Chief Rabbi welcomes new provision for Jewish organ donors

The Chief Rabbi and Board of Deputies have warmly welcomed a remarkable caveat to the Organ Donation (Deemed Consent) Act, which came into effect this week.

The addition to the Act, which changes the system of organ donation from “opt-in” to “opt-out” in England, means that halachic considerations will be taken into account and families will always be consulted.

The change was made from “opt-in”, where people had to register their willingness to donate their organs after death, in order to improve the level of organ transplants. “Opt-out” essentially means that — with three exceptions — a person will be assumed to have agreed to organ donations, if they are medically eligible.

The exceptions are people under 18, those who lack the capacity to understand the change, and people who have lived in England for less than 12 months, or who are not living here voluntarily

Because Jewish law regarding organ donation is complex — and its interpretation can differ from rabbi to rabbi — the OCR and the Board have been in close consultation for more than two years with NHSBT (National Health Service Blood and Transplants). 

Now, a groundbreaking, cross-community arrangement has been agreed, whereby a person will be able to register, to declare that their faith is important to them, and that they are Jewish. A specially trained nurse will then speak to the person’s family and ask for a designated religious authority to advise whether organ donation can take place. 

The system is not up and running yet because of the Corona pandemic — but when it begins, Chief Rabbi Ephraim Mirvis will be among those saying that should the question of organ donation arise with him, he will ask for halachic advice to be sought.

The new proviso will cover all parts of the Jewish community, from the strictly-Orthodox to the Liberal movement. Other faith groups will also be able to benefit from the arrangement.

In a letter to the Jewish community, Professor John Forsythe, medical director of organ and tissue donation and transplantation at NHSBT and Dr Dale Gardiner, the national clinical lead for organ donation at NHSBT, say “the essential principle we want to reinforce is that a person’s faith and beliefs will be respected in discussions with their families about donation, should the opportunity arise —whether or not they have recorded their decision in the register. 

“Our specialist nurses explore someone’s faith and beliefs when discussing the possibility of donation, to ensure that if donation does go ahead it only does so if in line with these beliefs. The family can consult a faith leader, if they so wish. If a family has any concerns, our specialist nurses will support them to address these and agree the best approach”.

Professor Forsythe and Dr Gardiner say they want to give “greater clarity, to people who want to donate but want more reassurance around how their faith or beliefs would be respected if they can donate their organs or tissue when they die”. 

A spokesman for the Chief Rabbi told JN: “While the Deemed Consent organ donation legislation becomes law this week, our ongoing engagement with NHSBT entirely reassures us that until the impact of Coronavirus on the NHS significantly and measurably subsides, Deemed Consent will not yet be implemented. 

“Indeed, NHSBT have themselves stated that the current situation means, where an individual’s decision is not known, they will continue to help families make donation decisions on behalf of loved ones. This is a hallmark of the current ‘opt-In’ system and demonstrates a continued commitment to it in the interim”.

The spokesman said that the OCR’s work with NHSBT “has delivered an essential accommodation within the opt-out system which will allow a person to declare on the Organ Donor Register that their wishes for donation are entirely subject to guidance from their chosen religious authority.

The effect of this accommodation will be to allow observant Jews to engage positively with the new system, safe in the knowledge that their faith will be respected. In sufficient time ahead of Deemed Consent’s actual implementation.”

Once the new system is operational, the spokesman said, people would be able to register their personal preferences on the Organ Donor Register at any time and to change these at any point. There will be no deadline for registering.

Board of Deputies Vice President Amanda Bowman welcomed the agreement with NHSBT. She said: “It is now clear what the government’s organ donation reform means in practice — that families will always be consulted to ensure the deceased wishes are carried out. We have been reassured multiple times on this front.

“We are pleased that the system has been updated with new and projected features that enhance religious freedom — from a faith declaration on the organ donor register, to the ability for families to access rabbinic advice.

“Although the new system will not be implemented until after the Covid-19 pandemic is over, the Board of Deputies will be working with denominations to ensure the Jewish community is aware of how to navigate the new system.

“Our aim must be for as many Jewish citizens as possible to engage with the new system, in a way that is compatible with their beliefs so we can save lives and defend religious freedom”.