform system of compensation, where the donor is allowed to get a pre-defined amount of money or other benefits (such as health or life insurance). No one would beallowed to be paid any more or less than the pre-determined amount, if the donor is a stranger. This would prevent many of the issues you mention.

        • I am concerned that this would still allow those who could afford to pay more than the going rate to tweak the system to their advantage to the point where people would be bidding for matching organs and bidding wars would erupt, negating the benefits of increasing availability of organs. In addition, it would not solve the problem of poor people feeling forced to sell an organ due to their economic plight that they wouldn’t have given up otherwise.

      • “First of all, a correction. Bone marrow donation can now be accomplished through filtering the cells (similar to donation of platlets) without a surgical procedure or general anesthesia, thereby greatly lowering the risk and discomfort.” Not completely accurate. The long-term effects of filgrastim on healthy donors is still unknown. Having said that, I would encourage everyone to register with the Gift of Life or similar organization as you can save someone’s life. I am registered and almost donated my bone marrow the old fashioned way (as I didn’t want to get the filgrastim injections). The patient backed out a week or two vefore surgery. Hopefully, b\c he made a complete recovery.

        • I too, am a bone marrow donor and I did it with Filgrastim injections. I have been getting blood tests and check ups for many years since and have had no negative sequela. I preferred the filtering method to the risks of anesthesia and discomfort of drilling into the pelvis for marrow.

        • i was suppossed to undergo transplant six weeks ago,i backed out because i was not in remission and got a psak that it was assur to undergo such a risk.i am very ill and in need of tefiiloth harabim and rachamey shamaym
          if you were the donator,kol hakavod.the identifying factor seemed to be your refusal of filgtastim injections which i was told the donor did not want
          this morning the doctors thought i was okay for a transplant but today the blood work came back negatively
          machshava tova hakadosh boruch hu metzaref l’maaseh

      • Disregarding the halachic issues involved, I disagree strongly with your position. The arguments in favor of drug legalization are valid and should not be dismissed. If fact, we should have learned our lesson with Prohibition which did nothing to reduce alchohol consumption but was the single most important reason for the creation of organized crime in this country. The outright prohibition of marijuana and cocain has, to no suprise, created similar and even more violent criminal cartels. Economics 101 teaches that when a product or service is prohibited, a shortage created whic will be filled somehow. Prohibiting trade in human organs does nothing to stop the trade but insures that it will be done in less than idal conditions,and will support a criminal enterprise with all that entails. But there is an even stronger argument for free trade in human organs. If a woman can abort a fetus on the grounds of being in control of her own body, a control that the Supreme Court of the United States has guarranteed, surly a person could sell or otherwise dispose of his kidney, for instance. It’s his body after all. He should also be able to bequeath his organs to his heirs for their disposition or sale. You cite the case of poor folks selling their organs low. You say that as if it’s a bad thing. The key is informed consent or do you subscribe to the elitist view that laymen are unable to grasp the concepts involved. You are right. When people are desparate they sometimes resort to deparate measures. So what? This is a classic instance where free market economics would be the best solution.

        • Yes, informed consent in important, but most poor people are undereducated and don’t fully understand the risks involed in being a voluntary donor. True, they are small in number but when something hapens it can go very badly. I have been involved in cases where the donor had a longer course and more complicated recovery than the recipient. And economic desperation can make them ignore very real risks to their detriment and regret later in life.
          To say that we should allow drug legalization and compare it to Prohibition is mistaken. Sacramental and recreational use of alcohol has a long history of use and social acceptance. Yet we still have many cases a year of drunk driving and operation of machinery while intoxicated causing accidents and fatalities. Cocaine or heroin or marijuanna even when used in modest doses can be much more addictive than alcohol and incapacitate someone much more severely than alcohol can and lead to much more risk to themselves and others they interact with. Drug legalization is not an option due to the risks it presents to society, and neither is legalization of organ sales.

