Chief Rabbi backs new organ donation system in England

A spokesman for the Chief Rabbi said discussions with the NHS Blood and Transplant over the past two years had “delivered an essential accommodation within the opt-out system which will allow a person to declare on the organ donor register that their wishes for donation are entirely subject to guidance from their chosen religious authority.

“The effect of this accommodation will be to allow observant Jews to engage positively with the new system, safe in the knowledge that their faith will be respected.”

Amanda Bowman, vice-president of the Board, said it was “now clear what the government's organ donation reform means in practice - that families will always be consulted to ensure the deceased wishes are carried out. We have been reassured multiple times on this front.”

The Board was "pleased that the system has been updated with new and projected features that enhance religious freedom - from a faith declaration on the organ donor register to the ability for families to access rabbinic advice.”

She added, "Our aim must be for as many Jewish citizens as possible to engage with the new system, in a way that is compatible with their beliefs.”

The Office of the Chief Rabbi intends to provide further detail on how the new system will operate before it is introduced.

A leading Reform voice, Rabbi Jonathan Romain, of Maidenhead Synagogue, said, “Until now, many lives have been lost through the inability to use the organs of people who never bothered to sign a consent form.

“In many cases that I have dealt with personally, relatives have derived great comfort from the fact, that despite a tragic death, at least their loved one helped others to live through their heart, liver or other organs."

Very few people would refuse a transplant if their own life depended on it, he said, "so it is right to make the reverse assumption about giving organs”.

A person signing the organ donation register will be able to record their faith – and also to nominate a next of kin to ensure their wishes are respected.

Senior figures in NHS Blood and Transplant offered reassurances that a person's faith would be respected in a letter to Jewish groups.

"In an opt-out system people still have a choice about whether or not to donate and can record their decision at any time – before or after the opt-out system comes into effect," wrote Professor John Forsythe, medical director of ogan and tissue donation and transplantation in NHSBT and Dr Dale Gardiner, national clinical lead for organ donation.  

"Where donation is a possibility, families are always consulted to ensure we know what the person who has died wanted to happen.

"The essential principle we want to reinforce is that a person’s faith and beliefs will be respected in discussions with their families about donation, should the opportunity arise - whether or not they have recorded their decision in the register."

NHSBT specialist nurses "explore someone’s faith and beliefs when discussing the possibility of donation, to ensure that if donation does go ahead it only does so if in line with these beliefs," they said.

" The family can consult a faith leader, if they so wish. If a family has any concerns, our specialist nurses will support them to address these and agree the best approach."

It was "unlikely" that donation under the new system would proceed under during the current Covid- 19 pandemic, they said.

One of the concerns for the Orthodox authorities has been instances when the medical definition of death might differ from the halachic one, leading to the possibility of an organ being removed from someone considered still alive in Jewish law.

The Jewish Organ Donation Association welcomed the Chief Rabbi's support for signing the organ donor register.

Richard Schoub, director of its medical advisory board said it was "critically important to communicate the law change to the Jewish community and encourage an open discussion on Judaism's positive view on organ donation."

He added, "We are all feeling the immediate devasting impact of COVID-19. The virus is also having a significant knock on effect in reducing the number of life saving transplants. Now more than ever, we need to come together as a community and have conversations with our close family about our intentions so we can help saves lives in the future." 

Wales introduced a similar, so-called “opt-out” system for donation five years ago and Scotland plans to move to one next year.