Organ donation 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.
Until 2008, there was no law prohibiting organ trafficking in Israel.[1]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. [2]
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), 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 various medical benefits. In addition, the law criminalizes organ trafficking, receiving compensation for organs, or acting as an organ broker. [2]
Israel operates a National Transplant and Organ Donation Center, established in 1993[3] 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 dos not properly address halachic questions, Israel's Chief Rabbinate has decided to issue an organ donor card of its own, which allow organ harvesting from the potential donor only if brain death is determined according to the strictest letter of the law.[4]
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 percent, which is 50 percent lower than the rate in most Western countries[5]. The percentage of people who hold an organ donation card in Israel is only 8 percent; in Western countries the rate is 30-40 percent. 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. 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.'" [6]
According to organ trade expert Nancy Scheper-Hughes, writing of the situation before the 2008 laws, Israel has become a "pariah" in the organ transplant world. The lack of donations due to Jewish custom has heightened the disparity between the supply and demand of organs. At the same time Israel has refused to criminalize organ trading. This has led to the popularity of "transplant tourism" in which patients in need of organs travel to medical centres abroad to receive organs.[7] Israeli organ brokers advertise on 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. [6]
The former lack of regulations against organ trafficking made Israel a focal point for the international organ trade. This benefited the state by exporting the organ shortage overseas. Israelis are given up to $80,000 to pay for organs abroad. [6]
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. [6]
In 2004 a South African organ trading operation providing 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. [6][8] The transplant operations were performed in Durban and Johannesburg, South Africa. South African investigators estimate a total of 200 transplants took place. Kidney recipients were given a higher standard of care than the donors, who were only monitored for a maximum of three days. The private South African healthcare company Netcare was associated with the transplants, providing facilities and doctors.[6][8] The ring was 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. [6][8]
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Main article: Aftonbladet-Israel controversy |
In August 2009 the Swedish tabloid Aftonbladet ran an article[9] in which some people who were interviewed in 1992 claimed that the Israeli Defense Force took organs from Palestinians who died in Israeli custody; the interviewees and the author of the article presented no evidence to support their claim, apart from the fact the bodies appeared "ripped open". The Israeli Army spokesman explained that bodies are routinely autopsied in such cases, and denied any theft of organs. The author of the article, Donald Bostrom, claimed in it that at the time he was approached by unnamed UN staff who said that "organ theft definitely occurred", but were "prevented from doing anything about it." Bostrom spoke to Israel Radio on 19 August 2009 and replied that "But whether it's true or not — I have no idea, I have no clue."[10] Bostrom does not explain why he did not publish these claims until 2009, 17 years after he heard of them. No one else has made such claims, despite Bostrom's claim of it being a widespread phenomenon. Bostrom told CNN that the purpose of his article was to call for an investigation into the claims about stealing organs in the early 1990s.[11]
Another Swedish newspaper, Sydsvenskan, criticized Aftonbladet for publishing what Sydsvenskan called "an anti-Semitic conspiracy theory."[12] The brother of the Palestinian featured in the photograph alongside the article, Jalal Ghanem, could not confirm the allegations made by the Aftonbladet, but he said that there were stitches that ran from the chest down to the bottom of the abdomen.[13] The family mentioned that a Swedish photographer was present at the funeral of their son, Bilal Ahmed Ghanem, and that this was the only time they had met. Bilal's mother "denied that she had told any foreign journalist that her son's organs had been stolen", and a relative, Ibrahim Ghanem, "said that the family never told the Swedish photographer that Israel had stolen organs from the dead man's body."
The Palestinian claim in the article sparked an angry reaction by Israeli Foreign Ministry official Yigal Palmor, who associated the article with the medieval blood libel.[14]
Elisabet Borsiin Bonnier, the Swedish ambassador to Israel, strongly condemned the article, stating: "The article in the Swedish newspaper is shocking and terrifying for us Swedish, as it influences the Israeli citizens... The embassy can not emphasize more its disgust."[15] The Swedish foreign ministry and the Swedish foreign minister Carl Bildt distanced themselves from the ambassador's statement and underlined that Sweden is a democracy with freedom of speech, and that the state's representatives should not comment on individual articles in newspapers.[16]