Jerusalem – Does Radical New Way to Boost Organ Donation Discriminate Against Ultra-Orthodox Jews?


    In this photo made Feb. 24, 2010, an orthodox Jewish man walks past an ambulance next to a hospital in central Jerusalem. Israel is launching a potentially trailblazing experiment in organ donation: Sign a donor card, and you and your family move up in line for a transplant if one is needed. The new law is the first of its kind in the world, and international medical authorities are eager to see if it boosts organ supply. But it has also raised resistance from within Israel's ultra-Orthodox Jewish minority. (AP Photo/Dan Balilty, File) Jerusalem – Israel is launching a potentially trailblazing experiment in organ donation: Sign a donor card, and you and your family move up in line for a transplant if one is needed.

    The new law is the first of its kind in the world, and international medical authorities are eager to see if it boosts organ supply. But it has also raised resistance from within Israel’s ultra-Orthodox Jewish minority.

    These opponents say it discriminates against them because their religious convictions forbid the donation of their organs, and while they are unlikely to get the law reversed, they have the political clout to slow its implementation.

    Only 10 percent of Israeli adults hold donor cards, compared with more than 30 percent in most Western countries. The actual rate of families donating a deceased’s organs is 45 percent, but in other countries it rises to 70 percent, according to Jacob Lavee, director of the heart transplant unit at Israel’s Sheba Medical Center.

    The low rate of organ donation is thought to be partly driven by religious considerations. Most rabbis have no problem with transplants to save lives; their objection is to profiting from or needlessly mutilating cadavers. But 99-year-old Rabbi Yosef Sholom Elyashiv takes a different view, and he is one of ultra-Orthodox Jewry’s most influential leaders, claiming 100,000 followers among Israel’s 6 million Jews. Elyashiv forbids organ donation before cardiac death, but allows his followers to receive lifesaving donations.

    Lavee, the doctor who helped draft the law, hopes that a broader pool of organs will ultimately benefit everyone, but he acknowledges that one of his primary motivations is “to prevent free riders.”

    “This is the first time that a non-medical criterion has been established in organ allocation,” he said. “It will rectify the unfairness of the situation where people who are unwilling to donate wait in the same line as those who are willing.”

    The measure opens a new dimension in the worldwide quest to overcome organ shortages. One solution — a legalized organ market — is ethically fraught. Another is called “presumed consent,” where whoever doesn’t opt out is considered a donor.

    Spain, France, Austria and Belgium have adopted the latter model and rank among the top European nations in percentage of deceased donations, according to a U.N. study. But experts here say “presumed consent” would have been much trickier to get through the Israeli Parliament.

    Writing in the December issue of The Lancet, the British medical journal, Dr. Paolo Bruzzone of Sapienza University in Rome said the Israeli initiative made more sense.

    “Certainly, giving holders of donor cards priority in organ allocation sounds more acceptable than the introduction of organ conscription or financial incentives for organ donation,” he wrote.

    Luc Noel, coordinator of clinical procedures at the World Health Organization in Geneva, praised the Israeli law for its educational value and for introducing a “community spirit” to the field of organ donations.

    “The bottom line here is doing to others as you would like others to do to you and that is where the community has a role,” he told The Associated Press.

    Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, said the Israeli measure was ethically sound — he called it “reciprocal altruism” that would benefit society as a whole. But he doubted those signing donor cards would gain a significant advantage, because their queue would become much longer.

    The only place where a limited version of the Israeli measure has been tested before is in Singapore, whose 1987 law introduced incentives for donors such as waivers for hospital charges and partial coverage of funeral expenses.

    Israel’s parliament passed its far more comprehensive legislation in 2008 by a wide margin, including votes from Shas, the mainstream ultra-Orthodox party, and it is to take effect after a huge campaign to explain the new regulations and their complicated point-based system to the public.

    But Israel’s unwieldy system of coalition government makes implementation uncertain. One of its members is an ultra-Orthodox party made up of Elyashiv’s followers. Among its lawmakers is Yaakov Litzman, who happens to be the deputy health minister (the top post is vacant).

