Religious views on organ donation

Religious views on organ donation are generally very favorable, although there is a debate in certain religious groups on the validity of current brain death criteria. Accordingly, the more theologians are accepting of current brain death criteria, the more they are likely to support organ donation.

General overview

All major religions either accept organ donation or accept the right of individual members to make their own decision. Most religions like the Roman Catholic Church are in favor of organ donation as acts of charity and as a means of saving a life. Jains, who regard compassion to be a main principle of their faith, donate organs pro-actively[1] Some impose certain restrictions.[2] For example, Jehovah's Witnesses require that organs be drained of any blood due to their interpretation of the disallowance of blood transfusion from the Bible,[3] and Muslims require that the donor have provided written consent in advance.[3] Orthodox Judaism considers it obligatory if it will save a life, as long as the donor is considered dead as defined by Jewish law,[3] which is a matter of debate among different rabbis. A few groups disfavor organ transplantation or donation; notably, these include Shinto[4] and those who follow the folk customs of the Romani.[3]

Debate surrounding brain death

Christianity

1981 report

The 1981 federal report, Defining Death, found that Catholic and Protestant theologies did not object to brain death criteria. Indeed, Dennis Horan, president of the pro-life group Americans United for Life, stated:

Legislation limiting the concept of brain death to the irreversible cessation of total function of the brain, including the brain stem, is beneficial and does not undermine any of the values we seek to support.

In recent times, the findings of the 1981 President's Commission Report have been questioned.[5] The new attack on brain death criteria has been multi-pronged. First, the view that brain death marks the end of the integrated unity of the human organism has been questioned. Alan Shewmon has argued that the body as a whole is the central integrator of the organism rather than the brain.[6]

He appeals to, among other reasons, brain dead pregnant women who have lived up to 200+ days and given birth to healthy children, as well as to a brain dead boy who lived over fourteen years on a ventilator and with basic nursing support. Others have argued that there is insufficient evidence that the entire brain is dead in a brain dead individual.[7] Some brain dead individuals have continuing EEG activity[8] and others maintain normal or near-normal body temperature, implying continuing hypothalamic function.[9]

Roman Catholic medical ethics

In Catholic medical ethics, Pope Pius XII stated that death is determined by medical experts and it "does not fall within the competence of the Church."[10] Advocates of brain death criteria have claimed that this implies that the church is bound to support the view of the medical community on this issue. More recently, the Pontifical Academy of Science has upheld Catholic doctrine.[11]

Nevertheless, there was some Catholic dissent on neurological criteria for death.[12] In addition, a volume consisting of essays by opponents of brain death criteria who participated in a 2005 conference at the Pontifical Academy of Sciences was published in 2006 by a publisher outside the Vatican.[7]

In 2008, an article of the Osservatore Romano expressed the wish that the debate on brain death be re-opened because of new developments in the medical world. A Vatican spokesman said that the article presented a personal opinion of the author and "did not reflect a change in the Catholic Church's position".[13]

The pope's body is also not used for organ donation.[14]

Islam

The majority of Islamic religious leaders accept organ donation during life (provided it does not harm the donor) and after death in order to save life. Most religious leaders do not accept brain death as a criterion and consider cessation of all signs of life including heart beat as a precondition for declaring death.[15][16][17]

Despite this position by Islamic religious leaders, Muslims are oftentimes uncertain about whether or not Islamic tradition considers organ donation to be forbidden. This uncertainty stems from ambiguity caused by conflicting opinions among some Islamic leaders regarding this issue. Moreover, a lack of support along with a generally negative attitude toward organ donation and transplantation has been reflected in surveys of diverse Islamic populations. This overall negativity towards organ donation has resulted in low rates of participation in organ donation by practicing Muslims even in cases where donation would be considered permissible by religious leaders.[18][19]

Judaism

Jewish medical ethics takes a unique approach. It encourages live organ donation, such as kidney transplant, partial liver lobe (Adult/Child) transplant and the like, when two basic conditions are met, firstly, that the operation does not (significantly) endanger the life of the donor, and secondly, that the recipient's life will be saved through this donation. However, opinions are divided on the issue of organ donations which will permanently end the donor's heart beating, in a case when the donor is brain dead. According to one school of thought,[20] the definition of death is indicated by irreversible cessation of heart beat. Hence, this view does not allow vital organs to be removed from a brain dead patient, as stopping the heart from beating is, in their view, tantamount to killing. Conversely, the other school of thought[21] (which include many Orthodox rabbis and Israel's Chief Rabbinate) the determination of death is based on brain function irrespective of a beating heart. Therefore, according to their view, removing vitals organs from a brain dead patient for the sake of saving a life, is in fact permissible, and even encouraged.

As a result of these two orthodox schools of thought, Orthodox Jewish ethics remains divided over key death-related policies. Tactically, opponents to the brain death criterion have requested waivers from state law, as a matter of religious freedom, so as to continue relying on traditional indicators.[20][21] Meanwhile, proponents of the brain death criterion, such as Halachic Organ Donor Society have been active in advocating organ donations and transplants either at brain death or even at cessation of heart beat, where donation of corneas and skin is still medically possible.

Buddhism

According to Buddhism, it is a great Merit to donate one's own flesh for the sake of another. The lord Buddha is also believed to be sacrificed himself by jumping into a fire in order to nourish a lost and starved villager in woods, in a previous life as a rabbit.[22]

The choice of making the donation has to be made by the donor him/herself according to Buddhism. It's not clear brain death is a form of death according to Buddhism. But if it considered as death, in which case one cannot make decision oneself, it's a good deed for one who died and also for the ones involved in decision making and contributing.

