These articles are copied from the November `95 issue of UNOS Update. Please save these articles and disseminate them widely. See UNOS' home page for more information on donation and transplantation. http://www.unos.org
See also:
The Mitzvah of organ donation by Rabbi Joseph H. Prouser
"The Ethics of Organ Donation, a lecture by Rabbi Moses Tendler"
Sermon on Organ Donation "DON'T HANG UP THE PHONE, IT'S YOUR COVENANT CALLING" By Rabbi Brian Zimmerman
"Organ Transplant: Soon It May Be a Routine Part of the Jewish Death Ritual", The Jewish Voice/December 1996
Jewish law ruling on organ donation
Special Shabbat encourages organ donation as a mitzvah by TERESA STRASSER
Organ Donation in Jewish Law by Rabbi Robert Dobrusin
Life and Death by Rabbi Joel Schwab
Alisa Flatow's memorial on the web.
From UNOS Update, Nov. '95
All Take and No Give?
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by Adena K. Berkowitz
Dr. Joel Rosh, a pediatric gastroenter- ologist and Orthodox Jew who for six years co-directed the liver transplant program at New York's Mt. Sinai Hospital, tells a story of an Israeli girl who flew with her family to the U.S. for a liver transplant.
On the plane, the young girl, while on life support, was declared brain dead. The team that had been assembled to try to save her life now turned to her family and asked if they would donate her remaining healthy organs. They said no.
"The Israeli family explained, 'We feel for the other families and we want to help, but we have asked our rabbi and he has said at it is not permitted under Jewish law.' "
That's one story about Jews and organ donations. Here's another:
Alisa Flatow, 20, a Brandeis University senior, took the year off to study in a Jerusalem yeshiva, deciding before Passover this vear to travel by bus with a few friends to a lotel at Gush Katif, a Jewish settlement in the Gaza Strip. She never made it: A Hamas suicide bomber drove his van into the bus, mortally wounding her and many Israeli soldiers, seven of whom were killed instantly.
Arriving from his home in West Orange, New Jersey, at Sorokin Hospital in Beer- sheva, Steven Flatow confirmed that the brain-dead young woman on life support was his daughter. The staff asked him a question: Would he be willing to donate his daughter's organs? After consulting with his wife, and making a conference call with their rabbi, Alvin Marcus, and Rabbi Moshe D. Tendler of Yeshiva University, an author- ity on Jewish medical ethics, Alisa's parents decided to donate her organs to six people on a waiting list who were clinging to life.*
"People have called it a brave decision, a righteous decision, a courageous decision. To us it was simply the right thing to do at the time," says Flatow. "I didn't know what all the media attention was about. As I was leaving Israel, at the airport, I mentioned this to a journalist who said to me, 'You really don't understand, do you?' "
What Flatow didn't understand was the emotional impact his family's gesture had on a grieving Israel - an impact captured by Prime Minister Yitzhak Rabin in May when he told American Jews that "Alisa Flatow's heart beats in Jerusalem." But the Flatows' decision also drew attention to a painful issue - a perception that Jews, Israeli and n American, religious and secular, are more reluctant than most to donate their organs after death. Citing "religious objections," some Jews have allowed organ donation to become an exception to their well-deserved reputation for generosity.
For close to 30 years, transplants have been performed in the United States and Europe with ever-increasing success for kidneys, livers, hearts, pancreases and lungs, as well as bone marrow. But not enough people donate organs. To date, over 40,000 people remain on waiting lists in the United States, desperate for organs. According to the United Network for Organ Sharing (UNOS), 40,233 people were registered for organs in 1994, but only 18,251 transplants were performed; 3,098 people on the wait- ing list died. Every month, 2,000 people are added to the UNOS register.
With few exceptions, the only viable or- gan donations are from brain-dead donors whose breathing and circulation are being maintained artificially. While polls show most Americans are willing to become do- nors, too few families actually give their consent when a tragedy occurs; only 5,000 donors are available each year, out of a po- tential pool of 10,000 to 15,000 donors. Such shortages fuel frustration and suspi- cion, as when doctors for the ailing Mickey Mantle were erroneously criticized for giv- ing the former Yankee star special treatment in his successful search for a new liver.
