WLC 136 and Organ Donation/Transplantation

[Clark-Tillian]

Recently a thoughtful and judicious parishioner proffered a query on the moral question regarding organ donation and transplantation. After studying and thinking through the matter, I told him that within reasonable limits (tricky, I know) that organ donation/transplantation would not be sinful; the assumed ethics of the medical establishment, though, are a major concern. But I'm not asking about the topic generally, but rather, specifically focusing on the clause in WLC 136 that reads "the neglecting or withdrawing the lawful and necessary means of preservation of life". In light of that clause, do you think withholding or refraining from Organ Donation and/or Transplantation is sinful?

 

[Andres]

No, I don't think neglecting to donate one's organs is sinful. If so, couldn't we also contend it's sinful to not donate monies to cancer research? The key clause seems to be "necessary means of preservation of life". How far do we carry out "necessary"?

 

[Tirian]

I think the major issue here though is the rapture. When believers are raptured from the earth, presumably their organs will disappear from the person who has them which would be catastrophic. Therefore it must be sinful to donate your organs.

 

[Mushroom]

I think the major issue here though is the rapture. When believers are raptured from the earth, presumably their organs will disappear from the person who has them which would be catastrophic. Therefore it must be sinful to donate your organs.

 

[Unoriginalname]

I do not think the average citizen has the duty to provide his organs for donation. I really do not have a detailed argument for it, I would just comment that if we have a moral responsibility to donate organs upon death then would we also have a duty to regularly donate blood, register for bone marrow donation, and be a live donor for kidneys?

 

[Zach]

I think it's a good question to ask. It shows that we really do care about how best to care for both our own bodies and our neighbors. When I first received my drivers license I registered as an organ donor but the second time around, not being sure about the lawfulness of doing that, I refrained. Personally, I don't think we should be required to be organ donors but after thinking it through I don't think it is sinful either. I don't think not having two kidneys would prevent God from raising me on the day of Christ.

 

[jandrusk]

I think if you could donate a given organ that would result in the preservation of that persons life without endangering yours, then you would be fulfilling WLC 136. If you knew this and did not donate, I would just ask the question, "How would this be different than seeing two thugs attempting to murder someone and doing nothing about it?"

 

[Contra_Mundum]

Someone here on the P-B has argued against the propriety of organ-donation in general. I can't fully recall the argument, but the key principle actuating it is that modern medicine regards the body as a machine and a factory. The matter (as Josh points out above) is one of "ownership." Do we own our bodies to the extent that we may donate our organs, does our stewardship extend to that level? Do we really have the right to dispose of our organs (postmortem) like we do with our other property, per our Last Will and Testament?

If the body is just a factory for producing organs, then is the society that so regards it merely one or two steps away from organ-harvesting? From the involuntary donation--at first, only postmortem; later on, from those deemed "undesireable" or "unproductive" to the collective--of those "organic products" that could extend the lives of the more useful?

I'm not presenting this position in its defense, but am putting it into the discussion for balance. At present, I'm willing to go part-way in allowing the benefit of true, voluntary donation to the extent that it affirms the value of all life, and the tragedy of death (under the Curse). But I shudder to think of the unscrupulous lengths wicked man will go, to make money off the lives of the less-fortunate, the incarcerated, the "burdens" on society. And the unspeakable lengths the wealthy and powerful will go to cheat death, by any means possible.

And I think that modern, godless society is not only fully capable of implementing those options; unquestionably it already does so in grosser and milder forms. The "lawful" uses, the "beneficial" and the "humanitarian" uses of organ-transplants, provide sufficient cover for the "black market" trade in the same goods. Meanwhile, the so-called medical "ethicists" of the day, in their educational ivory towers and their government-funded rubber-stamp institutions, are busy justifying more and more the utilitarian perspective.

And all that (and perhaps more) is what Christians must come to grips with on the topic, and not only whether the 6th commandment allows or encourages the practice.

