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Split over May’s plan for opt-out organ donation

Board says removal of organs raises religious issues, while transplant experts within the community hailed the move

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Jewish medical experts are overwhelmingly backing a proposed change to the organ donor system, despite significant reservations aired by the Board of Deputies.

During her speech at the Conservative Party conference last week, Theresa May said the government would set up a public consultation on organ donation, including switching from the current “opt-in” system, where patients give consent for the use of their organs, to “opt-out”, where organs are presumed to be available for transplant unless objections have been recorded.

The Board responded that “while, in principle, Judaism encourages organ donation in order to save lives… the removal of organs raises religious issues, centring on the point at which death is presumed to occur. The government will need to consult carefully in order to protect freedom of religious practice.”

In its “Jewish manifesto” published before the general election in June, the Board said it “prefers the continuation of an ‘opt-in’ process, with regular encouragement, to an ‘opt-out’ process. This is because the latter risks a person having their organs taken against their and their families’ wishes, which could cause very grave distress to families of the deceased.”

However, transplant experts within the Jewish community hailed the possible change. Jeremy Crane, a consultant transplant and vascular surgeon, described it as “a very positive step forward, opening up conversations within families with the aim of organ donation becoming a societal norm”.

He argued that “until these conversations turn into action, the UK’s ethnic communities will continue to suffer in particular. Our patients are dying daily due to a shortage of organs.”

Anthony Warrens, a professor of renal and transplantation medicine, said that “about three people die in the UK needlessly on the transplant waiting list every day just because we don’t have enough organs to save their lives. Yet we know most people would like to donate if given the chance.

“The change from an “opt-in” to an “opt-out” presumption is likely to change that and save many, many lives. So we need to have a very good reason for opposing it. Anyone who does not wish to donate his or her organs will have full rights to register their objection and not do so. All that is being asked is that people think about it and make an active decision. With the lives of so many people at stake, that doesn’t seem such a big ask.”

A spokesperson for the Chief Rabbi’s office confirmed that his “longstanding position… reflects that of the Board of Deputies, which consults with the chief rabbinate on the issue.”

However, representatives of other communal denominations praised the idea.

Rabbi Jonathan Wittenberg, senior rabbi of Masorti Judaism UK, said: “Our body is the gift of God, and for organs to be used for pikuach nefesh — to save life, is a great mitzvah. We would encourage organ donation and have no difficulty with opt-out rather than opt-in, so long as there are adequate safeguards for the [organ donation] process.”

Rabbi Danny Rich, senior rabbi of Liberal Judaism, said he had “long been an advocate of the ‘opt out’ position. If as a result more organs become available for transplant then, in accord with the Jewish principle of pikuach nefesh, who would not welcome this?”

Elliott Goss, a member of Edgware Reform Synagogue, was diagnosed with acute kidney failure last year. The wait for a kidney via a deceased donor was not an option because the waiting list is five years long. He managed to receive a kidney via a new pooling initiative, where his wife donated one of her kidneys to an anonymous donor and he received one suitable for him in return.

“For me this is a no-brainer, having been on dialysis for nine months,”, he said, describing the need for a larger pool of donors as “critical. “Others spend years waiting for a donor. And obviously some people die and never get a donor.”

He added: “The impact on the NHS will be interesting because they’re under massive strain as it is, and with the pool of organs being donated at a quicker rate there’s going to be a strain to perform the operations.”

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