In the general community, families voice a number of familiar objections to donation: According to Jeffrey Prottas of Brandeis University, the former chairman of the Or- gan Donor and Procurement Committee of the National Task Force on Organ Transplantation, they include misconceptions that the donating process will mutilate a loved one's body and an erroneous but persistent belief that the donor's family will be charged for the procedure. Others simply are unaware of their loved one's desires to be- come a donor.
For many Jews, particularly the Orthodox, this reluctance is compounded by several factors: concern about violating hala- chic, or Jewish legal structures against desecrating the dead or benefitting from a dead body (see Responsa, MOMENT, June 1995); the traditional view that the deceased be buried whole; and disagreement over whether to accept brain death as a halachic definition of the end of life.
Organ banks do not keep track of donors based on religious identity, but my discussions with medical ethicists, experts, rabbis and doctors across the country support the view that too many Jews are reluctant to become organ donors. Issack Neuman, an Orthodox Jew and coordinator of the New York metropolitan area' s organ procurement program, says that only about five percent of Orthodox Jews asked to be donors consent; as a group, Jews are only slowly beginning to match the general population' s 60 percent consent rate. Many non-Orthodox and non- observant Jews, who often tend to demur to Jewish tradition on end-of-life issues, are also reluctant to give. At Conservative and Reform congregations where I have spoken, I have often been told by members of the audience that Jewish law absolutely forbids being an organ donor.
In 1987, Dr. Thomas Starzl, an American pioneer in transplant surgery, warned a transplant conference in Israel that if Jews do not start giving, they will not get organs (of course any attempt to bar an ethnic group from receiving organs would be challenged legally). Sure enough, in 1992, French health authorities barred all their hospitals from performing organ transplants on Israelis, mostly because of Israel's "organ deficit" in Eurotransplant, the European transplant coordinating body (Israel and members of the European Community previously had joint agreements on health care; most Israelis seeking liver transplants travelled to France). And while France and Israel signed a two-year agreement last December to allow Israelis to receive liver transplants under certain conditions, most other European countries still do not accept Israelis for transplants.
In 1994, 50 Israeli patients needed heart transplants, and only 12 hearts became available; 700 people were on lists for kidneys, but only 12 received transplants from people who had died. While 700,000 Israelis have signed donor cards this seems to have little impact on their surviving relatives. "I can only remember one or two cases in which donors actually had signed a donor card," says Nurit Shimron, national coordinator of the Israel Transplant Association.
This reluctance comes despite statements by rabbinic organizations representing the major denominations endorsing the concept of brain death and encouraging donations. In 1990, the Rabbinical Assembly passed a resolution urging all Conservative Jews to become donors. The Union of American Hebrew Congregation's 1991 health care proxy - a medical living will - likewise encourages Reform Jews to become organ donors.
The Orthodox Rabbinical Council of America's "Health Care Proxy" gives physicians permission to remove the signee's corneas, kidneys, lungs, heart, liver and pancreas "for the sole purpose of transplantation." The directive also stipulates that physicians obtain the "concurrence" of an Orthodox rabbi or a member of the RCA's Bioethics Commission.
"People come up all the time and say, 'I thought Judaism opposed this because of resurrection of the dead and the need to be buried complete,' " says Judith Abrams, a Reform rabbi in Missouri, Texas, who has written widely on medical ethics (see Responsa, MOMENT, December 1994). "I reassure them that most Orthodox authorities permit organ donations if the (standard) brain-death criteria are met. What's more, if you do this incredible Mitzvah, God will somehow make it up to you in the world to come."
Rabbinic authorities are not, however, unanimous on the brain death standard. Agudath Israel, the ultra- Orthodox organization, does not recognize brain death and does not endorse organ donations. In Israel, prior to the Flatow tragedy, the haredi, or right-wing Orthodox rabbinate opposed donations by Jews (a ruling by the late, revered Rabbi Shlomo Zalman Auerbach on brain death was considered ambiguous).
However, those who oppose donations do not prohibit Jews from receiving organs, a distinction that drives many ethicists and rabbis to distraction. "If a person is not dead by our halachic definition when he is brain dead, then to go and take an organ from a non-Jew means you are killing a non-Jew to save a Jew!" fumes Tendler. "I cannot imagine a more horrendous ruling." In 1992, Rabbi Marc Angel, then president of the RCA, called the all-take no-give policy "morally repugnant."
