Choose Life

Living donor kidney transplant procedure (Mayo Clinic)

V'Chai Bahem! Torah law is designed to live by. Not die by. That is an overriding law of the Torah. It means that whenever one is confronted with violating a Torah law that would save a life, one must violate that law. Except for the 3 cardinal sins of murder, biblical level adultery, and idol worship that is what we are required to do. Whether it is our own life or someone else’s.

What happens when an ethical principle is involved?  ...principles that if violated may send a terrible message or result in terrible collateral consequences? Should we allow someone to die and not violate those ethics?

An article in Stat News raises this question. 

Briefly, a surgeon involved in a complicated surgery needed information compiled by Nazis during the Holocaust. It is rather well known that Josef Mengele (Y'mach Shemo) did medical experiments on human Guinea pigs – Jews that he picked out at Auschwitz on their way to their death. He commenced experiments that among other things blinded, maimed, permanently sterilized, and otherwise tortured those Jews in a variety of ways. Many of them dying in the process!

But - the results he got from those medical experiments can actually save lives. Should we be allowed to use those results? Is it ethical? The surgeon in that case used that information and the operation was a success. But she later wondered if she had done the right thing. 

I can understand the desire not to use medical knowledge obtained that way. What Nazis like Mengele did is reprehensible at the highest levels! I cannot begin to imagine how those who survived his experiments and were permanently damaged by them - feel. To condemn Mengele and what he did is beyond obvious. There is a special place in Hell reserved for people like that.

But once we have the medical knowledge and can save lives with it, in my view - it must be used. We must always choose life.  How do we tell a dying patient that we know how to save his life but we won’t do so because of the way we found out how to do it.

For those that still might say we should not use medical knowledge that way because it is unethical, I have to ask what the greater good is? What can be greater than saving a life?

This also raises the question of organ donations. If I understand the law correctly, buying an organ like a kidney from a potential live donor is illegal. It abuses the poor and favors the rich. Poor people that need the money will sell their organs to wealthy individuals in need of them and can afford to pay for them. In fact an entire industry can result where a broker can advertise for kidney donors enticing the poor to donate a kidney for a price… and then turn around and sell it at 10 times what he paid for it. Making it a very lucrative enterprise. But an obvious very unethical one. Kidney donations are relatively safe for healthy donors. But there is still a risk going under the knife. There always is.

The medical community has determined that buying and selling human organs is unethical and forbids it. When a patient needs a kidney the route taken is to find a donor (often a relative) willing to give up his kidney if it is compatible. Or to wait for someone who is about to die and transplant their kidney into the person that needs it. Because there are more people that need kidney transplants than there are kidneys available, they are put on a waiting list prioritized based on who needs it the most… or waiting the longest. (I think that’s how UNOS works.)

But what if there is no kidney available for someone that way? What if he will die if he doesn’t get one? Is it ethical to simply let him die and not violate the law by buying one? On the one hand it will save his life if he does. On the other hand if we let him do it - it will encourage the highly unethical enterprise of buying and selling human organs.  Which is the greater good?

In my view, once again, the answer is to choose life. Letting someone die because we refuse to let him buy an organ is the greater of two evils in my view.

That said, I do not believe that we should allow it to become a business. By the same token a person should be able to have available to him the means to save his life.  

Perhaps the answer is to have strict government regulations about how one may go about purchasing a kidney. Making it a non profit enterprise (like UNOS) with no middle man other that an ethics committee in a hospital. I’m not sure. It’s just a thought. But surely letting someone die because we will not allow him to buy one is much worse. Isn’t it?