26 August 2020
By Rabbi Dr Margaret Jacobi
As we approach the High Holy Days, we are confronted by profound questions about life and death and of the legacy that we wish to leave behind us. it is therefore appropriate that the week before Rosh Hashanah is Organ Donation Week (Monday 7 – Sunday 13 September 2020).
If we have not already done so, this is the right time to think about how we wish our organs to be used in the event of our death.
The saving of life is one of the most important mitzvot in Judaism. This has been abundantly clear in how we have responded to the Covid-19 crisis but is also true of how we approach medical issues in general, and in particular the issue of organ donation. If we decide we wish to donate our organs, we could potentially save the lives of not just one but several people.
That is why Judaism considers donating organs a mitzvah, one of the highest mitzvot we can perform, albeit after our death.
Although there has been some discussion amongst Orthodox rabbis about the definition of death most, including the Israeli Rabbinic authorities, agree that death defined by neurologic criteria (so-called ‘brain death’) is acceptable, allowing heart and lung transplants to be carried out.
Recent changes in legislation have meant that organ donation has once again been a subject of public discussion.
The Blood and Transplant Authority, which oversees organ transplants, has been working with different faith groups to ensure that the legislation takes into account the needs of religion and that the changes are understood. It also recognises that there is no single view within Judaism and that Orthodox, Progressive and secular Jews might have very different needs in terms of spiritual support.
Although the legislation has been described as ‘opt-out’, in fact there will be little change in practice. It is also worth bearing in mind that only about 1% of deaths will be in circumstances where organ donation is possible, since the deaths have to be in ITU and there must be no danger of infection from the organs.
If donation is a possibility, relatives will be approached by a specialist organ donation nurse (SNOD) who will be trained to discuss the issue sensitively with them. Even if their loved one was on the register, the SNOD will still need to ascertain that they had not changed their mind and that the relatives are comfortable with the donation going ahead.
As a member of the Transplant Authority put it, the importance of the legislation is to change the conversation from ‘why donate?’ to ‘why not donate?’ It takes time for this change of mindset to be effective but evidence from Wales, where similar legislation was introduced five years ago, indicates that this approach can be successful: there has been an increase in donation rates there from 55% in 2015, when the ‘opt-out’ legislation was introduced, to 78% last year
If you have not already do so, you may like to sign up on the NHS donor register: https://www.organdonation.nhs.uk/register-to-donate/.
However, equally important is to have a conversation with those who will have responsibility for decisions in the event of your death, whether family or close friends. This will make their decision so much easier. It might be a difficult conversation to have now, but it will be much harder for them if the conversation does not take place.
There is no greater mitzvah than saving a life and through registering and making your views known you can be in a position to do this should circumstances make it possible. As we approach the holiest of times, let us use it to think not only of how we might help others during our lives but also how we might help them after our deaths.