A Sermon by Rabbi Lisa Grushcow, Associate Rabbi at Congregation Rodeph Sholom, a Reform Congregation in Manhattan, for National Donor Sabbath in November 2006

Rabbi Grushcow is a Rhodes Scholar and the author of Writing the Wayward Wife: Rabbinic Interpretations of Sotah.



You can also download Rabbi Grushcow’s sermon here in PDF format

National Donor Sabbath

Vayera 5767

November, 2006

RABBI LISA GRUSHCOW, CONGREGATION RODEPH SHOLOM,

NEW YORK, NEW YORK

Rabbi Michael Gotlieb shares the following story:

Shortly after I graduated rabbinical school, I received a phone call. At the other end of the line was the voice of a woman, wanting to donate an organ. Feverishly, my thoughts turned inward as I began rehashing the material taught to me in my biomedical ethics courses: when life stops, what Jewish law says, how to comfort the bereaved... "Rabbi," she went on, "would you send someone over from your congregation right away to pick it up?" That's when I realized she had been referring not to her kidneys or corneas, but to her somewhat neglected, 30-year-old Wurlitzer.

As happy as I was to receive a Wurlitzer -- and that the women was in fine health -- I do wish more congregants would call me to discuss donating the other kinds of organs. It is, to be blunt, nothing short of a godly act. [1]

I do believe that he is right: organ donation is nothing short of a godly act. But let me share with you something else: I only checked the organ and tissue donation box on my own driver’s license three short hours ago.

At that time – 3:15 - there were 93,963 people living in this country on a waiting list for transplants. At 5:30 this afternoon, there were 93,983. [2]

The number of people in need is growing by the minute. And the difference between the number of people who need organs and tissues and the number of people who donate them is vast.

Last year, there were about 28,000 organ transplants in the US. About 6,000 of those were from living donors (who can donate one kidney or a lobe of a liver – nothing else). The other 22,000 were from 7,600 deceased donors who donated an average of 3.6 organs per donor. Every 13 minutes, a new name is added to the list. Every year, 6,000 people on the list die waiting for a liver, a kidney, a lung, a heart. [3]

So we know the need is great. We know that we have the ability – literally – to save other people’s lives. The question is: what stops us?

Dr. Joel Rosh, a pediatric gastroenterologist and Orthodox Jew who for six years co-directed the liver transplant program at New York's Mt. Sinai Hospital, tells a story of an Israeli girl who flew with her family to the U.S. for a liver transplant. On the plane, the young girl, while on life support, was declared brain dead. The team that had been assembled to try to save her life now turned to her family and asked if they would donate her remaining healthy organs. They said no. "The Israeli family explained, “We feel for the other families and we want to help, but we have asked our rabbi and he has said at it is not permitted under Jewish law.” [4]

Many Jews hold this belief. I am here tonight to tell you that that belief is false. But the impact of that belief has been very real. There are no statistics kept on the religion of donors and recipients, but it is widely known that Jews receive many more transplants than they give. We see this pattern confirmed in the statistics that are collected about countries. While most western countries have an organ-donor membership of 30%, Israel's remains at 3%, the lowest percentage worldwide. When you factor in that only 1.5% of hospital deaths are even eligible candidates for donation, you see how serious the discrepancy becomes. Israel actually was expelled from the European Union Organ Donor Network – not because of politics or anti-Semitism, but because Israelis accepted organs but did not donate them. [5] We are, in almost every way, a giving people. But when it comes to giving life through organ donation, we have not stepped up to the plate.

So we do we hold back? Why did it take me until this afternoon, preparing for this sermon, to sign on that dotted line? We are not malicious; we are not selfish; we are not stupid. We are, I think, afraid.

We are afraid, first of all, that agreeing to become a donor will hasten our own deaths. In halakha, traditional Jewish law, as well as in our broader culture, there is some debate about how one defines death. And there is a passionate Jewish belief in the value of life and the preservation of life. We do not want to do anything that might cut our own lives short, or keep someone from fighting as hard as possible to preserve them. So what I can tell you is that organ donation does not contradict that passion for life; rather, it affirms it. Organs are not taken from a person until they are declared dead by two physicians, neither of whom is involved with the transplant. Organs are not taken from someone who can breathe on their own. Organs are not taken from someone whose brain is active in any way. Someone may be kept on a ventilator to keep their organs working long enough to save someone else’s life, but the donor is not alive. There has been an awful case in recent months of corruption involving funeral homes and the illegal taking of human tissue from the deceased. But there has never been any such corruption cited involving a hospital prematurely taking a life. It simply does not happen.

But there is more that makes us afraid. We are afraid that our bodies will not be treated with respect. And that fear is based on a real Jewish value: kavod hamiet, the dignity of the dead. This is the value that tells us to care for the bodies of the deceased, to watch over them and wash them and bury them with love. So let me tell you that surgery for organ transplantation is like every other surgery in the care given to the body, and in the desire to keep a body whole. Because transplants need to happen so quickly, funerals are not delayed. And, on a deeper level, Rabbi Isaac Klein taught, “There can be no greater kevod hameit than to bring healing to the living.” [6]

Let me share with you this description of a transplant procedure, offered by Dr. Calvin Stiller: When the decision to transplant is made, the donor and the recipient are taken to the operating room. The donor’s body is treated with profound respect, because we are watching one of the most extraordinary acts a human being can accomplish. The surgical theatre is hushed and reverence for life prevails as the donor organ is removed and taken carefully to the sick, partially destroyed body of the recipient. The sick organ is removed to make way for the new healthy organ. We watch in silence as the retrieval of life from the donor occurs and the restoration of life in the recipient begins. We watch as the skin begins to clear, the body chemistry begins to improve and the brain gradually quickens as the new organ functions and restores life. [7]

I cannot hear that description without thinking of the image of God as mechayeh meitim, giving life to the dead.

