Although to the best of my knowledge the first human whole organ transplant was performed over thirty years ago, it is only in the last decade, in particular in the last half decade, that tremendous advances have been made in this field of medical endeavor. We have been reading about kidney transplants for so long that it has become, in a sense, “old hat.” When the first human heart transplant was performed a few years ago, however, this rather bold maneuver caused no little commotion in the medical community and in the general public alike. I suppose this results from the well-engrained notion that the heart is truly a central and vital organ. When the heart ceases totally to function, the whole body dies within minutes unless circulation is artificially maintained. Although the initial fervor for heart transplantation has abated somewhat for the time being, largely because of the rejection problem, intense research continues. In the coming years organ transplantation will become more and more common and will include more and more organs. Therefore the topic of the attitude of the Christian toward organ transplantation and, on the surface seemingly unrelated but nevertheless involving the same basic principles, toward the willing of our bodies for scientific research is a timely one.
When we consider organ transplantation we must do so both from the viewpoint of a recipient and from that of a donor. We must ask, “Could I, a Christian, accept an organ from another individual, living or dead?” We must also ask, “May I will that, after I die, various organs be removed from my body to be transplanted into another individual?” Regarding the willing of our bodies for scientific research and, I might add, for medical education, for this is the use to which many cadavers are put, we must ask whether we as Christians are permitted before God to do this. I believe you can sense that there is a basic principle involved both in willing that organs from our bodies be made available for transplantation and in willing our bodies for scientific research and medical education. In both cases we are willing that our bodies or, more specifically, our corpses be used in such a way that living individuals physically benefit from either directly or indirectly.
In all fairness I believe that physicians involved in organ transplantation will have to admit that here is still a large element of research and experimentation involved in their work. Yes, the surgical techniques have been worked out quite precisely. The techniques for each organ were well developed in work on animals before they were performed on humans. Thus the mechanics of transplantation present little problem. The problem is one of rejection of transplanted organs and tissues. Tissues from one individual when incorporated surgically into the body of another are recognized by the immune mechanisms of the body of the recipient as being “foreign” just as are invasions of the body by bacteria or viruses. The natural response of the body to such invasion is to form antibodies against the foreign material which then attack that material to destroy it. There are currently two methods being utilized to prevent or at least minimize rejection. The first is to attempt to match the tissues of donor and recipient as closely as possible. Techniques for “tissue typing” are being developed, but thus far research in this area has been quite disappointing. The second method is to suppress medically the immune mechanisms of the recipient’s body. The problem here is that immunosuppression is not selective. That is, in suppressing the immune mechanisms to foreign tissues the immune protective response to invasion by disease-causing microorganisms is also inhibited. Thus it is that many organ transplant recipients die not from rejection of that organ but form severe infection, primarily bacterial and fungal. The rejection phenomenon points up the unique genetic constitution of the individual.
In answer to the above posed questions, I would deal first of all with willing that our bodies be used for medical purposes after we die. As is true of so many situations we face in our daily living, Scripture gives us no specific dictums in this matter. Let us consider, however, our physical earthly bodies and what God has told us about them in His Word. We read in Genesis 2:7 that “God formed man of the dust of the ground.” We read further that God “breathed into his nostrils the breath of life and man became a living soul.” The human body then has its origin through the creative work of God in the “dust of the ground.” Man did not become “a living soul” until God breathed into his nostrils “the breath of life.” This tells me that the body is the dwelling place of man, his “earthly abode” as it has been called. The essence of man is his soul. Without the soul there is no life. What happens at death is that “the dust returneth to the earth as it was, and the spirit returneth unto God who gave it” (eccl. 12:7). It is common knowledge, is it not, that after death our bodies decay and ultimately crumble into dust. Oh, yes, we embalm them and place them in caskets in burial vaults, but the end result is the same. But the Christian knows that the grave is not the ultimate end of man. We know that in the Day of our Lord we shall be bodily resurrected (Ezekiel 37; Job 19). In our flesh we shall see God. It is primarily because of this knowledge, I assume, that we carefully bury our dead. Not that we believe our bodies must necessarily be kept protected and preserved until the Day of Judgment. All dead will be raised wherever their remains lie (Rev. 20), no matter how far scattered component parts may be. We do nevertheless believe our bodies should be treated with respect.
What can we conclude from the above discussion? First of all I would say that we must not fell that our bodies must necessarily be buried intact and all in one place. If this were so, a Christian might never consent to an autopsy on a loved one, since in this procedure certain organs and tissues are removed for microscopic study and sometimes for preservation for educational purposes. I believe we may consent to the performance of autopsies when there is good reason for their being done. Autopsy findings have contributed much to medical knowledge, which knowledge has benefited Christian and non-Christian alike. Granting then that giving authorization for a physician to perform an autopsy on a Christian deceased loved one is permissible, why would it not also be permissible to, before death, will our bodies for medical uses – organ and tissue removal for transplantation, medical education (this involves primarily cadaver dissection in anatomy courses) and research? I believe it is – if for some reason one should feel so inclined. As a matter for practical consideration, I believe you should know that as a rule, medical centers have no difficulty filling their requirements for cadavers – in fact, there is often a surplus. I would also add that you may be assured that human cadavers are treated with proper respect by medical personnel.
I would also add a note of admonition concerning organ transplantation. We should never will our own organs of the organs of a deceased loved one for transplantation with the notion that in so doing a small part of us or our loved one “lives on.” This may sound absurd, as indeed it is. Nevertheless, this is the ridiculous plea that certain transplant surgeons use when they seek to convince individuals of the merit of granting authorization for organ removal for transplantation. I am certain no intelligent Christian would fall for such a line. On the positive ledger, however, it is conceivable that a transplant recipient might, in the period that is added to his life by a successful organ transplant, come to a saving knowledge of Christ. If this should occur, it would certainly not be because the singer was thereby given a “second chance” to “accept Christ,” but solely because it was the will of God from all eternity to save that elect sinner at that point in time. God does work in wondrous ways. This would, for me at least, be one valid consideration in reaching a decision regarding organ donation.
As far as the first question we posed is concerned, namely, whether it is permissible for the Christian to accept an organ from another individual, living or dead, I would say the following. First, about the only organ being transplanted from living donors today is the kidney. The reason for this is that each normal individual has two functioning kidneys and is not adversely affected if one of them is removed. Not so with the heart and liver and, for technical reasons, the lung. All of these organs are, on the other hand, being transplanted from deceased individuals. As I see it, the overwhelming consideration for the Christian contemplating the above proposition is whether a reasonable possibility exists that in receiving the transplanted organ a prolongation of his earthly pilgrimage will be gained in which he can function well enough to render profitable service to his Creator and Redeemer. Currently that possibility varies with the organ involved. It is subject to considerable further variation as research continues.
There may be those who will argue that medical science is seeking through organ transplantation to usurp the power of God to determine the time of death of an individual. This is, of course, impossible. Moreover, the same argument could be applied to the use of medications which are literally life-saving or life-sustaining. How true it is that “for everything there is a season…a time to be born, and a time to die” (Eccl. 3:1, 2) – and “whatsoever God doeth, it shall be forever: nothing can be put to it, nor anything taken from it…” (Eccl. 3:14). Our sovereign God is on the throne. Comforting thought. Praise His Holy Name.
Originally Published in:
Vol. 30 No. 3 May 1970