Transplants and Transfusions

Q. Some religions believe that blood transfusions and organ transplants are contrary to the laws of God. What are the teachings of Gaudiya Vaisnavism in regard to these and other modern breakthroughs in biotechnology and medical science?

A. Today's scientific and medical breakthroughs, such as organ transplants, stem cell research, bioengineering, and genetic modification, are of great interest because they force Gaudiya Vaisnavism to cover new ground, as the science and technology that make them possible today was not readily available centuries ago when the Gaudiya scriptures were written. Thus they bring up ethical and spiritual questions that Gaudiya Vaisnavism has no pat answers for, as there are no scriptural verses that devotees can refer to that would definitively answer all the questions that many of these medical breakthroughs pose.

Perhaps the appropriate emphasis here is that humanity must think deeply before tampering significantly with nature. Reverence for nature is important. It is not merely superstition. The systems of nature are unlimitedly complex and powerful, and we, either individually or collectively, are but a small part of nature. In the pursuit of short-term advances, which are often only as far as one can see (especially for those lacking a spiritual worldview), the long-term outcome can often be disastrous. Therefore it is important to determine values. What kind of humanity is most desirable? Will our technological or scientific leaps make people more kind and compassionate?

For example, if through genetics the way that we approach medicine is significantly altered in the future, will it make for a kinder world? That is to say that if we know from birth by the study of a child's genes that he or she will be likely to develop a life threatening disease, then how will this alter the way in which society relates to that child? Will he or she be able to get health insurance? Will he or she be less desirous or will the quality of his or her life–the sacredness of life–continue to be honored? It would be disastrous if through technological advances we live longer but meaner lives.

After all, although evolutionary theory posits that the more complex an organism is the more advanced it is because it thereby has the power to dominate over others and survive, our human sensibilities seem to say that the most advanced species would be the kindest species, and that might does not always make right. I have often said that the only apocalyptic scenario that made much sense to me–that had the most potential to come true–was an environmental one. The line between appropriately conducting oneself as a steward of nature and playing God is a fine one. To the extent that we err on the side of the latter we stand to lose significantly.

Q. Did Srila Prabhupada take any position on blood transfusions and organ transplants?

A. The Bhagavad-gita says that the soul is seated on a machine made of matter, yantra rudrani mayaya. Srila Prabhupada often refers to it as such. When necessary certain parts of that machine may be replaced. Indeed, in several conversations about heart transplants Srila Prabhupada said that changing a part of the body has no effect on the soul. In one such conversation Dr. Singh asked, "We know that the spirit soul is within the heart. What happens (in the case of a heart transplant) to the spirit soul in each heart?"

Srila Prabhupada replied, "The Vedas describe the heart as a sitting place for the soul. So when they transplant hearts, they simply change the soul's seat. The same soul remains. Changing hearts is just a change of material bodily organs. The heart is not the real source of life therefore changing the heart does not prolong the duration of life. The soul is destined to live in a particular body for a certain number of years. You may change whatever part of the body you like, but you cannot change the duration of the life of that body."

When specifically asked about blood transfusions Srila Prabhupada replied, "Well, that is not bad. Because if one life is saved by transfusion admission… He is not dying. He is living. He is contributing his blood. So if he is contributing, you are saving some life, there is no harm."

Q. Srila Prabhupada said that an organ transplant would not change the duration of one's life. Can you explain this?

A. Ayurveda or Vedic "life science" (ayuh = life + veda = science) and traditional yoga practice have much to do with pranayama or the regulation of the breath. When Srila Prabhupada says that one cannot change the duration of life in a particular body, he is referring to the yogic worldview, which teaches that one's lifespan is determined by the number of breaths a person is allotted by their karma. Apparently it may be possible to increase one's duration of life by regulating breathing and changing lifestyle, but the ability to do so is still within the realm of karma. The yoga tradition teaches that with one's final exhalation the soul leaves the body through the mouth, taking its next birth in the situation that corresponds to one's karmic destiny.

Thus Srila Prabhupada is merely emphasizing to his students that longevity is determined more by one's karmic destiny than by medical science and that in spite of all its prospects, medical science will never be able to increase one's life unlimitedly. His statement was made more than thirty years ago when the very first heart transplants were being performed and some hypothesized that organ transplants offered the potential for eternal life. Today organ transplants are not primarily aimed at increasing an elderly person's life for a few years. More often they are for those who are still young but will have little or no life without them. Can an organ transplant increase the duration of one's life? Obviously a transplant may allow one to exist longer in a particular body, if of course it is that person's karma to receive and survive the operation.

Q. A life-threatening illness can be a huge impetus for a healing journey of purification and self-correction on many levels, what to speak of offering an opportunity to reach out to God. Why should a person be cheated out of such an opportunity through unnatural and artificial means such as drug therapies and organ transplants performed by members of a corrupt medical establishment that kills millions of babies every year through abortion?