 

[Clark-Tillian]

Thanks for the replies, folks. Most were thoughtful and at least one provided comic relief. However, as the OP I'd like to rewind the discussion a bit. I posted this specifically on this forum so I could limit the question. I'm torn by all these theological/philosophical issues, as well. But I'm mostly interested (with this question) in the interpretation of that clause in WLC 136. Andres made a good point; in light of the clause, where do we draw the limits? Justin is on the right track. I'm new on PB and not trying to be persnickety but I'm using the question to probe WLC 136--it's a catechetical/confessional question.

 

[JoannaV]

I think organ donation would be above and beyond WLC 136, maybe. There are questions about whether it is lawful, but that seems to be a subject for a another thread. Your question seems to be whether, if it is lawful, it is necessary.
If someone needs a kidney, are you obliged to donate one of yours just as you would give a starving man half of your grain, or do you keep it because it is actually a necessary means to preserve your own life in case one day your other kidney fails? As in, God has allotted each man (generally) two kidneys to see him through from birth to death, whilst grain is something he gives us day by day. I really don't know. And then organ donation after death is different again.

Anyhow following along to see the discussion!

 

[Clark-Tillian]

Joanna, yes. "Your question seems to be whether, if it is lawful, it is necessary." That's exactly what I'm asking. If it's lawful, then is it demanded by, to WLC 136? I'm interested in the interpretation of that clause/question. Obviously, we'd all agree (I hope) with the general tenor and specifics (depending on you subscriptional take) of the answer. Beyond that, however, how far do we press it?

 

[DeniseM]

There is a DVD put out by Vision Forum called Should We Starve Grandpa? that touches a bit on this topic. The main topic is "the merciful disposal of the elderly", but it also discusses the ethics involved in organ donating. A doctor gives explanation of how a man that comes into the ER after a motorcycle accident, that is an organ donor, in many cases, is not treated as aggressively as the non-donor that comes to the ER in the same condition. If the medical community can make money off of harvesting your organs for "needy" patients, why bother to put in the full effort to save your life?(This is the temptation that the medical community is having to struggle with.) I guess it comes down to who's life you have more of an obligation to preserve? Is it yours or some stranger(your neighbor)?

From Vision Forum's DVD description:

"Our modern culture of death is training the present generation to look at the elderly as unwanted and disposable. And as those in their twilight years increase in staggering numbers over the next decade compared to the shrinking workforce that follows behind them, this refrain will inevitably arise: "You've had your day, and your life is no longer worth living." How will the Church respond to these critical quality of life issues? What if doctors tell you that your aging loved one is in a permanent vegetative state and that it is merciful to withhold food and water from him? What is the definition of "brain death," and is it biblical? When does a person actually die? Are organ donations appropriate and wise? Doug Phillips, Dr. Mo Gill, Dr. Ed Payne, Dan Becker, and Jay Valenti address these and other pivotal questions in this important symposium on the sanctity of life."


I don't necessarily have a problem though with a live person donating an organ to a loved one or someone else in need. I would think of it as an act of love and mercy. I don't think that we could hold anyone accountable for not wanting to give up an organ, as if that person contributed to their death if they don't donate, though. It certainly is a difficult topic to really pin down.

 

[Scottish Lass]

I don't see it as demanded by 136. If it were, we'd need to be on a list for all things possible to donate (blood, kidney, etc.).

I don't think it's a coincidence that we have more blood than we need and that our bodies make more---God designed us that way. It protects us in case of a tragedy, but also allows me to give a pint every two months or so.

But "can" and "must" are not the same. Should I render immediate first aid if a tragedy occurs in front of me? Yes, to the best of my ability. Must I give my kidney or part of my liver to another whose organ(s) may have failed as a result of unrepentant sin? No. I could well be wrong, but I've always looked at phrases like 136 as more immediate aid/defense, etc.

