End-of-Life in Halakha #4: Living Organ Donation

Sefer Meirat Einayim 426

In Hagahahot Maimoniot they wrote that the [Talmud] Yerushalmi concludes that one must even enter into potential danger for this. This was cited by Beit Yosef who commented "it would seem that the reason for this is that the other one (the victim) is definite and he (the rescuer) is only questionable." This [ruling] was omitted by Shulchan Aruch and Rama, and one can suggest that the reason for this is that since Rif, Rambam, Rosh, and Tur did not include it in their codification, they (Shulchan Aruch and Rama) omitted it as well.

Aruch LaNer Sanhedrin 73a

According to what Beit Yosef wrote in Choshen Mishpat in the name of the [Talmud] Yerushalmi that one must potentially risk his life in order to save someone else's life, one must ask: why does the Gemara question the necessity for the verse mandating saving a life once we have a verse for hashavat aveidah; if [Hagahot Maimoniot's idea is correct] it [the verse mandating saving a life] is certainly necessary for this case [of potential risk]. [Yet] according to the codifiers who omitted this law, everything works well, because they are of the opinion that our Talmud [Bavli] disagrees with the Yerushalmi.

Igrot Moshe YoD 2:174

According to what I wrote that the prohibition against standing idly by your neighbor's blood has the same status as other negative prohibitions, one cannot be obligated to risk one's life in order to save someone else from definite death because regarding other negative prohibitions, it is not only unnecessary but prohibited to risk one's life. In fact, it is just the opposite, for if one must violate Shabbbat in order to save oneself from a questionable danger, certainly one cannot enter into danger to avoid violation of Shabbat or other negative prohibitions. Therefore, one cannot require someone to potentially endanger himself even if it is to save someone else.

However, it is logical that there is a difference between the prohibition against standing idly by and other negative prohibitions, in that one is prohibited from risking one's life in order to avoid violation of a negative commandment...

but in order to save a life, even though it is a negative commandment, it is permissible to endanger oneself since this will accomplish saving a Jewish life.

Teshuvot R. Akiva Eger, Pesakim no. 60

The intention of Rabbeinu Shimshon is not that there is actual danger or potential danger. Rather there is great pain and suffering and there is a remote possibility - a one in a thousand chance - that this may become dangerous. Even though we don't treat the current condition as an actual danger or potential danger, nevertheless, since it can become dangerous, we use the term "danger"...

We find a similar idea in Perek Kirah (the third chapter of Masechet Shabbat) where it states that one can rely on R. Shimon in a pressing situation. Rashi explains that we are dealing with danger. [One can ask:] doesn't one violate any biblical prohibition for actual danger or potential danger? Why then, must one rely on the opinion of R. Shimon? Rather one must conclude that there is no current potential danger, but there is a remote possibility that it will become a dangerous situation, and that is considered a pressing situation where one can rely on the opinion of R. Shimon.

Responsa Radbaz 3:627

One cannot violate Shabbat for the threat of loss of limb. However, we have not heard of [an obligation] for one to accept a threat instead of one's friend ... even though he has an obligation to save him with his money, this obligation does not extend to risking one of his limbs ... Furthermore, [the verse] states 'Her ways are ways of pleasantness,' and the laws of the Torah must correspond to reason and logic, so how can we think that a person should allow someone to blind him or to amputate a limb in order that he (the threatener) won't kill his friend. Therefore, I see no reason for this and it is only a meritorious act. Praised is the portion of one who can withstand this. If there is a potential danger, he is a pious fool, because his life vis-à-vis the potential danger supersedes the definite death of his friend.

Minchat Yitzchak 6:103

Regarding our discussion about the medical innovation of transplanting a kidney from a healthy person to someone suffering from renal failure, [we discussed] if it is permissible for a healthy person to allow someone to take one of his kidneys for the purpose of healing his friend. We spoke about the issue of someone who sees his friend drowning in the river if he has to potentially risk his own life in order to save his friend. Radvaz in a responsum distinguishes between cases where there is danger and cases where there is no danger, and in our case, there is certainly danger in the procedure itself and in the future because he now lacks a kidney. Also, that which is implicit that the dispute (regarding risking one's life to save another) is only whether it is obligatory, but (everyone agrees that) it is permissible if he desires to do so, that is only true if by risking his own life he will certainly save his friend.