Those who reject the brain death definition to permit donating but sanction receiving transplanted organs, including Rabbi Aaron Soloveitchik of Yeshiva University's Rabbi Isaac Elchanan Theological Seminary, see it differently. In their view the gentile donating the organ would do so anyway; the recipient is not responsible for this decision or the organ's removal, and thus is in no way prohibited from benefitting from it.
The Alisa Flatow case may have broken the logjam on this issue. Within a few weeks of her death, a statement was issued by Rabbi Yehoshua Scheinberger, the "minister of health" for the Eidah Haharedit, an umbrella body for Israel's ultra-Orthodox. It allowed ultra-Orthodox Jews to accept the brain-death definition and donate organs but with several conditions: It is forbidden, he declared, to transplant Jewish organs into bodies of "non-believers," gentiles or Arabs who hate Israel. (Most secular Israelis, he said, would not fall under the category of non-believers.) In addition, he insisted that an Orthodox rabbi sit on the committee that approves the transplants. Both conditions were rejected by the Israel Transplant Association, but negotiations are underway.
Scheinberger's conditions were widely criticized. Rabbi David Feldman of the (Conservative) Jewish Center of Teaneck, New Jersey; and an expert on Jewish medical ethics, said Scheinberger was not speaking as an authority, and even if he was "he was wrong. There is no basis in halacha or in Jewish morality to support limiting a donation to a Jewish or an observant Jewish recipient, and it is important that people be
disabused of the idea." Tendler regards Scheinberger's statement as an error "halachically, emotionally and sociologically" and a "hillul ha 'Shem" - a desecration of God's name. Nevertheless, he calls Scheinberger's positive ruling on brain death "a great thing."
Israeli transplant experts like Nurit Shimron, however, say it is too early to tell what practical impact Scheinberger's views will have on donations. Dr. Mordechai Kramer, an Orthodox Jew and coordinator of the lung transplant program at Hadassah Hospital, believes that donations continue to lag because of misconceptions about brain death. "If you ask people on the street, will they give, the majority say yes. But when it comes to their family members, most are not ready to do it. With a brain dead patient, people think he will get better. And that isn't only the haredim but non-Orthodox as well.
In the United States, a number of rabbis report an increased awareness of donations since Alisa Flatow's death. "People have been talking about it a lot and it has brought another level of consciousness to the debate," says Rabbi Zahara DavidowitzFarkas, coordinator of Jewish chaplaincy at New York-Cornell Medical Center.
"I was able to convince people who previously had said 'Isn't this forbidden?' to realize what Jewish tradition says about donating organs," says Rabbi Brian Zimmerman of Temple Beth Ami in Rockville, Maryland.
Those who continue to reject brain death are also being urged to remember another halachic concept, mishum aivah, "because of enmity," which holds that certain Torah laws can be suspended to prevent hatred between Jews and non-Jews. I don't believe that in our own age we have to worry about anti-Semitic outbreaks because of low organ donations from Jews. But we do have to reexamine our commitment to the larger community.
Jewish organizations should seize the momentum of the Flatow example and redouble their efforts to encourage donation. At the same time, they should help transplant teams make sure that Jewish law is followed, that kevod ha-met, respect for the deceased, is upheld, that the body of the donor is draped properly and that all blood and tissue is buried with the body in accordance with Jewish law.
The public has to be reassured that donating an organ doesn't mean death will be hastened in any way (for example, doctors involved in removing a patient's organs for transplantation are prohibited by law from certifying the patient's death).
Most of all, families need to talk to one another. For even if an individual signs a donor card, it is the family that makes the ultimate decision to participate in a lifesaving venture.
Says Rabbi Tendler: "Alisa Flatow will not only get credit in heaven above for the four people alive, walking around with her organs, but the many hundreds who will be saved because other people will be inspired to follow her example."
*Of the six, two are known to have died following the operation: Serena Shmuelevitz, 40 (kidney and pancreas) and Shabtai Rehamim, 23 (liver). The known survivors include Malka Nir, 48 (lung), and Jacob Salinas, 56 (heart). Alisa's corneas were saved for later transplantation.
From UNOS Update, Nov. '95
When Is Death? -------------- by Adena K. Berkowitz
The trend in Jewish legal tradition favors actions that lead to pikuach nefesh, saving a life, over prohibitions protecting the sanctity of the body. Nevertheless, the rabbinic acceptance of organ donation was slowed by disagreements over whether to accept "brain death," a concept that emerged only in the late 1960s.