A. Organ transplants do not deny one the opportunity to go on a healing journey. Transplant patients have merely selected a particular healing methodology that differs from one that you would have chosen. Surely many of them pray before and after the transplant, and undergoing such a medical procedure requires one to be just as introspective about spiritual life as does any other life-threatening situation. Furthermore, sometimes babies are born with defective organs, and transplants are their only chance to survive to the point where their mental faculties are developed enough to allow them to "reach out to God."

Otherwise, we acknowledge that the world is full of corruption, but whatever corruption exists in the medical establishment does not make organ transplantation equal to abortion. Modern medicine is also full of good intentions and organ transplantation is lauded by almost everyone as a great achievement. Over the past decade scientists have made major inroads into regenerating damaged organs and tissues. They've successfully grown liver cells, skin, bone and cartilage, and now there are promising signs that bladders can be grown and transplanted without fear of rejection. Scientists are also growing organs from would-be recipients' own cells. In the future transplanting organs grown from one's own cells may be a common practice.

In any case, one has the choice to receive or reject the procedure-to donate organs or not to donate them, so why should anyone try to dissuade educated people from endorsing this practice? Although I remain open to well-considered and truly compelling reasoning against organ transplantation, that is not to be found in your statement. The only argument you offer against the practice is that it is unnatural and thus against God's law. The same argument could be used against every technological development since the industrial revolution. To label scientific breakthroughs that one dislikes as unnatural while embracing other developments seems questionable. Who doesn't drive or ride in a motorized vehicle? Our param guru Srila Bhaktisiddhanta Saraswati Thakura did so at a time when religious protocol for a sannyasi dictated otherwise. His message was to use everything that the new technological world has to offer in Krsna's service.

Q. Doesn't Gaudiya Vaisnavism favor naturopathic and other types of alternative medicine that deal with the root cause of disease, rather than so-called modern medicine, which more or less treats only symptoms?

A. As for treating the root cause of disease, bhakti is the only viable method. Why? Because according to scripture disease is caused by karma, which in the ultimate issue is rooted in ignorance of the soul (avidya). Even transcendental knowledge (jnana) cannot cure disease because it does not have the power to stop karma that is already manifesting (prarabdha-karma). Scripture says that only bhakti has this power. So if we were to follow the reasoning that modern medicine does not treat the root, we would be led to the same conclusion with regard to naturopathic medicine, homeopathic medicine, acupuncture, chiropractic, or whatever-that they only treat the symptoms without getting to the root because they do not engage people in suddha-bhakti. By this line of reasoning hearing and chanting Krsna nama is the only real cure for disease. There is no doubt some truth in this, but we do not insist that no other approach to treating disease is worth entertaining.

Q. Should devotees donate their organs to others at death? Should they accept donated organs?

A. Interestingly, there are a number of stories in the Puranas about organ transplantation. In one Siva is said to have transplanted an elephant's head onto his son Ganesa.

Srila Prabhupada was not against blood transfusion and organ transplantation. It has also been brought to my attention that a respected present-day Gaudiya acarya has just received a blood transfusion. So overall we can conclude that there is no prohibition in Gaudiya Vaisnavism against these two medical procedures, although I feel that there may be a subtle distinction between blood transfusions and organ transplantation, in that blood is constantly regenerated.

All considered, your question brings up an issue that is as complicated as it is interesting. Not complicated from the secular or scientific point of view, but complicated from the devotional point of view. Devotees believe that an organ is a manifestation of a person's prarabdha karma and that a devotee's body (sadhaka-deha) is special because it is a material body that is gradually becoming spiritualized and free from karma through the influence of Krsna's internal energy (svarupa-sakti). Death is said to be the expiration of one's prarabdha-karma, but in the case of a transplant, the organ and the karma appears to live on and become part of someone else's karma.

So it is one thing to say, "I am not this body," and another to say, "This body belongs to Guru and Krsna." The first is Vedanta–the second is bhakti. We bhakti-Vedantins are not free to do with our bodies as we like, or as the secular world dictates, because the tradition's emphasis on respect for a sadhaka-deha is considerable. This respect is not just for those who have perfected their sadhaka-deha, but for all devotees and ultimately for bhakti. We see the body as a sacred temple of God, a vision brought to life by the serious practitioner and backed by a wealth of philosophy. Thus the idea of dissecting and dismembering a body that has been completely dedicated to Krsna's service in order to donate its organs may be somewhat unsettling to most devotees, and rightly so. Yet should a Vaisnava out of compassion for people in general choose to donate his or her organs, it would be hard to argue against such an act of mercy. Out of compassion, Vasudeva, the uttama bhagavata leper, allowed worms to feed on his body, and if they fell off, he would pick them up and put them back on. Who can argue with this?

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