          • Undereducated doesn’t mean stupid. Poor people make major life decisions every day, as do we all. Some of their decisions may be ill considered as are the ones we sometimes make. The best assumption to make is that everyone is at least as smart as you are or I am.
            Prohibition never affected sacremental alcohol or wine or beer for personal consumption. It’s intended effect was to outlaw commercial manufacture and sale. It failled miserably at that and had the unintended consequence of creating the national crime syndicate. Yes excessive alcohol consumption is involved in many societal problems, but history has shown (at least to me) that the cure was worse than the disease. The same can be said for the ban on narcotic drugs. Just because alcohol, or heroin of marijuana may be bad for you is not, to my mind, reason to ban them. If for no other reason than the slppery slope. If we start banning things that ar bad for you, we start with the stuff, like narcotics that are REALLY bad for you and we progress to Bloomberg banning trans fats, how about banning tobacco? The argument that some raise that there is societal monetary cost for dealing with addiction or unhealthy lifestyle, I find to be specious. “Why should I have to pay the costs of somebodies addiction?” The example I like to cite is the issue of school taxes. Why should I have to pay exhorbitant taxes for a service I don’t use? My children are long past school age. My grandchildren attend private yeshivas. Why should I have to pay that tax. The stock answer, with which I agree, is that an educated populace is a public good in which all benefit, even if not directly. Well, personal freedom is also a public good, perhaps the most important one. If allowing more personal freedom has an additional monetary cost to society, it is well spent because it benefits society as a whole

    4. While I haven’t had a chance to digest this article, I have to worry that some people will take this as a heter to allow people to do what was done in this scandal. To say it cost so much because of all the peopel who have to be “schmeered” gives a flavor to the enterprise of paying needy people to sell their organs to benefit rich people. To hide under the gloss of this being a mitzva makes me nauseous.

      • the reason why it costs so much is because of greed. this man says he is doing a mitzvah and trying to help people ……. that is rubbish – if you were really trying to help you wouldnt make ill people pay $160000 for HEALTH and mosr people would remain in debt for the rest of their lives. STRESS=BAD HEALTH – which could result in organ failiure….. yippee chance to rip off another $160000 or is there an offer of buy one get one half price?????

    5. #5 David. If you’d be desperate for you life in need of an organ, and the only way you could get one in time would be to buy one, you’d think a little differently.

      • Not if buying one was illegal.

        When I was in need of a kidney, I pursued ONLY legal means: (1) I put myself on a cadaveric transplant list with a local hospital; and (2) I quietly spread the word in my Kehillah. I made NO attempt to buy a kidney, since that was illegal.

        The rest I left in Hashem’s Hands. What did He do? He sent me my chavrusah of 30 years, who was a match and was (and is a Tzaddik, and) willing to donate one of his kidneys. The transplant took place two and a half years ago. Modeh Ani, Modim, Asher Yatzar, and a lot of other Tefillos have taken on new meanings to me since then.

        The bottom line: one must balance Bitachon with Hishtadlus. And the latter means, one must do everything within Hallacha, which includes Dina D’Malchusa.

        If one is bashert to survive, one will survive; if one is R”L not, then no matter what one does, legal or illegal, it won’t help.

        • That is so beautiful. And what if Pikuach Nefesh is Doche Dina Dimalchusa? Then you are in the confines of halacha and obligated to do so!!!!!!!!!!!!!!!!!!!!!!!!

          • Nisht azoi Pashut.

            One is required to give one’s life before violating even a d’Rabbonon if the violation is b’farhesya.

            Kal v’chomer Chillul Hashem b’farhesya, which generally is the result of violating Dina D’Malchusa.

    6. The reason why a market for selling kidneys is even even exists is because there is a lack of suffecient voluntary donors in the community. That situation is about to change. There are several new organizations (the most prominent being ‘Renewal’) are going to bring awareness to this issue with the backing of leading gedolim. I am confident that after being educated on the importance of the issue and of the minimal risk to the donor that klal yisroel will overwhelm the donor pool thereby negating the whole issue of selling kidneys. Perhaps it is one good thing that will come out of the current tragedy.

    7. If I couldn’t find a friend or family member who was a match, I’d join the waitng pool just like anyone else. I’d rather die than take advantage of a poor person and force him to undergo a risky procedure that he wouldn’t otherwise just so I could live. And I mean that with all sincerity. Does that make me a better person or Jew than you? I don’t know. But at least I’d be able to sleep at nights.

