Do Chareidim Contribute Their ‘Fair Share’ of Organs?

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harvesting-organsBy Rabbi Boruch Wolf

I once attended a tribute event for living kidney donors, and was intrigued by the lack of diversity in the room. Though there were sectarian distinctions, the common thread was that they were all Chareidim. The room was filled with Chassidim, some yeshivish individuals, and a couple of Sephardic Jews. I had imagined that the diversity of the donors would extend to their religious levels of observance, but was amused that the distinctions remained nuanced in sectarian adherence.

It is not my province to render halachic rulings; I leave that to poskim (rabbinic authorities). Herein, I will address some realities and seek to dispel fictitious notions.

Chareidim are often criticized regarding their willingness to accept organs from cadavers, especially in light of their unwillingness to register as organ donors themselves. However, if one of these critics were to examine the facts surrounding Chareidi organ donation, they would find their indignations to be unfounded.

Consider the following: Each year, there are 160 altruistic kidney donations in the United States. Of those, one Jewish organization alone, Renewal (in Boro Park, Brooklyn), facilitates 30. (They enabled 45 to materialize this year, 30 of which were altruistic. The other 15 were donations to family members or close friends. In fact, the majority of Renewal’s donors meet their recipients for the first time in the hospital as they’re being prepared for surgery.)

According to these numbers, 18% of all altruistic donations nationwide come from one Chareidi organization alone! Of the 30 donors, all are frum (religiously observant), and 85% are what would be considered “Chareidi.” Furthermore, consider that not all Chareidim donate through Renewal; the amount of Chareidi/frum kidney donors compared to any other American demographic is staggering-in a good way!

Kidneyregistry.org states that kidneys transplanted from living donors last nearly twice as long as cadaveric donations. Now, suppose the Chareidi Rabbinate would congregate to reexamine their position on cadaveric kidney donation, and determine that it’s a mitzvah to register to donate one’s organs upon mortality. Do you think there would be a consequential difference in the amount of available kidneys due to the influx of Chareidi signatories?

Let’s examine some hard data: The overwhelming majority of people who have signed up to be [afterlife] organ donors are NOT qualified to donate upon death. It is the extreme minority whose organs are actually viable for transplant. According to Hrsa.gov, there are currently 118,929 people in America awaiting an organ. 81.5% of those people need kidneys. The average waiting time for a kidney is three to five years, depending on blood type. Sadly, 5,000 of them will die annually while awaiting their kidney.

101.4 million Americans (33.8% of America’s population of 300 million) are enrollees in state donor registries as of January 1st, 2012. According to the New York Times, there are approximately 11,000 kidney cadaver transplants that occur each year. Because America’s [annual] mortality rate is 0.7995%, roughly 810,700 registered donors die each year (which means there should be 1,621,400 prospective kidneys which become available annually to the ill renal patients).

Despite the above figures, only slightly more than one half of one percent of kidneys are in fact transplanted! The only explanation is that 99.5% of the kidneys don’t receive medical clearance for transplant because they lack viability; otherwise, there would be no waiting list at all (as 1.6 million kidneys fill the need many times over and would eliminate the existence of a waiting list).

Approximately 500,000 Chareidim reside on America’s blessed shores (Wikipedia/University of Manchester). Based on the US mortality rate, approximately 3,998 of them will die this year. Using our earlier illustration where the [Chareidi] Rabbinate would encourage signing the donor card, and Chareidim would become inspired to register as donors (and would match America’s 33.8% figure of registered donors), that would amount to 1,351 registered Chareidi donors dying this year, leaving behind a theoretical 2,702 kidneys to be harvested for cadaveric donation. Taking into account that 99.32% wouldn’t be viable [for transplant use], merely 18 additional [Chareidi] kidneys would be added to the national “kidney inventory” each year.

The 18 potential Chareidi kidneys that would become available (if the Chareidi Rabbinate would encourage after-life donation), is substantially lower than the 30 [altruistic] figure that Renewal actually facilitates yearly. That is even without taking into account that kidneys stemming from live donors have nearly double the lifespan of the cadaveric kidney.

One Chareidi organization alone compensates-and then some!-for all those [potentially] lost kidneys due to the Chareidi Rabbinate’s hardline stance. So, the next time you hear someone professing slander upon the Chareidi community with the notion that they consume organs when needed, yet refuse to donate, you will know the true response: Chareidim DO donate life!

