Angela Siatta, an organ donation coordinator, remembers a Buddhist mother who wrestled with the decision to donate her son's organs when he died.
"She said, 'I think it's a great thing, but I'm not sure if it's the right thing for my religion,' " recalled Siatta, a registered nurse who works for Intermountain Donor Services. "(Buddhists) believe that the spirit is still with the body until the heart stops. And then the spirit is gone. He was brain dead, and that's a legal definition of death, but because his heart was still beating, she wasn't sure whether his spirit was still there. And so she wanted her Buddhist priest to come and meet with her."
The priest arrived at the hospital, and after several hours of private conversation in which the religious leader assured the family the young man's spirit was gone and the decision was a personal choice, the mother decided to donate his organs.
"She really wanted to make sure it was the right thing," Siatta said, "and she did feel like it was the right thing after she was able to (speak) with her priest. … It turned out to be a very positive experience for her."
The number of Americans signing up to be organ donors is rising overall, but many are still hesitant — some because of misconceptions about what their religion teaches on the subject. Meanwhile, the gap between the number of people waiting for a transplant and the number of organs available is widening.
During the time it takes to read this article, another name will be added to the waiting list — something that happens every 11 minutes, according to the U.S. Department of Health and Human Services.
There are currently more than 111,000 people on the list. And while an average of 75 people receive a transplant each day, another 20 people die each day waiting for transplants due to a shortage of donations.
As many as 20 percent of those who decline to be organ donors in Utah and Idaho mention religion, estimates Alex McDonald, director of public education for Intermountain Donor Services, a nonprofit organization that maintains the donor registry for the region.
And yet, no major religion prohibits organ donation. Some faiths leave the decision up to the individual. Others actively encourage organ and tissue donation as an act of love and charity. Pope Benedict XVI has been outspoken in favor of donation and carried a donor card himself until he assumed the papal throne, according to the Vatican.
Even Jehovah's Witnesses, who believe the Bible prohibits blood transfusions, still allow for organ or tissue donation if all blood is removed before the operation.
Yet, myths persist about the positions of religious groups on organ and tissue donation.
For example, McDonald said, "A lot of people are concerned about the resurrection and feel that they have to have all of their parts to be resurrected." Among non-Christians, like the Buddhist mother, concerns may be different. McDonald said IDS's policy is to encourage people to check with their religious leaders. "Don't take it from us. Please explore and find out," he said.
He also said religious reservations are often not grounded in any specific teachings, but rather represent a more general hesitation.
"A lot of times, when people are uncomfortable with donation but they aren't quite sure why, that's kind of a fallback position because nobody wants to get in an argument about other people's religions, so that's a good way to kind of get out of that discussion," he said.
Joel Newman, assistant director of communications for the national organization United Network for Organ Sharing, has had similar experiences discussing organ donation with people.
"I think people have individual spiritual beliefs that are perhaps a little bit different from what the official position of, say, the Catholic Church is. (Some) Catholics may feel that the body needs to stay intact and … whole in order to get to heaven," he said.
Newman also suggested that religious issues crop up more often when people haven't discussed organ donation with loved ones ahead of time.
"The greater issue is just that people haven't really thought about it … and then something happens and they're placed in that position where, with really no information, they now have to make this very important decision," he said. "I think it's more the fact that the discussion doesn't take place, more than it's, 'Yes, we talked about it, and yes, we think it's against our religion, and no, we're not interested.' "
Culture may also play a role. Donor networks in Texas and Arizona have found that Latinos are considerably less likely to register as organ donors and that their hesitance often has to do with religion. The same has been documented among African-Americans, Polynesians and other ethnic groups. And because matches for organ donation are more common within similar ethnicities, this leaves many minority patients without transplants.
In Utah and Idaho, however, consent rates are as high as among Hispanics as among the white population, according to McDonald, and he credits IDS's outreach to the Latino community.
"With the Hispanic population, it's really a matter of trust. Do they trust the organization, and do they trust we're telling the truth?" he said. "We have a Spanish-speaking person on our staff, Rocio Mejia, who does education in the Hispanic community and also works with families at the hospital who are Spanish-speaking. She speaks the language, and she is from Mexico, so she understands the culture, so it's not part of the English-speaking white community asking them for their loved ones' organs."