    Another is Moshe Gafni, who said the law is “antidemocratic.”

    “If I can’t contribute organs because of my religious beliefs, the state shouldn’t be allowed to harm me,” he told The AP.

    The Health Ministry’s legal adviser, Meir Broder, seemed to suggest the final formula was unsettled, saying it was still being fiercely debated among ethicists, lawyers, doctors and religious leaders.

    “We are trying to find the point of balance between encouraging people to sign donor cards and not penalize those who don’t,” he said, but didn’t elaborate.

    The debate derives from Judaism’s tricky definition of death.

    Most leading Orthodox rabbis — as well as Israeli law — agree that a person dies when his brain-stem stops functioning. A minority opinion, endorsed by Elyashiv, holds that as long as a person’s heart beats he or she is alive and therefore the organs cannot be harvested. Donation in Israel after cardiac death is rare and only done in special circumstances.

    One prominent ultra-Orthodox Jew who endorses the law is Yehuda Meshi-Zahav, head of Zaka, a widely admired first aid and rescue service. He says everyone should obey his rabbi, but he carries a donor card and says “Preservation of life overrides everything.”

    Robby Berman, founder and director of the Halachic Organ Donor Society, a Jewish organization based in New York, said ultra-Orthodox Jews can’t have it both ways.

    “My position is if you are not part of the solution, you are part of the problem,” he said. “Every Jew has a right to be against an organ donation, but then you can’t come and say ‘give me an organ.'”

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    1. Every Jew has a right to be against an organ donation, but then you can’t come and say ‘give me an organ.'”

      Hate to say it, but I sort of agree with the logic of this law. It is unfair for people who refuse to donate organs to be on equal footing with people who never donate. We have the right to our beliefs and values, but it may be unfair to expect others not to respond in kind.

      • Others? You mean the person who is the actual donor? Okay then leave that to the donor to decide if he wishes to give to only other donors. Or in his generosity, he will give to all in need. What they will accomplish is that those who become donors won’t necessarily be those giving out of understanding and altruism but also those that suddenly need be concerned about their own life. You forget organ donation is not a system. It is a personal decision.

    2. I dont understand. a person needs hishtadlus and bitachon. hishtadlus here is to get on the organ transplant list and bitachon is to believe in hashem. in yeshiva i learned that it doesnt matter what you do for a living, if hashem wants you to be rich then as long as you create a kayli then hashem can fill it with as much as he wants. thus it shouldn’t matter what number on the transplant list you are?!

    3. Too bad. Don’t expect help from others when you are unwilling to provide that help on a reciprocal basis. The law doesn’t say you cannot get a organ transplant, only that you go to the back of the line which is the ONLY fair way to allocate scarce organs. This is not welfare where you can expect society to subsidize you while you sit at home doing nothing. This is life and death and those who offer life to others should be the first to get help when C’v they are in need.

      • Yes, many Orthodox Jews, particularly in the USA have donated a kidney. I am in touch with many kidney donors from Boro Park, Williamsburg, Monsey, Lakewood, etc. Rabbi Ephraim Simon of Chabad of Teaneck, a father of 9, donated a kidney I had made his kidney match. My brother donated a kidney as well – to someone on my list of people in need of a kidney.

        Rabbi Dovid Goldwasser of Brooklyn, endorsed my project and wrote about the mitzvah of kidney donation under acknowlegements in his book called “Tishrei”

        About 99% of Orthodox Rabbis say it’s allowed to donate a kidney while alive… It’s just an individual thing. A Rabbi might suggest to someone not to donate a kidney, if , for example, they are married and their spouse does not want them to do it or for other personal issues.

        If someone is in good health – no cancer, diabetes, high blood pressure, or kidney stones, they need not worry, as before anyone donates a kidney they are checked out from head to toe to make sure they are healthy enough to donate a kidney.

      • kidneys can come from live dnors, as can some liver portions, bone marrow. but hearts, lungs and other vital organs cannot. they are usually harvested after brain death but with the body kept alive by machine, because the organ starts to die once the blood flow stops and the harvest itself wastes precious time after cardiac death making the organ inviable for transplant.

