Kidney Mortality Cannot Be Cured Without Kidney Morality

07/29/2009

Kidney Mortality Cannot Be Cured Without Kidney Morality

by Benjamin W. Corn, M.D.
Special to the Jewish Week

Our world has once again been rocked by scandal. As the ink dries on the Madoff sentencing we have all become hypersensitive to even the slightest of deviations from the norm. Whether or not the circle of rabbis and entrepreneurs from New Jersey are found guilty of the constellation of crimes attributed to them, most of us have already begun the process of beating our chests, well before the High Holiday season kicks off, for the collective sins that we will bear.

The intricate web of corruption and the very creativity of the money laundering schemes that supposedly transpired have taken on a surreal quality. But as a physician, I find it most difficult to assimilate the concept of organ trafficking particularly when it is
practiced by community pillars and religious leaders.

Just one year ago, I bubbled with pride when even segments of the ultra-Orthodox community in Israel boldly expressed halachic pragmatism in revising the fundamental definitions of life and death to enable organ harvesting and eventual transplant. That decision, which Knesset Member Otniel Schneller quickly folded into legislation, resolved the most extreme dilemma faced by Israeli citizens (infamously known for their withdrawals from but not their deposits to the International Organ Bank). From this point onward, harvesting an essential organ in the absence of cardio-pulmonary criteria for death, would no longer force our ethical pointer to teeter between the greatest mitzvah (saving of a life) and the most heinous sin (i.e. murder). Thousands of us immediately signed up for donor cards which bear the famous Maimonidean edict that "all who rescue the life of even one soul have essentially rescued an entire world" (Laws of Sanhedrin, Chapter XII). The prominent display of these words on the card is arguably more significant than the engraving of the phrase "In God We Trust" on US tender because Israeli card-holders are thereby proclaiming "In Man We Can Trust!"

How tragic then, that the reported 1,500% markup extracted by Mr. Rosenbaum and colleagues on the value of the illicitly traded body parts has effectively resulted in religious Jews undermining a noble development that was gaining traction. How contemptible that there was a willingness to take advantage of not only a desperate donor/seller facing a life of poverty but also a vulnerable recipient/buyer contending with premature mortality secondary to renal failure

There is another irony that hovers over the situation.

In ancient times, spiritual traits were ascribed to each of the anatomical organs. Some of these characteristics (e.g. the heart as the source of love or the gallbladder as the seat of anger) remain with us on a sentimental level. In the Babylonian Talmud (Tractate Brachot 61a), the kidneys were regarded as a symmetrical set of paired organs that metaphorically represented the battle between our evil conscience and our good conscience. Framed in contemporary psychological terms, the twin kidneys constitute a primordial scale balancing the individual's id and super-ego. In circumstances where evil inclinations prevailed there was an expectation that the concept of "Mussar Kilayot" would obtain. The latter term, which has been incorporated into today's Hebrew lexicon, can be explicitly translated as "the morality of the kidneys" but figuratively refers to the feelings of pain that a human being experiences after wrongdoing. There is an underlying assumption that such remorse could then awaken the good conscience when it slumbers. Isn't it unfortunate that the businessmen who apparently exploited kidneys as a new currency declined to integrate an old moral precept that is symbolically embedded in the very same organ?

Dr. Corn is a Professor of Oncology at the Tel Aviv University School of Medicine and the Chairman of the Life's Door Foundation.

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