Hinduism

Life after death is a strong belief of Hinduism and is an ongoing process of rebirth. It is a perpetual circle of birth and rebirth of the soul, so the physical body is insignificant. This could be seen as reflecting positively on the concept of organ donation and transplantation in Hinduism.[23] Other Dharmic faiths hold similar views.

Jainism

In Jainism, compassion and charity are considered to major virtues. Organ donation has been widely supported by the Jain community leaders and monks.[24] It has been reported that in Mumbai, 85-90% of all organ donations including eye donations, are by Jains and Gujaratis (a significant fraction of them are Jain in Mumbai).[25] Gujarat has had considerable success with the eye donation program due to a significant population of the Jain community, which considers eye donation as a sublime form of charity.[26]

References

  1. ↑ Stuti Shukla Transplant of Human Organs Act has grey areas, Indian Express Jul 03 2013.
  2. ↑ http://www.giveandletlive.co.uk/docs/ppt/RE%20PowerPoint.ppt
  3. 1 2 3 4 "American Red Cross -- Statements from Religions". American Red Cross. Archived from the original on September 17, 2008. Retrieved 2008-07-22.
  4. ↑ BBC - Religion & Ethics - Organ donation
  5. ↑ Potts, M; Byrne, PA; Nilges, RG (September 2000). Beyond Brain Death: The Case Against Brain-Based Criteria for Human Death. Dordrecht, The Netherlands: Kluwer Academic Publishers. ISBN 0-306-46882-4.
  6. ↑ Shewmon, D. Alan (December 1, 1998). "Chronic 'brain death': Meta-analysis and conceptual consequences". Neurology. 51 (6): 1538–1545. doi:10.1212/wnl.51.6.1538. PMID 9855499. Retrieved 2008-05-03.
  7. 1 2 de Mattei, R., ed. Finis Vitae: Is Brain Death Still Life? 2006, Consiglio Nazionale delle Rescherche, Rome.
  8. ↑ Young, Bryan; Shemie, Sam; Doig, Christopher; Teitelbaum, Jeannie (June 1, 2006). "Brief review: The role of ancillary tests in the neurological determination of death". Canadian Journal of Anesthesia. 53 (6): 620–627. doi:10.1007/BF03021855. PMID 16738299. Retrieved 2008-05-03.
  9. ↑ Shewmon, D. Alan (September 2001). "The Brain and Somatic Integration: Insights Into the Standard Biological Rationale for Equating Brain Death With Death". The Journal of Medicine and Philosophy. Routledge, part of the Taylor & Francis Group. 26 (5): 457–478. doi:10.1076/jmep.26.5.457.3000. PMID 11588655.
  10. ↑ "The Prolongation of Life" in The Pope Speaks 4:4 1958
  11. ↑ "The determination of brain death and its relationship to human death." Working Group, 10–14 December 1989, pp. xxvii-210
  12. ↑ Brain death is not death
  13. ↑ Vatican newspaper says new questions raised about brain death
  14. ↑ http://news.yahoo.com/s/ap/20110204/ap_on_re_eu/eu_vatican_pope_organ_donations
  15. ↑ Al-Mousawi, M; Hamed, T; Al-Matouk, H (December 1997). "Views of Islamic scholars on organ donation and brain death". Transplantation Proceedings. 29 (8): 3217. doi:10.1016/S0041-1345(97)00876-2. PMID 9414684.
  16. ↑ Khan, Faroque (1986). "The Definition of Death in Islam: Can Brain Death Be Used as a Criteria of Death in Islam?". Journal of the Islamic Medical Association. 18 (1): 18–21. doi:10.5915/18-1-4731. Retrieved 2010-06-13.
  17. ↑ Moazam, Farhat (September 2006). Bioethics and Organ Transplantation in a Muslim Society: A Study in Culture, Ethnography, and Religion. Indiana University Press. pp. 32ff. ISBN 978-0-253-34782-4.
  18. ↑ Padela, A. I.; Curlin, F. A. (2013). "Religion and disparities: Considering the influences of islam on the health of american muslims". Journal of Religion and Health. 52 (4): 1333–45. doi:10.1007/s10943-012-9620-y.
  19. ↑ Rasheed, S. A.; Padela, A. I. (2013). "The interplay between religious leaders and organ donation among Muslims". Zygon. 48 (3): 635–654. doi:10.1111/zygo.12040.
  20. 1 2 Bleich, J. David (1991). Time of death in Jewish law. Z. Berman.
  21. 1 2 See Moshe Tendler's elucidation of Rabbi Moshe Feinstein's responsa
  22. ↑ "Sutta Pitaka: The Jātaka Tales". Archived from the original on November 3, 2009.
  23. ↑ http://www.bbc.co.uk/religion/religions/hinduism/hinduethics/organdonation.shtml
  24. ↑ Maitri Porecha, Gurus' discourse: Donate organ, save life, DNA Aug 7, 2013
  25. ↑ Ratan Sharda Positive Side of Religion, News Bharati, 4/22/2013
  26. ↑ Sunil Shroff Legal and ethical aspects of organ donation and transplantation Indian J Urol. 2009 Jul-Sep; 25(3): 348–355.

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