Organ donation a controversial issue, mitzvah for Jews

MILWAUKEE — Harry Lensky, a Milwaukee area attorney and former synagogue president, has a sweatshirt that reads: "Don't take your organs to heaven, heaven knows we need them here."

This is neither a joke nor an intellectual abstraction for him. On Nov. 1, 1995, the 70-year-old Lensky received a new liver from a 43-year-old man who had suffered a fatal cerebral hemorrhage.

For seven to eight years before that, according to Lensky and wife Phyllis, he had been suffering from the effects of sclerosing cholangitis, a disease that narrowed the ducts in the marrow of his liver.

The disease impaired his liver's functions, leaving him jaundiced. It also led to frequent bacterial infections in his liver, resulting in many hospital trips.

Finally, the disease progressed to the point that their physician recommended a liver transplant. "I asked him what would happen if I didn't have it," Lensky said. "He replied, `You die.'"

Lensky was put on the waiting list in July 1995. His wife, who is now active in the Wisconsin Liver Foundation, said "he was very lucky" to get in four months a liver from someone who matched his blood type.

Despite a tremendous shortage of donated organs, some Jews are hesitant to make provisions for donating organs should something happen to them, according to rabbis who encourage Jews to become donors.

"I think most people have the misconception that organ donation is prohibited" under authoritative interpretations of Jewish principles and law, said Rabbi Lee Buckman, spiritual leader at a Conservative congregation.

"While that was true when it was only experimental, now that it has been proven to prolong and preserve people's lives, it is now permitted," he said.

Rabbi Ronald Shapiro, a Reform spiritual leader, said some of his congregation members have asked him "whether they were committing some kind of transgression" by donating their organs.

"They felt there was a Jewish tradition about body and soul needing to be able to reunite, yet they really felt they wanted to [become donors] to preserve individual life."

Throughout the Jewish world, religious leaders appear to have taken the position echoed by Rabbi David Brusin, spiritual leader of a Reconstructionist congregation. "The overriding issue," he said, is that organ transplants save lives. "The rest of the issues are fine points and personal things."

Still, intense disagreements over the issue persist.

Rabbi Tsvi G. Schur, director of the Jewish Chaplaincy Service in Milwaukee, said that in the Orthodox communities some were reluctant to donate because of wanting their organs to go to other Jews.

They say this, Schur emphasized, not out of disdain or hatred for non-Jews but on grounds that "all Jews are one family" and one has an "obligation to save a member of one's family first."

But Schur said that the late Rabbi Moshe Feinstein, a renowned authority on halachah (Jewish law), issued a ruling saying that "today in a mixed society, everybody needs everybody else" and that "there is no question" that Jews can donate organs to non-Jews.

Some Orthodox and Conservative Jews have expressed concerns about Jewish eschatology — ideas about what will happen at "the end of days." Those teachings include the idea that one must be buried with all of one's body parts so that when the Messiah comes and the dead are resurrected, one will resurrect completely.

But Schur stated that commentaries on those ideas have said that organs that have been donated for the halachah-valid purpose of life-saving "will be regenerated or you will be able to live without them."

More technical halachic issues around transplants are being debated within Orthodox and Conservative Judaism. In the Orthodox community, said Schur, the big issue is determining when death occurs so that organs may be removed.

One camp is willing to go with the modern medical definition of death as cessation of brain activity — "brain death." Others adhere to the more traditional definition, that death occurs when breathing and heartbeat stop.

The medical problem is that organs are more likely to be successfully transplanted if taken from someone brain dead rather than heart dead. The halachic problem is that "you can't kill someone to save someone else," and therefore some Orthodox authorities consider removing a beating heart from a brain-dead person as murder, Schur said.

In the Conservative movement, Buckman said, the primary debate is over whether donating an organ is a meritorious but optional act of kindness, or is an obligation under the commandment "Do not stand by the blood of your neighbor" (Leviticus 19:16) — i.e., if you have the means and opportunity to help someone in mortal peril, it is a sin to refrain.

To the Lenskys, such debates seem academic.

"For a family to decide to donate organs is the kindest, biggest mitzvah they can do," said Phyllis Lensky.