        • Which part is dumb, that Hashem is actually the one to decide who needs organs or who will get them, or that Hashem actually stands by the side of those who protect the sanctity of life for its own sake?

          • If Hashem decides who gets the organs, then the law doesn’t matter, so don’t worry about it. If, however, he lets nature take its course, then it’s a perfectly just law. Chareidim want everything and want to give nothing. They don’t deserve preferential treatment for anything.

            Chareidim do not care about the sanctity of anything, much less life.

            • Well said # 22. The law doesn’t matter. You stand in line for organ donation, while I’ll stand in line for syata dishmaya. You may think Chareidim give nothing, but the the world exists ONLY because of the people who study and keep Torah. Notably, the world’s obsession with the sanctity of life (which is slowly blurring to quality of life) stems from the Torah’s prohibition to kill somebody until his heart beats, even if he’s completely incapacitated.
              Now pat yourself on the back for your brain dead mentality to punish those who keep the sanctity of life alive will do you any good. You’re on the same bandwagon as those who believe that closing shop on Shabbos is bad for business.

            • Studying Torah while ignoring the bits you don’t like does not help the world in the slightest. Such hypocrisy destroyed the first Beis Hamikdash. Chareidim are quick to protest (violently) when things don’t go their way. That is not Torah. They make up rules that have no basis in Torah and hold an entire country hostage to their whims. That is not Torah.

              So I’ll gladly respect those that hold the world upon their learning. Chareidim are not those people.

      • I have news for your – all kinds of people are in need of an organ. Yes, even those who keep the Torah.

        Diabetes is one of the major causes of kidney failure. Blood pressure can be another cause. There is a mitzvah, V’nishmartem es Nafshosaichem. Even Talmidei Chachomim have diabetes, high blood pressure and kidney failiure

        You can’t eat all the cholent, french fries, kishka, fried chicken skins, other fried and fatty foods and cookies that are high in transfat and think, oh, I keep the Torah, nothing will happen to me.

        Hashem wants us to take care of our health. If we neglect our health, we are going against what Hashem wants from us.

        Also – there are Torah people too who have PKD – Polycystic Kidney Disease that need a kidney. This is a hereditary condition. There are Torahdika people out there too who have this disease.

        For those who don’t have PKD – people have to start taking care of their health and not wait for G-d forbid a health problem to arise.

        • I have news for you ms kidney donor from boro park… Rabbi Goldwasser is in line with the p’sak of Rav Elyashiv and all other gedolim that hold only “cardiac” death is considered dead.
          Don’t pick and choose which parts of the Torah fits your life style.
          The same Tora that says V’nishmartem says “thou shall not kill”.
          Pulling the plug on a ventilator is “murder”.
          Chaya you have to learn that although you did a “GREAT” thing by donating a kidney you still have to listen to das Torah in “all” halachos.

          • Rabbi Goldwasser is for living kidney donation. Period I don’t know how he rules with cardiac death, etc. I am just talking here about living kidney donation.

            Who’s talking about pulling the plug? Not me.

      • if you truly believe that following the Torah will do you no harm and only hgelp, what is the issue here?

        If hashem does not let you donate organs *heart etc. so be it. And if that puts you are the bottom of the list, that is what hasem wants. hashem is just, and this law is very just.

        NOW to all who cannot read, no one says people who do not donate do not get organs, all it says if two people are up for one organ the who who is willing to donate goes first. To think otherwise is being a pig, a user, soemone who only want to take and not give?

    4. I think it’s fair to give priority to who has actually donated. Whoever donates blood or a kidney should go on top of the list if they are in need. Of course I won’t exclude others from getting an organ but this gives an incentive and security to who decides to donate.

      • While I would personally never donate (for halachic reasons and because my organ could end up saving the life of a sonei which is often the case in EY) or receive an organ (because of the limited lifestyle that results after transplantation) a fair compromise would indeed be adding those who donate at least 3 pints of blood and 1 unit of platelets a year to the list for that year.

