Moral ethical dilemmas … what do Jews say about “X”



IT’S UP TO YOU: Get Your Organs Here!

We’ve all read of recent attempts to sell kidneys and other internal organs via the Internet. And when Mickey Mantle, the Hall of Fame baseball player, suddenly received permission to undergo an operation to replace his failing kidney, a furor arose because many suspected that his standing on kidney transplant lists was affected by his celebrity. Selling organs is against the law in the United States and in many countries around the globe. Opposition to the sale of organs is based on several considerations. Many people believe that organ transplantation is truly about the allocation of scarce medical resources. To be fair, organs for transplant should be allocated on the basis of fairness, meaning according to qualities of the prospective recipients such as need and likelihood of survival. Other qualities not directly related to the medical condition of prospective recipients, such as social class, celebrity or economic capacity, should be irrelevant. Some physicians are worried that rich people will use their financial clout to force or coerce poor people to sell them organs. To insure fairness, some believe that the allocation of organs should be determined by impartial medical and ethical experts, such as specially constituted hospital review boards, and not the market. And yet, in some places around the world, poor people are able to sell their kidneys for $1,700 or more. Such a windfall might be the difference between life and death for some families. Shouldn’t people have the freedom to control their own bodies and do with them what they believe is in their best interest?

Now, IT’S UP TO YOU: Should selling bodily organs be a private transaction determined by individual, personal choice or should selling organs require the permission of impartial third-party experts?

ONE JEWISH ANSWER is that there are two questions involved in this choice.

  1. Is organ donation permissible according to Jewish law under any circumstances?
  2. Is the selling of organs ever permissible according to Jewish law?

In general Jewish law permits the donation of bodily organs, although there are some special conditions. Leviticus 13:5(?) teaches us v’chai bahem, “You shall live by them [the mitzvot].” The supreme value of Jewish life, the rabbis conclude from this verse, is that the system of mitzvot ought to support human existence, making life possible and better. For the purpose of saving a human life, piku’ach nefesh, there can be no objection to organ donation, according to the journal Medical Ethics and Judaism. Traditional authorities would set this aside for the sake of the interment of a whole body, although more liberal authorities typically would not.

Rabbi Abraham S. Abraham points out that a person who, because of poverty, sells one of his kidneys for the purpose of transplantation is still fulfilling the mitzvah of piku’ach nefesh. We very well might share Rabbi Abraham’s moral concern about a world in which such a state of affairs exists. Nonetheless, one might also want to credit a poor person’s fulfillment of a mitzvah even though he or she has multiple, complex motivations; who does not?

The practice of selling body parts should be limited or qualified by the purpose of the sale. On the grounds that the human body is God’s creation, not simply ours to do with as we wish, then it would seem appropriate that our management of our bodies should be in accord with God’s purposes, not ours. As God’s partners in creation, we are permitted to exploit the gifts of God’s creation, but only as partners in effecting God’s purposes, namely, in creating a godly society. Under what conditions would the sale of a bodily organ contribute to this goal? It is one thing to sell an organ in order to obey the mitzvah of piku’ach nefesh, or even for the purpose of parnasah (making a living), and quite another to sell a bodily organ in order to buy a new plasma screen television. Bodily organs are not essentially different from God’s other gifts. Although, in the story of creation in Bereishit (Genesis), God calls the creation of humankind tov me’od (very good) and not merely good, it is clear that the creation of the human being is part of the same scale of moral valuation as God’s other gifts. Selling an organ cannot be a simple matter for personal gain, but not more or less so than the sale of other resources in God’s creation. The sale or exploitation of any of God’s gifts is subject to other considerations, particularly moral considerations, besides profit and loss.