The following exploration represents a fraction of the available literature on this topic and is intended to provide a framework for discussion rather than a guide for practical decisions. For practical questions, please consult a rabbi who is both competent in the relevant intricacies of Jewish law and well-versed in modern medicine.

Does Jewish law permit organ donation? To address this question, it’s important to understand the potential halachic issues involved. For the purposes of clarity, this article will be divided into three parts:

Organ Donation From the Living

The living can donate several organs, for example, and most commonly, a kidney. The primary halachic consideration here is whether or not one is permitted to voluntarily enter into a situation of danger1 in order to save another’s life.

In a well-known letter, the Radbaz—16th-century chief rabbi of Egypt, addresses a situation where a Jew in captivity was told that unless he allowed his arm to be cut off, the captors would kill his friend. The Radbaz ruled that Jewish law did not obligate him to undergo that personal danger, even at the expense of his friend’s life, but he would be permitted to do so if he so chose.2

Based on this letter, several contemporary halachic experts rule that although one is not obligated to donate an organ for another, it is certainly permitted and would be considered a mitzvah to do so.3

Nevertheless, there are several halachic experts who express reservations. Rabbi Menashe Klein, a post-war halachic decisor, ruled that although it is permitted to endanger oneself for the sake of the community, one may not endanger oneself for an individual.4 (It’s important to note that his responsum was written in 1973, when the risk to the kidney donor was higher than it is today.)

In his Code of Jewish Law, the first Rebbe of Chabad, Rabbi Shneur Zalman of Liadi (known as the Alter Rebbe), writes that it is not permitted to endanger oneself even to save a friend from certain death.5 Although the Alter Rebbe is not discussing kidney donation per se, and the degree of personal risk is not defined, it is conceivable that, by extension, the Alter Rebbe may have had similar reservations with respect to kidney donation.

As such, if one is considering donating a kidney, it is best to ask your own rabbi.

Organ Donation From the Dead

There are certain situations in which organs will be harvested when the patient is “brain-dead,” even though his or her heart may be kept beating through the use of supportive devices. In such scenarios, identifying the halachic moment of death is of paramount importance, which will be dealt with in the next section.

For now, let’s assume that we are dealing with someone who is already considered dead according to Jewish law. What halachic considerations may arise when the patient is unequivocally dead?

There are three widely-cited concerns:

  1. The prohibition against deriving benefit, hanaah, from the dead.6 Using an organ from the dead appears to be in direct conflict with this prohibition.7
  2. The prohibition of nivul, defiling the dead,8 which would presumably be an issue when harvesting an organ.9
  3. The requirement of kevurah, burying the dead.10 An organ removed from the dead body would not receive the burial it requires.11

Harvesting an organ from the dead seems to conflict with these three principles, but there is an important additional factor that must be considered: Will this transplanted organ save a life, a situation known as “pikuach nefesh,” such as a kidney or liver?12 Or is it something non-vital, like a cornea transplant?13

In the former scenario, when a life is on the line, many halachic authorities rule that just as the threat to life overrides most areas of halacha,14 it overrides these three principles as well.15 A letter from Rabbi Yaakov Emden, a well-known 17th-century halachic expert, is often cited to support this view. Asked whether doctors may perform an autopsy to better understand the cause of death, and thereby possibly benefit other patients in the future, Rabbi Emden ruled that such a desecration of the dead would only be permitted if there were a “dangerously ill patient, present before us,” who would benefit from it immediately.16 In line with this view, many halachic authorities allow harvesting an organ from the dead if there is a patient on hand whose life will be saved,17 and some even consider such a donation a mitzvah.18 Nevertheless, there are still some who opine that the requirement of burial is not waived even in the case of immediate threat to life.19

What about when the organ will not save a life, such as a cornea?20 There is a lengthy responsum from Rabbi Unterman,21 where he asserts that when an organ is transplanted from the dead to the living, it is, in a sense, “resurrected.” As such, it no longer requires burial, and would no longer be considered deriving benefit from the dead.22 There are, however, other halachic authorities who disagree with the entire premise of the “resurrected organ” and rule that indeed the prohibitions still apply.23

Organ Donation and the Moment of Death

In many instances, and certainly when it pertains to heart transplants, the organs are transplanted from patients who are brain dead,24 but whose hearts and lungs are kept functioning through artificial support. The question then arises, does halacha consider patients in this state alive or dead?

If they are still alive, harvesting their vital organs would constitute murder25 and could never be permitted.26 But if they are dead, the discussion becomes essentially that of the previous section in this article. Therefore, it is critical to discuss the defining moment of death in the eyes of halacha—a high-stakes battle which rages on to this very day.

Much ink has already been spilled on this complex discussion, the details of which are beyond the scope of this article. But at the risk of oversimplifying, some of the major views define death as:

  1. Cessation of spontaneous respiration.27
  2. Cessation of both cardiac and respiratory function (and even if spontaneous respiration ceases, as long as the heart beats the patient is considered alive).28
  3. Brain death.29

Moreover, for those who consider cessation of spontaneous respiration to define death, there is the opinion that perhaps brainstem death ought to be an indication of the moment of death,30 because once the brainstem dies the ability to breathe spontaneously ceases.31

If one were to consider brain death the halachic moment of death (either as the defining moment itself32 or as the indicator that the defining moment is upon us33), then a brain-dead patient is truly dead and harvesting his or her organs does not constitute murder. The only halachic issue would be harvesting organs from the dead, dealt with previously.

In fact, the Israeli Chief Rabbinate has taken this approach since 1986, stating that cessation of respiratory function defines death, and that therefore brain death—which implies that the ability to spontaneously respire is gone—is an adequate indicator of death. This ruling has obvious implications for when organs can be harvested, and they attach several conditions to their ruling to ensure that it is carried out to the highest halachic standard.34

But there are many leading halachic experts who maintain that brain death does not constitute death;35 the brain-dead patient is very much alive and therefore one may not harvest his or her organs. According to these authorities, one needs to wait until the patient is dead from a cardiorespiratory standpoint before harvesting organs.36

As such, if one were to state that he is willing to have his organs harvested only once cardiorespiratory function ceases, in theory that would be acceptable to these authorities, but there are still several significant concerns. While the patient is still alive from a cardiorespiratory standpoint (and therefore considered completely alive according to these viewpoints), any activity done to the patient while preparing for the organ harvest which would shorten or terminate his life, either deliberately or inadvertently, would be considered murder.37 At the same time, as long as the patient is being kept alive until they are ready to harvest his organs, there is the concern that we are actively prolonging the suffering of one who is imminently dying, which may be forbidden.38

Therefore, according to the many opinions cited above, harvesting organs from a brain-dead patient is certainly forbidden, and even stipulating that the harvest wait until cardiorespiratory death ensues may be problematic.

It should be noted that even the halachic authorities who rule that an organ may not be harvested from a brain-dead patient permit the recipient to accept such an organ in order to save his life.39

Conclusion

It bears repeating that this article provides a broad overview but is neither comprehensive nor authoritative. For any practical questions, please consult a rabbi knowledgeable in both Jewish law and modern medicine, and may we soon realize the final redemption, when “the eyes of the blind shall then be opened, and the ears of the deaf shall be unstopped. The lame shall then skip like a hart, and the tongue of the mute shall sing, for water has broken out in the desert and streams in the plain.”40

Learn More on Organ Donation:

Watch Rabbi Adin Steinsaltz on: “Organ Donation.”
Read: Organ Donation in Judaism
Watch: Meet the Rabbi Who Donated a Liver to a Total Stranger
Or, see all that Chabad.org has to offer on the topic of Organ Donation.