By Rebekah Arsenault

Across the world, Jewish people pray in the same way. A Jewish man from  Ohio can travel to the Czech Republic, enter a synagogue, and find the exact same prayers in the hymnals. That man will also be able to pray with the Czech congregation with no language barrier, because in every country, Jews pray in Hebrew. This kind of communal bond is very important to religious communities, creating a sense of kinship during the most important ritual of all – worship.

It is the concept of death – and its relevance in organ donation and transplantation – where Jewish groups experience a profound disconnect. When inquiring about Judaism’s perspective on organ donation, Jews do not always find the same answers from one temple to another, let alone over oceans.

Like Christianity, the Jewish religion has divided over time into distinct denominations. The religion’s evolution has followed societal changes to accommodate current cultural paradigms. Regardless of sect, all Jews believe in one God and hope to create a life God would find worthy at the time of death. In crafting such a life, most Jews attempt to perform as many good deeds – known as mitzvahs – as possible. With regard to organ donation, many American Jews immediately consider the biblical passage: “Do not stand by idly while another’s blood is shed.” In the last several years, a number of rabbis and Jewish scholars have attempted to raise awareness among their communities about the importance of organ donation, and how organ donation can be considered the greatest mitzvah of all.

But even today, many Jews find themselves at a spiritual crossroads when considering organ donation. Experts in Jewish law as well as organ donation professionals agree the conflict mainly springs from interpretations of Jewish law regarding care and treatment of the deceased. These interpretations vary among sects, and in turn, the conflict escalates and weakens from one sect to another.

By far, the Orthodox sect of Judaism sheds the dimmest light on organ donation. As the strictest denomination, Orthodox Jews live by detailed laws and procedures and have experienced the most minimal – if any – cultural effects upon their observances. Orthodox rabbis occupy a much stronger role in the life of Jewish families than in other sects, and this compounds the quandary for Jews.

In a recent interview, Orthodox Rabbi Lazer Rivkin, of Bais-Temple David in Tampa, Fla., said, “Rabbis do not make decisions, we simply provide education.” Further discussion with the rabbi confirmed the deep struggle involved in following faith to the letter and taking advantage of medical advances at the same time. “There is no question about the benefit of organ donation,” he said. “It becomes a weighing of belief versus the ability to save life. In our faith, keeping the body whole and sacred and returned to earth is law. However (in organ donation), there is the aspect of saving life and giving life, which is at odds with the first concept.”

Nowhere in the world is this complexity more apparent than in Israel, a country which stands as a reflection of the more traditional Jewish beliefs. According to Dr. Eytan Mor, Director of Israel’s Rabin Medical Center Organ Transplantation Department, his country’s organ donation rate – at 4 percent – “remains one of the lowest in the Western world.” Considering these rates a “failure” on the part of Israelis, Dr. Mor believes the reason for low donation rates as “cultural resistance to donation and objections of Orthodox rabbinical leaders to the brain death concept.”

Can brain death accurately be considered a concept, rather than defining the physical state of death? Harvard Medical School began working toward an acceptable medical and legal definition of death in the late 60s. As a result of their criteria, a number of state legislatures, as well as a presidential commission and legal and medical communities began recognizing brain death in the early 80s. But on his Web site on Jewish law, Rabbi Yitzchok A. Breitowitz points out Orthodox Rabbi Dr. Judah David Bleich - the Chair in Jewish law and ethics at Yeshiva University in New York - holds the position that “the brain dead patient is still alive.”

The Jewish family’s predicament becomes more apparent when noting how teachings can vary from rabbi to rabbi, even within the same sect. In 2006, a Chief Rabbi of Israel, Orthodox Rabbi Shmuel Eliyahu, arrived at a different conclusion than Rabbi Bleich. “According to his (Eliyahu’s) analysis, death occurs when the brain stem stops functioning,” wrote Anthony Ramirez of the New York Times.

Those of us with lives touched by organ donation and transplantation understand how difficult the decision can be for families. In the moment of their deepest grief, they are asked to consider the impact the loss of a loved one can have on others. For most Jewish families – not only the Orthodox – this dilemma stems from profound misinformation persisting within the Jewish community.

Rabbi Michael Torop, rabbi at the Conservative Temple Beth-El in St. Petersburg, Fla., recently reminded his congregation that, “Jewish law has developed alongside medical advances. We have newer definitions of death in Jewish law. Judaism favors organ donation, which has become viewed as a modern mitzvah as well as an obligation regarding our relationship to humanity and God.”

In an attempt to close the rift, Conservative Rabbi Robert Dobrusin explained on his Web site that “Jewish tradition did not know of the concept of brain death, establishing death as the cessation of respiration and circulation. Thus, the first rabbis approached with the question of “post mortem” organ donation refused to allow it, calling the taking of organs from an individual in this situation to be murder. This objection has been overruled by almost all rabbinic authorities, certainly all within the Conservative movement.”

Judaism’s third sect, Reform, offers strong approval and encouragement for organ donation. In the Spring 2007 issue of Reform Magazine, Elisa Ruth Schindler wrote, “The Reform Movement has been advocating organ donation for nearly 40 years.”

At LifeLink Foundation, a Tampa, Fla.-based non-profit organization dedicated to the recovery and transplantation of organs and tissue, the manager of Public Relations stated she meets many Jewish people who are unclear about their religious obligations regarding organ donation. “I’ve been able to share information that clarified the recent religious perspectives of the Jewish faith,” said Jennifer Krouse. “There is substantial literature demonstrating Judaism’s approval and encouragement of organ donation.” Of course, in the end, the decision is made by the family, regardless of the information shared. “It’s a very personal decision,” said Krouse.

There is no doubt when faced with that personal decision, many people turn to their belief systems for assistance. As it does for most divisive issues, ongoing education provides the strongest promise to increase organ donation within Jewish communities. Summing up the miracle of organ donation, Rabbi Torop of St. Petersburg told his congregation, “Transplanted organs are restored to life. They are not dead. They do not require burial with the deceased.” And a conversation with any transplant recipient reveals the gravity of that statement. Almost as a matter of course, regardless of religion, recipients include donor families in their prayers and give thanks for the gift of life they received. Some rabbis have stated they hope organ donation may one day be part of the Jewish death ritual. “I look forward to the time when all Jewish families make faith-based decisions to donate their loved ones organs,” said Krouse.

Perhaps one day throughout the world, as they pray in the same way, Jewish families will also consent to organ donation in the same way. One of the oldest Jewish proverbs states, “To save one person is to save a whole world.” Such is the way organ donation works: one person at a time, until the waiting list clears.

Rebekah Arsenault serves as Marketing Coordinator for the LifeLink Foundation. She concentrates on providing educational outreach opportunities for the LifeLink HealthCare Institute, a physician practice providing comprehensive medical, surgical and transplant care for patients in end-stage organ failure. Rebekah is pursuing a Masters degree in Bioethics at the University of South Florida.

This article originally appeared in the May 2008 issue of aakpRENALIFE.

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