In all but brain death, earlier rabbinic authorities had paved the way for organ donation. Rabbi Ezekiel Landau, the famed 18th-century halachic authority known as the Node B'Yehudah, was asked whether an autopsy could be performed on a patient who had died of a kidney stone, in hope of finding a way to prevent such cases in the future. Landau weighed the Talmud's prohibitions against mutilating the dead (Hullin 1 lb, Bava Batra 154a) against the possibility that information gleaned from an autopsy could save another's life. Landau held that if there is a choleh lefaneinu, an ill patient before us, then the usual ban on autopsies could be overridden for the sake of pikuach nefesh.
The "patient before us" principle could be interpreted narrowly, but countless rabbis have since cited this requirement as justification for a more universal perspective on human suffering. In 1965, for example, the Israeli rabbinate and Hadassah Hospital entered into an agreement which allowed autopsies not only for immediate lifesaving but also to aid in detecting hereditary illnesses and gathering criminal evidence. Similarly, potential organ donors are assured that their organs will be used immediately, and not stored in a "bank."
In the late 1960s, pikuach nefesh was applied to allow transplants of the cornea. Then-Ashkenazi Chief Rabbi I. Y. Unterman held that, given all the dangers that blind people might face, such an operation could literally save their lives. But would the ruling apply if the transplant recipient was blind in only one eye? Would this then violate the prohibition of "benefitting" from the dead or allowing the deceased donor to be buried without all body parts? Unterman responded that a cornea ceases to be "dead" once it is transplanted and revived. Desecration, meanwhile, applies only to a visible incision or removal of a visible, external organ: The eye can be removed and the eyelids of the deceased closed.
Transplant technology requires that organs be "harvested" from bodies whose cardiac and respiratory functions may be maintained only by mechanical means. Traditionally, death was defined as the cessation of the heartbeat. In 1968, an ad hoc committee at Harvard Medical School urged that death be defined as the irreversible cessation of all functions of the brain, including the brain stem. The Harvard criteria have been adopted by the medical establishment (a President's Commission on medical ethics endorsed the criteria in 1981).
The cessation of breathing was considered absolute evidence of death in the Talmud (Yozna 85a), a view later adopted by the 12th century sage and physician Maimonides and in the Shulchan Aruck the Code of Jewish Law. Later rabbinic authorities, such as the Hatam Sofer (1762-1839), added cessation of cardiac activity to cessation of respiration as conclusive evidence of death.
Brain death defied both of these criteria. Initially, the late Rabbi Moshe Feinstein (1895-1986), the preeminent American Orthodox rabbinic authority of his time, resisted the concept of brain death.* In a responsum written in 1968 he called the person who removed the heart of a brain dead patient a murderer. But in a later responsum, written in 1976, he appeared to accept the brain death definition (Ig'grot Moshe, Yoreh De'ah, Vol 111, No. 132). As Feinstein wrote that year to the chairman of the New York State Assembly's Committee on Health, "the sole criterion of death is total cessation of spontaneous respiration. In a patient representing the clinical picture of death, i.e., no signs of life such as movements or response to stimuli, the total cessation of independent respiration is an absolute proof that death has occurred." [Emphasis added.]
- Rabbi Tendler of Yeshiva University, Feinstein's son-in-law and a professor of Talmud and biology, expanded on Feinstein's thinking to become the chief proponent of the halachic acceptability of brain death. He invokes Rabbi Feinstein's later responsum on heart transplantation, which begins with a discussion of decapitation. Feinstein, quoting Maimonides, argues that an animal is to be considered dead even if its limbs continue to move after it is decapitated. Tendler compares brain-stem death, or what he calls physiological decapitation, to this physical decapitation, and regards it as a halachically acceptable definition of death. In 1986, the Israeli Chief Rabbinate accepted the halachic validity of brain death to permit heart transplants in Israel, but the rabbis required certain tests to determine that there is no brain activity.
A leading critic of the acceptance of brain death in Jewish law has been Rabbi J. David Bleich, professor of Talmud and Jewish Law at Yeshiva University and Cardozo Law School. Bleich also cites Feinstein in his responsa, and questions the validity of tests performed to determine total cessation of brain stem activity and sticks to the traditional definition of death: cessation of all respiratory and cardiac activity.