Siatta, the IDS organ donation coordinator, also explained how the donation process is sensitive to cultural and religious beliefs. "I have had many donor families that are Catholic, especially Hispanic Catholic families who want their loved one to hold the rosary the whole time, even when we go to the operating room," she said. "Those are important things for them, and we'll honor those wishes."
In addition to reaching out to minorities, organ donation groups also engage directly with religious groups.
UNOS, which manages the nation's organ transplant system under contract with the federal government, produces a clergy manual that local organizations like IDS can purchase and share with faith leaders, Newman said.
It also promotes "Donor Sabbath," an event observed two weekends before Thanksgiving in congregations around the country. Local houses of worship bring in guest speakers, preach sermons, publish messages in their bulletins and otherwise encourage parishioners to talk about donation and sign up to be donors.
"It's a very targeted way to try to get that discussion into the faith community," Newman said.
During National Donate Life Month in April, IDS hosted an interfaith panel of religious leaders, including a Baptist minister, an LDS bishop, a Catholic priest, a Jewish rabbi and an Episcopal priest. All spoke positively about donation, McDonald said.
For example, Jewish rabbi Ilana Schwartzman said that in the Jewish religion, anything you can do to save a life overrides other religious obligations, McDonald recalled. "I can't remember how many (commandments) they're supposed to follow every day, but if you can save a life, all of that goes out the window because that's the most important thing you can do," he said.
For some others, faith plays yet another role in organ donation.
Lucile Jensen's son Conrad passed away 13 years ago. She describes the experience of organ donation as a spiritual blessing during a time of intense pain.
"It's just an impossible time to make any kind of decision. It's a tragedy when things like that happen and usually without a lot of time for you to think about it," she said. "I can't even describe the anxiety and the fear and the dread and the loss and everything — it's just very stressful. Your body and your mind can't think right."
When Jensen and her husband realized the seriousness of Conrad's condition, they walked to her husband's office to offer a prayer together before returning to the hospital to make the excruciating decision.
"I didn't think at the time, 'Is my religion for or against it?' because I felt more than knew that it wasn't against it," she said. Jensen is LDS.
Today, Jensen maintains a relationship with three recipients of Conrad's organs, including Jill Hyde, who received his heart. Seeing Hyde marry and adopt a child has validated the decision to donate, Jensen said.
"My family had incredible experiences," she said. "We would say that (donation) gives you … a co-experience with joy as you go through your loss."
For a comprehensive list of religious groups and their positions on organ donation, or http://www.organdonor.gov/ to become an organ donor, visit organdonor.gov. In Utah or Idaho, visit Intermountain Donor Services.
Religious groups and organ donation
There is general agreement among most religions that donation is an act of charity in support of human life.
Buddhists believe organ and tissue donation is a matter that should be left to an individual's conscience. Reverend Gyomay Masao, president and founder of the Buddhist Temple of Chicago, said, "We honor those people who donate their bodies and organs to the advancement of medical science and to saving lives."
Organ and tissue donation is considered an act of charity and love, and transplants are morally and ethically acceptable to the Vatican.
The Church Of Jesus Christ Of Latter-day Saints
The church believes that "the donation of organs and tissues is a selfless act that often results in great benefit to individuals with medical conditions." It also holds that decisions about donation are individual ones to be made in conjunction with family, medical personnel and prayer.
The Greek Orthodox Church supports donation as a way to better human life in the form of transplantation or research that will lead to improvements in the prevention of disease.
Donation is not only permitted, but encouraged. Muslim scholars of the most prestigious academies are unanimous in declaring that organ donation is an act of merit and in certain circumstances can be an obligation.
Judaism sanctions and encourages organ donation in order to save lives. The Conservative Movement's Committee on Jewish Laws and Standards has stated that organ donations represent not only an act of kindness, but are also a "commanded obligation" that saves human lives.
The Southern Baptist Convention has no official position on organ donation. "Such decisions are a matter of personal conscience," writes Dr. Steve Lemke, provost of the New Orleans Baptist Theological Seminary.
"The United Methodist Church recognizes the life-giving benefits of organ and tissue donation and thereby encourages all Christians to become organ and tissue donors," reports a church policy statement.
Source: U.S. Department of Health and Human Services.