What Does the Bible Say?

The statistics show that the supply of organs and tissues is not meeting the current demand. However, few
objections to organ donation and transplantation are made on religious or biblical grounds. Even when a group
opposes donation on religious grounds, most will extend their belief systems to allow for donation and
receiving of replaceable organs and tissues, such as blood and bone marrow. Most arguments for and against
organ donation and transplantation fall into two major categories: those dealing with expressed love to one’s
neighbor and those dealing with treatment of the body.

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.” This principle is also
cited by Richard Hughes, a tissue recipient himself, when he describes the tangible act of loving one’s
neighbor.

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.
People are to express this love toward God and one another because of who God is, and because we are created
in his image. Jesus extends the scope of who may be one’s neighbor in the parable of the Good Samaritan
(Luke 10:25-37) and in Matthew 5:43-44. The overarching principle is that we are obligated as Christians to
love everyone. Jesus’ life and words exhort all people to love brother, sister, neighbor, enemy and stranger.
One way to express this love is through the convenient provisions of modern technology that make organ
donation and transplantation possible.
Although donation may be permissible or even obligatory based on the principle of loving one’s neighbor,
does it violate biblical teaching in other areas such as the resurrection of the body, totality, self-mutilation,
prolonging life and natural order? The second major category involves issues concerning the body itself.

Resurrection Bodies
Many Christians may fail to donate organs because of the idea that a total body will be necessary at the
resurrection. This concern is addressed in an editorial by Carroll Simcox entitled The Case of the Missing
Liver. In arguing for the permissibility of organ donation, Simcox includes the teachings of Paul concerning
the resurrected body. A proper understanding of 1 Corinthians 15:35-49 teaches a tremendous difference
between the physical body at death, which may be buried or disposed of in various ways, and the spiritual body
of the resurrection. If the end-time resurrection of our bodies means simply the reoccupation of the previous
body, then the entire doctrine of resurrection presented in the Bible is erroneous.
Paul uses the analogy of the difference between a seed and the product of that seed to illustrate the difference
between the earthly body and the resurrected body. What is planted is not the same as the end product of the
seed. Neither is the physical body the same as the future spiritual body. The fact that Jesus’ recognizable
resurrected body was similar to his crucified and buried body supports an argument against organ donation.
Jesus’ resurrected body bore scars from crucifixion (Luke 24:39) and was evidently nourished by physical food
(Luke 24:42-43), but it also was supernatural and had qualities his physical body did not possess (John 20:19).
Simcox concludes that Jesus was in a transitional state between an earthly body and a heavenly body.” This is
supported by F. F. Bruce’s comment that “the form in which Jesus rose from the dead was one in which he
could be seen, but his present existence is in the spiritual realm” (1 Timothy 3:16; 1 Peter 3:18). The earthly
body will not enter into the heavenly inheritance (1 Corinthians 15:50). Based on these facts, there can be no
justification for prohibiting organ donation and transplantation because of the need for a physically intact body
prior to entering the resurrected state.
The Principle of Totality
The next moral response to organ donation and transplantation is related to the principle of totality. This
principle advocates maintaining the wholeness of the body but is extended to allow for removal of a part of the
body, if it is done in the interest of or for the benefit of the whole person. This would permit, for example, the
amputation of an extremity in order to save the rest of the body. In addition to the assumed need for totality in
the resurrection of the body, the principle of totality includes charitable donation and mutilation of the body.

Some theologians, ethicists and health care professionals currently advocate a further extension of the principle
of totality. They begin by redefining benefit of the whole person. This expanded definition provides for the
promotion of spiritual and moral well-being of an individual as well as physical, emotional and mental well-
being; a person may ultimately benefit if given the opportunity to donate organs or tissues as an act of charity.
The resulting conclusion is that charitable giving (usually understood to be giving with no intention of
receiving anything in return) of organs and tissues allows for the improved well-being of the giver as well as
the recipient.

