Chief rabbi rules against donor cards and organ donation after brain stem death

BMJ 2011; 342 doi: (Published 14 January 2011) Cite this as: BMJ 2011;342:d275
  1. Jacqui Wise
  1. 1London

The United Kingdom’s chief rabbi, Jonathan Sacks, has issued an edict that carrying donor cards is unacceptable and that the current organ donor system is incompatible with Jewish law.

The ruling comes after years of debate among rabbinical authorities over the definition of death and when an organ may be removed for transplant purposes. The new statement from the chief rabbi and his rabbinical court, the London Beth Din, says that organs may be removed for transplantation only at the point of cardiorespiratory failure, rather than at brain stem death.

The latest figures for 2010 show that 66% of donations came from donors after brain death and 34% from donors after cardiovascular death, NHS Blood and Transplant said.

The BMA warned that the edict may reduce the number of donations. Three people die every day in the UK because of the shortage of organs for transplantation. An association spokesman said, “Organ donation and transplantation is a huge success story, and it will be a tragedy if the number of organs available started going down and fewer lives could be saved.” The BMA said it is a matter of urgency that the chief rabbi meet with organ donation experts to discuss the issue.

Lord Sacks’s statement said that a living person may donate an organ, such as a kidney, to save someone else’s life providing that the donor does not put his or her own life at major risk. Jewish law also permits donation after death as long as the organ is needed for immediate transplantation. However, the statement says: “Live people (irrespective of how close to death) may not donate organs to save another person’s life if in doing so it will hasten their own demise.”

The statement says: “There is a view that brain stem death is an acceptable Halachic [following Jewish law] criterion in the determination of death. However, it is the considered opinion of the London Beth Din that in Halacha cardiorespiratory death is definitive.”

The chief rabbi’s office says that it is already in consultation with the UK medical profession about the possibility of devising a method whereby the number of organs donated by Jews can be increased in accordance with Halacha. It wants Jews to be able to register directly with the NHS national organ donor registry with the clear provision that a Halachic authority is contacted if and when donation is anticipated and for the donation to be carried out within Halachic rules.

The chief rabbi said, “At this point, however, since the national registry system is not set up to accommodate Halachic requirements, donor cards (even those purporting to be Halachic) are unacceptable.”

James Neuberger, associate medical director for NHS Blood and Transplant, said that it would welcome the opportunity to discuss this important issue with the chief rabbi. “NHSBT respects the views of all religions and has received public support from all the major faiths in the UK towards organ donation. It is a very personal choice, and anyone with questions around how their religion reflects the donation of organs is urged to discuss it with their local faith leader,” he said.

“Organ donation only occurs after someone has died, whether it is by cardiac or brain stem death, and individual donors’ wishes are always at the centre of discussions with their relatives.”

He added: “We do not record donors’ religions on the organ donor register (ODR), but anyone in favour of donation or joining the ODR should inform their relatives of any beliefs they hold that reflect their religion so that this can be taken into consideration at the time donation is being discussed.”


Cite this as: BMJ 2011;342:d275

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