 

[Clark-Tillian]

Thanks again. Anna, I agree--I do not think that WLC 136 demands we go all out regarding organ donation. This might be one of those issues that where 136 is best used in a casuistic sense--on a case by case basis.

 

[lynnie]

What about the "golden rule" ? Do unto others as you would have them do to you?

If it was your own kid that needed a transplant, or your beloved spouse, or you, (not as a result of chronic sin that would kill off the new organ) wouldn't you wish that nice person who just died in a car crash had been willing to donate their pancreas or kidney or whatever?

I got a test once to see if I had Alpha-1 antitrypsin deficiency. Turned out I did not, thank God, but some folks born with it end up getting lung or liver transplants. I cannot imagine standing before the great white throne and explaining to God why I wasn't willing to give my lung or liver to a beloved wife and mother, or teacher or pastor or missionary, when I could have saved a life if I just checked that little organ donor box.

Just my opinion.

 

[Clark-Tillian]

Lynnie, those are good points. I'm just more specifically asking about WLC 136 in this regard.

 

[Peairtach]

If it is right for someone to lay down their life for their friend, I don't see how in principle organ donation or blood donation is wrong.

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[Edward]

You probably need to look beyond the simple question that you asked (the answer to which I'd give as 'it depends') and look more deeply at the circumstances.

First, I'd divide the list into live donations and 'postmortem' donations. (And even there, there is a scale of risk to the donor from blood to marrow to kidney, for example). It is much easier to make a case that this class of donation would fall under the mandate of 136.

For 'postmortem', the issues are more complex. First, is the academic definition of death morally appropriate. It was chosen in part because it facilitates donation. But you can come up with instances of folks living for years after the determination, and a few cases of recovery after doctors have wanted to 'pull the plug'. So checking the card may, in fact, cause your death.

Layered on top of that are unethical transplant programs where the lists are manipulated to provide organs to a celebrity who doesn't otherwise qualify over an ordinary person who does.

And I'll leave out the instances where the transplant has killed the recipient (thinking here of the hospital that gave four patients fatal cases of rabies).

As for me, I've donated blood and I'm on the marrow registry, but I won't check the box on my driver's license.

 

[Clark-Tillian]

You probably need to look beyond the simple question that you asked (the answer to which I'd give as 'it depends') and look more deeply at the circumstances.

First, I'd divide the list into live donations and 'postmortem' donations. (And even there, there is a scale of risk to the donor from blood to marrow to kidney, for example). It is much easier to make a case that this class of donation would fall under the mandate of 136.

For 'postmortem', the issues are more complex. First, is the academic definition of death morally appropriate. It was chosen in part because it facilitates donation. But you can come up with instances of folks living for years after the determination, and a few cases of recovery after doctors have wanted to 'pull the plug'. So checking the card may, in fact, cause your death.

Layered on top of that are unethical transplant programs where the lists are manipulated to provide organs to a celebrity who doesn't otherwise qualify over an ordinary person who does.

And I'll leave out the instances where the transplant has killed the recipient (thinking here of the hospital that gave four patients fatal cases of rabies).

As for me, I've donated blood and I'm on the marrow registry, but I won't check the box on my driver's license.

Edward thanks, excellent observations. That's the discussion I'm after. I agree that WLC 136 demands casuistic nuances. I'm very concerned with the "post-mortem" aspects of donation for the reasons you mention. I wasn't aware of the rabies incident. Man alive, that's an dreadful situation. The ethics of "live" organ donation possess more clarity, in my view. However, the potential danger to the donor in a live donation also demands consideration via 136. I think the potential donor and recipient would need to weigh the potential risks against the potential benefits and with pastoral counsel and prayer make a decision. I don't think WLC 136 demands that we participate in donation and/or reception but I do think it demands we give thought to the issue.

