Orthodox Christian FAQs

What have Orthodox bishops taught about organ donation?

All statements of Orthodox synods that we have found have been generally supportive of organ donation while offering guidance. In general:

• Organ donation is approved as a generous act of love. It is praiseworthy, but not a moral obligation.

• Free permission is required for organ donation, either the permission of the donor or a family member. 

• Human body parts must never be commodified or sold. 

Read more about position of Orthodox synods of bishops here. 

Why would a Christian want to donate organs after death?

Organ donation saves lives. If I am drowning, and you throw me a life preserver, you have saved my life even though I will surely die some years later. Similarly, someone with end-stage liver disease, kidney failure, or heart failure will typically die of their condition without a transplant. During his ministry on earth, Jesus healed people both spiritually and bodily. Healing was an act of compassion (Mt 14:14, 20:34) and a demonstration of the Father’s work through the Son (Jn 11:40-41). After Pentecost, his apostles continued his healing ministry (Acts). Organ donation belongs to this Christian tradition of healing. It can be a visible demonstration of compassion and love of the dying neighbor. It is also a way of practicing Christian hospitality (philoxenia) or the love of the stranger. Deceased donation is almost always donation to the stranger.

Does organ donation disrespect or desecrecate the deceased body?

The Orthodox Christian tradition strongly opposes cremation. Deacon Mark Barna, author of A Christian Ending, explains that all bodies are sacred insofar as they preserve the image of God; but the body of one that was baptized, anointed, and received the Eucharist is particularly sacred and must be treated as such. Orthodox funeral rituals require the presence of a body.

This might seem to speak against organ and tissue donation, which involves surgical removal of solid organs, intestine, some skin, some bone, corneas, and other tissues. The Orthodox moral theologian, Fr. John Breck, notes that some Orthodox Christians have opposed organ donation for this reason.

However, cremation is not motivated by love, hospitality, and the desire to extend Christ’s healing mission. Further, there is precedence within the Orthodox tradition for using pieces of the deceased body for healing, namely, relics. Pilgrims frequently travel to visit relics that have been associated with physical healing. Relics may consist of a whole incorrupt body, a skull, bones, or even desiccated portions of the body such as fingers. Thus, we know it is possible to use portions of a deceased body for the purpose of healing in a spirit of love and respect. Christ Himself allowed His body to be cut and wounded for the healing of others. And consider this: every surgery patient allows their body to be cut—often with pieces removed—for the healing of their own bodies. How much more then is it allowable for us to undergo some degree of bodily harm after death to save the life of another?

Is an Orthodox funeral possible with organ donation?

Organ donation can lead to some delays—about one day on average—in delivering a body to a funeral home or church. But it does not prevent a prompt burial without embalming or an open casket funeral. It is important to let the organ procurement organization (OPO) know about your funeral and burial plans, including whether you plan to do embalming. 

Is 'brain death' consistent with an Orthodox theology of human death?

No Orthodox synod of bishops has opposed the use of brain death criteria for determining death, and some have explicitly permitted their use.

It also appears to be the general opinion of Orthodox bioethicists that brain death criteria are permissible. Here are two examples.

Tristram Engelhardt, Jr, an Orthodox bioethicist and physician, writes: "After the early periods of gestation, when a person’s brain is destroyed, that person is dead, although certain human biological life may continue in cell cultures, tissues, and organs. The remains of the body can be transplanted without transplanting the person. The kind of human life sustained in cells, tissues, organs, and even in decapitated bodies is not that of a person." (Foundations of Christian Bioethics)

Similarly, Fr. John Breck writes: "From a Christian perspective the most basic requirement for ‘personhood’ is the unity of the body and soul. However we may define ‘soul,’ it is clearly related to the brain function (although it is certainly not limited to that). That is, once ‘brain death’ occurs, the organism is dead." (The Sacred Gift of Life)

Are some organs too special to donate?

Yes, some organs are too special to donate. This would include the brain, which deeply connected to memories, thought, emotion, and volition, and reproductive organs. However, brains are not transplanted, and reproductive organs or gametes are not removed without special permission, which an Orthodox Christian would withhold.

Some Orthodox Christians wonder about the heart, because it is sometimes considered the seat of the nous or spiritual mind, which is why some say the Jesus Prayer is a prayer of the heart. Some think this language refers to the heart only poetically, while others think it refers to the muscular organ itself. In any case, no synod of bishops has prohibited donating the heart, and some explicitly say it is permissible. In principle, one might donate a deified or saintly organ–but this could only be good for the organ recipient!