*At one point Rabbi Feinstein reasoned that a heart transplant was a "double murder" - its victims the "patient" whose organs were removed, and, because early success rates were low, the recipient.
-AKB
From UNOS Update, Nov. '95
Rabbi, Doctor, Transplant Coordinator Issack Neuman Converts Jews to Principles of Donation --------------------------------------------------------
It was a Thursday night late in August at the Concord Plaza in Brooklyn. Hundreds of Chasidim, a branch of Orthodox Jews, were gathered for the wedding of Rabbi Abraham Kahn.
Men with beards and boys with side locks, each dressed in the traditional black trousers and hats of their people, chatted excited]y, apart from the women, as all awaited the Grand Rebbe, who would perform the marriage ceremony.
Because of an automobile accident, the Rebbe was nearly three hours late, but the crowd was patient, its members enjoying the extended opportunity to mingle prior to the exchange of vows.
What better occasion to discuss organ donation.
Well, that's not exactly what Issack Neuman thought when Rabbi Kahn invited him to his wedding.
But Kahn insisted, r so that's what he was doing, introducing himself to different guests, bringing up the ' subject of donation and hoping to bring a little insight into a subject shunned as sacrilege for years.
"He told me we were not going to make many friends, but we had to go because the rabbi invited us," said New York Regional Transplant Program media liaison Larry Swasey, who, as a heart transplant recipient, accompanied Neuman as proof that transplantation works. "We know we opened some minds."
Neuman - a Chasidic rabbi, physician and, for the past five years, a transplant coordinator for NYRTP - took on the job of Jewish outreach after a 1993/94 incident in which the Chasidic community, galvanized by the plight of a Chasidic teenager in need of a double lung transplant, took matters into its own hands. Members of the community tried everything to get the teenager a donor. Everything, that is, but donate themselves.
You see, it's against their religion.
Or so they thought.
Jewish law, or halacha, prohibits desecration of the body, and Jews have traditionally taken that to mean that autopsies, embalment and organ or tissue donation are not permitted. In addition, disagreements over brain death have divided the community. By not accepting brain death, Jews were unable, in most cases, to donate after death.
Rulings by rabbinic councils over the past several years, however, have placed greater emphasis on the importance of the mitzvah, or good deed, and pikuach nefesh, saving a life, than prohibitions arguing against the removal of organs and tissues after death.
Neuman - a Chasidic rabbi himself, coming from a family in which his father and five brothers are all rabbis - uses the same Talmudic teachings as his opponents to open minds closed by preconceived beliefs.
"Education to them [rabbis and Jews] is very important," Neuman said. "I like to fight them with the same book.... Some rabbis say you can donate and others say you can't. I say, 'let them make up their own minds."'
At first, Neuman's interaction with the Jewish community as a transplant coordinator was limited to approaching Jewish families on the subject of donation at the time of a loved one's death. Now he actively seeks meetings with rabbis and their congregants to educate them on the halachic precepts in favor of donation. All on his own time.
Rabbi Kahn is his primary source of contacts.
"I've had my plans disrupted numerous times because a rabbi will see me at a certain time. I know it's now or never. I have to go when the opportunity is ripe," Neuman said.
"Many times we speak with rabbis late at night," Swasey added. "If you turn them down once they aren't going to call you back. It's a spur of the moment type thing, where they've been turned on to this. If they hear this is allowed, they want to hear about it now. They could drop it just as quickly."
The desired result is the opportunity to address the rabbi's congregation, either from the pulpit, at a breakfast, through the men's or women's club or through a special evening presentation.
In fact, as Swasey spoke to a reporter on this subject, his other phone line rang. He was asked to go with Neuman to address a congregation on Rosh Hashana, the Jewish New Year. He accepted on the spot.
That same week, NYRTP received a request from Gary Bretton-Granatoor, rabbi of the reform Stephen Wise Free Synagogue. He wanted 2,000 donor cards to distribute following his organ donation sermon on Yom Kippur, the Day of Atonement. Ushers offered the cards after the service and additional cards were available on a nearby table. More than 1,000 donor cards were taken.
Ephraim Rubinger, rabbi of Oceanside Jewish Center on Long Island, recently invited Neuman to speak on the Jewish ethical perspective on donation following the pediatric heart transplant of one of his congregants.
"There is a lingering doubt as to whether transplants are permissible or not," Rubinger said. "But he [Neuman] spoke with erudition. That reassured people."