Source: The Algemeiner Journal

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22 COMMENTS

  1. Interesting Footnote: The blood drives in our Jewish communities of Boro Park, Flatbush, etc. are the BIGGEST community blood-drives in all of the United States.

  2. I don’t mean to argue with the message of your letter, but as someone with a mathematical background, I must point out a flaw in your numbers. You took a 99.43% number that came from cadaver kidneys, and used it to figure out how many “extra” kidneys came from Chareidim. What you failed to figure out was how many “extra” kidneys came from living donors who are not chareidi, and add it to your statistics.

  3. @Modern Orthodox, calculating living donors numbers separately is perfectly logical, why should it be included it with the cadaver numbers…

  4. comment #2 is correct also we take dead hearts lungs ect… so that further mitigates your argument this piece is another example of the low tactics of chardi journalism undoubtedly the writer is aware that there are many other organs involved but ignores that and assumes that his intentionally dishonest assessment of the situation will placate the more morally inclined charidim who see the unfairness of there position and will now be able to feel even more self righteous and attribute all complaints about them to antisemitism.

  5. Supposed we DON’T contribute our fair share. Why is that a problem? The only reason we don’t is because the Torah doesn’t allow us speed up death. Why the need to explain or apologize for that?

  6. @2, I think you may have been mistaken as the purpose of that section of the message was to figure out the number of kidneys would potentially be taken from cadavers and the comparison of that number to the number already given. And @ juda, it would do you well to hide better your internal contempt at the hareidi society. He clearly mentions the percentage of kidneys needed as opposed to the other organs. It doesn’t mitigate an argument to point out something which lacks relevance. His topic is kidney donations which comprise the majority of organs needed in the United States. My assumptions about the type of person you are aside, if you deem it appropriate to attack the hareidim and their journalism (which it never is), do so with a logical, reasonable outlook, and not one coming from a strictly emotional and immature place.

  7. #3: Let’s say you have a pool of 1 million non-Jews, and 100,000 Chareidim.

    33.8% percent is in the registry, so that’s 338,000 non-Jews. If 0.5% of kidneys from cadavers aren’t cleared for medical use, that leaves you with about 27 kidneys. (1,000,000*0.007995*0.338*2*0.005=27.02)
    That’s a rate of 0.0027%.

    Now, let’s say the Chareidim give at the rate in the article above. The article said 30 kidneys for 500,000 chareidim. For 100,000, that would mean 6 kidneys. That’s a rate of 0.006%, which is obviously higher than the non-Jewish rate.

    But you have to take other things into consideration. How many chareidim give kidneys after death? Probably none, so the rate stays constant at 0.006%. Now take into account how many non-Jews give kidneys when they’re still alive. That raises their donation rate above 0.0027%.

    The other thing to take into account is that the mortality rate and total population takes into account those who can’t donate kidneys, either because they are too old, or are too sick. You should exclude them. It should be, how many people who are able to donate kidneys do so?

    The fact remains that the Jewish population is definitely more inclined to help out a stranger and donate a kidney while the donor is still living. This is a tremendous chessed and should not be overlooked! But to claim it makes up for donating organs after death is just wrong.

    Please note that I’m not advocating for donating organs after death! I am not signed up as an organ donor, nor do I want to be! Each person should follow their own Rav. But trying to justify it with bogus statistics is misleading, and should not be done.

  8. Of the 30 altruistic donations, how many went to other charedi or frum recipients?

    If all or most, that shows that charedim have a broader definition of who is a close friend.

    That is admirable, but it isn’t pure altruism. The thought is that if the donor is ever in need (of a kidney or anything else), another frum person will be there to help.

  9. I think this article is very dangerous. If we were to stand by a ruling complicating our donor ability and express pain that we can’t donate and go against our Torah it would be at least a principled stance. To start trying to defend it mathematically and logically opens us up to a slew of criticisms anytime something is proved to be invalid. For example, when you say altruistic kidney donations, I assume you mean donations to non family members. While this is wonderful, it needs to be said that in all likelihood, these kidneys are still not available to the general public; just to our Jewish brethren. While I have no issue with people wanting to focus their charitable intentions in our community, it does not reinforce our willingness to be donors; just our understanding that our “family” extends beyond our immediate blood relatives. Make no mistake – this is a beautiful idea and action, but to say we donate more than our fair share of organs is untrue. In all organ donations we take from the public and do not return. In kidney donations we do the same. The likelihood of someone who is giving me the opportunity to receive their heart, receiving my kidney is extremely small. I can state that I would be posthumous donor if only I was unafraid of the halachik ramifications. Are we all on the level were our adherence to the Torah is so great that we can say we are unashamed of not being donors? Is there no Safek that brain death can be halachik death? Even if we Pasken to the contrary, perhaps that is a Chumrah? I think it much more likely that we are just too selfish to let it actually bother us. I don’t advise organ donation. That is not my place or intention. Lets not pretend that we are so magnanimous either.

