Eugene Melnyk’s recent liver transplant has caused quite a stir. After not finding a match among family and close friends, the owner of the Ottawa Senators hockey team went public with a plea for someone to donate a liver. He had weeks to live, and thankfully, hundreds came forward to volunteer, and the transplant went ahead a few days after the plea was issued.

Many have questioned the ethics involved, since Melnyk has advantages that other, more anonymous people waiting – and often dying – for a transplant lack. Others without the fame and resources to reach out across Canada for donors aren’t so lucky. And sadly, all but 26 of those who volunteered to donate a portion of their liver were unwilling to donate to another person in need. While no one (to the best of my knowledge) has suggested Melnyk did anything wrong – it’s to be expected that a person will do whatever they can to save their life, and Jewish law would likely insist that a person pay whatever it costs to procure an organ – many have expressed discomfort at this “two-tiered” approach to medical care, in which the rich and powerful have access that others don’t. 

But since I have seen few suggestions about what to do instead, we will briefly discuss what I understand to be the approach of Jewish law regarding the constant shortage of organs.

In Jewish law, medical ethics must be viewed through the prism of what will save the most lives, and there’s little doubt that offering payment for willing donors would greatly increase the supply of organs, most likely well beyond the demand. If hundreds volunteered to help save the life of a hockey team owner, how many more would respond if they were to receive say $50,000 for an organ? Somehow we have been trained to view such as crass, unethical and even disgusting. But why? Our sages understood that money is a great motivator, and what better use of money than to save lives. Of course, it would be better if people would donate organs voluntarily, but how many people must die before we realize there just aren’t enough people willing to do so? 

Paying donors should not and does not mean that the rich will have better access to organs. Money for this should come from government-funded health care, and organs can still be implanted based on criteria currently in use. 

Ironically, this should please those concerned about the ethics of the Melnyk donation. We can pay donors without allowing anyone to jump the queue. Currently, priority lists of recipients only exist for organs from the deceased, and I see no reason why a person could not agree to donate organs after death with a (smaller) payment going to his estate. 

There is no reason that when organs are received for payment – from the living or the dead – they could not be assigned based on the priorities established by organ donor teams. Those who volunteered to donate organs with no expectation of remuneration could continue to donate them to whomever they desired.

This seems to me to be a win-win situation, and one in consonance with the best of Jewish values. And whatever such a system may cost, it’s likely much less than the savings realized by not having to treat people as their organs fail and they die a slow death while using up medical resources. 

I realize some may disagree with me, but please suggest a better alternative. If saving lives is our No. 1 priority, this seems like a no-brainer. This is especially so in the case of a liver transplant, since a liver can regenerate. 

We wish Melynk and the donor a refuah shleimah and welcome 26 wonderful people who have agreed to become organ donors. Let us do our utmost to increase that number using whatever incentives may be needed. 

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