    5. As usual, the article misstates the situation. Thelarge majority of major rabbis in Israel do not accept brain-stem ‘death’ as equivalent to death.(Brain-stem ‘death’ is not the ‘brain death’ referred to in the responsa of Rabbi Moshe Feinstein; that was based on the notion that the whole brain was completely dead, liquefied, etc, which is not necessarily the case in brain-stem ‘death.’)

      It is outright discrimination for the child of a person whose religious beliefs preclude organ donation to be refused a needed organ on that basis. Why should a child’s medical need for a life-saving organ be affected by the beliefs of his parent?

      There are tens of thousands of strictly orthodox Jews that are not ‘part of the problem.’ They volunteer for a myriad of organizations. They feed and clothe the poor, they man organizations like Yad Sarah. They are part of the solution. As for those who wish to harm the chidlren of such altruistic people, based solely on their deeply held religious beliefs against the takin of a life even to save a life: remember that the word ‘live,’ spelled backwards, is evil.

      • DR Zacharowicz :
        Would you be so kind as to explain the logic of why there is no contradiction between refusing to donate a liver or heart (because one considers it murdering the donor) and being on the receiving end in EY, where the donors are most likely Yehudim?

      • I would also like to ask Zacharowicz why he accuses those who drafted this bill of “wishing to harm the children of such altruistic people.”

        Do you really believe that those behind this bill “wish to harm” certain children?
        All they are saying is that families who sign donor cards will have priority. This does not preclude charedi children from receiving a donation, even if their parents refuse to donate.

        Dr. Zacharowicz, as an activist in this area, I understand why you wish to advocate for your position, but I wonder why you believe that laws of motzi shem ra, etc do not apply when characterizing those whose views are different from yours. Do you really think that it is fair — or permitted — to say about htem that they “wish to harm” charedi children?

      • Everything else about the child is effected by his parents: where he lives, who he marries, education, welfare status, schools, doctors, proclivity to disease, so why should organ donation be any different? The children of poor Haitians have a much smaller chance of getting into MIT than the children of MIT grads yet they can work hard, strive and try to overcome their backgrounds to get into MIT. The same thing with Chareidi children, they will have to pray harder, bribe more doctors, and have askanim blackmail more officials than say, children in Ramat Aviv to get an organ.

      • you are clever to make this a childrens issue which it is not

        let me ask you in your opinion dr z
        is it discrimination against ADULTS to give preferences to those who sign a donation card over non signers – both religious and non religious non-signers?

    6. This is the ultimate chutzpah. “We won’t sign donor cards but we demand to get the benefits from those who do”. Obviously, these ehrlich yidden are badly in need of brain donors if they seriously think for a moment that anyone will take their complaints about the law seriously.

    7. So those in bad need of an organ, as death approaches fill out a card, their own organs are already of no use, then they get a life saving organ, if they survive they call back their signature, I am sure it is possible & if not..
      Don’t vorri der yiddelech vill find a vay round anyting. Vat u sai?

    8. eKidneys are the most needed organ. A kidney from a living person can last many years longer than a kidney from a deceased person. More living kidney donation needs to be encouraged.

      There are many articles on the internet about the safety of living kidney donation. Oh, there are risks, as ,every time you go under anesthesia, there is a risk – but kidney donation is lower risk then, for example….

      Childbirth is a lot riskier than kidney donation.
      Living in certain parts of Israel is a lot riskier than kidney donation.
      Driving in a car in Israel, is a lot riskier than kidney donation. (Or here too)
      Going into the army in Israel, is a lot riskier than kidney donation.

      There are people who have come from Israel to the USA to try to get someone to donate a kidney to them. I have 2 people here now from Israel who are trying to get a kidney. And I know of others who came here from Israel who already got a kidney. And others in Israel who are thinking about coming here. It’s a shame they have to leave the country to get a kidney.

      I am in touch with many people who donated a kidney and we are all doing great, Boruch Hashem.

    9. Question – Don’t the organs disintegrate when a person dies?

      So, if you sign an organ donor card in Israel, you or your family get moved up. And the people who don’t sign an organ donor card, if in need of a kidney – they should get a family member or friend to donate one, since the kidney usually lasts longer anyhow.

