Organ donation in Israel
Encyclopedia
Organ transplantation in Israel is regulated by two laws passed in 2008. The first law defines "brain death
" as an indication of death for all legal purposes, including organ donation. A second law provides financial and other benefits to living donors and outlaws organ trafficking. Despite this, due to the large population of observant Jews in Israel and misconceptions about what is permissible under Jewish law
, the rate of organ donation in Israel is significantly lower than in most Western countries.
approved two laws designed to regulate organ donations. The first law defines brain-respiratory death as a situation in which person who has no blood pressure
, fails to breathe without external life support systems and has no response from the pupils or any other reflex
es is declared dead by two certified doctors.
The second law provides for various benefits to living organ donors, such as monetary reward from the state in the amount of 18,000 NIS (roughly US$5,000), priority on the transplant list should they require a future organ donation, waived self-participation fee for any medical service resulting from the donation, and the attainment of a "chronic patient" status, which entitles the holder to additional medical benefits. In addition, the law criminalizes organ trafficking, receiving compensation for organs, or acting as an organ broker. This law was cited as a model by proposed 2009 legislation in the US.
Since some religious Jews feel the 2008 law does not properly address halachic questions, Israel's Chief Rabbinate has decided to issue an organ donor card of its own, which allows organ harvesting from the potential donor only if brain death is determined according to the strictest letter of the law - for example by requiring that brain death be confirmed using electronic equipment rather than just the determination of a physician.
The Halachic Organ Donor Society is active in Israel trying to raise awareness about Halachic acceptance of brain-stem death and support of organ donation. Most Israelis are secular but when it comes to death, most turn to Orthodox rabbis to seek guidance. That is why Israel has one of the lowest organ donor rates in the Western world. The Halachic Organ Donor Society has succeeded in recruiting more than 230 rabbis to register for organ donor cards. It has given presentations to over 30,000 Jews around the world to encourage them to donate organs to the general public.
Yaakov Levi, the director of the Heart Transplant Unit at Sheba Medical Center
has called for organs to be allocated first to those who are willing to donate their own organs and have possessed a donor card for several years. This call was accepted and incorporated into the 2008 law. According to the New York Times, "Organ donation rates in Israel are among the lowest in the developed world, about one-third the rate in Western Europe, in large part because of what Health Ministry officials and doctors describe as a widespread impression that Jewish religious law prohibits transplants as a 'desecration of the body.'"
of Organ Watch (in 2001), Israel had become a "pariah" in the organ transplant world. The lack of donations due to Jewish custom heightened the disparity between the supply and demand of organs. This led to the popularity of "transplant tourism" in which patients in need of organs travel to medical centres abroad to receive organs. Prior to the 2008 law prohibiting it, some Israeli organ brokers advertised on the radio and in newspapers. Kidneys, which are the most traded organ, may fetch up to $150,000 for brokers who usually pay the donors far less.. Nancy Scheper-Hughes said to the media that Israeli "tentacles" reach around the world with bank accounts around the world. She was criticized for the alleged antisemitic tone of her remark. She also said to the media that an Israeli doctor told her that Jews buying organs from gentiles was payback for the Holocaust. She has since said that the doctor said it in jest.
Levy Izhak Rosenbaum of Brooklyn was alleged in July 2009 to have been conspiring to arrange the sale of an Israeli citizen's kidney
for $160,000. According to the complaint, Rosenbaum had said that he had been involved in the illegal sale of kidneys for 10 years. Acting US Attorney Ralph Marra said "His business was to entice vulnerable people to give up a kidney for $10,000 which he would turn around and sell for $160,000". Anthropologist and organ trade expert Nancy Scheper-Hughes claimed that she had informed the FBI that Rosenbaum was "a major figure" in international organ smuggling 7 years ago, and that many of Rosenbaum's donors had come from Eastern Europe. She also heard reports that Rosenbaum held donors at gunpoint to ensure they donated their organs.
The Jewish weekly newspaper The Forward
reported in the wake of this scandal that an Organ Trafficking Prohibition Act of 2009, sponsored by Democratic Senator Arlen Specter
of Pennsylvania, has yet to be officially introduced in the U.S., but that its proposed language cites Israel as a model of a country that has enacted a law providing benefits for organ donors.
The lack of regulations against organ trafficking prior to 2008 made Israel a focal point for the international organ trade. Israelis are given up to $80,000 to pay for organs abroad.
In the 1990s, many organ brokers performed the transplants in Turkey
and sourced donors from Moldova
, Romania
and Russia. However, some patients died and the Turkish and European media exposed the practice, forcing brokers to move to South Africa and China, among other places.
