Religions struggle with organ donation

Question about when life begins and ends at heart of dilemma in many faiths

October 25, 2002|By Teresa Watanabe | Teresa Watanabe,SPECIAL TO THE SUN

For Los Angeles screenwriter Robert Avrech, it was a wrenching choice between two of his greatest loves: his Orthodox Jewish faith and the life of his only son.

His son, Ariel, is in critical need of a lung transplant. Avrech knew of a man who had just collapsed on a softball field and was in a coma. But Avrech, guided by his religious and moral compass, would not approach the family about a possible organ donation.

It seemed "ghoulish," he said. He saw a slippery slope that would turn the desire for healing and life into a morbid wish for death to harvest organs. Wouldn't that make him no better than a Nazi?

Even after the man died, Avrech declined to approach the family because, he said, his Jewish values, particularly the need to show reverence to the body and respect for mourning, overrode even his desperate desire to save his son's life.

"It's a difficult situation for me because I want to save Ariel's life," Avrech said slowly.

Avrech's case underscores the sometimes wrenching dilemmas - and vast divergence of belief - that occur in the religious world over the issue of organ donations. All religions cherish the value of saving lives, but questions of when death begins and when donated organs may be used have raised a thicket of moral issues.

In Japan, for instance, an ancient religious belief that cutting a corpse defiles the individual's spirit has severely hampered organ donations. Not until 1997 did the nation recognize brain death as legal death.

The Roman Catholic Church, by contrast, has an "upbeat, positive attitude" toward organ donation, said James Walter, the O'Malley professor of bioethics at Loyola Marymount University in Los Angeles. The positive Catholic tradition stems from the 1940s, when theologians began promoting organ donations as an act of charity.

Within Islam, organ donations are encouraged under the Quranic exhortation that "whoever gives life, it is like giving life to all human beings," said Dr. Maher Hathout, a retired Muslim physician and member of the Kuwait-based Islamic Medical Conference.

In the Jewish world, debate rages between religious movements and even within them.

"Unless you have a very, very definite cause, and usually an immediate need, Judaism attaches a high value on keeping the body intact," said Rabbi Yitzchok Adlerstein, a professor at Loyola Law School in Los Angeles.

Those attitudes, however, appear to be changing in at least some sectors of Judaism. In 1995, legal scholars from the Conservative movement, the Jewish grouping with the highest number of U.S. synagogue members, approved a rabbinical ruling that not only declared organ donations permissible but said they were an obligation under Jewish law.

Since the 1995 decision to deem organ donations a religious obligation, many Conservative congregations have promoted them through sermons, fliers and distribution of donor cards, said Rabbi Bradley Shavit Artson, dean of the Zeigler School of Rabbinic Studies at the University of Judaism.

The issue, however, remains highly controversial within Orthodox Judaism.

Rabbi David Bleich, a professor of the Talmud at Yeshiva University in New York, said the majority of Orthodox scholars reject the brain-death standard. Traditional Jews cannot be party to pulling the plug on a patient before the heart and respiratory functions stop, he said. He added, however, that Orthodox Jews could receive organs extracted from brain-dead patients as long as they had nothing to do with obtaining them.

That position provokes a withering rebuttal from Rabbi Moshe David Tendler, a professor of medical ethics and chairman of the biology department at the same Yeshiva University. He said Jews who reject brain death should not then be able to harvest organs from brain-dead patients, or they would be akin to "hit men" waiting for others to kill someone so they benefit.

As the debate rages, Ariel Avrech needs new lungs. At the minimum, he needs donations of two lung lobes, which can be extracted in what medical experts regard as a relatively safe procedure. The 21-year-old rabbinical student suffers from pulmonary fibrosis, a severe scarring of the lungs caused by chemotherapy he has undergone since a brain tumor was diagnosed at age 14.

The family's Orthodox community has rallied. Members of Avrech's synagogue, Young Israel of Century City, in Los Angeles, have brought food, gifts and even daily services to his home during the High Holy Days. The Jewish Healthcare Foundation has distributed an e-mail on Avrech's plight throughout the Americas, Europe, Brazil and Israel.

For his part, Ariel Avrech says his ordeal simply represents the challenges God presents everyone, challenges that have helped him grow.

"People have displayed tremendous courage, bravery and generosity, and they wouldn't do this if I weren't sick," he said. "I see all of the beautiful things coming out in this world because of me."

Teresa Watanabe writes for the Los Angels Times, a Tribune Publishing newspaper.

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