Who is your neighbor?
It was during my medical evaluation in Dallas when the surgeon brought up the ethical considerations for surgery in a way that I didn't anticipate. He said that apart from the joys and emotional benefits we receive from an altruistic act, the surgery would be considered unethical for the donor. He went on to explain what he meant. Donating a kidney does not improve the health or the life of the donor in a physical sense. Now, if all goes as hoped and expected, it should not decrease the donor's life or health either. However, if you only consider the surgery from the donor's perspective, it would be unethical. And that's why you must consider it simultaneously with the recipient's perspective.
I'm struck by the similarities to the cross...if you consider Jesus sacrifice from solely his perspective, his death was tragically unethical - for He was innocent on all accounts, according to God and Pontius Pilate, the Roman governor of Judea who who presided over his trial and ultimately ordered his crucifixion.
God made him who had no sin to be sin for us, so that in him we might become the righteousness of God. 2 Corinthians 5:21
As soon as the chief priests and their officials saw him, they shouted, “Crucify! Crucify!” But Pilate answered, “You take him and crucify him. As for me, I find no basis for a charge against him.” John 19:6
Yet we see his death on the cross in a radically different light when we consider what it did for us.
But what does the Bible say about all of this and how should we consider the ethics of organ donation and transplantation? When I was challenged to dive into this topic a little deeper to enrich my journey, I came across this article by Bobby A. Howard (RN, BSN, MDiv) in my research. There's a lot packed in there so I'd encourage giving it a read if you're interested in considerations such as resurrection bodies, and the natural order. While I found it interesting, I didn't personally struggle to reconcile many of those particular considerations in my own journey, but that isn't to downplay their importance.
The topic that did stand out to me in the article, which did play a significant role in my journey was the command to “love your neighbor.”
In his book Christian Ethics in Health Care, John Wilkinson writes that the first ethical principle on which organ donation and transplantation may be justified is that of “love for one’s neighbor.”
I'll continue to quote this section from Howard's article here, bolding the overarching principle that influenced my conviction to donate:
Although the command to “love your neighbor” was quoted by Jesus (Matthew 5:43), Paul (Romans 13:9) and James (James 2:8), it may be traced back to Leviticus 19:18. This passage justifies its use in the ethics of organ donation and transplantation. The Hebrew word translated love in Leviticus is used in the Old Testament to describe the love one should have for a neighbor, as well as the love one should express toward God (Deut 6:5) and strangers (Deuteronomy 10:19). In examining the meaning of the Hebrew word translated love (ahab), Eugene Merrill says it refers to a covenant love connoting emotion and sensual love, and also a Spirit-led tendency toward obedience to the commands of God.
You see, one of the things that made the decision to donate difficult for me was not only the implications to my health, but also because I didn't really know Alan. While everyone seemed to think he was a great guy, I didn't yet have a personal connection to him. I realized that the surgery felt optional to me, in a way that felt very different had the recipient been a close family member or friend. Had it been someone I had known and was endeared to, I felt the decision would have come from a different, more compelling motivation. Alan felt optional. Is that really what I was saying? It grieved my heart when I could admit what I was feeling. That's when the question was dropped in my spirit, "Daughter, who is your neighbor?" God gently invited me to sit with Him in the question and drew me to Mark 12.
One of the teachers of the law came and heard them debating. Noticing that Jesus had given them a good answer, he asked him, “Of all the commandments, which is the most important?”
Love God, love others. There is no greater commandment than these. I've heard it said before that following God isn't easy, but it is simple. God loved Alan just as much as I loved those dear to me, actually more, and he was calling me to do the same. Gently the Lord started helping me to align my will with His.
I finally felt myself start to get my footing after I called a friend of a friend who had donated his kidney several years ago. He had started his journey with a willingness to donate completely altruistically, to anyone who was in need for which he was a match. I was deeply moved by his story. Ultimately he did end up directing his donation after God crossed his path with a woman on the transplant list, and she became a treasured family friend. I was so touched by his story that as soon as I hung up the phone, I looked at Steve and I said, it's time...it's time to talk to Alan. No more distancing myself from the celebration, it was time to get to know my "neighbor." On May 5th - we called Alan.
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This started as a private blog to help document my kidney donation journey and the theological, biblical, and ethical considerations for organ donation. It is shared with you here in hopes it might help with your own journeys of discernment and surrender.