    8. SELLING organs in the U.S. is illegal, so regardless, that is OUT of the question. Giving up an organ shortens that individuals life span, and they are subject to other health conditions.

      • know your facts before you post…giving up a kidney DOES NOT shortan your life span. in fact statistics show that people who donate one of their kidneys live longer

        • Hashem gave you 2 kidneys for a reason and without claiming to know why He did so, I’d suggest that it is improbable that the reason is to shorten life span.

        • Have you thought about the possible complications that can occur during and/or after such a procedure?

          No one knows when a person will die, even if they do live longer than the statistical “average.” We do not know how much longer these individuals could have lived. Maybe they died at 90, but could have lived till 110? So your so called “statistics” are faulty.

          • There has been research for years why a person needs 2 kidneys when the human body operates with less power then 1 kidney has.

            I donated my kidney in 2001, when I asked a rav about the research he answered me there is a big Jewish doctor in PA that told him once that the only reason a person might have 2 kidneys is that hashem is giving him the oppurtunity to donate 1 to a person in need.

          • I just wish I can hear your “krumah kup” if chas v’shalom you or your kid are in need of a kidney.
            did you see the Rashi in parshat mishpatim
            V’rapei Ylrapei:
            M’kan s’niten l’roveh l’rapeh.
            we obviously do go by the medical specialists.

            • “I just wish I can hear your “krumah kup” if chas v’shalom you or your kid are in need of a kidney. “

              Your “chas vshalom” statement is completely negated, when it follows the words, “I just WISH.”

        • All that study showed was that kidney donors lived longer than the general population. But it could be due to other factors. Kidney donors could be healthier in the first place.

          • Yes, but if poor people who lead less healthy lifestyles and typically have higher rates of kidney failure begin to donate for the money, they will end up on dialysis at an even earlier age than they do now, and will cost all of us more down the road in medicaid. It’s a no win situation and money for organ donation should not be attempted. The individual and society will end up having to pay for it physically, financially, and morally.

            • you must be a democrat playing the fear button without knowing the facts. people “never” get kidney failure in one kidney…
              why do you think poor people have a better chance at kidney failure? cause they don’t fress their faces in fancy rest with red meat and wine?

            • My political persuasion has nothing to do with the science of renal medicine. You can get cancer in one kidney. You can get a clot in the artery leading to one of your kidneys, and you can get a calculi (kidney stone) in one of your kidneys. If you were destined to develop kidney disease due to your genetic makeup, you will develop it regardless if you have one or two kidneys. Yes, poor people are more likely to develop kidney diease from hypertension or diabetes since they have poor health habits and are less likely to eat a healthy diet or exercise predisposing them to develop kidney disease earleir in life and at a higher frequency than the average population. I am not saying people shouldn’t be altruistic donors, by all means go ahead but know the risks and the benefits.
              If you’re fressing with red meat and wine I hope you’re not at least doing it now during the Nine Days and maybe youll consider reducing your intake? Kidney failure can happen on a rich man’s diet as well as a poor man’s diet of junk food.
              And finally, yes I am a democrat, but my education in medicine and knowledge of transplant medicine has nothing to do with the facts I have mentioned above.

    9. Well there is a simple means of making more organs available: default consent instead of default refusal to take organs…

      So if supplying organs is so important to you, make a campaign that everyone should be considered a donor unless they explicitely stated otherwise.

      This leads to a donor rate of over 90%, while the opposite system (donation only with explicit whish of the donor) never grows over 30%.

    10. Any surgery that requires general anesthesia and invades the body to that extent, particularly the abdominal cavity, poses a significant risk. Furthermore, how can anyone predict that the donor will live a “normal” life afterwards? Anything can happen to that existing kidney and in the case of a woman, should she have to rely on less than one wholly functioning one, she would be unable to bear children. Hashem is the great designer and the giver and taker of life. He didn’t make spare parts. I’m sorry if that flies in the face of all the academic arguments of the poskim. Sometimes, all that’s necessary is common sense and humility in the face of clear evidence of Hashem’s handiwork.
      I would ask Chocham Ovadia, people die of all sorts of diseases everyday for which we can do nothing but stand by. According to your reasoning, is that not also shedding blood?

