Halacha for Thursday 5 Tammuz 5777 June 29 2017

Corneal Transplants

Question: Is it permissible to transplant a cornea from a deceased person into the eyes of someone who cannot see or is this forbidden?

Answer: This issue of transplanting the cornea of a deceased person into the eyes of someone blind is a truly serious one and it borders on several grave Torah laws. We shall now explain this briefly.

Firstly, there is a well-known Torah prohibition to derive benefit from a dead body. Similarly, there is likewise a sacred obligation to bury all of the various parts of the body in their completion; thus, when the cornea is removed from the deceased’s eye, the obligation to bury it is not being fulfilled. Additionally, another issue that must be discussed is that when the eyes of the deceased are being operated on to remove the cornea, the deceased individual is being desecrated which is also a very grave sin.

Regarding the issue of operating on the deceased in order to help the living, the greatest luminaries of the generation approximately two-hundred years ago were already asked about this, for in those days, medicine began to become more developed and doctors would commonly dissect corpses in order to learn more about the various organs of the body and to discover more about what how various diseases common at the time affect the body in hopes that these studies would bring about a cure for other people who had contracted such diseases. Thus, such autopsies would bring about benefit for the living as this would allow doctors to discover new medical breakthroughs which were thus far not available and allow people to live longer, healthier lives.

When the great Noda Bi’huda (Hagaon Rabbeinu Yechezkel Ha’Levi Landau zt”l of Prague, 1713-1793) was asked about this, he replied that even if there was room for leniency regarding dissecting corpses in order to discover how to heal other ill people, this would only apply in an immediate, life-threatening situation. For instance, at that time, a cholera outbreak had struck in the city and taken many lives and the doctors believed that autopsying the bodies of the dead would aid in finding a cure for the other ill members of the city. The Noda Bi’huda ruled that in this situation there was room for leniency to allow for an autopsy because this was a life-and-death situation and nothing stands in the way of a life-threatening situation. Thus, although performing an autopsy on a corpse is a Torah prohibition, it would be permissible in a life-threatening situation. Nevertheless, if there was no immediate danger at the time, i.e. if there was no illness currently plaguing the city and it is not expected to arrive any time soon, there is no room to allow an autopsy to be performed in order to discern how to cure illnesses that may emerge in the future. The reason for this is that if we claim that anything which may result in a life-threatening situation pushes away the entire Torah, it would then become permissible for doctors to study medicine on Shabbat and even to travel to medical experts to study medicine. Similarly, it would then be permissible to pave roads on the way to hospitals on Shabbat, for this touches on a life-threatening situation. This would eventually lead to completely permitting many fundamentals of the Torah. This is certainly in contrast to the Torah’s view, for only when there is a clear and present life-threatening situation before us may one transgress any of the Torah’s laws in order to save the individual’s life; however, doing so to save a life of an individual that may be in danger at a later time would certainly be prohibited.

On the other hand, Hagaon Harav Yaakov Ettlinger zt”l writes, in his Responsa Binyan Zion, that one may not perform an autopsy on a corpse even in a case of life-and-death unless the deceased agreed to this while he was still alive. He discusses this matter lengthily in several responses in his Sefer. Many of the great Acharonim, including the Maharam Schick and the Chatam Sofer, discuss the above opinions.

Regarding our question, it is possible to claim that removing a cornea from the eye of a corpse in order to transplant it into the eye of a blind man is a matter of life-and-death, for the Gemara (Avodah Zara 28a) states that a danger in the eye can pose a danger for the entire body. Nevertheless, this claim is incorrect since the Gemara only refers to an illness of the eye which can then affect the entire body. However, a blind man who is otherwise healthy is not in danger of death as a result of his blindness.

Nevertheless, Hagaon Harav Yechiel Yaakov Weinberg zt”l writes in his Responsa Seridei Esh that this still may indeed be considered a life-threatening situation since a blind person may fall into a pit or trip over some impediment as he walks in the street which may cause him to die. Thus, giving him the gift of sight would be taking him out of a life-threatening situation. He proceeds to support his view with sources.

Maran Rabbeinu Ovadia Yosef zt”l was asked this question approximately fifty years ago by Hagaon Harav Ben Zion Abba Shaul zt”l and Maran zt”l wrote him back a lengthy response where he discusses all of the possible angles of the question and he writes that transplanting a cornea is different than the other organs of the body since benefitting from a cornea by transplanting it into a live person’s eye is not forbidden according to Torah law and is merely forbidden by a rabbinic injunction, as well as other halachic leniencies he records there. However, halachically speaking, Maran zt”l writes that it is difficult to permit this with regards to deceased Jews, for we are obligated to honor them and warned against desecrating their bodies after their death, as well as other issues which we cannot delve into in the context of this Halacha.

Thus, he writes that there is only room for leniency when the cornea is being taken from a non-Jewish corpse, since there is not as much a prohibition to benefit from the body of a deceased non-Jew as there is with regards to a Jewish corpse. However, one should not use the cornea of a Jewish corpse since desecrating the body and deriving benefit from a Jewish corpse is a Torah prohibition.

Nevertheless, if it is very difficult to obtain a cornea from a non-Jew, Maran zt”l writes that if the deceased instructed during his lifetime that his corneas should be donated to the living, in extremely pressing situations where no other alternative is available, according to the letter of the law, it will be permissible to remove his cornea in order provide the gift of sight to another Jew. (Clearly, they must be careful not to desecrate the deceased in any other way than what is minimally necessary to remove the cornea.) However, if there is an alternative to obtain the cornea from a non-Jewish corpse, there is no room for leniency.

Summary: One may take a cornea from a non-Jewish corpse and transplant it into the eyes of a blind Jew. Similarly, if it is unknown whether the cornea is from a Jew or non-Jew, it is likewise permissible to act leniently and accept they cornea donation. Nevertheless, one may not act leniently and remove a cornea from a Jewish corpse unless the deceased left specific instructions that his cornea should be donated after his death. Even in this situation, there is barely room for leniency and it is only permissible when it is nearly impossible to obtain a cornea from a non-Jew. However, if obtaining a cornea from a non-Jewish corpse is at all possible, there is absolutely no room for leniency.

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