In 2004 a South African organ trading operation providing American, Iranian and Israeli recipients with organs from Brazilian, Russian and Romanian donors was raided by authorities in South Africa and Brazil, who arrested 15 members of the ring including a recipient and a donor. The donors were paid $10,000 for a kidney, while the recipients were charged $120,000 to receive one. The ring was allegedly controlled by an Israeli, Ilan Peri, who was arrested for tax evasion by the Israeli government who claims he owes $5 million and also for submitting false invoices to a government health plan for the South African organ donor operations.
In April 2010, six Israelis were charged with running an international organ trafficking ring and breaking promises to donors to pay for their removed kidneys. One of the arrested suspects is a retired army general, Israeli police said. The traffickers offered up to $100,000 per kidney but in at least two cases didn't pay the donors after the organs were surgically removed, police said.
As a result of all the abuses of the illegal market in human organs, there is a growing movement of activists in Israel and in America to legalize a Government-regulated program to offer financial incentives to people for living kidney donations and to families for deceased donations from brain-stem dead donors. This movement is headed, among other organizations, by the Alliance for Organ Donor Incentives.
published an article alleging that in 1992 the Israeli Defense Force took organs from Palestinians who died in Israeli custody. The allegations were denied by Israel, and the article caused a diplomatic row between Israel and Sweden. In December an interview was broadcast on Israeli television during which Israel's chief pathologist, Dr. Yehuda Hiss
, discussed the harvesting of organs
in the 1990s at the Abu Kabir Forensic Institute
. The interview was followed by a confirmation from Israeli officials that organs were taken in the 1990s without the permission of families of the deceased. Officials denied that the practice continued, and noted that both Israeli and Palestinian organs were taken without permission. "We started to harvest corneas for various hospitals in Israel," Israel's chief pathologist, Dr. Yehuda Hiss
said in an interview on Israel's Channel 2 network. "Whatever was done was highly informal. No permission was asked from the families," he said.
Brain death
Brain death is the irreversible end of all brain activity due to total necrosis of the cerebral neurons following loss of brain oxygenation. It should not be confused with a persistent vegetative state...
" as an indication of death for all legal purposes, including organ donation. A second law provides financial and other benefits to living donors and outlaws organ trafficking. Despite this, due to the large population of observant Jews in Israel and misconceptions about what is permissible under Jewish law
Organ donation in Jewish law
Under Jewish law, organ donation raises some questions, and has traditionally been met with some skepticism. However, it has met increasing acceptance as medical transplantation methods have improved. In both Orthodox Judaism and non-Orthodox Judaism, the majority view holds that organ donation is...
, the rate of organ donation in Israel is significantly lower than in most Western countries.
Legal status
Until 2008, there was no law prohibiting organ trafficking in Israel. In 2008, the KnessetKnesset
The Knesset is the unicameral legislature of Israel, located in Givat Ram, Jerusalem.-Role in Israeli Government :The legislative branch of the Israeli government, the Knesset passes all laws, elects the President and Prime Minister , approves the cabinet, and supervises the work of the government...
approved two laws designed to regulate organ donations. The first law defines brain-respiratory death as a situation in which person who has no blood pressure
Blood pressure
Blood pressure is the pressure exerted by circulating blood upon the walls of blood vessels, and is one of the principal vital signs. When used without further specification, "blood pressure" usually refers to the arterial pressure of the systemic circulation. During each heartbeat, BP varies...
, fails to breathe without external life support systems and has no response from the pupils or any other reflex
Reflex
A reflex action, also known as a reflex, is an involuntary and nearly instantaneous movement in response to a stimulus. A true reflex is a behavior which is mediated via the reflex arc; this does not apply to casual uses of the term 'reflex'.-See also:...
es is declared dead by two certified doctors.
The second law provides for various benefits to living organ donors, such as monetary reward from the state in the amount of 18,000 NIS (roughly US$5,000), priority on the transplant list should they require a future organ donation, waived self-participation fee for any medical service resulting from the donation, and the attainment of a "chronic patient" status, which entitles the holder to additional medical benefits. In addition, the law criminalizes organ trafficking, receiving compensation for organs, or acting as an organ broker. This law was cited as a model by proposed 2009 legislation in the US.
