A Request⤒🔗

The editors received a request from a consistory to write an article about donating organs. It is my privilege to do so. During an ethics lecture in November 1995, I talked about this subject with the students who were in their fourth year. It was an interesting exchange of views, in which I shared material. They asked their questions and gave critical comments. I will also include parts of that discussion in this article, without mentioning specifically where that happens in what follows. I refer to the connection. Then the reader notices that there is a relation between the instruction at our university and the information for office-bearers. 

The Right to Self-determination←⤒🔗

It is not my intention to discuss all the details about this subject. It is about the broad lines. The key question, in my opinion, is: is it allowed to donate organs according to the Bible — firstly, during our life and subsequently, as a result of a stated last will, after death? What are the objections against it? On what grounds do you make that kind of decision? 

The main objection about donating organs is often that our own body is not at our disposal. We received our life from God, including our body. That means, in life and death, we have to leave our body in God’s hand. We reject the right of self-determination. With that, some people say, it is neither allowed to donate organs. Besides, we mutilate our body. This is not permitted, even after death. I summarize all these considerations as the motivation for the right of self-determination.

The Ideology of the Engineering of Life←⤒🔗

A second argument is that donating organs fits in with the thought that the medical science has control over health. I am referring to the notion of the engineering of life. In that pattern it fits that someone’s death can and may be accelerated to keep his organs in as good a condition as possible to benefit someone else. Human haughtiness plays an important role in all of that. We would participate in that when we donate organs. It is not illusive to think that experiments will be performed with the organs that are donated. The haughtiness of the ideology of engineering life, is what I call the second motive. 

Emotions←⤒🔗

As third motive I mention the emotions to be processed. That applies to the surviving relatives. It also applies to the organ recipients. They live with organs someone else donated after that person’s death. The original carrier could no longer live. Is it then allowed for the receiver to live because of the goodwill of the donor?

Furthermore, I speak about emotions, because the subject of donating organs can only be discussed when a person dares to think about his own death. Many people get emotional when they do this. In addition to the last sentence, there is also the matter of dealing with mourning. With this subject, mourning certainly needs pastoral attention. 

Another emotional moment is the thought that the receiver of the donated organ can live on in sin. Take a criminal, for instance. Would you like to donate your kidney(s) to a criminal?

The Gospel Teaches Us to Give and Share←⤒🔗

The main objections have been summarized in three points. How do we respond to it? First, one can donate an organ with the wrong motives; for instance, to wield and demonstrate one’s right to self-determination. But you are not responsible for the motives of someone else. You have your own motives.

Paul asks that we present our bodies as a living sacrifice to God (Rom. 12:1 and 6:19). Martyrs are called to do that in the most literal sense of the word. They sacrifice their lives for the testimony of Jesus Christ (see also Rev. 12:11). Paul writes with gratitude that the Galatians would, if it would have been possible, have had their eyes pulled out and given them to him (Gal. 4:15). Apparently, Paul had an eye disease. This “transplant” was technically and medically not possible. Would Paul have mentioned the possibility if he would have disapproved of donating eyes? 

Anyway, if we want to help a fellow man in submission to God, one cannot blame us for haughtiness or challenging God’s providence. Transplantation is one of the medical options. We make use of many more medical-technical possibilities. Then we also do not feel that we take the decision out of God’s hand. Then we pray for God’s blessing. We leave the progress and result up to him.

After death our body returns to dust (Gen. 3:19). We need to have respect for the body of a deceased person. That body is subject to decay from the moment death has occurred. We condemn violation of a corpse. The use of the organs of a deceased person seems permissible to me if that person has given consent for that during his life. His motives are the deciding factor for granting that permission. Someone else cannot decide for him, neither after his death — unless the other (the family) is sure to act according to the spirit of the deceased. The proposed law points in that direction: every citizen has to make his own decision. A Central Register will be kept about these decisions. 

Jesus Christ gave his life. Believers also have to do that sometimes. Wouldn’t we then, as a form of service, be allowed to do that for a fellow human being? I answer this question in the positive but add a number of conditions to it. First, we have to agree on the criterion of death. It has to be certain that the person is dead, before his organs are taken out of his body. How that is determined will not be discussed now. That also means that the death of a person may not be expedited, to get the organs in as good a condition as possible for transplantation. That is an absolute condition for me. If people are not sure about this, people should renounce their declaration of willingness to be a donor. Next, it is not allowed to experiment with the organs. Fourthly, the receiver has to keep his identity. That means no transplants of brains or germ cells (if that would even be possible). People should not be allowed to receive money for the organs to be donated, including while they are still alive. Then the comparison with prostitution would come to the fore. And what about the objection of the ideology of the engineering of life? About this, I also say, if other people adhere to and pursue this, they cannot blame me for it, can they? I have my own motives and my own intentions and objectives. It is possible to talk about emotions. Pastoral counseling is required in the aforementioned cases. That applies to thinking about one’s own death and about mourning. What is the motive? Love for one’s neighbour out of thankfulness for the sacrifice of our Lord Jesus Christ!

No Obligation←⤒🔗

Can someone be required to donate organs? No! He who asks it as a moral duty of a fellow human being, thereby says that the other fails if he refuses to give up organs. I do not want to go that far. Donating organs is such a delicate subject and so personal, that it should remain a voluntary act. It may not be imposed as an obligation, let alone as a right that society demands of its citizens. Great caution is appropriate. Caution and clarity. Doctors who appeal to donate organs should respect the objections. They should respect the various elements of caution. 

Finally, one of our students said that one should ask the person who fundamentally objects this, if he would still say no, if, humanly speaking, it would concern the continuation of his own life; or the life of his wife, child, or grandchild? He who would like to receive an organ in such a case cannot object to someone being a donor. Christ gave himself. Are we then allowed to prevent someone to help a fellow human being with organs that otherwise would return to dust? My answer will be clear — however, not without the above-mentioned reservations.