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Organ Donation And Presumed Consent

The Prime Minister’s coughing fit during her speech at the October 2017 Conservative Party Conference, meant that what she said was largely ignored in all the attention given to how she said it.

But those who did listen attentively will know that Theresa May promised to take a radical step in the way organ donations are handled. Until now, if someone passes away, and they have organs that might be of use to someone else – such as their heart or lungs – then they cannot be taken unless the deceased was carrying an organ donor’s card or the family gives consent.

The problem is that many people do not carry a donor’s card – not necessarily because they are against donating, but because they do not know about the system – or they do know, but have not got around to getting one; so either ignorance or inertia means that their organs are not available.

It can also involve some traumatic discussions for the relatives, trying to work out whether the deceased would or would not have wanted permission to be given. The result is that there is a shortage of organ donations, so people whose lives could be saved are dying, and all for the want of someone not carrying a donor who would have said yes had they been asked.

Theresa May is therefore suggesting that henceforth consent will be presumed and doctors will have the right to take an organ unless the person has requested in advance that this should not happen.

From a Jewish point of view, there are powerful arguments both for and against. One major objection is that, traditionally, the body is regarded as a ‘holy vessel’ – because it has housed a soul created by God – and therefore the body has to be honoured as much as if it still contained a living person.

There is also a biblical ban against making any cuts to a body – which are obviously necessary to remove an organ – but cutting the body in biblical times was a pagan practice. For organ donations, though the incisions are not part of an idolatrous rite, and are done surgically by a physician.

Another objection is the fear that if a patient is dying and they have an organ that is needed for someone else, then the donor’s death may be speeded up so as to facilitate exchange of the organ. Hastening one person’s death to save another is certainly not acceptable morally, but is also illegal and so highly unlikely to take place.

Then there is the issue of personal autonomy and the fact that our body belongs to us, not to the government or NHS. So while it may be very worthy to donate organs after our death, we alone should make the choice.

But if those are valid views against changing the current situation, there are even stronger Jewish opinions in favour of presumed consent. One is that of reciprocity: that at some point we may desperately need an organ from someone else, in which case we have to be willing to provide our organs to others in a reverse scenario.

There is also a pastoral consideration: families may be deeply upset at losing a relative in tragic circumstances but can feel comforted by the knowledge that his/her organs were used to save the life of someone else. This certainly applied when a young man in my community died suddenly and his organs were given five separate people… and his parents coped much better because of it.

But the main argument is that whatever the ethics of personal autonomy and despite biblical objections to making cuts, there is the higher value of saving a person’s life… and that trumps all the other considerations.

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