The life you save

It's either a little bit of altruism, or turning to Dr. Frankenstein. Israelis will need to decide.

By JEREMY MAISSEL
February 26, 2008 20:09
4 minute read.
The life you save

organ transplant 88. (photo credit: )

 
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A couple of weeks ago newspapers reported on an organ-transplant racket in India. Over 500 Indians had kidneys removed by a team of doctors running an illegal transplant scheme. The gang, including four doctors, five nurses, 20 paramedics, three private hospitals, 10 pathology clinics and five diagnostic centers, supplied kidneys to rich Indians and foreigners. The donors were day laborers, bicycle rickshaw drivers or impoverished farmers who were persuaded, duped or even forced at gunpoint to undergo surgery. Despite the scale of the venture, police have been unable to put their hands on those involved, and the Times of India called on the government to investigate "the nexus between the organ traders and the police." Advances in medicine and medical technology in the field of organ transplantation have created all sorts of new ethical problems. Transplantation is a reliable and routine procedure and thousands of people now await organs - some in order to save their lives. But medical advances have overtaken society's ability to provide answers to nagging practical and ethical questions. High demand in the West means high prices for organs. Like in the past, when textiles and manufacturing industry, and more recently call centers, turned to the less developed world to provide cheap labor, it now seems that the rich world can also get its organs there at knock-down prices. PERHAPS FURTHER medical advances will provide the answer. The New York Times recently reported that "medicine's dream of growing new human hearts and other organs to repair or replace damaged ones received a boost… when researchers reported creating a beating rat heart in a laboratory." Research at the University of Minnesota has been dubbed "a landmark achievement" and "stunning" advance. The idea behind the research is surprisingly simple. Scientists took a dead rat heart and removed all the cells, leaving the valves and outer shell, which acted as scaffolding. They then injected heart cells from new-born rats, and with electrical stimulation and an artificial circulation simulating blood pressure, eventually got the heart to pump and produce a pulse. After only two weeks they had a beating rat heart capable of pumping a small quantity of blood. With humans, scientists would take human hearts from cadavers to provide the "scaffolding" and inject stem cells from bone marrow, muscle or young cardiac cells to grow the organs. Dr. Doris A. Taylor, head of the Minnesota team, told the Times the research "opens the door to this notion that you can make any organ: kidney, liver, lung, pancreas - you name it and we hope we can make it." But the prospect of producing a functioning human heart is at least 10 years away. IN ISRAEL alone there are over 1,000 people on the transplant list, and about 100 of them die each year before an organ can be found. If we are not going to turn to crime, or wait for what some newspapers termed "Frankenstein's laboratory" to bring organs back to life, where are we going to get the organs from? British Prime Minister Gordon Brown recently put his weight behind a "presumed consent" scheme. The British version of the proposal would mean consent for organ donation after death is automatically presumed, unless individuals had opted out of the national register or family members objected. We in Israel need a more radical approach. Of course, we would first need a reliable, open, accessible national register and the entire adult population would be surveyed to allow anyone who wants to opt out to do so. But people opting out would also waive the right for them or their immediate family to receive an organ in the future. People who would expect to receive an organ should, if only logically, let alone on moral or egalitarian principles, be willing to donate organs. We would also need to see stringent checks in place to ensure that the harvesting of organs was properly administered and monitored, with religious authorities - be they Jewish, Muslim or Christian - involved to ensure public confidence and support. THE PRIMACY of the value of life in Jewish tradition would lend the best argument in support of the scheme among Jewish Israelis. Initial hostility from Orthodox authorities to organ transplantation, more specifically to heart transplants, was based on poor results. Transplants were regarded as "double murders" where beating hearts were harvested and recipients died soon after their operation. Advances in immunosuppressive drugs have transformed survival rates, and now for many years numerous leading Orthodox Zionist authorities (such as rabbis Shlomo Aviner, Benny Lau, Michael Melchior, Yuval Sherlo, Shlomo Riskin, Yoel Bin Nun and Yehuda Amital - to name but a few) actively support donor card programs. Haredi leaders' reluctance has more to do with a general antagonism and mistrust toward the state and its institutions than any halachic objections. An opt-out scheme is a radical suggestion, but it is a better alternative than stealing organs or waiting for a "Dr. Frankenstein" to complete his research. Still better than all these would be a huge recruitment of new volunteers here in Israel to carry donor organ cards. Only about 400,000 - or 8.4% - of the adult population carries an Adi organ donor card, compared to 15-20% in other Western countries. People with a heart should sign up and ensure that their friends and family, colleagues and acquaintances carry an Adi donor card. It is a small gesture that could make a world of difference. The writer is a member of Kibbutz Alumim and a senior educator at the Melitz Centers for Jewish Zionist Education. To obtain an organ donor card go to: www.agudatadi.org.il

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