      I think that Israel is encouraging more people to sign organ donor cards, so more lives will be saved. And if they are going to say we can’t do this because it would possibly discriminate against the ultra-orthodox who wouldn’t sign organ donor cards, then a lot less lives will be saved, bottom line.

    10. In the USA, those who donate a kidney while alive, if they will ever need one in their lifetime, G-d forbid, they get moved up the list.

      No one can have any objections to that.

    11. Its interesting to see how the chilonim and MO’s make a big stink out of the ultra orthodox not contributing.
      Did you know that an Israeli in need of a kidney cannot get a kidney from a “non” related donor. Although legal the bureaucratic social workers will disqualify him or her under the disguise of being mentally unstable do donate.
      There have been many “frum” kidney donors who have gone so far as to travel to the USA and donate a kidney to save another’s life.
      The ultra orthodox may have an issue with cardiac death but in other instances like kidneys, the dog loving and animal protecting lefties object to them.

      • Most agree that its a mitzva to donate, BUT in cases where the donor needs to be put to death all Torah giants agree its ussur.
        Rav Elyashiv gave a p’sak recently that its ussur to go to China (where its know they kill prison inmates for organs) and buy an organ there.

    12. I have so many people who have contacted me who are in desperate need of a kidney I don’t need the compliments here – thanks anyhow to those who have said nice things. And I appreciate it. But my kidney donation really was no big deal.

      But what is really needed here , bottom line is just more people to come forward to donate a kidney so more lives can be saved. And there is nothing halachically wrong with that. Of course not everyone is able to, because of their own health situations and other possible personal issues.

      If more people were educated about kidney donation, more people would come forward. Like most people don’t realize you can live just as well with one kidney as with two. When one goes, the other goes at the same time. Look at all these people on dialysis – most have 2 kidneys, but still need a kidney.

      So – as I said before,don’t think my kidney donation was a big deal. The hardest part was keeping it from my mother – that was really very tough. I didn’t tell her until after I donated a kidney, and Boruch Hashem she took it well. But until I told her, I had to worry she would find out, because one thing she is afraid of is surgery.

    13. What allows one who holds that an organ taken from a person who’s heart hasn’t stopped is assur (as most harvested organs are) to take an organ in Israel where the Rov are Jews?

      • There is no issue with not donating, as many people hold the person is still alive. However,when the same people insist on receiving a heart from someone still halachicly alive (according to them) is beyond piggish

    14. I have been in other secular media and I think when Jewish person gets into the secular media about good things they are doing, it is a Kiddush Hashem. Tell me if I am wrong.

    15. Great idea…let’s expand it to EVERY life saving situation. If you don’t support the local fire department, your house goes to the bottom of the list if there is a fire. Same with the hospitals – let’s see how much you donated and then the hospital will decide how long you wait in ER. Ditto with police and all other emergancies, and don’t forget libraries and community centers.

      But let’s go even further…Zaka and Hatzalah responding according to your level of donation and/or participation.

      On the other hand, just sign the organ card AND RECIND IT! (Everyone can change their mind). That way you have your cake and eat it too!

      • I have to say, I am proud of many of the commentators that see one must follow the Torah, and even if it looks like it cost you, they truly believe that at the end it will work out. Or, just feel that it is a fair law.

        To the others I guess you are fakers and no true believers, since you feel following daas torah will harm. Reliving, truly believing, means facing the music when believing can harm you. Like turning down the biggest deal you will ever make, since it needs to be done on Shabbos

    16. Gafni misses a basic point. By not giving him an organ, the state is not “harming” him, it just is not helping him. And why should it help him, if he is not part of the system? There is nothing anti-democratic here. In fact, it is a very democratic law. Only those people who contribute are part of the organ pool. This is the most fair way to distribute organs.

    17. Perhaps a middle ground would be possible. Donating blood, bone marrow, kidneys can all be done safely from a living donor. Someone who is willing to make these donations should be the same as one who signed a donor card.

      • Yes, marrow is just as important as an organ (but matches are very rare so that the number of non family donors is small from what I understand). However, a blood and platelet donor who is on the marrow registry should be treated as a donor card holder as after all he has already donated whereas the donor card holder has just expressed willingness to donate.

