By: Shmuel Ben Eliezer Jewish Press February 8, 2006
Dr. Stuart Greenstein, professor of surgery at Montefiore Medical Center, is a religious Jews and kidney transplant doctor who has guided many religious Jews through this complex process from the perspectives of the donor and recipient. He recently spoke to The Jewish Press on the issues surrounding organ transplantation and his involvement in trying to make organ donation more acceptable among members of the Orthodox community.
There are many misconceptions regarding living donor transplants. Most people think it is halachically unacceptable, but that is not accurate. Many rabbis, including Chassidic , say that it is permissible and possibly even obligatory in lifesaving situations. Among those who have promoted the practice with their followers are the Bobover, Belzer and Pupa Rebbes.
Greenstein believes that there is a stigma against donors, especially when it comes to shidduchim. Other people who are familiar with the issue believe that it is more of a concern that in the time of resurrection, the body must be whole.
In the past year, Greenstein performed about 120 transplant operations. Of those, about 10 percent have been for religious Jews. “There is a definite need for more people to donate kidneys and other organs,” he insists.
There are two kinds of operations that can be performed to harvest a kidney from a living donor. There is the open incision and the laparoscopic incision. The latter is very small and leaves a tiny scar, while the open incision is the more traditional operation and leaves a more significant scar. The average hospital stay for an open incision is four days.
Israel has the smallest population percentage signed up for organ donations. However, they have an agreement with Cyprus, whereby in exchange for needed organs, they teach doctors from Cyprus how to perform transplant operations.
Recently Israel became the first country to allow payment to organ donors to alleviate the shortage of organs.
Every year, roughly 5,000 Americans and 100 Israelis die from organ failure. Dialysis is not a viable answer, as about 23 of every 100 people die during the first year of undergoing kidney dialysis.
A person can live a perfectly healthy life with only one kidney. Statistics show there are rarely any complications. People are afraid that they are putting their lives in danger by donating a kidney. Additionally, they believe that doing so is a violation of halacha. But being a soldier, policeman or fireman presents greater physical risks and yet they are halachically acceptable professions.
Says Greenstein, “Just think, people have no problem having only one kidney; so we have to ask, why did Hashem give us two kidneys? Perhaps it is so you would have an extra one to donate and save [a life].”
For years now, it seems as though a week does not go by when there arenâ€™t at least a few advertisements in The Jewish Press about the need of a kidney donation for a seriously ill person. Unfortunately, many people donâ€™t pay much attention to these ads, while some say a quick “lo aleinu” (not for us). Yet others say a quick prayer for the afflicted
Chaya Lipschutz saw the ads three years ago, and took it as a call to action. She called the number in the ad and discovered that a man living in New Jersey had severe kidney disease and was in desperate need of a kidney. He was on the national list of people waiting for a kidney donation, but the wait for a donor was very long due to the many people in need of a kidney and the scarcity of people willing to donate their kidney to a stranger. Chaya decided that she wanted to help this person and began the process of donating one of her kidneys.
She expected the obvious medical tests to check for compatibility with the patient. But first, the hospital said that she had to meet with a social worker to determine if she was psychologically prepared for what she was proposing to do. She was asked, “If you are not related to the person who you are interested in helping, what is your motive?” They also wanted to make sure that she was not getting paid for it, since it is illegal in the United States to get paid for donating a kidney.
Chaya felt that everything went well with the social worker. But to her surprise, she was told that she was turned down.
This bothered her tremendously, since there was such a large shortage of available kidneys; yet the hospital would turn down a perfectly good kidney from a healthy person for some vague reason. It had not been an easy decision to donate a kidney, and when she was turned down, she felt very frustrated.
Being a religious woman, she had grown up with the concept that the saving of human life is one of the guiding rules of Judaism. The rabbis teach that the saving of even one life is considered equal to saving the whole world. So Chaya tried again to donate a kidney for other patients who had advertised in The Jewish Press, and who would be having their procedures at other hospitals. But once again her good intentions came to naught. In one case she was found not to be medically compatible, and in another the patient had three people who were compatible and the doctors chose one of them.
For the next few years, she did not pursue her desire to donate a kidney, but the idea never left her.
In the summer of 2005, she once again became aware of the many ads in The Jewish Press and decided it was time to try again.
“Since I was first tested, I had seen many ads in various Jewish newspapers for people in need of a kidney,” Chaya said. “I noticed all ages â€“ including a young child. Every time I saw an ad in the paper, it broke my heart.
“At the time I saw these ads, I was already in the process of being tested. But who will donate kidneys to all those other people who needed them? What if they donâ€™t find anyone to donate a kidney to them? How I wished I had a whole bunch of kidneys so I could save all these lives!”
She decided to do everything in her power to accomplish this great mitzvah before Rosh Hashana.
Thus, she answered an ad for a woman in New Jersey in need of a kidney who was presently getting regular dialysis treatments. The tests indicated that she was a perfect match for Mazal, and the operation was completed successfully two weeks before Rosh Hashana.
Today Mazal is off dialysis and is leading a perfectly healthy life.
Chaya did not stop there. She has been talking to everybody she meets, trying to convince them to also become a living donor.
During the recent Jewish Expo at New Yorkâ€™s Javits Center, Chaya used her own money to rent a booth in order to spread the word about this important cause. She also printed flyers for distribution. During the three day event, she was joined by Mazal and another donor. They spoke to hundreds of people, a good percentage of whom said that they would give this important issue serious thought.
It is important that the question of halachic acceptability of organ transplantation is much less complex than most people believe. Most rabbis agree that there is no problem with donating a kidney as a live donor, and many even encourage it. There is a bigger problem when it comes to cadaver donations (donations taken from a dead body). According to Rav Moshe Feinstein, zt”l, the main issue is determining the exact time of death. It is not permitted to take an organ before a person is considered halachically deceased.
Rav Feinstien determined, after much consultation with prominent doctors, that a person is dead when there is no activity in the brain stem (Rabbi Moshe Feinstein â€“ Igrot Moshe, Yoreh Deah II, 174).
Rav Ovadia Yosef also decided that transplants are not only permissible, but might even be obligatory in necessary situations. The issue was raised by Israeli MK Tzachi Hanegbi, who campaigned to sign up his fellow legislators to become organ donors. Among others, Prime Minister Ariel Sharon signed up.
Other issues that must be considered are that it is not permissible to donate to an organ bank or for study by medical students. The organ must be for immediate use, though the recipient does not have to be Jewish.
According to Rabbi Dr. Moshe Tendler, “Nine people in America die every day waiting for an organ transplant. If everybody donated organs at death, there would be no waiting list. Human life is identical â€“ Jew or non-Jew, chassid or secularist.” Saving any human life is halachically mandated, so [much so] that we [may] transgress the laws of Shabbat to do so.”
For more information about the halachic issues of organ transplants, go to www.HOD.org or contact Chaya at KidneyMitzvah@aol.com