    11. I’ve read the Wall Street Editorial. Regarding compensation, I might agree with providing fumeral expenses, or tax credits or a generous contribution to a charity of their choice. But I am still against direct compensation, even through a third party. Once the genie is let out of the bottle, the entire system will degenerate to a profit making affair, and people will be hurt, injured or worse even die from a procedure that they should not have undertaken, and would not had they not been so desperate for financial recompense.

    12. perhaps it is time for the religious jewish community to band together and start a legal organization to promote altruistic kidney donations that conform with halacha and with appropriate state and fereral laws..financial issues would be transparent and partnerships with non jewish groups can flourish to make kidneys available to even more people.. this even might be a sanctification of God’s name and place the religious jewish community in a positive light…

    13. The article is good, but off the mark.. The issue in the case last week is not whether it is permissible for a Jew to donate or sell his organs. The issue is whether it is permissible for a Jew to be the recipient of organ donations or sales, when the donor may no longer wish to donate, and also whether a Jew is allowed to force a non Jew to give up an organ when the recipient Jew will otherwise probably die without it.

      • “when the donor may no longer wish to donate” Can someone please explain to me how someone in the west is forced to donate?? Why not stay off the operating table. Are they forcibly escorted by henchmen??

    14. I have a few friends and neighbors that donated a kidney to other people with kidney failure. All of them are BH healthy, and happy to save another persons life with such a meaningful charity, literally giving away “a piece of themselves” to save a human life.

    15. How many people are given the death penalty each year in the US? Why aren’t those who are physically healthy given an execution by harvesting of vital organs? At the very least the condemned should be given a choice of the method of execution, and execution via organ harvesting should be one of the options. Someone who is on death row for murder should at least be given the opportunity to save lives via his demise.

    16. To #6

      It was reported here on VIN that they actually WERE forced to sell the organs at gunpoint, and told that they wouldn’t be able to return to their home country unless they complied.

    17. Did I missit? I think no one here, not in the article and not in the responses, addressed the big question of whether o9r not it is pewrmissible to donate your organs after death. In other words, after death, they remove your vital organs where can still be used for up to many or even days after. What about that kind of donating? Is that allowed?

      Also, yes, there is an organization which I just sent a check to, and they deal with organ donations and they say they are Orthodox. here is their address…….
      http://www.hod.org or their phone number is, 212-213-5087.
      The name is HOD, Halachic OrganDonor.

      • Most poskim don’t allow giving organs after death because they’re useless once you’re dead.

        Organs only have value when taken from someone who is living to a certain extent. Modern medicine defines death at a point that the person would be considered alive according to halacha. Therefore, the rabbonim have forbidden it since the doctors will kill someone to take the organs. They consider the donor already dead but we don’t.

        • What you write refers mainly for heart donation. Other organs have signficatly different requirements and many organs can be harvested after halachic death.

          Following are the approximate preservation times for a variety of organs and tissues.

          Kidney up to 72 hours
          Liver up to 18 hours
          Heart up to 5 hours
          Heart/Lung up to 5 hours
          Pancreas up to 20 hours
          Corneas up to 10 days
          Bone Marrow varies by individual program
          Skin 5 years or more
          Bone 5 years or more
          Heart Valves 5 years or more

          • What kind of lead time do doctors look for?

            In any case, the aivarim are osur behanaa and their use would only be allowed in case of pikuach nefesh.

        • There are many great and learned Rabbonim who hold by brain stem death allowing virtually all cadaver organ donations. Take a look at the website for Halachic Organ Donation Society http://www.HODS.org You will find all the halachic sources and the written opions regarding this issue.

          • Thanks for the link.

            Apparently, Rav Moshe held that cessation of breathing is death in Jewish law regardless of whether the heart is beating. I don’t know how this relates to brain stem death.

    18. the bottom line we liberals are anti life, pro death. Its is permissible for a mother to kill her own child (late, mid, or early term abortion) but it is forbidden to help save someone who needs a kidney.

