Organ transplantation in Israel

Last updated

Organ transplantation in Israel has historically been low compared to other Western countries due to a common belief that organ donation is prohibited under Jewish law. This changed with the passage of new organ donation laws in 2008. If two patients have the same medical need, priority will now go to the patient who has signed an organ donor card, or whose family members have donated an organ (though medical necessity still takes precedence). This policy was nicknamed don't give, don't get. [1] The law also defines "brain death" as an indication of death for all legal purposes, including organ donation. Additionally the law provides financial reimbursement to living donors for medical expenses due to donation and lost time at work. Organ trafficking is explicitly banned. Health insurance plans can no longer reimburse patients who go abroad to receive transplants.

Contents

Currently, although the rate of organ donation is still relatively low, it is rising. [2]

Until 2008, there was no law prohibiting organ trafficking in Israel. [3] In 2008, the Knesset 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 reflexes is declared dead by two certified doctors. [4]

The second law provides for various benefits to living organ donors, such as reimbursement for medical expenses and lost work up to 18,000 NIS (roughly US$5,000), priority on the transplant list should they require a future organ donation, [5] 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. [4] This law was cited as a model by proposed 2009 legislation in the US. [6]

Organizations

Israel operates a National Transplant and Organ Donation Center, established in 1993 as an institute of the Ministry of Health. [7] 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 ultra-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. [8]

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. This public awareness campaign has increased the number of Israelis who have signed organ donor cards.

Prevalence of donations

Both Orthodox Jews and the majority secular Jewish population often cite Jewish law as the reason for not donating. [9] The rate of agreement to organ donation is only 45%, which is 50% lower than the rate in most Western countries. [10] The percentage of people who hold an organ donation card in Israel is only 14 percent; [11] 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. [5]

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 law prohibits transplants as a 'desecration of the body......'" [12]

Organ trafficking

According to organ trade expert Nancy Scheper-Hughes 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. [13] 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. [12] 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. [6]

The lack of regulations against organ trafficking prior to 2008 made Israel a focal point for the international organ trade. Health insurance would reimburse Israelis for organ transplants done abroad, but this has been banned in the new law. [14]

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 reveal

In August 2009 the Swedish tabloid Aftonbladet published an article revealing that in 1992 the Israeli Defense Force took organs from Palestinians who died in Israeli custody. [15] The allegations were denied by Israel, and the article caused a diplomatic row between Israel and Sweden. [16] However the author of the article, Donald Boström, spoke to Israel Radio on 19 August 2009 and said he was worried by the allegations he reported: "It concerns me, to the extent that I want it to be investigated, that's true. But whether it's true or not — I have no idea, I have no clue." [17]

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. [18] 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," 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. [19]

See also

Related Research Articles

<span class="mw-page-title-main">Organ donation</span> Process of voluntarily giving away organs

Organ donation is the process when a person authorizes an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive, through a legal authorization for deceased donation made prior to death, or for deceased donations through the authorization by the legal next of kin.

<span class="mw-page-title-main">Organ transplantation</span> Medical procedure in which an organ is removed from one body and placed in the body of a recipient

Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be transported from a donor site to another location. Organs and/or tissues that are transplanted within the same person's body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source.

The Uniform Anatomical Gift Act (UAGA), and its periodic revisions, is one of the Uniform Acts drafted by the National Conference of Commissioners on Uniform State Laws (NCCUSL), also known as the Uniform Law Commission (ULC), in the United States with the intention of harmonizing state laws between the states.

Prior to the introduction of brain death into law in the mid to late 1970s, all organ transplants from cadaveric donors came from non-heart-beating donors (NHBDs).

<span class="mw-page-title-main">Kidney transplantation</span> Medical procedure

Kidney transplant or renal transplant is the organ transplant of a kidney into a patient with end-stage kidney disease (ESRD). Kidney transplant is typically classified as deceased-donor or living-donor transplantation depending on the source of the donor organ. Living-donor kidney transplants are further characterized as genetically related (living-related) or non-related (living-unrelated) transplants, depending on whether a biological relationship exists between the donor and recipient. The first successful kidney transplant was performed in 1954 by a team including Joseph Murray, the recipient's surgeon, and Hartwell Harrison, surgeon for the donor. Murray was awarded a Nobel Prize in Physiology or Medicine in 1990 for this and other work. In 2018, an estimated 95,479 kidney transplants were performed worldwide, 36% of which came from living donors.

