Background
Since transplantation of solid organs was first introduced as a treatment modality in the 1950s the UK Jewish community has engaged with the process – as (potential) recipients and donors, as their families, and as doctors and other healthcare professionals who work professionally in this field.
At the time that this was first introduced, the late Chief Rabbi, Lord Jakobovitz, was recognised as a world authority on Jewish medical ethics. He interpreted halachic issues on this topic, broadly favouring transplantation. He emphasised the importance of saving life (“pikuach nefesh”) and recognised that the recipient need not necessarily be “lying in the bed adjacent” (“choleh lefanecha”).
The original 1954 human organ donation was of a live kidney between twins. Later, retrieval of organs from deceased donors became more frequent. With the advent of heart and lung transplantation, questions about when a donor could be declared dead became more important.
There have been many biomedical advances that have affected organ donation subsequently. These include improved maintenance treatments for recipients, changes in surgical approaches, organ preservation, accurate compatibility matching between donor and recipient, and the use of post – transplantation suppression of the immune response.
In the UK there are too few organs available to meet demand. Thus there have been several initiatives to increase donation. This has included faith communities.
In order to demonstrate that it was possible for even more observant Jews to participate in deceased organ donation for transplantation a document was prepared with the Court of the Chief Rabbi which was presented by Prof David Katz in 2010 at a launch event for patient leaflets which can be accessed here. The Jewish principles which underpin this are that (i) organ donation is permitted to save lives; (ii) that the process should respect the body of the deceased; and (iii) that the needs of the bereaved family should be respected.
The national organisation responsible for transplantation services and for promoting organ donation is NHS Blood and Transplant (NHS B and T).
Further details about NHS B and T can be accessed at https://www.nhsbt.nhs.uk/
Organ donation law between the different parts of the UK still varies. In Wales since 2015 “deemed consent” has applied. In England in 2020 the law changed to “deemed consent”. The NHS B and T website gives details of the different laws.
To coincide with the new system:
- New faith – specific leaflets have been prepared to take into account the change in the law. The one which describes the Jewish approaches can be accessed here.
- NHS B and T have introduced a faith and belief statement into their protocols which can be accessed here.
- NHS B and T have also introduced a Jewish faith statement detailing how the safeguards work which can be accessed here.
- The Board of Deputies has produced a summary document which explains how the new system works and how potential donors can invoke the necessary safeguards to ensure appropriate family consultation which can be accessed here.
The Human Tissue Authority is the regulatory body which draws up codes of practice for organ donation. In particular this acts as the core document for the Specialist Nurses in Organ Donation (SNODs). The relevant Code of Practice (Code F) can be accessed here.