Transplant shortage? Get radical

During 2006 there was an 84% increase in the number of Israelis carrying organ donor cards, Yet that's still only 7% of the population.

By JEREMY MAISEL
human heart 88 (photo credit: )
human heart 88
(photo credit: )
Israel's biggest-ever organ donor campaign was launched recently. During 2006 there was an 84% increase in the number of Israelis carrying ADI (the national registry of potential organ donors) organ donor cards, according to Israel Transplant and ADI. Yet that's only 7% of the population. The month's campaign involves some novel initiatives. The Education Ministry is to encourage 200,000 11th- and 12th-graders to sign up at least one person each. One thousand Rotary club members are committed to signing up 10 people each. Even the IDF is participating by distributing registration postcards to soldiers upon their discharge. Previous campaigns have stressed the support of Orthodox religious figures. Rabbi Shlomo Aviner, a leading religious Zionist halachic authority, recently publicized an article with an unequivocal demand that people sign up for donor cards. Aviner is not the only religious figure to lend support to this cause; leading Orthodox rabbis Yehuda Amital, Yaakov Werhaftig, Shlomo Riskin and Yuval Sherlo all carry cards. Although of interest to the Orthodox - Israel's Conservative and Reform rabbinates have long supported organ donations - how would this influence Israel's mainly secular population? AS AVINER writes in his article, when it comes to organ donation, suddenly everyone, religious and non-religious alike, becomes a mystic, dithering as they reflect on issues such as the importance of the body in the resurrection of the dead. Aviner dismisses such deliberations, saying there is nothing more important than donating organs that could save someone's life, and they should put the metaphysics aside. The campaigns get supportive, widespread coverage in the media, but despite all efforts the results fall short of what is needed. In spite of the 17.7% growth in the actual number of donated organs in the past year (278 lifesaving transplants, compared to 258 the previous year), this number is still 25% lower than required. There are 1,123 Israelis currently on the waiting list, 35 of them children. The Knesset Health Committee has criticized the growing trend of patients who travel to China, paying for organs retrieved from executed prisoners. These trips achieve semi-official approval when they are financed by the health funds. The operations are performed in Chinese government hospitals, and there are even suggestions that organs are provided to order from the abundant number of prisoners on China's death row. It's hard to criticize families and their loved ones who pursue this foreign option; they would die waiting for organs to become available in Israel. WHAT CAN be done to improve the situation? First, the law concerning permission to go ahead with the postmortem harvesting of organs needs to be changed. Currently the ultimate decision lies with the family, regardless of whether the person carried an organ donor card, or expressed their agreement when alive. In the UK, The Human Tissue Act, which came into effect in September 2006, ensures that if a person registered their wish to donate organs for postmortem transplant, these wishes take precedence over objections of next-of-kin. Secondly, in practice, the number of families agreeing to donate organs is pitifully low. Out of 162 brain deaths in the last year, each of whose organs might have saved many lives, only 74 families gave their consent - 46%. When a patient on the waiting list dies, it is heartbreaking; when a patient dies even though an organ exists that could have saved his or her life, that's an unpardonable tragedy. A radical initiative is required. ISRAEL SHOULD adopt an opt-out policy whereby following brain death all organs are automatically eligible for harvest and transplant unless the person, while alive, formally declared an objection. Maybe your initial reaction is shock at a violation of civil liberties; that society would "own" your organs unless you register an objection. Or you fear that the all-powerful state would steal away bodies and indiscriminately whip out organs. Certainly there would have to be adequate frameworks to monitor and regulate the process - including consultation with religious authorities. And administering a fair and accessible procedure to register objections would also provide a few headaches. But the ultimatum should be made clear: If you are not willing to donate your organs, you waive your right to receive an organ should you, or another member of your family, ever require one. As with every important issue on Israel's national agenda, we have to consider the halachic view on the issue - and surprisingly, it is plausible that there would be no objection. Jewish law gives almost insurmountable importance to the value of human life. However sympathetic we are to people's feelings, surely they would not outweigh a person's life. I'm not sure I've even gone far enough. After someone has died, they have no use for their remains. And if an organ from a defunct body could give someone life - surely that would outweigh even the departed's objections registered during his lifetime? A system where all healthy organs from brain deaths are eligible for harvesting and transplant, with an opt-out scheme for objectors, would alleviate suffering and save lives. If you don't have an Adi organ donor card, sign up for one now at www.health.gov.il/transplant/eng1.htm or call *6262 from any cellular or Bezeq phone. The writer, a member of Kibbutz Alumim, is senior educator at Melitz Centers for Jewish Zionist Education.