מספר מזהה: 6793

- מכון שלזינגר - https://www.medethics.org.il -

ADI Card

שאלה:

1. When signing an ADI card, is there a need, or even a benefit, to select the option that a religious authority of the family's choosing will verify the decision…?
It appears that the Israeli law, as agreed by the Israeli Rabbinate, already confroms to halacha and that all cases are reviewed by a Rabbi (Prof Steinberg?) to ensure compliance.
Therefore, what is the benefit of this option and may one sign the card without selecting it?
 
2. How does one donate non-life-saving organs, such as corneas and skin and is there any reason not to , according to halacha?
It appears to me that in halacha, vision is so important that it would be allowed.
Skin, can be life-saving in cases of burns; would skin donations be allowed for coametic uses per halacha and is that included in the ADI card?
 
Thank you

תשובה:

1. It is advisable to select the option that a religious authority verify the decision, for two reasons:  a) While much of the Israeli law is agreed upon by virtually all authorities, certain sections are subject to dispute, and one's personal Rav may rule otherwise. b) Since dealing with a public medical system, review by a personal Rav provides additional confirmation that the halachic (and medical) protocol was properly followed.
2. Regarding corneas, a number of authorities consider loss of eyesight in both eyes as potentially life-threatening. (See Dr. A. Steinberg, Encyclopedia of Jewish Medical Ethics, vol. I, Blindness, p. 108.) Accordingly, cornea donations would certainly be permitted in this case. Loss of vision in one eye, though, would not be considered life-threatening, and requires additional clarification. (See Prof. A.S. Abraham, Nishmat Avraham, Y.D. 349:2(3[2]); Responsa Yabia Omer, Y.D., 3:20-23.)There are three primary issues associated with donations from a corpse: defilement of the deceased, the prohibition of benefit, and annulment of burial.

  a. Regarding the issue of defilement, this belongs to the realm of mitzvot between man and his fellow, for which permission of the donor suffices according to many authorities. (See Rabbi Dr. Mordechai Halperin, Hashtalat Aivarim min Ha'met, Refuah U'mishpat, vol. IV, pp. 31-38.)

  b. Regarding the prohibition of benefit, some poskim contend that something that which is reincorporated into a living being is no longer considered benefitting from a corpse. (See Dr. A. Steinberg, Encyclopedia of Jewish Medical Ethics, vol. III, Transplantation, p. 1098;)

  c. Regarding the issue of burial, this may be permitted on the same basis, since it is incorporated in a living being. (See discussion in Nishamat Avraham, ibid.). In addition, some maintain that there is no requirement of burial on a small piece, less than an olive-size.
Thus, there is substantial basis to allow cornea donations.
(see also Asia, vol. 65-66, pp. 160-162 that Rav S.Z. Auerbach zt"l permitted cornea donations.)

3. In practice, skin is almost always used for cases of serious burns, which are considered life threatening on account of the risk of infection and fluid loss. Therefore, it may be donated.

Rabbi Meir orlian