A proposed new policy on organ donation in Wales is causing consternation, with the Board of Deputies warning it could be the “thin end of the wedge” for Britain as a whole.
The Welsh government intends to switch to an “opt-out” system where doctors can presume that organs are available for transplant unless the deceased had indicated their objection — rather than the current “opt-in” where people carry donor cards declaring their consent.
Rabbinical opinion is divided over the move, which has drawn opposition from major churches in Wales and other faiths.
Dayan Yisroel Lichtenstein, head of the Federation Beth Din, said that it should “send alarm bells ringing throughout the Jewish world”.
The proposed legislation, he said, represented “a major shift in governmental thinking about human rights and interference in an individual’s personal property — his own body.
“It has no place in a democratic society, and sets a dangerous precedent that must be opposed.” Dayan Yisroel Lichtenstein
“It has no place in a democratic society, and sets a dangerous precedent that must be opposed”.
But Liberal Judaism chief executive Rabbi Danny Rich argued that the Welsh government had taken a “courageous decision” to change policy — which is likely to be debated by Welsh Assembly members early next year.
Rabbi Rich said: “It remains the case that large numbers of people have not made their wishes known, which puts both medical practitioners and the bereaved into an impossible situation where they must make an immediate decision in the moment of crisis, resulting in many potential life-saving organs not being used.”
Differences over organ donation exist not only between Orthodox and Progressive rabbis, but within Orthodoxy itself.
A statement on organ donation issued last year by Chief Rabbi Lord Sacks and the London Beth Din was criticised by some Orthodox rabbis abroad for adopting too conservative a definition of death which would restrict donation.
The Beth Din believes that organs for transplant may be taken only after the heart and lungs have stopped — cardiorespiratory death — but some Orthodox rabbis argue for brain-stem death as an acceptable principle.
The Board of Deputies — which favours an improved opt-in system — was among religious groups rejecting the principle of opt-out in submissions.
Medical professor David Katz wrote on behalf of the Board that the proposals would “place considerable stress on families”. Rather than being asked to donate, he said, they would be expected to understand that they would be “deemed to consent”, but could still decline permission.
He said that “upholding the general principles of individualised consent is important for the Jewish community. The current biomedical emphasis on consent stems directly from worldwide concerns about the abuses perpetrated against Jews and others under the Nazis.”
The Welsh proposals, he said, were “unusually disturbing as they could represent the thin edge of a wedge into UK ‘best practices’.
The state will now have ‘deemed consent’ but the relatives will have a burden of proof to provide convincing information that the donor would have objected.”
A spokesperson for the Assembly said that the change would increase the number of organs available for transplant.
“It is fundamental to our approach that the wishes of the deceased are paramount, with safeguards for the family,” she said.
Stanley Soffa, chairman of the South Wales Jewish Representative Council, has raised Jewish worries in a meeting with the Assembly’s medical director.
See the links below for the arguments for and against the opt-out system from Rabbi Danny Rich and Dayan Yisroel Lichtenstein