That brings us, though, to another fear. This is a fear that we as Reform Jews should theoretically be immune to because we reject the belief that our bodies will be resurrected. But there is a fear deep within some of us that maybe we’re wrong, maybe there will be a messianic age in which the dead are restored to life, and if we’re missing our organs, we’ll be in serious trouble. The best response to this that I’ve found comes from the website of the Halachic Organ Donor Society, which notes:

Some people believe that organs should be kept in the cadaver because they are necessary in order to be resurrected from the dead. This is pure fantasy because immediately upon death, organs begin to rapidly decompose and after a few months are gone. Indeed, even if one were to believe that resurrection is dependent on the bodily state of the cadaver, the only Jewish source which mentions such a thing refers to luz bone, a vertebrate of the spine, as the point from where resurrection stems from. In addition, if the Almighty Lord decides to resurrect a dead person, he assuredly will have the power to supply missing parts. [8]

It’s hard to argue with that. But even if one could, our tradition tells us that pikuach nefesh, saving a life, is a paramount virtue that takes precedence over almost everything else.

So what stops us? What stops us, I believe, is the deepest fear of all: the fear of death. The story is told of Raba and Rabbi Nachman. Raba was sitting before Rabbi Nachman as he lay dying. As he sank close to death, Raba asked Rabbi Nachman to please reappear to him after he died. Rabbi Nachman appeared to him in a dream, and Raba asked him, “Did you suffer pain?” Rabbi Nachman replied, “As little as in taking a hair from a cup of milk. But if the Holy One, Blessed be God, were to give me the chance to come back to this world I would not, because the fear of dying is so great” (Talmud, Moed Katan 28a). Now, I have written my will and my living will and signed my health care proxy, but signing the back of my driver’s license was still the hardest thing. It forces us to imagine not only dying but being dead. It forces us to imagine our bodies being in the world without us inhabiting them. Such imaginings are not generally how we like to spend our time. I understand that. But my discomfort, your discomfort, our fear should not prevent us from the possibility of saving lives. And at the end of the day, that is what organ and tissue donation is all about.

I am asking you tonight to join me in signing the back of your driver’s license. I am asking you tonight to join me in signing the donor card in the Union for Reform Judaism’s pamphlet on the Gift of Life. And I am asking you tonight to speak with those you love, so that if they are ever in the terrible place where they are asked what your wishes would have been, they will know the answer. Without their consent, you will not be able to save a life. And without your guidance and your blessing, they will not be able to know that you wanted to perform this final mitzvah.

In 1995, Alisa Flatow, a Brandeis University senior, took the year off to study in a Jerusalem yeshiva. She decided before Passover to travel by bus with a few friends to a hotel at Gush Katif. She never made it: A Hamas suicide bomber drove his van into the bus, mortally wounding her and many Israeli soldiers. Arriving from his home in West Orange, New Jersey, at Sorokin Hospital in Beersheva, Steven Flatow confirmed that the brain-dead young woman on life support was his daughter. The staff asked him a question: Would he be willing to donate his daughter's organs? After consulting with his wife, and making a conference call with their rabbis, Alisa's parents decided to donate her organs to six people on a waiting list who were clinging to life. [9] In the words of Yitzhak Rabin z”l, Prime Minister at the time, “Alisa Flatow’s heart [still] beats in Jerusalem.” When the time comes, may we have that privilege: may our hearts still beat, and may our lungs still take in breath; may our eyes still see, and may our last act be godly.

1. Rabbi Michael Gotlieb, “A Godly Act” (http://www.jewishjournal.com/old/coverorgan.4.7.0.htm).
2. United Network for Organ Sharing (www.unos.org), November 10th, 2006.
3. Statistics from Elaine Berg, CEO of the New York Organ Donor Network, private communication, November 10th, 2006.
4. “All Take and No Give?” by Adena K. Berkowitz, Moment Magazine, 1994.
5. From the Halachic Organ Donor Society website (www.hods.org).
6. Rabbi Isaac Klein, A Guide to Jewish Religious Practice (New York: JTS 1979), p.275 (cited in Life and Death Responsibilities in Jewish Biomedical Ethics, ed. Aaron L. Mackler, p.463).
7. Calvin Stiller, M.D., Lifegifts: The Real Story of Organ Transplants (Toronto: Stoddart, 1990), pp.166-67 (cited in Life and Death Responsibilities in Jewish Biomedical Ethics, ed. Aaron L. Mackler, pp.458-59).
8. http://www.hods.org/English/issuesE.shtml#superstitions.
9. “All Take and No Give?” by Adena K. Berkowitz, Moment Magazine, 1994.