Bibliography

This website draws heavily upon the article by John B. DuBois, "Is Organ Donation After Death a Moral Obligation of Orthodox Christians?" Forthcoming in Synergeia: The Journal of the Orthodox Christian Association of Medicine, Psychology, and Religion (OCAMPR).

Here are references to additional literature and resources consulted in developing information for this website. 

Barna, J. Mark, and Elizabeth J. Barna. A Christian Ending. A Handbook for Burial in the Ancient Christian Tradition. 2nd ed. Manton, CA: Divine Ascent Press, 2017.

Bauer, Keith, Sara Taub, and Kayhan Parsi. "Ethical Issues in Tissue Banking for Research: A Brief Review of Existing Organizational Policies." Theoretical Medicine 25 (2004): 113-42.

Bjeletich, Elissa D. In God’s Hands. A Mother’s Journey through Her Infant’s Critical Illness. Chesterton, IN: Ancient Faith Publishing, 2013.

Breck, John. The Sacred Gift of Life. Orthodox Christianity and Bioethics. Crestwood, NY: St. Vladimir’s Seminary Press, 2000.

"Policy Statements on Contemporary Moral Issues." Bulgarian Eastern Orthodox Diocese of the USA, Canada and Australia, 2023, accessed Sept 15, 2023, https://www.bulgariandiocese.org/policies.

Dominguez-Gil, B., N. Ascher, A. M. Capron, D. Gardiner, A. R. Manara, J. L. Bernat, E. Minambres, et al. "Expanding Controlled Donation after the Circulatory Determination of Death: Statement from an International Collaborative." Intensive Care Medicine (Feb 26 2021). https://doi.org/10.1007/s00134-020-06341-7. https://www.ncbi.nlm.nih.gov/pubmed/33635355.

DuBois, James M. "Avoiding Common Pitfalls in the Determination of Death." National Catholic Bioethics Quarterly 7, no. 3 (2007): 545-60.

———. "Organ Transplantation: An Ethical Road Map." National Catholic Bioethics Quarterly 2, no. 3 (Autumn 2002): 411-51. http://www.ncbi.nlm.nih.gov/pubmed/12854598.

Eelco, F. M. Wijdicks, N. Varelas Panayiotis, S. Gronseth Gary, and M. Greer David. "Evidence-Based Guideline Update: Determining Brain Death in Adults." Neurology 74, no. 23 (2010): 1911. https://doi.org/10.1212/WNL.0b013e3181e242a8. 

Engelhardt Jr, H. Tristram. The Foundations of Christian Bioethics. Exton, PA: Swets & Zeitlinger, 2000.

Greer, D. M., S. D. Shemie, A. Lewis, S. Torrance, P. Varelas, F. D. Goldenberg, J. L. Bernat, et al. "Determination of Brain Death/Death by Neurologic Criteria: The World Brain Death Project." JAMA 324, no. 11 (Sep 15 2020): 1078-97. https://doi.org/10.1001/jama.2020.11586. https://www.ncbi.nlm.nih.gov/pubmed/32761206.

Harakas, Stanley Samuel. "An Eastern Orthodox Approach to Bioethics." Journal of Medicine and Philosophy 18, no. 6 (1993): 531–48.

"Guidelines for Clergy." 2023, https://www.oca.org/files/PDF/official/2023-OCA-Guidelines-for-Clergy.pdf.

Iserson, Kenneth V. Death to Dust: What Happens to Dead Bodies? Tucson: Galen, 2001.

"Transplant of Organs." 2014, https://patriarhia.ro/transplant-of-organs-6021-en.html.

"The Basis of the Social Concept of the Russian Orthodox Church." Updated August 13-16, 2000, https://russianorthodoxchurch.ca/en/the-basis-of-the-social-concept-of-the-russian-orthodox-church/2408.

Talbot, David, and Anthony M D’Allesandro, eds. Organ Donation and Transplantation after Cardiac Death. New York: Oxford University Press, 2009.

"Family, the Joy of Life." 2019, https://antiochpatriarchate.org/en/page/2460/#Part3.2.

"Basic Positions on the Ethics of Organ Transplantation." 1999, accessed June 9, 2023, https://www.bioethics.org.gr/en/03_b.html#4.

Toumi, Rabee. Orthodox Christian Bioethics. The Role of Hospitality (Philoxenia), Dignity, and Vulnerability in Global Bioethics. Pickwick: Eugene, OR, 2020.

Tserkov, Russkaia Pravoslavnaia. The Great Book of Needs. Vol. III, Waymart, PA: St. Tikhon’s Press, 1998.

"Deceased Donation." United Network for Organ Sharing, 2023, accessed September 14, 2023, https://unos.org/transplant/deceased-donation/.