 

[Jack K]

In postmortem organ donations in particular, there seems to be an inherent denial of the resurrection of the body: "You won't need that organ after you die, so the kind thing to is to let someone else use it." Well, we believe we will be using those organs in the future. Our whole bodies will be brought back to life and made incorruptible.

Now, no doubt God is able to sort out the body parts if they somehow get separated from us. But it still feels like some failure to hope in the bodily resurrection often goes along with organ donation.

That would seem to settle the issue for me... except that we do have the commands to preserve life and to be kind to others. These make the issue far less cut and dried than it first appears. So I would never chastise a person who, out of love for others or concern for life, became an organ donor. And if it were me or someone I love receiving the transplant, I'd probably be very grateful. Still, I sense there's an underlying lack of hope in the resurrection and an over-concern to maximize the length and comforts of this life that's behind the whole organ donation push in the first place, and I wonder if the availability of these procedures is actually good for us.

 

[earl40]

I think the major issue here though is the rapture. When believers are raptured from the earth, presumably their organs will disappear from the person who has them which would be catastrophic. Therefore it must be sinful to donate your organs.

This is as good a reason to not believe in a pretribulation rapture as I have ever read outside the scripture, which I will assume you do not believe.

 

[earl40]

In postmortem organ donations in particular, there seems to be an inherent denial of the resurrection of the body: "You won't need that organ after you die, so the kind thing to is to let someone else use it." Well, we believe we will be using those organs in the future. Our whole bodies will be brought back to life and made incorruptible.

Now, no doubt God is able to sort out the body parts if they somehow get separated from us. But it still feels like some failure to hope in the bodily resurrection often goes along with organ donation.

That would seem to settle the issue for me... except that we do have the commands to preserve life and to be kind to others. These make the issue far less cut and dried than it first appears. So I would never chastise a person who, out of love for others or concern for life, became an organ donor. And if it were me or someone I love receiving the transplant, I'd probably be very grateful. Still, I sense there's an underlying lack of hope in the resurrection and an over-concern to maximize the length and comforts of this life that's behind the whole organ donation push in the first place, and I wonder if the availability of these procedures is actually good for us.

As a father who has 2 children who have CF I have no concern that The Lord can restore the original lungs to perfect health at His comming even if they were thrown away after the transplant...BTW they have not had such Thank God. Also the quick and the dead will be raised with new bodies.

 

[Clark-Tillian]

In postmortem organ donations in particular, there seems to be an inherent denial of the resurrection of the body: "You won't need that organ after you die, so the kind thing to is to let someone else use it." Well, we believe we will be using those organs in the future. Our whole bodies will be brought back to life and made incorruptible.

Now, no doubt God is able to sort out the body parts if they somehow get separated from us. But it still feels like some failure to hope in the bodily resurrection often goes along with organ donation.

That would seem to settle the issue for me... except that we do have the commands to preserve life and to be kind to others. These make the issue far less cut and dried than it first appears. So I would never chastise a person who, out of love for others or concern for life, became an organ donor. And if it were me or someone I love receiving the transplant, I'd probably be very grateful. Still, I sense there's an underlying lack of hope in the resurrection and an over-concern to maximize the length and comforts of this life that's behind the whole organ donation push in the first place, and I wonder if the availability of these procedures is actually good for us.

Jack, even though we've veered a tad from WLC 136, I'd like to ask you a question. More of a brain-tease I suppose. Could one not say that an organ donor is showing explicit affirmation, rather than inherent denial, of the resurrection? In other words, "God in his omnipotence will reunite all my body parts at the Resurrection, therefore, as I am able potentially to save a life, I will become an organ donor." Just a thought, not denying your assertions.

 

[Mushroom]

A Christian dies and is buried. Many years pass and the cemetery is forgotten, and an apple orchard is planted over it. A tree absorbs some of the man's physical material through its roots, produces an apple with it, and another Christian eats it and it becomes a part of kidney. Who gets that material in the resurrection?