        And as usual the entity which rules EY leads the world in anti-Torah laws.

    18. A few thoughts:

      1. Kidney donation is an exception because it can be done from a live person. The organs being discussed here (heart, lungs, liver) can only be removed after death. For it to work medically, you have to define “death” early enough for the organs to still be useful. Unfortunately, most poskim do not accept this definition of death al pi halakha. The article that claims R. Elyashiv’s opinion is the minority one is incorrect — it is the mainstream opinion.

      2. If one holds that “brain death” is not death, then in effect you are participating in killing the donors. I don’t see how you can accept organs from someone where the doctors in effect killed him.

      3. Can we apply the logic of this law to other areas? How about all the Charedi chessed organizations making a policy that they will not help someone if people in his family have not in some way been involved in chessed — either as a volunteer or as a donor — then he gets no help. Do you think that might not raise an outcry if such a policy were adopted?

      • Regarding point #3:
        The rule change doesn’t preclude those who don’t sign the cards from receiving organs. It just gives priority to those who have signed the cards. Because so few sign the cards, and a correspondingly small percentage ultimately donate, this means there are fewer organs available. But if there are organs available even someone who didn’t sign could still receive one. So your analogy is flawed.

        Here is a better one:

        Imagine that a chareidi chessed organization campaigned for funds in e”y, but only chareidim donated. As a result, the organization can buy only a few oxygen tanks. If this organization then decided that it would give priority to donors (or their close relatives) needing oxygen tanks, and then offer any remaining oxygen tanks to other Israelis, would it be condemned for this decision?

        In the US, mothers who donate umbilical cord blood to a public bank are given priority if they or their children need cord blood later (and are given the blood they donated, if it’s available). Do you think this is wrong too?

        • plz compare apples to apples…when mothers donate umbilical cord blood they are not dying from the prcedure….the secular medical field in Israel is requiring people to sign donor cards which to “most” poskim is “murder”

          • I agree that donating umbilical cord blood is not the same as donating organs after brain death, and I do agree with the gedolim who are against signing the cards. But the secular medical field isn’t requiring people to sign cards at all. They are just considering giving priority to those who sign the cards. Those who don’t sign the cards will still be allowed to receive available organs.

      • the law is just,

        it just says donors move up the list, it does not say non donors do not get it.

        A compromise could be, that on your donor card, it asks, do you want you organ to go to a non donor participant. If the person says no, then simply Cherdiem will not get that organ under any circumstances. Hey it is their body parts they should have some say

    19. I don’t see the problem with the law. At worst it leave chareidim who refuse to donate organs no worse off than they were before. How can you accept what you are not willing to give? Why isn’t that mitzvah habaah be-aveirah.

      BTW, I support kidney donation. But this whole discussion is about other organs that cannot come from a live donor.

    20. I don’t understand the objection. If taking an organ from someone who is still alive is murder, it should be asur to receive such an organ because you are benefitting from the deliberate muder of another. And this would apply to non-Jews as well as Jews.

    21. If one is not willing to donate an organ, that person should not be allowed to receive an organ. It is only fair. There is a cost to following the Torah. Deal with it.

    22. I’m signed up as a donor on my DMV license. I don’t believe in tribal superstitious interpretation of the Torah that does not follow consistent logic. First it claims that the dead Jews of 3000 years will be raised from the ground some day, but at the same time this logic is against organ donation because the body will be incomplete?

      You’re telling me that God will have the power to put together the bones of Moshe Rabeinu, but some how will be out of power to put together a person who donated his heart to save another person instead of letting it rot and feed the worms in the ground?

      This law is absolutely fair and logical. The Charedim as usual want to reap the rewards from others in society while not giving back ANYTHING. Don’t pay equal share of taxes because most of them don’t work and on social service programs in Israel, don’t risk their children for national defense like the rest of the Jews and non Jews, don’t produce high skilled workforce that will benefit the society because they don’t educate their children like the rest of the Israelis, don’t contribute to the national organ bank, but are eager to accept another person’s donated heart, liver, lungs, kidney.

