Question 216:

Does Christianity permit organ transplants? Is there a difference between living and dead organ donors?



The large area of living in the service of others also includes the possibility of enabling the restoration of health or the saving of the lives of other people through the transfer of tissue and organs. […]

The possibility of organ transplant raises questions and difficulties. There are different issues surrounding the transplant of organs from a living donor and from someone who has just died.

Live donation is only ethically acceptable if it concerns organs that come in pairs, such as kidneys. It is also acceptable only if the donor’s life and health are not endangered in any way and if it can be assumed that the donor will suffer no other substantial and irreparable damage to his own life, his health and his ability to work. On the other hand, there has to be reasonable hope that the organ transplant prolongs the life of the recipient or that it can substantially improve his health. And finally, an organ transplant has to be the only means of saving the recipients life. A further prerequisite is that the motivation for the donation is the love of ones neighbour and that the donor has given his approval freely, after careful thought and comprehensive education. These days, organ transplants from living donors are largely avoided. They can only be accepted in rare cases as an extraordinary personal sacrifice. No-one must be put under moral pressure.

Different problems arise when we look at the transplant of organs of people who have just died to a recipient for whom the transfer of the organ (kidney, heart, liver) is life saving or life extending.

Many people have deep seated fears and reservations about serving as an organ donor after their death or to make this decision on behalf of a relative. Many believe that reverence of the dead body prohibits this violation of the physical integrity of the deceased. Others fear that dying people could prematurely be declared dead.

Because from an ethical point of view the removal of an organ is only permissible when there is certainty that the organ donor is dead, it becomes imperative to determine the moment of death with certainty. In view of the advances of modern medicine the last apparent sign of life (the last breath or the last beat of the heart) are no longer sufficient because circulation and breath can be maintained artificially. Many opt to replace the earlier definition of clinical death with the definition of brain death. This consists in the complete and irreversible breakdown of the overall function of the brain. The determination of brain death is a certain indication that the decay of this human life is no longer reversible. From that moment on it is acceptable to remove organs for transplantation.

The possibility to determine the final death of a person can remove the fear that organs may be taken before he has died. Furthermore, the removal of organs from a dead person is subject to certain conditions because it is an interference with the integrity of the dead body. Government laws therefore regulate the conditions for removing organs. Important is the consent of the donor given prior to death, or in the case of deceased persons, the consent of the relatives. [Organ transplants are] not morally acceptable if the donor or his proxy has not given explicit consent. (CCC 2296). Only in urgent cases in which an immediate organ transplant is the only means of saving another person, can the aim of saving a life take precedent over the requirement to preserve the integrity of the dead body. Government regulations and medical guidelines are aimed at preventing abuse, thus for example the absolute prohibition of the buying and selling of human organs.

Overall, Christian churches believe that organ donation is an opportunity to practice charity beyond death, but they also support the careful evaluation of each individual donation (cf. God is a friend of life joint declaration of the German Bishops Conference and the Council of the German Protestant Church, VI, 4: organ transplants). Carrying a donor card cannot be compulsory, consent must always be free and considered and motivated by love. („Katholischer Erwachsenen-Katechismus“ (German Catholic Adult-Catechism by the German Bishops Conference), Vol 2, p. 314-316.)

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Prof. Dr. Christian W. Troll,

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