Donation of Organs, Tissue, and Whole Blood

ELCA Church Council Action CC04.04.14

Passed by the 2004 ELCA Church Council.

Whereas
Contemporary Cultural Situation
In the United States and elsewhere in the world there is an acute shortage of organs, tissue, and, often, whole blood.¹ This shortage seems likely to continue unabated for the foreseeable future in light of the demand created by the remarkable success of transplant procedures and related medical advancements coupled with the resistance to donating and the effort required to do so.

Several concerns arise as a consequence of these shortages:

• The equitable distribution of the existing supply and the high cost of transplantation
• Increased illegal “trafficking” in the buying and selling of organs and tissue
• Social pressure advocating laws to permit the buying and selling of organs and tissue
• The need to evaluate a variety of proposals for increasing the supply of organs and tissue, for example: 1) shifting the practice of required consent to presumed consent (that is, changing the law to assume the deceased is a donor unless family members indicate otherwise); or 2) technical efforts at xenotransplantation (human use of organs from non-human species)

Church Precedent
The predecessor bodies of the Evangelical Lutheran Church in America (ELCA) recognized the donation of organs, tissue, and whole blood as a means to save and renew life and health and as a blessing of God given through human beings.² This is illustrated in affirmations such as: "The Lutheran Church in America [LCA] recognizes that the donation of renewable tissue (e.g., bone marrow) and live organs (e.g., a kidney) can be an expression of sacrificial love for a neighbor in need [and] encourages its members to consider the possibility of organ donation and to communicate their wishes to family members, physicians and health care institutions" (LCA, 1984).

The 2003 ELCA social statement “Caring for Health: Our Shared Endeavor” affirms that cure and healing are shared endeavors in which care for another may include personal sacrifice. The statement also cautions “against the ways in which motivation to maximize profit and to market health care like a commodity jeopardizes health and the quality of health care for all” (ELCA, 2003, page 6).

Resolved
In light of the situation and the longstanding commitments of this church and its predecessors, the Evangelical Lutheran Church in America affirms that it:

• regards the donation of organs, tissue, and whole blood ³ as an act of stewardship and as an appropriate means for contributing to the health and well being of other persons;
• recognizes that the donation of live organs (e.g., a kidney) can be an expression of sacrificial love for a neighbor in need;
• recognizes that the donation of whole blood and renewable tissue (e.g. bone marrow) by those who are able can be an expression of care for a neighbor in need;
• urgently encourages its members to consider donating organs, tissue, and whole blood;
• encourages those willing to donate organs or tissue to communicate their wishes to family members and appropriate professionals such as a pastor or other rostered church leader, physician, or other health care provider;
• urges those individuals, as well, to make the necessary legal arrangements, including the use of a signed donor card and other legal instruments such as living wills and durable powers of attorney for health care;
• affirms that the human dignity of all donors and recipients should be respected and that all coercion and manipulation be absent from the donation process;
• calls upon its pastors and other rostered leaders to become familiar with the moral and legal issues as well as with clinical procedures involved in organ and tissue donations so that they may be prepared to counsel persons and families considering donation;
• urges its pastors and other rostered leaders, congregations, synods, agencies, and institutions to initiate and sponsor programs of education and moral deliberation on organ, tissue, and whole blood donation;
• calls upon government to: a) maintain or to develop public policies that will encourage voluntary donations; b) discourage coercive donations; c) forbid the buying and selling of human organs, tissue, and whole blood; d) hold accountable those involved in such illegal activities; e) and ensure the efficient, equitable access to organs, tissue, and whole blood for medical procedure;
• recognizes the existence of various efforts (presumed consent, xenotransplantation, cloning organs, and so forth) to increase the supply of organs and tissue that do not involve buying and selling them. It further recognizes that some of these may represent notable shifts in the economic, moral, social, and theological assumptions of current practice. This church calls for continuing deliberation and careful moral assessment of such proposals.

Endnotes

1. One measure of this crisis is that in 2000 approximately 72,000 patients in the United States were waiting for a solid organ transplant. In that year less than 6,000 cadaveric organs were donated along with about 5,000 kidneys from living donors. Human Cloning: Papers from a Church Consultation (Chicago: ELCA, Division for Church in Society, 2000), page 71.

2. The 1982 LCA social statement “Death and Dying” encouraged donation as a means of sharing life with others (page 7). In 1984 the LCA adopted a resolution specifically on organ donation.

3. Germ line and fetal tissue or cells are not included in the concerns of these resolutions. Likewise, the resolutions do not involve blood “plasma” for which the donor may be paid.