    23. Replies to #44, 48 and 57 etc:

      This public forum is not the venue for discussing the intricacies of Jewish law in this regard. Rav Elyashiv shlita has made it clear that in his view even whole brain death (let alone brain-stem ‘death’) is not death according to Jewish law. Hence, as I understand it, he forbids the receipt of vital organs taken from a ‘brain dead’ individual in Israel. Similarly, he has forbade Israelis from going to China to procure vital organs, concerned as he is about the possibility of ‘donors’ actually being killed in order to provide organs (even if the ‘donors’ are condemned criminals, arranging their execution for the day of arrival of the potential recipient is an act of desecration of HaShem’s name, in his view, and strictly forbidden).

      I do not advocate ‘my’ position, I only report on the positions taken by the large majority of poskim, lead by virtually every Gadol. I have spent much time meeting with Gedolim and learning these sugyas from them.

      [to be continued]

      • Thank You, DR. Z. for your numerous postings.

        I was wondering whether you would like to address the questions I asked of you.

        Specifically, why you characterized this bill as being motivated by “wishing to harm” charedi children and why one could simultaneously hold that removal of hearts and livers is murder, yet be willing to be a party to this murder by being a beneficiary of it.

        Wouldn’t the former be motzi shem ra and the latter be contradictory to what you say is Rav Elyashiv’s position?

    24. [continuation of prior post]

      It is quite obvious that if the decision as to who will be the recipient of a particular organ depends not solely on MEDICAL criteria but rather on whether one’s immediate adult relative signed an organ donor card, that is discrimination–and a breach of the sacrosanct duty of doctors to decide such life-and-death matters based on medical triage, not politics, religious ideology, or other medically irrelevant factors.

      The result may very well be that a child who otherwise might have received a vital organ will be denied that organ simply because his father or mother followed the view of any of the myriad of rabbis who forbid signing these organ donor cards. If that is not discrimination, what is?

      The secular Israeli doctor who initially chose to advocate this clearly radical approach in the British journal LANCET has made it quite clear that he is aiming at the chareidi community.

      Finally, please note that I do not advocate my position. I try to report on the opinions of the many poskim with whom I have learned this sugya, from YU to chareidi orthodox ‘camps,’ including Sefardic poskim and Ashkenazic poskim. Nearly all do not accept ‘brain death.’

      • there is a flaw in your thinking.

        It is not that no live will be saved it is just who’s live A or B. since B joined the pool and A did not it makes absolute sense to give B priority,

        To bad for people who do not want to donate that is a consequence of you decision. And if you refuse on religious grounds, talk to G-d

        of course if a is the only match he gets the organ.

    25. For well over 2 years, the Rabbinical Council of America has had a halachic committee working on end-of-life issues including the halachic definition of death. The committee interviewed or sought to interview virtually every posek involved in this issue. Major efforts were extended in this regard.

      Regrettably, for unclear reasons, the manuscript has so far not been distributed or published.

      If your rav is a member of the RCA, why not ask him when that manuscript might be coming out, and what is the reason for its publication being delayed 🙂

      Regrettably, in secular medicine doctors and nurses have gone far beyond the issue of ‘brain death.’ The current fad is ‘withdrawal of care’ (aka pulling the plug) on patients with poor prognoses. This stems from “futile care theory.” Many doctors, once sworn to heal, now advocate hastening a person’s death due to quality of life considerations.

    26. The whole thing is a little baffling, because there is a clause on the back of the card that the carrier can include that states:
      “בתנאי שאיש דת לפי בחירת המשפחה יאשר את התרומה לאחר מותי”
      “Provided that a cleric chosen by the family will approve the donation after my death.”
      So as long as you include this, what’s the big deal to sign it?

    27. 86 unfortunately “they” (the ones in charge) are not trusted by the rabbonim. And for good reasons! They may say they will only remove after brain death and even wait for stem cell death or even cardiac death and then by “mistake” they will make an error and take it out prior to the agreed term. That is a major problem with the medical field. They are not trusted.