This position may be criticized as a “perversion of the notion of charity.” It describes the existence of a
paradox when one acts in charity in order to promote self-fulfillment. This debate focuses on proper
understanding of the Greek word for love (agapao), which is the verb used in each of the New Testament
quotes from Leviticus 19:18. It describes a love that is more than emotional love for those closest to us. It
describes self-denying. Spirit-guided love toward all mankind, whether or not we deem them worthy of such
love. If an act of love exemplifies Christlikeness, then it is permissible, but if the motive is giving in order to
benefit the wholeness of the giver, then the act is not justified.

The Issue of Mutilation

Finally, it is important to address the issue of mutilation as it relates to the principle of totality. Albert Jonsen
reports that the issue of mutilation dates back to the ancient question of whether or not we have the right or
authority to mutilate our bodies. Generally the answer is no. As stewards of God’s creation, including our
bodies, we should typically view self-mutilation and consent for allowing mutilation as detrimental. Some
religious leaders, however, have relied on the extended principle of totality to allow for mutilation (or removal
of a part) that would benefit the whole.

Wilkinson relies on passages in Matthew 5:29-30, 18:8-9 and Mark 9:43-48 to justify limited mutilation when
the end goal is positive benefit to the whole person.” In each of these passages, Jesus teaches that we should
rid our bodies of hands, feet or eyes if that part causes us to reject the salvation provided through faith in him.
Understanding these passages in context will reveal, however, that Jesus is not advocating self-mutilation. In
hyperbolic style, Jesus is emphasizing the seriousness of permitting sin into one’s life and is encouraging
extreme measures to prevent sin. Therefore, these passages do not contextually offer guidelines to either justify
or prohibit the mutilation involved in organ donation and transplantation.

Life Prolonged
Prolongation of life is another moral issue that may be associated with organ donation and transplantation. The
obvious goal of this medical advancement is prolonging life that has been potentially shortened by failure of
some part of the human body. In some cases, such as transplanting corneas or bone tissue, the immediate goal
is improved quality of life, not the extension of life. Several biblical passages appear to support procedures that
may prolong life or offer improved quality of life.

The account of Jesus raising Lazarus from the dead (John 11:1-44) parallels the prolongation of life after organ
replacement. Although this event did extend Lazarus’s life and give him and his family new opportunities, we
must be careful to see the major emphasis of the biblical passage. Jesus says, “This illness does not lead to
death: rather it is for God’s glory, so that the Son of God may be glorified through it” (John 11:4). Glory for
God was the motive behind this miraculous resuscitation. He would be glorified through the miraculous raising
of the dead, as ultimately only God can be. He would be glorified through the initiation of the events that
would lead Jesus to the cross immediately following this event. G. Campbell Morgan says this event represents
a supernatural and miraculous resuscitation.” Thus, the Bible does not condemn the prolongation of life in
certain instances.
The Gospel accounts record twenty-three times that Jesus healed or raised someone from the dead. In some
cases, Jesus healed and prolonged life for someone facing imminent death (John 4:46-53). At other times Jesus
restored the function of a part of the body to improve the quality of life (Matthew 8:2-4; Mark 2:3-12; Luke
18:35-43 and John 5:1-9). Old Testament passages also offer support for prolongation of life. Elijah prayed to
God, and the life of the dead child for whom he prayed was restored (1 Kings 17:19-22). Elisha performed a
similar act, as life miraculously returned to a dead child (2 Kings 4:32-35). In summary, providing that motives
and methods are consistent with Scripture, the Bible does not prohibit prolonging life through the medical
procedures of organ transplantation.
The Natural Order
A final consideration relates to the correlation between organ donation and transplantation and the possibility
of interfering with the natural order. Some people feel that organ transplantation is contrary to natural law,
supporting the concept on the basis of the inevitable rejection by one’s body of a newly transplanted organ or
tissue. Developing technology, however, has decreased the risks of rejection. In the early 17th century the
practice of blood transfusions resulted in many deaths because incompatible blood was given. Then in 1900
Karl Landsteiner discovered blood types and thus eliminated the extreme risks involved in transfusions.

