Christians can conclude that … Bible ‘does not prohibit organ donation and transplantation’

Should Christians support organ donations and transplantation?

SINCE medical doctors Joseph Murray and David Hume performed the first successful living-related kidney transplant from identical twins in 1954, the science of organ transplantation has advanced by leaps and bounds. About 50 years later, there have been successful heart, pancreas, pancreas islet cell, intestine, lung, liver and heart-lung transplants. This medical technology has helped thousands of individuals.

Should Christians support this ever-growing practice, and should they be organ donors?

The Bible does not deal directly with the issue of organ donation since it is alien to the biblical world. The task of the Christian thinker, then, is to see if what the Bible says about God, human beings, the nature of our physical bodies, and our relationship with one another, has light to shed on the topic.

The Bible teaches very clearly that our physical bodies are the temples of the Holy Spirit (1 Cor 6:19-20), and that we should therefore be good stewards of our bodies. It therefore prohibits any form of self-mutilation. Yet, the New Testament also urges Christians to love one another in a self-sacrificial way. The supreme example of the unconditional love that is demanded of God is Jesus Christ, who gave His life for the sake of sinful humanity.

Jesus taught that His disciples are to love not just their neighbours, but also their enemies. Just as Jesus loved us and gave up His body for us, so we are commanded to love one another: “Beloved, if God so loved us, we ought also to love one another” (1 John 4:11).

Jesus also exhorted His disciples to serve others, and by doing so they are in fact serving their Lord. Thus, when Jesus spoke of caring for the hungry, thirsty, homeless, naked, sick and imprisoned (Matt 25:35-46) He implied that the unconditional love of His disciples must extend to even strangers. “Verily I say unto you”, Jesus said, “inasmuch as ye have done it unto one of the least of these my brethren, ye have done it unto me” (Matthew 25:40).

In light of this central biblical teaching about Christian love, the Christian can conclude that the Bible does not prohibit organ donation (and transplantation). In fact, the Bible in a sense encourages this act of sacrificial love and service. The clearest statement from a leader of the Christian community in favour of organ donation comes from Pope John Paul II, who in his encyclical entitled The Gospel of Life (Evangelium Vitae) wrote: “There is an everyday heroism, made up of gestures of sharing, big and small, which build up an authentic culture of life. A particularly praiseworthy example of such gestures is the donation of organs, performed in an ethically acceptable manner, with a view of offering a chance of health and even of life itself to the sick who sometimes have no other hope.”

Although there are no strong objections to organ donation and transplantation from the Christian standpoint, there are some very real and pressing ethical concerns, hinted at in the statement just quoted. The first has to do with the concern that the procurement of organs for transplantation does not put the donor in harm’s way. That is to say, obtaining organs for transplant must abide by the strict ethical codes that govern the practice of medicine in general.

Related to this is the important issue of informed consent: the authenticity of such a decisive gesture requires that individuals be properly informed of the procedures involved and are in a position to consent or decline in a manner that is both free and conscientious. This is especially pertinent in the case of the living donor.

In addition, steps must be taken to ensure that the donor is not under any pressure or duress to offer one of his or her organs for transplantation. Pressure faced by the donor can come in very subtle ways, for example, in the unspoken expectations of members of the family or even from the sick person in need of the organ. The decision to offer a part of one’s body for the health and wellbeing of another must be made without pressure and any expectation of reward. It is precisely in this sort of giving that the nobility of the act as a genuine gesture of love is seen.

We must address, albeit very briefly, the issue of the sale and purchase of organs for transplantation. Given the principles already laid out in this essay, we must conclude that from the Christian standpoint the sale and purchase of organs for transplantation must never be allowed. This is because such activities would result in the commercialisation of human organs where the latter are seen as items of exchange or trade. This is a violation of human dignity because it essentially looks upon the human body as an object that can be bought and sold at the right price.

Other ethical objections to this practice, such as the exploitation of the poor, are also important considerations. But they are secondary reasons for prohibiting organ sales. The primary reason has to do with the fact that such a practice violates human dignity and will corrode the moral fibre of human society if it is allowed to flourish.

Space allows me to deal very briefly with just one more ethical concern with organ procurement that relates to cadaveric donors: the problem of “brain death”. Through the ages, death is understood as the state of the body without life – cold, blue and rigid. In 1968, however, an ad hoc committee at Harvard recommended the neurological criterion for determining death.

According to this view, the patient is said to have died when there is a cessation of brain activity. This definition of death is preferred to the tradition cardiopulmonary criterion (which maintains that death has occurred when heart and lung activities have ceased) because it allows the procurement of organs for transplantation. When harvesting organs for transplantation, time is of the essence: without circulation, the heart and liver are damaged in three to five minutes, while the kidneys are damaged in about 30 minutes. The neurological criterion for determining death, however, has been challenged by some doctors and ethicists alike, and continues to be a subject of considerable debate.

Dr Roland Chia is Dean of Postgraduate Studies and Lecturer in Historical and Systematic Theology at Trinity Theological College. He worships at the Fairfield Preaching Point in Woodlands.