<span class="mw-page-title-main">Organ transplantation in China</span>

Organ transplantation in China has taken place since the 1960s, and is one of the largest organ transplant programmes in the world, peaking at over 13,000 liver and kidney transplants a year in 2004.

Organ procurement is a surgical procedure that removes organs or tissues for reuse, typically for organ transplantation.

Nancy Scheper-Hughes is an anthropologist, educator, and author. She is the Chancellor's Professor Emerita of Anthropology and the director and co-founder of the PhD program in Critical Medical Anthropology at the University of California, Berkeley. She is known for her writing on the anthropology of the body, hunger, illness, medicine, motherhood, psychiatry, psychosis, social suffering, violence and genocide, death squads, and human trafficking.

Certain fundamental Jewish law questions arise in issues of organ donation. Donation of an organ from a living person to save another's life, where the donor's health will not appreciably suffer, is permitted and encouraged in Jewish law. Donation of an organ from a dead person is equally permitted for the same purpose: to save a life. This simple statement of the issue belies, however, the complexity of defining death in Jewish law. Thus, although there are side issues regarding mutilation of the body etc., the primary issue that prevents organ donation from the dead amongst Jews, in many cases, is the definition of death, simply because to take a life-sustaining organ from a person who was still alive would be murder.

Organ trade is the trading of human organs, tissues, or other body products, usually for transplantation. According to the World Health Organization (WHO), organ trade is a commercial transplantation where there is a profit, or transplantations that occur outside of national medical systems. There is a global need or demand for healthy body parts for transplantation, which exceeds the numbers available.

In December 2006, The UK Government set up the Organ Donation Taskforce to identify barriers to organ donation and recommend actions needed to increase organ donation and procurement within the current legal framework.

Many different major religious groups and denominations have varying views on organ donation of a deceased and live bodies, depending on their ideologies. Differing opinions can arise depending on if the death is categorized as brain death or cease of the heartbeat. It is important for doctors and health care providers to be knowledgeable about differentiating theological and cultural views on death and organ donations as nations are becoming more multicultural.

"Harvest" is the 14th episode of the second season of the American television show Numbers. Inspired by a Christian Science Monitor article about organ tourists, people who travel to a different country to give their organs for money, and an algorithm developed in the United States, the episode features Federal Bureau of Investigation (FBI) agents and mathematicians attempting to locate a missing organ tourist before she is killed.

The Declaration of Istanbul was created at the Istanbul Summit on Organ Trafficking and Transplant Tourism held from 30 April to 1 May 2008 in Istanbul, Turkey. The Declaration clarifies the issues of transplant tourism, trafficking and commercialism and provides ethical guidelines for practice in organ donation and transplantation. Since the creation of the declaration, over 100 countries have endorsed the principles. Some nations have subsequently strengthened their laws against commercial organ trade, including China, Israel, the Philippines, and Pakistan.

<span class="mw-page-title-main">MOHAN Foundation</span>

MOHAN Foundation is a not-for-profit, registered non-government charity organisation in India that works in the field of deceased organ donation and transplantation. MOHAN is an acronym for Multi Organ Harvesting Aid Network.

Allegations of forced organ harvesting from Falun Gong practitioners and other political prisoners in China have raised concern within the international community. According to a report by former lawmaker David Kilgour, human rights lawyer David Matas and journalist Ethan Gutmann of the Victims of Communism Memorial Foundation, political prisoners, mainly Falun Gong practitioners, are being executed "on demand" in order to provide organs for transplant to recipients. Reports have said that organ harvesting has been used to advance the Chinese Communist Party's persecution of Falun Gong and because of the financial incentives available to the institutions and individuals involved in the trade. A report by The Washington Post has disputed some of the allegations, saying that China does not import sufficient quantities of immunosuppressant drugs, used by transplant recipients, to carry out such quantities of organ harvesting.

Organ donation is when a person gives their organs after they die to someone in need of new organs. Transplantation is the process of transplanting the organs donated into another person. This process extends the life expectancy of a person suffering from organ failure. The number of patients requiring organ transplants outweighs the number of donor organs available.