Technological advances continue to eliminate the rejection of organs through closely screening donors and
recipients, and then developing medications that will combat specific rejection of the transplanted organs.

Many medical advances involve tampering with the natural order, which appears to be supported by Genesis
1:28. Here mankind is commanded to kabash, or bring under subjection, the earth. This does not allow for
exploitation and abuse but makes us stewards of the earthly resources God has created. John and Paul Feinburg
argue that if we are not to intervene and subject the natural order to a Spirit-led dominion, then God has
commanded us to do something immoral, namely subduing the natural order. This would be impossible.
Therefore, organ donation and transplantation cannot be immoral solely on the grounds that they interfere with
God’s natural order.
It also may be asserted that the morality or immorality of organ donation and transplantation can partially be
determined by the motive behind tampering with the natural order. If we pridefully use technology with the
attitude that we know more than God, then the act may be deemed immoral. However, if we humbly use
technology in a way that glorifies God, with an understanding that God is in ultimate control, then the act may
(but not always) be considered a moral act.

The Scriptural Application

Organ donation and transplantation may be justified using biblical principles in most cases. Certain instances
negate this justification, such as improper and ungodly motives and attitudes, allowing a living person to
donate vital organs resulting in virtual suicide, and the marketing and improper allocation of the organs and
tissues.

Giving organs or tissues may certainly fall within the realm of loving one’s neighbor. Giving of essential
organs before death that would result in suicide would fall under exceptions to this provision. However,
Simcox states that to fail to donate organs and tissues when possible is selfish and contrary to biblical charity.
The parable of the Good Samaritan demonstrated the standard that everyone is a neighbor and that people
should be willing to love in a way that meets the needs of their neighbor. This includes giving first aid and the
best health care possible. In the current era, this includes organ donation and transplantation.

Concerning the resurrection of the body, 1 Corinthians 15 clearly teaches that the bodies we occupy at death
are not the same as the glorified bodies we will occupy in the spiritual realm. The belief that the condition of
the body at death will be the same as that of the resurrected and glorified body is overly simplistic and
unrealistic. An intact, permanent physical body is not required for a perfect, glorified body in the resurrection.
The Bible says that we occupy frail physical bodies that were originally created from dust and to dust shall
return (Genesis 3:19; Job 34:14-15; Psalm 104:29; Ecclesiastes 3:20, 12:7). The earthly body is uniquely
different from the future glorified body. The argument of totality in prohibiting organ donation and
transplantation is a vague, weak and changing principle that offers no significant assistance in the debate
concerning organ donation and transplantation.
The parable of the Good Samaritan (Luke 10:25-37) demonstrates that the literal example of love from a
neighbor consisted of bandaging wounds, pouring on oil and transporting the injured man for help. Archibald
Robertson records that anointing with oil was the best medical care available in that day and that this formula
testifies to the importance of medical care along with prayer. Today prolonging life through the best medical
technology available and with the power of prayer should be the focus of every person in a similar situation.
To deny organ donation and transplantation on the grounds that prolonging life is not biblical or moral would
also require the denial of all health care and medications that treat abnormal characteristics of the body.
If a practice or procedure is not contradictory to biblical principles, then it should be permissible. This is the
case concerning organ donation and transplantation. All arguments for permitting them on biblical grounds
have been demonstrated as sound and often irrefutable. Some scholars even promote this practice as not simply
permissible but obligatory, based on the biblical mandate to love one another. Those who prohibit organ
donation and transplantation on a biblical basis have weaker arguments with a large number of inconsistencies.
It may be affirmed on biblical grounds that organ donation and transplantation is at least a permissible practice
and may potentially be viewed as obligatory.

Bobby A. Howard, RN, BSN, MDiv, was a trauma ICU staff nurse at North Carolina Baptist Hospital in
Winston-Salem for eight years and in the minister of education/youth at Mt. Carmel Baptist Church in
Asheville, North Carolina. He designed and taught a trauma nursing seminar in Croatia in 1994.