"Donate your organs, move up the queue"

Mar 15, 2010JERUSALEM - "Israel is launching a potentially trailblazing experiment in organ donation: Sign a donor card, and you and your family move up in line for a transplant if one is needed.

The new law is the first of its kind in the world, and international medical authorities are eager to see if it boosts organ supply. But it has also raised resistance from within Israel's ultra-Orthodox Jewish minority.

These opponents say it discriminates against them because their religious convictions forbid the donation of their organs, and while they are unlikely to get the law reversed, they have the political clout to slow its implementation.

Only 10 per cent of Israeli adults hold donor cards, compared with more than 30 per cent in most Western countries. The actual rate of families donating a deceased's organs is 45 per cent, but in other countries, it rises to 70 per cent, according to Mr Jacob Lavee, director of the heart transplant unit at Israel's Sheba Medical Center.

The low rate of organ donation is thought to be partly driven by religious considerations. Most rabbis have no problem with transplants to save lives; their objection is to profiting from, or needlessly mutilating, cadavers.

But Rabbi Yosef Sholom Elyashiv, 99, one of ultra-Orthodox Jewry's most influential leaders, takes a different view. He forbids organ donation before cardiac death, but allows his followers to receive life-saving donations.

Dr Lavee, who helped draft the law, acknowledges that one of his primary motivations is 'to prevent free riders'.

He said: 'It will rectify the unfairness of the situation, where people who are unwilling to donate wait in the same line as those who are willing.'

The measure opens a new dimension in the worldwide quest to overcome organ shortages. One solution - a legalised organ market - is ethically fraught. Another is called 'presumed consent', where whoever does not opt out is considered a donor.

Spain, France, Austria and Belgium have adopted the latter model and rank among the top European nations in percentage of deceased donations, according to a United Nations study.

But experts here say 'presumed consent' would have been much trickier to get through the Israeli Parliament.

Mr Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, said the Israeli measure was ethically sound - he called it 'reciprocal altruism' that would benefit society as a whole.

The only place where a limited version of the Israeli measure has been tested before is in Singapore, whose 1987 law introduced incentives for donors such as waivers for hospital charges and partial coverage of funeral expenses.

Mr Robby Berman, founder and director of the Halachic Organ Donor Society, a Jewish organisation based in New York, said ultra-Orthodox Jews cannot have it both ways.

'My position is, if you are not part of the solution, you are part of the problem,' he said. 'Every Jew has a right to be against an organ donation, but then you can't come and say, give me an organ," he said." AP

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