Rubinger said it made an "absolute" difference that Neuman was a rabbi. Numerous questions were asked, he said, and Neuman's knowledge of Jewish law made him very persuasive. "A lot of people left feeling that in good conscience, they could fill out a proxy allowing them to be donors."
Referring to the presentation, Neuman said, "I asked how many people believed organ donation was against their religion. No one raised a hand. It used to be that everyone 'knew' it was against their religion to have an autopsy, to donate organs. It was handed down generation to generation. But at the JCC, this perception was nullified, showing progress was being made."
Thinking back to an address Neuman gave several weeks earlier, Swasey recalled how every time someone raised a question in opposition to donation, Neuman was able to counter it with Jewish law.
"You could see the heads nod up and down in agreement," Swasey remarked. Afterwards, he said, people came up expressing a feeling of freedom in being able to choose. "Lots of people had wanted to donate but had felt it was against their religion."
Anna Alexander of Wesley Hills Synagogue has heard Neuman speak twice on donation. After hearing him the first time, she insisted her husband accompany her to the next presentation. She wanted him to hear Neuman's lecture firsthand.
"We were touched by the things he said," she remarked. "What really got to me were the personal descriptions of situations in which he could have helped someone, but he couldn't talk the family into donating the or- gans. He talks in a very personable way. Describing the specific families, without naming them, and bringing it close to home - you could see it, feel it in a sense. The fact that he could tie everything together [with halachal made it more sincere to me.
"We definitely feel more concrete about it now. I would've never considered it be- fore. It created discussion."
"He is marvelous," declared Leah Gould, a registered nurse who heard Neuman speak. "He was able to take the whole audience and convert them. He proved that people's old ideas can be readjusted to think that there are new ways of doing things. He did a mar- velous job."
"It's hard to hold back my enthusiasm when it comes to Issack Neuman," added Rabbi Leb Tropper of Kol Yaakov Torah Center Synagogue and associate director, United Coalition for Orthodox Synagogues of Rockland County. "He is a sincere, caring person - his morals are of the highest stand- ards. I see him doing this 24-hours a day. His whole persona gets the message across. He is a dying breed of people. He's a real badge of honor to the medical profession."
The fact that rabbis are interested in meeting with him and inviting him to speak to their congregations is proof that progress is being made, Neuman added. Before, it was a closed subject.
The death this year of 20-year-old Alisa Flatow, an American Jew studying in Israel, killed by a suicide bomber, and the decision by her parents to donate her organs, is responsible for pushing the issue of donation further into the Jewish consciousness, Neuman noted. "It slapped everyone in the face and woke everyone up."
With literally thousands of synagogues in New York City and a Jewish population of about 3 million, Neuman believes his job is far from over. He chooses not to wait for a call from Rabbi Kahn with the name of someone wishing to hear from him. When visiting donor hospitals, he asks the hospital chaplains if they know a rabbi they feel would be receptive to the subject and gives them a call.
He's even given sermons on the topic when on vacation.
"Some people may think it's not worth the effort, because Jews are a small group," Swasey commented. "But some Jewish doctors won't refer donors, Jew or gentile, because they think it's against their religion. People have to believe in it themselves or they aren't going to be able to teach others or encourage others."
Neuman has spent considerable time talking to Jewish neurosurgeons about donation, often bringing with him either Swasey or Stuart Greenstein, M.D., a kidney transplant surgeon at Montefiore Medical Center and an Orthodox Jew.
"A lot of Jewish doctors who never made a referral now do," Swasey said. "We can see the change in attitude.... He's a god-send."
Neuman notes that there are still Chasidic rabbis who don't believe in brain death and who will not permit their congregants to register for a transplant. To accept an organ, they say, would be tantamount to murder.
To counter this belief, NYRTP is in the midst of planning a formal round table discussion on donation for area rabbis to address this very subject. Not only will Neuman address how brain death and organ donation fit within Jewish law, but he will ask participants how best to keep the mo- mentum going.
Referring to the Chasidic teenager who died before she received a double lung trans- plant, Neuman asked plaintively, "Why do we have to wait for a Caroline Weber to get involved?"
To learn more about setting up a similar Jewish outreach program, contact Issack Neuman or Larry Swasey at New York Regional Transplant Program, (212) 870-2240. UNOS
November 1995