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Is It Kosher to Donate Kidneys Only to Other Jews?

A well-known religious journalist in Israel declared the "Jewish-only" donation of his kidney. His act is imperfect, but not immoral

A doctor with an organ transport after a donation in front of a clinic.Credit: Robert Kneschke/Shutterstock

By Robby Berman. Haaretz, Jul 17, 2023

In the streets of Jerusalem in recent months we’ve seen increasing reports of religious Jews spitting on priests, breaking into Christian cemeteries and smashing crosses, throwing rocks at churches and screaming at Christian tourists to "go home." In the West Bank, Jewish settlers have rampaged through Palestinian villages, setting cars and houses on fire.

And for the first time in Israel’s history, members of a far-right Jewish supremacist party have senior posts in the Cabinet including Itamar Ben-Gvir, who has been convicted for support for terrorism and racist incitement who is now minister of national security.

Last week Arnon Segal, a national religious Jew and journalist, felt no compunction about publicly announcing that his altruistic kidney donation (a live person’s kidney donation to a stranger) would be conditional: “My sole condition is that the kidney go to a Jew. This is my nation and my community.”

Segal’s statement can be seen as reflective of the current climate in Israel that arguably normalizes a sense of Jewish supremacy. But as someone who has worked in the field of organ donation more than 20 years, I have a more nuanced take on it. Israel has the highest percentage of living kidney donors (both to strangers and to family members) than any other country. The overwhelming majority of these donors are from the religious Zionist and ultra-Orthodox communities. And a large number, but not all, donate only on the condition that the donation go to a fellow Jew.

I challenge the popular sentiment, seen in a wave of backlash against Segal, that what he said and did was deplorable. Because while I condemn Jewish supremacy, I do not condemn Segal for wanting to donate only to a Jew.

In my work on organ donation as the founder of two organizations that do outreach on the subject, I have lectured in 16 countries and delivered more than 900 lectures to more than 50,000 Jews trying to convince them to sign organ donor cards. In other words, I urge them to agree to become donors after they die – donations that would come from them that would be available to the general public. As such, I have had a lot of time to think about this issue.

Segal decided to give away the most personal property he owns, a part of his body, and he should have the right to decide who gets it. He has made it clear that he feels his nation, his people, is his extended family. And it is commonly accepted in society that one has a right to help one’s family before helping other families.

In a perfect world, Segal would have donated his kidney to whoever is next on the transplant waiting list because presumably that person could die soon without a transplant.

However, we don’t live in a perfect world. And since not enough people donate organs about 75 Israelis die every year waiting for a transplant that never comes.

We need to do everything we can do to increase organ donation. If that means allowing people to donate organ based on affinity to that person so be it. The imperative to save lives is more important than waiting for the world to become a perfect place where everyone focuses on the greater good, not exclusively the wellbeing of their own group.

The option Segal placed before us is not to direct his kidney to a Jew or to a non-Jew. The choice was to give his kidney to a Jew or give it to no one. And if you deny him the right to give it to a Jew and then you criticize him for not donating his kidney at all then you need to criticize yourself, me and the millions of other Israelis who have not donated a kidney.

Helping the people you identify with is human behavior whose motives are not necessarily immoral. It happens all the time without condemnation. A Christian woman can leave in her will all her money to her Church even though perhaps the nearby mosque needs more financial support: no one will accuse her of being immoral.

In 2008, Rabbi Yeshayahu Heber told me he wanted to start an organization that would encourage Jews to donate kidneys to other Jews: unrelated altruistic kidney donors. While I knew of individual cases of altruistic kidney donation I did not believe that he could start a movement based on particularism. I told him he was crazy. Thank God he didn’t listen to me and he started his organization, Matnat Chaim (Hebrew for “The Gift of Life”) in 2009. As a result his organization has facilitated over 1,200 kidney transplants. He was right. I was wrong.

Israel was rated as the country with the largest number per capita of live kidney donations by the World Health Organization last year. Arguably Herber’s organization has a lot to do with that. Herber, who had been a recipient of a kidney donation, himself died of Covid in April 2020 at the age of 55.

I’m a utilitarian. If we need to use particularism to motivate people to donate kidneys to people in their own community, then that is what needs to be done. Some people request only to donate to women; some request only to donate to children. Whatever we need to do to save lives should be done.

Segal saved a life. His act was moral. His act was a good deed, as we say in Judaism, a mitzvah.

Despite the condemnations he’s been receiving by many in Israel, it’s important to remember the positive consequences of his act, even if , by making it conditional to his own people, it is less a pure act of altruism.

In addition to directly saving a life, Segal’s kidney donation took a Jewish recipient off the waiting list which in turn bumped everyone else on the waiting list, Jews and non-Jews, up the list, benefiting everyone. If you refuse to allow Segal to donate his kidney to a Jew and therefore, given his mindset, he doesn't donate his kidney, everyone is worse off.

Gabi Gabai, a friend of mine, is a religious Jew, a settler, and an officer in the IDF, who donated his kidney altruistically a few years ago.

Unlike Segal, he agreed to have his kidney donated to a non-Jew and saved a life of someone who is not Jewish.

Gabai’s kidney donation was arguably a more “moral” kind of donation than Segal’s. But that doesn’t make Segal’s donation immoral.

Segal saved the life of stranger by having an organ in his body surgically removed, a procedure whose recovery can be painful and takes several weeks to recuperate. It’s something that most of us, myself included, have not done. We should applaud him.

That Israeli society is changing as the population becomes increasingly religious and that a messianic Jewish outlook that had been on the margins of political influence now has significant power is something that needs to be addressed.

But we shouldn’t be sidetracked by Segal’s conditional kidney donation. This is not the major problem we are facing right now as a country.

Robby Berman is the founder of the Alliance for Organ Donor Incentives and founder and former director of the Halachic Organ Donor Society.

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