In principle, Judaism supports and encourages organ donation to save lives (pikuach nefesh). According to Jewish law, halacha, saving a life nullifies almost all of the commandments in Judaism, with the exception of those prohibiting murder, illicit sexual relations, and idol worship.

There are three biblical commandments that guide how to handle the remains of a deceased person: «Nivul Hamet,» a rule that prohibits unnecessary mutilation of a corpse and is the basis for why autopsies are generally prohibited; «Halanat Hamet,» the commandment that prohibits delaying the burial of a body; and «Hana’at Hamet,» which prohibits deriving any benefit from a corpse. In all three cases, pikuach nefesh, saving a life, nullifies them.

Ultimately, the critical issue with organ donation is defining the moment of death. There is a debate in the Talmud about the definition of death. One view is that death is indicated by the irreversible cessation of breathing. The other is that death occurs with the irreversible cessation of the heartbeat. [Tractate Yoma, 85:A]. Most of our sages’ commentaries lean toward the former. Furthermore, modern medicine has established that the brainstem controls breathing, and if the brainstem is not functioning and dies, a person can never breathe on their own again.

Do we define death as the cessation of brain or heart activity? As long as a person’s heart is still beating, organs can be routinely harvested, even if brain activity has ceased. However, once a heart stops beating, organs are deprived of oxygen, and it becomes more difficult to successfully remove and transplant them. If Judaism defines death as the cessation of brain activity, organ transplants are a viable option for Jews. If we define death as the cessation of heart activity, then removing an organ before this point would be murder. Pikuach nefesh does not nullify murder. One cannot kill someone to save another’s life.

Virtually all religious movements within Judaism accept the death of the brainstem as the moment of death, and therefore support organ donation for transplants. Even the Conservative movement considers this action almost a commandment. The only ones who do not accept it are groups of ultra-Orthodox Jews, «Haredim,» who consider cardiac arrest as the moment of death, a position that runs counter to that accepted by the rabbinate in Israel and Orthodox rabbis such as Zalman Nechemia Goldberg.

The belief that a person must be buried with their organs in order to be resurrected from the dead when the Messiah arrives has no basis in classical Jewish sources. The fact is that, at death, all organs, tissues, and muscles decompose. The Book of Ezekiel, for example, relates that the resurrection would be from dry bones. Organ donation is definitely a mitzvah.

By Marcos Gojman.

Bibliography: HODS website, Halachic Organ Donor Society, and other sources.