Close on the heels of the organ donation debate stirred in Israel by Avi Cohen's demise, comes another equally intense debate in Britain. Lord Jonathan Sacks, the chief rabbi of Orthodox Jews in London, has said that organ donor cards, in their current form, are not permissible under the Jewish law of Halacha. He belongs to London's Beth Din, which has ruled that a person is only dead when their heart and lungs have stopped (cardio-respiratory failure) and forbids the taking of organs from brain dead donors. As the current donor scheme in Britain makes no allowances for such religious preferences, Rabbi Sacks has demanded changes to existing donor cards. He said that donors should be able to make it clear that they agree to the removal of organs after their heart stops, but not if they are brain-dead. Either way, a rabbinical authority should be consulted before anything is done.

The British Medical Association and the National Health Service's Blood and Transplant Service already face a shortage of organ donors as they try to care for 8,000 patients who desperately need transplants. They now seek meetings with the chief rabbi, fearful that the controversy could cut the number of Jewish donors, who are vitally needed if the close tissue matches needed for patients from ethnic minorities are not to be affected.

The Lancet (Volume 377, Issue 9762, Page 271, 22 January 2011) in an article has stressed the need for faith leaders and doctors to work together to avoid sowing distrust and confusion. Religious doctrine needs to be interpreted with deep understanding, humane wisdom, and humility. It also emphasizes that any position and policy at the end of life—religious, ethical, or medical—should fulfill three criteria. First, it must be based on sound scienific evidence and understanding. Second, it must have the best intention for both the person whose life has ended and for the person who needs an organ to prolong life. In other words, it must do no harm. And third, it must be understandable and supported by the individual within his or her cultural and belief context.