Religious views on organ donation are generally very favourable, although there is a debate in certain religious groups on the validity of current brain death criteria. Accordingly, the more theologians are accepting of current brain death criteria, the more they are likely to support organ donation.
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All major religions either accept organ donation or accept the right of individual members to make their own decision. Most religions like the Roman Catholic Church are in favor of organ donation as acts of charity and as a means of saving a life. Some impose certain restrictions.[1] For example, Jehovah's Witnesses require that organs be drained of any blood due to their interpretation of the disallowance of blood transfusion from the Bible,[2] and Muslims require that the donor have provided written consent in advance.[2] Orthodox Judaism considers it obligatory if it will save a life, as long as the donor is considered dead as defined by Jewish law,[2] which is a matter of debate among different rabbis. A few groups disfavor organ transplantation or donation; notably, these include Shinto[3] and those who follow the folk customs of the Gypsies.[2]
The 1981 federal report, Defining Death, found that Catholic and Protestant theologies did not object to brain death criteria. Indeed, Dennis Horan, president of the pro-life group Americans United for Life, stated:
Legislation limiting the concept of brain death to the irreversible cessation of total function of the brain, including the brain stem, is beneficial and does not undermine any of the values we seek to support.
In Catholic medical ethics, Pope Pius XII stated that death is determined by medical experts and it "does not fall within the competence of the Church."[4] Advocates of brain death criteria have claimed that this implies that the church is bound to support the view of the medical community on this issue. More recently, the Pontifical Academy of Science has upheld Catholic doctrine.[5]
Nevertheless, there was some Catholic dissent on neurological criteria for death.[6] In addition, a volume consisting of essays by opponents of brain death criteria who participated in a 2005 conference at the Pontifical Academy of Sciences was published in 2006 by a publisher outside the Vatican.[7]
In 2008, an article of the Osservatore Romano expressed the wish that the debate on brain death be re-opened because of new developments in the medical world. A Vatican spokesman said that the article presented a personal opinion of the author and "did not reflect a change in the Catholic Church's position".[8]
In recent times, the findings of the 1981 President's Commission Report have been questioned.[9] The new attack on brain death criteria has been multi-pronged. First, the view that brain death marks the end of the integrated unity of the human organism has been questioned. Alan Shewmon has argued that the body as a whole is the central integrator of the organism rather than the brain.[10]
He appeals to, among other reasons, brain dead pregnant women who have lived up to 200+ days and given birth to healthy children, as well as to a brain dead boy who lived over fourteen years on a ventilator and with basic nursing support. Others have argued that there is insufficient evidence that the entire brain is dead in a brain dead individual.[7] Some brain dead individuals have continuing EEG activity[11] and others maintain normal or near-normal body temperature, implying continuing hypothalamic function.[12] The pope's body is also not used for organ donation.[13]
The majority of Muslim religious leaders accept organ donation during life (provided it does not harm the donor) and after death in order to save life. Brain death is not controversial and most religious leaders do not recognize it and consider cessation of all signs of life including heart beat as precondition for declaring death.[14][15][16]
Jewish medical ethics takes a unique approach. It accepts organ donation as a meritorious charitable act, but with two conditions: that the donor be deceased before removal of the organ and that the organ be treated respectfully (and not, for instance, merely discarded if it for some reason becomes unusable). One of the ethical problem stems from a lack of consensus on the definition of "deceased." According to the strictest interpretation of halachah, "deceased" means the cessation of circulation, respiration, and brain activity. For most organs, once the heart stops beating and circulation stops it is too late for the donation to be medically useful. Nevertheless, for the adherent to this view, removal of organs prior to cessation of heartbeat would be tantamount to murder. Given the nature of the market for donated organs, the second condition would limit donation to a case where there is a known and ready need for that specific organ. Alternatively, a promise can be made to ensure a proper burial for a donated organ in the event that it is not transplanted. A movement to promote organ donation from Jews to the general population in consonance with halachah has been spearheaded by the Halachic Organ Donor Society.
Despite the adoption of whole brain criteria in the United States and "brain-stem" criteria in the United Kingdom, there has been some opposition to the brain death criteria (aka Neurological Criteria of Death). Some Orthodox rabbis have staunchly defended the definition of death as indicated by irreversible cessation of heart beat.[17] Conversely, some Orthodox rabbis and Israel's Chief Rabbinate have adopted determinations of death based on brain function irrespective of a beating heart.[18] As a result, Orthodox Jewish ethics has been sharply divided over key death-related policies. Tactically, Orthodox Jewish opponents to brain death have requested waivers from state law, as a matter of religious freedom, so as to continue relying on traditional indicators.[17][18] Meanwhile, proponents of organ donation such as Halachic Organ Donor Society have been active in advocating organ donations and transplants either at brain death or even at cessation of heart beat, where donation of corneas and skin is still medically possible.
According to Buddhism, it is a great Merit to donate ones own flesh for the sake of another. The lord Buddha is also believed to be sacrificed himself by jumping into a fire in order to nourish a lost and starved villager in woods, in a previous life as a rabbit.[19]
The choice of making the donation has to be made by the donor himself according to Buddhism. It's not clear brain death is a form of death according to Buddhism, whether the soul has left the body or not. But if it considered as death, in which case one cannot make decision of ones self, it's a good deed for one who died and also for the ones involved in decision making and contributing.
Life after death is a strong belief of Hinduism and is an ongoing process of rebirth. So, the physical body is insignificant. This could be seen as reflecting positively on the concept of organ donation and transplantation in Hinduism.[20]
Other Dharmic faiths hold similar views.