Organizations
Israel operates a National Transplant and Organ Donation Center, established in 1993 as an institute of the Ministry of Health. The center incorporates the ADI organization, founded by private citizens, which maintains a database of donors and sponsors donor cards. As of 2009, the database contains around 500,000 names of donors, about 10% of Israel's adult population.Since some religious Jews feel the 2008 law does not properly address halachic questions, Israel's Chief Rabbinate has decided to issue an organ donor card of its own, which allows organ harvesting from the potential donor only if brain death is determined according to the strictest letter of the law - for example by requiring that brain death be confirmed using electronic equipment rather than just the determination of a physician.
The Halachic Organ Donor Society is active in Israel trying to raise awareness about Halachic acceptance of brain-stem death and support of organ donation. Most Israelis are secular but when it comes to death, most turn to Orthodox rabbis to seek guidance. That is why Israel has one of the lowest organ donor rates in the Western world. The Halachic Organ Donor Society has succeeded in recruiting more than 230 rabbis to register for organ donor cards. It has given presentations to over 30,000 Jews around the world to encourage them to donate organs to the general public.
Prevalence of donations
Due to the large population of orthodox Jews in Israel, organ donation is a controversial issue. The rate of agreement to organ donation is only 45%, which is 50% lower than the rate in most Western countries. The percentage of people who hold an organ donation card in Israel is only 10 percent; in Western countries the rate is 30-40%. As a result, there are about 1,000 Israelis currently on the "waiting list" for organs, and it is estimated that roughly 10% of them die annually, due to a lack of donations.Yaakov Levi, the director of the Heart Transplant Unit at Sheba Medical Center
Sheba Medical Center
The Chaim Sheba Medical Center at Tel Hashomer , also Tel HaShomer Hospital, is the largest hospital in Israel.-Overview:The hospital was named after Chaim Sheba, the founding director. It was established in 1948 as the country's first military hospital to treat casualties of Israel's War of...
has called for organs to be allocated first to those who are willing to donate their own organs and have possessed a donor card for several years. This call was accepted and incorporated into the 2008 law. According to the New York Times, "Organ donation rates in Israel are among the lowest in the developed world, about one-third the rate in Western Europe, in large part because of what Health Ministry officials and doctors describe as a widespread impression that Jewish religious law prohibits transplants as a 'desecration of the body.'"
Organ trafficking
According to organ trade expert Nancy Scheper-HughesNancy Scheper-Hughes
Nancy Scheper-Hughes is a professor of Anthropology and director of the program in Medical Anthropology at the University of California at Berkeley. She is known for her writing on the anthropology of the body, hunger, illness, medicine, psychiatry, madness, social suffering, violence and genocide...
of Organ Watch (in 2001), Israel had become a "pariah" in the organ transplant world. The lack of donations due to Jewish custom heightened the disparity between the supply and demand of organs. This led to the popularity of "transplant tourism" in which patients in need of organs travel to medical centres abroad to receive organs. Prior to the 2008 law prohibiting it, some Israeli organ brokers advertised on the radio and in newspapers. Kidneys, which are the most traded organ, may fetch up to $150,000 for brokers who usually pay the donors far less.. Nancy Scheper-Hughes said to the media that Israeli "tentacles" reach around the world with bank accounts around the world. She was criticized for the alleged antisemitic tone of her remark. She also said to the media that an Israeli doctor told her that Jews buying organs from gentiles was payback for the Holocaust. She has since said that the doctor said it in jest.
Levy Izhak Rosenbaum of Brooklyn was alleged in July 2009 to have been conspiring to arrange the sale of an Israeli citizen's kidney
Kidney
The kidneys, organs with several functions, serve essential regulatory roles in most animals, including vertebrates and some invertebrates. They are essential in the urinary system and also serve homeostatic functions such as the regulation of electrolytes, maintenance of acid–base balance, and...
for $160,000. According to the complaint, Rosenbaum had said that he had been involved in the illegal sale of kidneys for 10 years. Acting US Attorney Ralph Marra said "His business was to entice vulnerable people to give up a kidney for $10,000 which he would turn around and sell for $160,000". Anthropologist and organ trade expert Nancy Scheper-Hughes claimed that she had informed the FBI that Rosenbaum was "a major figure" in international organ smuggling 7 years ago, and that many of Rosenbaum's donors had come from Eastern Europe. She also heard reports that Rosenbaum held donors at gunpoint to ensure they donated their organs.