    19. רבונו של עולם יש הרבה ישראלים הצריכים כוליא חדש – אנחנו מיום שניתנה תורה כלל ישראל עושין רק רצונך ולמה כשאנחנו שואלים ממך דבר מה שאתה כתבת בתורה ורפא ירפא למה תסתיר פניך למה יאמר הגויים איה אלקיך, שלח לנו מלך המשיח כי כבר אין לנו עוד כח, אפילו רגע אחת לסבול עול הגלות, רבונו של עולם למה לנו כל הצרות – כלל ישראל מלא חסדים טובים יש לנו הצלה יש לנו חברים יש לנו הרבה גמחים שכולם אהובים אנחנו עושים חסד אין לשער אנו עושים מצוותיו בחשכת הגלות אונז האבן שוין געהאט א היטלער ווי פול נאך טאטע העלפן אונז שוין ארויס פון דעם גלות – ויה”ר שנת תשס”ט ר”ת תהא שנת סימן טוב
      אמן

      • wonderful bakasha in the spirit of rabbi levi yitzcack and i need a yeshua more than almost anyone out there.the amazing chesed of total strangers such as #14 willing to help is a big limud zecuth
        but what about the tzaruth ayin,loshon hara,sinath chinam,what can you and i do about that?the reason i write and respond is not to be heard but to be mashpia to be dan lkaf zecuth,do not believe the media or the fbi
        to lump all those arrested in the same category is wrong especially choshive rabbanim where we are chayav to be dan lkaf zecuth
        take rabbi kassin,i am sure dwech convinced him that it is tzeddakah to help dweck and as a cong.they can give money to support the poor,so her you would have nothing illegal according to dweck but the fbi with their spin would turn it into laundering
        keep oj simpson in mind or blodget who caused billions in losses with the dot com bust,how much time did he serve
        and miliken made a cool billion,spent a few months

    20. From the indictment, it does not appear that Rosenbaum committed a crime.

      Below is 42 U.S.C. § 274e, the law that Rosenbaum is accused of violating. The statute allows compensation to the donor for “expenses of travel, housing, and lost wages incurred by the donor of a human organ in connection with the donation of the organ.” 42 U.S.C.A. § 274e(c)(2).

      Rosenbaum in paragraph 7 of the indictment correctly states, “Let me explain to you one thing. It’s illegal to buy or sell organs. . . . So you cannot buy it. What you do is, you’re giving a compensation for the time . . . whatever–-he’s not working. . . .” It appears that the buyer is not paying Rosenbaum for the kidney, but for the service of locating a willing donor.

      To the extent that Rosenbaum is paying the donor, it would be a crime only if the dollar amount exceeds the donor’s “lost wages.” 42 U.S.C.A. § 274e(c)(2). But since Rosenbaum never indicates how much the donor would get paid, there is no way to prove that he committed a crime.

      § 274e. Prohibition of organ purchases

      (a) Prohibition

      It shall be unlawful for any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation if the transfer affects interstate commerce. The preceding sentence does not apply with respect to human organ paired donation.

      (b) Penalties

      Any person who violates subsection (a) of this section shall be fined not more than $50,000 or imprisoned not more than five years, or both.

      (c) Definitions

      For purposes of subsection (a) of this section:

      (1) The term “human organ” means the human (including fetal) kidney, liver, heart, lung, pancreas, bone marrow, cornea, eye, bone, and skin or any subpart thereof and any other human organ (or any subpart thereof, including that derived from a fetus) specified by the Secretary of Health and Human Services by regulation.

      (2) The term “valuable consideration” does not include the reasonable payments associated with the removal, transportation, implantation, processing, preservation, quality control, and storage of a human organ or the expenses of travel, housing, and lost wages incurred by the donor of a human organ in connection with the donation of the organ.

      (3) The term “interstate commerce” has the meaning prescribed for it by section 321(b) of Title 21.

    21. Too much shaklah v’tariah here as usual. Use your own common sense. What this frummer yid did was disgusting and certainly not a chessed.

    22. A truly excellent and balanced article. If only this author would take on the monumental task of analyzing the neo-Nazi euthanasia philosophy of Herr Doktor Ezekiel Emanuel and the leftist brownshirts touting the Obamacare obamination..

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