Human organ trafficking in Egypt, as of 2014 mainly practiced in Cairo and the Sinai Peninsula, includes organ harvesting with induced consent, coercion, and outright theft. Egypt has become the largest hub of organ transplant in North Africa as one of the few countries that prohibited organ donation from deceased donors until 2010, with over 500 kidney transplant operations a year and the majority of these organs come from living donors. Sources in the organ trafficking process mainly come from vulnerable populations including domestic rural migrants, undocumented asylum seekers and informal labor. The emergence of cultural and religious increase in organ trade and transplant tourism contribute to the rocketing demand for organ trafficking market in Egypt. Human organ trafficking poses both physical and mental health consequences for victims. Although Egypt has been gradually updating legal frameworks to combat organ trafficking, the regulation has failed in reality protecting survivors and governing transplant professionals.

Organ transplantation in the Indian state of Tamil Nadu is regulated by India's Transplantation of Human Organs Act, 1994 and is facilitated by the Transplant Authority of Tamil Nadu (TRANSTAN) of the Government of Tamil Nadu and several NGOs. Tamil Nadu ranks first in India in deceased organ donation rate at 1.8 per million population, which is seven times higher than the national average.

Organ donation in India is regulated by the Transplantation of Human Organs and Tissues Act, 1994. The law allows both deceased and living donors to donate their organs. It also identifies brain death as a form of death. The National Organ and Tissue Transplant Organisation (NOTTO) functions as the apex body for activities of relating to procurement, allotment and distribution of organs in the country.

References

  1. ↑ "Israel's Organ Donation Law". Archived from the original on 2010-01-30. Retrieved 2010-01-30.
  2. ↑ Efrati, Ido (2016-01-28). "Organ Donations and Transplants in Israel Climb 30%". Haaretz.
  3. ↑ Scot Klarenbach; et al. (January 16, 2006). "A Review of the Economic Implications of Living Organ Donation: Donor Perspectives and Policy Considerations" (PDF). Retrieved 2009-08-29.
  4. 1 2 Knesset approves organ donation law
  5. 1 2 Organ Donation: Legal, But Still Controversial Archived April 16, 2008, at the Wayback Machine
  6. 1 2 Guttman, Nathan (2009-08-05). "Kidney Donation Scandal Sparks New Debate Over Specter's Organ Legislation". The Forward.
  7. ↑ Organ donation and transplantation, Orit Brawer Ben-David, p.143, Greenwood Publishing Group, 2005
  8. ↑ Organ donation to get halachic approval
  9. ↑ "Shimon Peres wanted Israelis to be organ donors — like him".
  10. ↑ Levi, Yaakov (2007-12-02). "Compensation for organ donation". Haaretz.
  11. ↑ http://www.health.gov.il/English/Topics/organ_transplant/Pages/kartis_ADI.aspx Israel Ministry of Health - ADI
  12. 1 2 Rohter, Larry (2004-05-23). "THE ORGAN TRADE: A Global Black Market; Tracking the Sale of a Kidney On a Path of Poverty and Hope". New York Times. Retrieved 2010-05-20.
  13. ↑ Scheper-Hughes, Nancy (July 2001). "The organ of last resort". UNESCO Courier. Archived from the original on 2002-06-13.
  14. ↑ Rohter, Larry (2004-05-23). "THE ORGAN TRADE: A Global Black Market; Tracking the Sale of a Kidney On a Path of Poverty and Hope". New York Times. Retrieved 2010-05-20.
  15. ↑ Aftonbladet: "Our sons are plundered of their organs"
  16. ↑ Boudreaux, Richard (2009-08-24). "Article about organ harvesting sparks Israel-Sweden tiff". Los Angeles Times . Retrieved 2010-02-21.
  17. ↑ Friedman, Matti (19 August 2009). "Israel furious over Swedish newspaper article". Associated Press. Retrieved 19 August 2009.[ dead link ]
  18. ↑ [ dead link ]
  19. ↑ "Israel harvested organs without permission, officials say - CNN.com". CNN. 2009-12-21. Retrieved 2010-05-20.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.