The Jewish weekly newspaper The Forward
The Forward
The Forward , commonly known as The Jewish Daily Forward, is a Jewish-American newspaper published in New York City. The publication began in 1897 as a Yiddish-language daily issued by dissidents from the Socialist Labor Party of Daniel DeLeon...
reported in the wake of this scandal that an Organ Trafficking Prohibition Act of 2009, sponsored by Democratic Senator Arlen Specter
Arlen Specter
Arlen Specter is a former United States Senator from Pennsylvania. Specter is a Democrat, but was a Republican from 1965 until switching to the Democratic Party in 2009...
of Pennsylvania, has yet to be officially introduced in the U.S., but that its proposed language cites Israel as a model of a country that has enacted a law providing benefits for organ donors.
The lack of regulations against organ trafficking prior to 2008 made Israel a focal point for the international organ trade. Israelis are given up to $80,000 to pay for organs abroad.
In the 1990s, many organ brokers performed the transplants in Turkey
Turkey
Turkey , known officially as the Republic of Turkey , is a Eurasian country located in Western Asia and in East Thrace in Southeastern Europe...
and sourced donors from Moldova
Moldova
Moldova , officially the Republic of Moldova is a landlocked state in Eastern Europe, located between Romania to the West and Ukraine to the North, East and South. It declared itself an independent state with the same boundaries as the preceding Moldavian Soviet Socialist Republic in 1991, as part...
, Romania
Romania
Romania is a country located at the crossroads of Central and Southeastern Europe, on the Lower Danube, within and outside the Carpathian arch, bordering on the Black Sea...
and Russia. However, some patients died and the Turkish and European media exposed the practice, forcing brokers to move to South Africa and China, among other places.
In 2004 a South African organ trading operation providing American, Iranian and Israeli recipients with organs from Brazilian, Russian and Romanian donors was raided by authorities in South Africa and Brazil, who arrested 15 members of the ring including a recipient and a donor. The donors were paid $10,000 for a kidney, while the recipients were charged $120,000 to receive one. The ring was allegedly controlled by an Israeli, Ilan Peri, who was arrested for tax evasion by the Israeli government who claims he owes $5 million and also for submitting false invoices to a government health plan for the South African organ donor operations.
In April 2010, six Israelis were charged with running an international organ trafficking ring and breaking promises to donors to pay for their removed kidneys. One of the arrested suspects is a retired army general, Israeli police said. The traffickers offered up to $100,000 per kidney but in at least two cases didn't pay the donors after the organs were surgically removed, police said.
As a result of all the abuses of the illegal market in human organs, there is a growing movement of activists in Israel and in America to legalize a Government-regulated program to offer financial incentives to people for living kidney donations and to families for deceased donations from brain-stem dead donors. This movement is headed, among other organizations, by the Alliance for Organ Donor Incentives.
The Aftonbladet accusations
In August 2009 the Swedish tabloid AftonbladetAftonbladet
Aftonbladet is a Swedish tabloid founded by Lars Johan Hierta in 1830 during the modernization of Sweden. It is one of the larger daily newspapers in the Nordic countries. Aftonbladet is owned by the Swedish Trade Union Confederation and Norwegian media group Schibsted, and its editorial page...
published an article alleging that in 1992 the Israeli Defense Force took organs from Palestinians who died in Israeli custody. The allegations were denied by Israel, and the article caused a diplomatic row between Israel and Sweden. In December an interview was broadcast on Israeli television during which Israel's chief pathologist, Dr. Yehuda Hiss
Yehuda Hiss
Yehuda Hiss is the chief pathologist at the Abu Kabir Institute of Forensic Medicine and has held this position since 1988...
, discussed the harvesting of organs
Organ harvesting
Organ harvesting refers to the removal, preservation and use of human organs and tissue from the bodies of the recently deceased to be used in surgical transplants on the living...
in the 1990s at the Abu Kabir Forensic Institute
Abu Kabir Forensic Institute
L. Greenberg National Institute of Forensic Medicine also known as Abu Kabir Forensic Institute, is an Israeli forensic research laboratory located in the Abu Kabir neighborhood of Tel Aviv, Israel.-History:...
. The interview was followed by a confirmation from Israeli officials that organs were taken in the 1990s without the permission of families of the deceased. Officials denied that the practice continued, and noted that both Israeli and Palestinian organs were taken without permission. "We started to harvest corneas for various hospitals in Israel," Israel's chief pathologist, Dr. Yehuda Hiss
Yehuda Hiss
Yehuda Hiss is the chief pathologist at the Abu Kabir Institute of Forensic Medicine and has held this position since 1988...
said in an interview on Israel's Channel 2 network. "Whatever was done was highly informal. No permission was asked from the families," he said.
External links
- National Transplant and Organ Donation Center and ADI organization