  10. Answer to #4 was already given in the post. “According to Hrsa.gov, there are currently 118,929 people in America awaiting an organ. 81.5% of those people need kidneys” That means that only 18.5% of the needed organ donations in the entire country are not being addressed by Renewal. The percentages still overcompensate the societal obligation by far.

    #4’s objection was also not the point that #2 made at all.

    I wonder though if #4 is so concerned by the obligation to help those in need of organ donations to actually be on line to donate a kidney with Renewal or has even considered donating financially to Renewal.

  11. 2 and 4,

    True the number 30 includes the non Chareidi donors (who are still frum, just not Chareidi), but as the overwhelming majority (approximately 85%) of the Renewal donors are Chareidi, we are talking about 25 Chareidi donors a year. (Not to mention that the other 5 are still facilitated through a Chareidi Organization and have Chareidi fingerprints upon them, to a degree).

    Also, as mentioned being that Kidneys are the most needed organ for transplant to the tune of 81.5%, let’s grant an additional 20% (to include liver, pancreas, heart, lungs etc.) to the 18% figure and that comes out to 21.6 organs that would hypothetically be ripe for harvesting from Chareidim verses the 25 Chareidi donations that Renewal facilitates annually, so your point narrows the compelling figure but still sustains (25 remains a higher number than 21.6) the assertion that Renewal alone DOES compensate for Chareidim’s lack of cadaver organ donation.

    Let’s not even mention that Chareidim’s death rate is considerably below the national average because Chareidim have such large families, at least double the size of the national average, which makes the Chareidi population so much younger, which makes the Chareidim’s death rate considerably lower which means less Chareidi cadavers…. So when I calculated the Chareidi death rate using America’s mortality rate, that wasn’t to the benefit of my point, but I had no reputable figure to go on, so I just used the national average, which totally inflates the hypothetical Chareidi cadaver figures.

    So if anything, though I’m not an actuary by profession, I know math and it’s obvious that I was playing the numbers quite safe and not wildly downplaying the value that Chareidim can have by subscribing to a more liberal halachik cadaver policy. There simply are very few cadavers lost due to Chareidi Rabbinic Authority’s hard-line policies.

    You point the finger at me and insinuate that my assertion is flawed, but I’d love for you or someone else to illustrate with hard data the picture that hundreds of Chareidi organs are being lost because of Chareidim’s stubborn halachik policy.

  12. Sorry Juda. You must have missed his statistic that about 85% of the organs are kidneys. Also you must have meant to write “their” in your last intentionally dishonest sentence.

  13. Juda,
    While Boruch doesn’t discuss the entire issue of organ donation after death (since he claims not to be a posek) he does discuss the ‘giving’ that is done by charedim. The fact that they cannot halachically give after death is miniscule by his estimation. What should amaze everyone is how generous they really are and emulate them and donate kidneys while alive (btw this is the longest list in the US for any organ.)

  14. MO,

    It seems to me that the writer is in fact not incorrect, because he was interpolating what the additional cadaveric donations would be. Thus he is comparing kidneys to kidneys.

    He did mention that 18% of ALL altruistic donors are from one organization that is a Jewish organization.

  15. What you fail to realize is that US law is, if a living organ donor later on in life requires an organ himself, UNOS (the organization that runs the nationwide organ harvesting) places that person at the top of the list to receive his organ, so a gentile and Jew receive that same “insurance policy”.

  16. There are two things you don’t mention.
    A) Renewal doesn’t choose to whom the kidney goes to, rather, they only offer profiles in order of when they were registered on their list. If for whatever reason the donor wants to skip over a profile and donate to a later profile on renewals waiting list, they are allowed to do so. So being that the all Renewal’s donors are Jewish, they will most likely skip over a gentile to donate to their own. However, if a gentile wants to place his name on Renewal’s list, I highly doubt Renewal would turn them away, they’d merely be forced to inform him that the chance of Renewal being able to clinch a kidney for him is very slim. However, plenty of Renewals recipients aren’t religious.