      • Yeah, you’re right. Those members of the medical field, those, those “doctors” who save lives on a daily basis – nazis! All of ’em! Can’t trust a single one!
        OK OK, enough with the sarcasm. Now, while I’ll agree with you that there are a few rotten apples out there, I think that it is an unfair and false generalization to say that the medical field as a whole “are not trusted.” Secondly, those few that “are not trusted,” will do wrong even if there is no donor card at all! So, this minority, card or no card, will make their “mistakes”, but the rest of the medical field would honor the included clause.
        I would like to add, that if the multitude of frum doctors, living in the states, would get up and move to Eretz Yisrael, there could be better supervision of these matters in the hospitals here.

        • I agree that as a whole they are good. But the gov’t is pushing an agenda here. Since most frum yidden dont trust the Israeli Gov’t, they definatley wont trust them with their life or even that they would keep their word. Sorry. The Gov’t is Nogeiah Badover as can be seen from passing such a law. If all doctors moved to Israel who will help us here in the states?

    28. I am curious as to how the reporter for this Associated Press story (which reaches thousands of newspapers) got the impression that most rabbis favor organ donation after brain death. That is certainly not the case when it comes to poskim. Despite misrepresentations elsewhere, such halachic luminaries who have ruled against accepting even whole brain ‘death’ as halachic death include Rav Waldenberg ztl (the Tzitz Eliezer), Rav Shlomo Zalman Auerbach ztl, Rav Aharon Soloveitchik ztl, Rav Joseph Ber Soloveitchik ztl (according to Rav Aharon ztl, but this is in dispute) and many other late Gedolim as well as yb’mch’lch Rav Elyashiv shlita, Rav Moshe Sternbuch shlita, Rav Neuwirth shlita, Rav Yitzchok Zilberstein shlita, Rav Herschel Schechter ztl (the protege of The Rav), Rav Mordechai Willig shlita, and many more poskim.

      The reason I put the term ‘death’ in quotes is that it is accepted by many neuroscientists that when brain ‘death’ is ‘diagnosed,’ that does not necessarily mean that each and every brain cell is dead and the brain is getting completely liquefied (as Rav Moshe Feinstein ztl was told). In fact, parts of the brain may be alive in 10% or more of such cases.

    29. The gemarah holds that brain death is death, not cardiac death. After all, what is the proof in the gemarah for proving that someone is dead? Putting a feather by his nose to see if he’s breathing, that is brain death, not cardiac death.

    30. “The gemarah holds that brain death is death, not cardiac death. After all, what is the proof in the gemarah for proving that someone is dead? Putting a feather by his nose to see if he’s breathing, that is brain death, not cardiac death.”

      Wow! Now that post #91 has cleared things up, we can just inform all the Gedolim of his / her conclusion, as they obviously have not learned the Gemara the way this anonymous poster did.

      My point, obviously, is that this is a matter of mamash pikuach nefesh–the very definition of life and death–and hence for anyone here to argue one way or the other is hubris in the extreme.

      Let’s leave the halachic machlokes to the major poskim–and let’s not countenance outright discrimination against our kinderlach and fellow frum Yidden.

    31. The concern that many have before agreeing to donate and signing donor cards is that hospital staff who know there is a donor card may want to RUSH the death in “brain death cases” so that they can immediately remove the organs — since there is a limited amount of time from death until recipient receives organ. But sometimes the life can still be saved.

      That’s something to think about…

    32. Does the govt also hand out money from programs only to people that pay taxes or do they pay public funding only to those that cant afford to pay. Lets pass a new law – You can only receive funding if you pay taxes

    33. Almost seven years ago I gave a kidney to a total stranger. It was the most wonderful experience that I have had in a long time. If you are able to donate, then by all means do it. You will never regret it!!

    34. In reply to SD:

      Contact me at or and I can privately address your concerns.

      Alternatively, you can attend the yarchei kallah held in Jerusalem every summer and have the opportunity to ask major poskim whatever questions you may wish (

      Notwithstanding what some prefer, not everything is for public consumption on the internet.

      I look forward to hearing from you, “SD”.


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