The Wisdom of Kidneys, Mahara”t Sara Hurwitz

Susan Smelin, a 54 year-old nursery school teacher in Riverdale, desperately needs a live kidney donor.  We have been running this call for help in our shul bulletin for a few weeks now, and few members of our community are considering donating their kidneys to this complete stranger.

Rav Eliezer Waldenberg, in the Tsits Eliezer (Vol. 9:45) says where there is clear possibility of mortal danger, one is prohibited from donating a kidney, deeming one a “chasid shoteh” a “pious fool” for doing so. However, Rav Ovadia Yosef’s research shows that the “danger in the removal of a kidney is minimal and that roughly 99 percent of kidney donors recuperate fully.” Thus, one is required to donate a kidney to save someone’s life. (Yehave Da’at 3:84). 

I know that the halahkic debate on both live and brain dead organ donation is more complex (see for a more in depth halakhic analysis).  But the decision to donate a kidney extends beyond halakhic considerations.  It is the ultimate dilemma: What moral bases is there to demand that we jeopardize our lives for another?  Conversely, can we justify standing idly by while someone is in mortal danger?  How can a moral society allow its members to turn a blind eye on someone in trouble?

I would like to use the following texts as a jumping point from which to analyze this dilemma.

The mishna in Baba Metzia (33a) states the law that if a choice must be made between retrieving his own lost object and his father’s lost object—his own lost object takes precedence.  The gemara, in support of this edict, that your property takes precedence over anyone else’s, cites Devarim 15:4 as proof: “However, there shall be no needy among you.”  And anyone who tries to put someone else before oneself, in the end will come to a state of neediness. 

A fundamental Torah value is the right and obligation to care for oneself.  And in fact, there is an overarching requirement to prevent oneself from becoming financially (or medically?) dependent on others.  Preserving ones own health and possessions is merely a fulfillment of this goal. 

And yet, having legal dispensation to put one’s own interests first does not imply that actually doing so is always in ones best interest.  If the attitude of “mine takes precedence” is a guiding principal in one’s life, then how can life possibly be fulfilling.  It is Martin Buber who has emphasized that human beings only becomes an “I” through the caring attention of a “you.”

Rashi, on our Gemara elucidates this point: Even though the text of the Torah has not imposed it upon him, a person “should go beyond the letter of the law and not insist on ‘mine takes precedence’ unless it involves an obvious loss to himself.” In fact, if a person insists on constantly putting himself first, he is rejecting his “responsibility for Deeds of Compassion and Charity, and in the end he will become dependent on other people.”   Putting himself first all the time undermines the bonds of social responsibility to others.  The key to prosperity then is not to worry about protecting one’s own self interests.  Blessings come about by striving to help others, even at slight risk and discomfort to oneself.

So on one hand, to survive and prosper, everyone must exercise a certain level of self-concern.  However, having the right to always put one self first does not make it wise to always do so. 

Back to kidneys…

I have no clear answer to give to members of my community about whether they should surgically remove their kidneys at some peril and discomfort to oneself in order to save another.  To use Rahsi’s language, one should “go beyond the letter of the law” to fulfill the Torah’s broader purposes—including the promotion of loving care between people.  For some, this may mean donating a kidney.  For others, it may mean preserving ones own health so that he may have the strength to help others at a later time. 

It is not coincidence that in Tanach, the kidneys are often metaphorically described as the seat of great conscience and wisdom (see Tehillim 16:7).  I am sure, that in each member of my community’s case, the kidneys will ultimately guide him or her to make the right decision.

2 Responses to The Wisdom of Kidneys, Mahara”t Sara Hurwitz

  1. Dov says:

    “Ovadia Yosef’s research shows that the “danger in the removal of a kidney is minimal and that roughly 99 percent of kidney donors recuperate fully.” Thus, one is required to donate a kidney to save someone’s life. (Yehave Da’at 3:84).”

    This make it seem that Rav Ovadia is ruling that one is required by Halacha to donate a kidney. What he actually writes is that it is “permissible and also a mitzvah” to donate a kidney to a fellow Jew in order to save their life. Had he wanted to say it was required, he could have quite easily written so.

    For the sake of accuracy, I strongly suggest that the post be changed to reflect Rav Ovadia’s actual opinion.

  2. All things in life are in balance. “Thou shalt love thine fellow as thineself” implies that a certain degree of self-love is obligatory, else how can one love another? There is also Hillel’s statement: “If I am not for myself, who will be for me, and if I am only for myself, who am I?”
    The chance of being a satisfactory donor for any given recipient is small. The chance of something going wrong with one’s remaining kidney after the donation is also small, but not impossible. There can be no “yes” or “no” answer to a question with this many variables. It is all very personal between the two patients, their doctor and their Rav.

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