    B) Irrespective of who gets the kidney, every time Renewal facilitates a kidney for a recipient, that recipient removes his name from the national list, so whoever was in line behind him, moves up a spot, so gentiles suffering with kidney disease derive measurable benefit as well.

  17. Modern Orthodox,
    First of all, let me say that I respect you greatly for reading my article and dissecting the numbers on its merits or lack thereof, using facts and not ad hominems. I also respect your obvious intellect.

    I left out the standard living donors and only took into account the altruistic donors for the following reason: I assumed Jews and gentiles alike love their families to the same degree and thus assumed that a gentile in a position to donate to a family member would be about similar in likelihood to donate as a jew who had a family member in need, so I figure that they can cancel each other out and just not deal with that. What is altruistic is donating an organ to a stranger. Even though to a lesser degree after death, but it’s certainly altruistic to a degree.

    I acknowledge that I failed to implement into the equation the 130 remaining altruistic donations that are obviously almost (if not entirely) all non Chareidi. However, being that 30 [kidney donations] of 500,000 [chareidim] is a large figure in comparison to 130 [kidney donations] of 299,500,000 [non chareidim/gentile] which is such a negligible figure, thus the effect on the numbers I presented in the article remains negligible and doesn’t change the numbers in a significant way (because there are 600 non chareidim in the USA for every 1 Chareidi, percentagewise, each chareidi donation effects percentages 600 times more than each non chareidi donation… Just imagine, for the general public to catch up to charedi altruistic living organ donation, they would need to up the 130 figure to 18,000!)

    Also notice, though I mentioned that organs from living donation last almost double the time of organs from cadavers, I still kept that argument out of my calculations of Chareidim’s contribution.

    I acknowledge that I used averages to calculate and there is more to statistics than simply averages as you’ve eloquently pointed out that the people dying aren’t necessarily enrolled to donate at the same rate as the general population…
    I used the numbers that I had at my disposal to the best of my ability (as I’m not an actuary!). If you (or someone else) prepare a report, more sophisticated than the methodology I used, I promise you I’ll read it with great interest. However, even if you want to make adjustments on certain figures based on realities that I didn’t take into account, I believe it would still sustain my main point that Chareidim do a great job in compensating for their lack of cadaveric donation. Have a most wonderful Shabbos.

  18. Another important factor that has not been entered into the equation is the fact that even if halacha abiding Jews were not to donate any organs if the Torah would tell us that is how we are meant to lead our lives, we would still be allowed on the list for donated organs. That means that we would be taking some of the kidneys that now are going to other people on the list.
    Because the Torah allows us to donate a kidney while we are alive, we are effectively providing those on the list, the vast majority of which are non-Jews, with life saving kidneys as well.
    I wonder what the statistics are for those who got a kidney donation who then register as posthumous organ donors. My hunch is that a very high percentage of recipients are on the donor registry. That would mean that we are affecting all the other organ donations in the country as well!
    Anyone who wants to look for or invent negative issues can do so about anything. In this case it is clear that the writer shared something that is absolutely positive and did it in an erudite fashion. We owe him gratitude for making this point so well.
    Thank you Rabbi Boruch Wolf (I do not believe I know who Rabbi Wolf is so no reason to think I ulterior motives to put in something positive)

  19. BW: Thank you for the kind words. While I wish I had the time to look through the numbers and try to put together a full report based on actual statistics, I think it would be extremely difficult. The statistics might not be available in the full detail that is needed. It would also take a lot of time, which I don’t really have available. Between my job, my studying for my continuing education, and spending time with my family, I don’t have much spare time. If you have a source for the statistics, let me know, and I can put it on my “back-burner” list of side projects.

    One point which someone made here (#10) does hold true. When a call is put out that a Jewish person needs a kidney, we are often all too eager to help. I once was going to donate one, but my Rosh Yeshiva told me not too, as I had a new family at time, and he said it wasn’t good for me to do it at that point in my life.

  20. Note to editor: help the Squimish section of your readership but not posting pictures explicit with blood and body parts- whether human or animal. We understand the story just fine without them. Tks

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