Convoluted, yes, but nearly the same conundrum as that presented by transplantation. Personally, I'm just gonna let the Lord sort it out.

 

[Peairtach]

A Christian dies and is buried. Many years pass and the cemetery is forgotten, and an apple orchard is planted over it. A tree absorbs some of the man's physical material through its roots, produces an apple with it, and another Christian eats it and it becomes a part of kidney. Who gets that material in the resurrection?

Convoluted, yes, but nearly the same conundrum as that presented by transplantation. Personally, I'm just gonna let the Lord sort it out.

Dabney discusses this in his Systematic Theology.

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[Pergamum]

Loving your neighbor as yourself encourages us to take great means to save or preserve the lives of others.

If it is lawful for a soldier to throw himself on a grenade to save his friends, surely he can consent to give his organs to save others once he is already dead.

 

[Free Christian]

This is something I have often wondered about and to be honest at this stage in my life I would donate. But the other points raised makes one think.
Who owns our bodies, us or God? God does, no if's. But can I use it to help another when I am gone? Isn't there a scripture passage John 15 v 13 about how there is no greater love than for one to lay down his life for a friend or another? Wouldn't doing that if we had no right in some way over our bodies, what to do with them, be wrong to lay down for another. To allow ourselves to be killed, damaging our life and body? If Jesus says that is an act of love then it is an act of love. Would not the giving of an organ be a much lesser thing to do than to lay down ones life they are presently living? To save another? Is not giving an organ likewise saving another? What if in laying down your life it involved your beings total destruction of everything including your organs, as in fire? And yet doing that would be considered Biblically an act of love! To me the answer lays in John 15.


I edited this post because something I raised, I later thought could be insensitive or distressing to another even though it was a real situation and happened and was not in itself wrong or offensive. If anyone did or was upset before this edit you have my sincere apologies.

 

[Clark-Tillian]

Thank you for all the input, friends. This is why I decided to finally join the PB. I love the Standards and love studying the detail of them.
As a pastor, I gain a good deal of profit in analyzing various aspects of the Standards to real or hypothetical cases.

 

[Jack K]

In postmortem organ donations in particular, there seems to be an inherent denial of the resurrection of the body: "You won't need that organ after you die, so the kind thing to is to let someone else use it." Well, we believe we will be using those organs in the future. Our whole bodies will be brought back to life and made incorruptible.

Now, no doubt God is able to sort out the body parts if they somehow get separated from us. But it still feels like some failure to hope in the bodily resurrection often goes along with organ donation.

That would seem to settle the issue for me... except that we do have the commands to preserve life and to be kind to others. These make the issue far less cut and dried than it first appears. So I would never chastise a person who, out of love for others or concern for life, became an organ donor. And if it were me or someone I love receiving the transplant, I'd probably be very grateful. Still, I sense there's an underlying lack of hope in the resurrection and an over-concern to maximize the length and comforts of this life that's behind the whole organ donation push in the first place, and I wonder if the availability of these procedures is actually good for us.

Jack, even though we've veered a tad from WLC 136, I'd like to ask you a question. More of a brain-tease I suppose. Could one not say that an organ donor is showing explicit affirmation, rather than inherent denial, of the resurrection? In other words, "God in his omnipotence will reunite all my body parts at the Resurrection, therefore, as I am able potentially to save a life, I will become an organ donor." Just a thought, not denying your assertions.

I suppose someone could be thinking along those lines. I just get a sense that the other way of thinking is more common. As with many matters, there may be no hard and fast rule about what you should do but much to consider regarding why you do it.

 

[Unoriginalname]

If it is a moral duty to provide organs for your fellow man (and I would assume that includes less invasive things like blood and bone marrow) does that mean the concept of savior siblings (siblings born for the purpose of providing an organ for a sick sibling) is ethically valid? I mean if providing an organ goes under the responsibility or people to preserve life, then wouldn't it fine for a parent to force one sibling to donate a kidney to another?