Organ Donation

In one of those strange coincidences, the subject of organ donation recently came to my attention from two separate directions. First, the news reported that a man who had an organ donor card was critically injured in an accident, and when he was declared brain-dead, his family refused to honour his intentions and donate his organs. Second, I have been editing some academic research into attitudes towards organ donation. It was strange to be working on a subject that was also reported in the news.

I have been carrying an organ donor card for many years, and I want to explain here why I consider it important, and why I consider people's objections to organ donation to be irrational.

Medical science enables doctors to take organs from recently deceased people and transplant them into patients suffering from various medical conditions. In some cases, these transplants can save lives, while in others they improve the patients' quality of life.

In the modern world, we are living in a relatively safe and sterile environment, and many people are never exposed to death and serious disease. These subjects, part of the cycle of life, have become taboo to some people, who prefer not to think about them or discuss them. Some people even refuse to draw up a will, thinking that this could somehow hasten their death.

The decision regarding the treatment of dead bodies is usually made based on religion, or on traditional practices. The main traditional methods are burial, cremation, and disposal at sea. In Israel, dead bodies are buried (rather than cremated), so this is the burial type I will discuss here. Burials are ceremonies aimed at helping the deceased's surviving loved ones come to terms with the death, and they create a memorial where the deceased can be remembered.

Most religious leaders believe that saving a life is important, and support or even encourage believers to donate their organs after death. However, a minority of religious leaders and believers seem to think that organ donation is not acceptable to their religion, for various reasons.

First, there is the sensitive issue of brain-death. When the brain ceases functioning, this is completely irreversible. It seems that some people confuse this state with reversible states such as coma, and therefore consider the brain-dead person still alive, or think that a miracle could happen and the person could regain consciousness.

Second, the issue of how the dead body is treated is sensitive for those who believe in the afterlife and/or in some form of reincarnation. In my understanding of these religions, the soul is a non-material essence of the person, which leaves the body at the moment of death, and so the removal and transplantation of bodily organs after death should have no impact on the released soul. As for reincarnation, the idea that the body should be kept whole until burial seems strange, considering that the flesh decays. Religions that believe the dead will rise from their graves in their physical bodies must assume a lot of miraculous intervention to restore the flesh, and in that case, why not also restore the organs that were donated upon death?

Third, some religious believers seem to have a negative opinion of science and medicine in general, to the point of accusing scientists and physicians of "playing God". To counter this objection, I suggest that believers take into account that human cognition was, in their own view, given by God, and as an omniscient being, God should know how the gift of intelligence is being used. It should not be possible for humans to "play God" against God's own intentions.

Finally, some people seem to believe that patients carrying organ donor cards would be considered as organ banks, and would therefore receive less medical support than other patients, since the health care workers would hasten their deaths in the hope of obtaining organs for other patients. This is an offensive slur against the morality and integrity of hospital staff, who work hard to save lives and alleviate pain and suffering.

My own position is that once I am dead, my body is no longer of any use to me, and I would prefer to think that it might be of use to another human being, rather than to think that it was just buried and allowed to decay. If it were possible to use every one of my dead body's cells to save lives, with the result that there was nothing left of my body to be buried, I would still do this. My loved ones would be able to remember me without a slab of stone marking the spot where my remains were decaying.

In order to clarify this issue in the public mind, and increase the number of potential donors, the following steps should be taken:

• A public information campaign explaining brain-death and showing transplant patients whose lives have been saved or improved.
• Religious leaders supporting organ donation should educate their coreligionists who oppose it.
• In some countries, I have heard, people renewing their drivers license have to opt out of signing an organ donor card, by ticking the box saying "I do not wish to donate my organs after death", which has increased the number of potential organ donors, compared with countries like Israel, where people have to opt in. This method is worth adopting.
• In general, society would be healthier if people had a more open and rational attitude to death and disease, treating these as aspects of life and things that will impact all our lives at some point, rather than as taboo.