Health Ministry refuses to finance expenses for US kidney donors who want to save Israelis

By JUDY SIEGEL-

The Health Ministry has declined to help pay New York's Halachic Organ Donor Society (HODS) thousands of dollars in expenses for each of the 14 Americans it has signed up so far to donate a kidney to Israelis needing a transplant, The Jerusalem Post has learned.

"Of course we are happy when lives are saved, but the ministry will not pay for the expenses of altruistic donors either in Israel or abroad," said Ministry Deputy Director-General Dr. Yitzhak Berlovich.

In a few weeks, Berlovich will convene a meeting of transplant and medical ethics experts to discuss the ministry's policy toward HODS and its campaign to send live kidney donors to Israel. Moral, medical, financial, and other aspects of the campaign will be discussed.

In September, HODS brought 38-year-old Eric Swim, a married man and father of two from Kansas City who was born a Christian but now observes Jewish ritual, to Israel. He donated one of his kidneys to Moshiko Sharon, a 10-year-old boy from Moshav Hodaya near Ashkelon, who underwent a successful kidney transplant at Schneider Children's Medical Center for Israel in Petah Tikva in mid-September.

The generous act received massive publicity in the American and Israeli media. In a phone interview from New York, HODS founder and director Robby Berman said he had raised $16,000 to cover the expenses of Swim and his wife, including compensation for his time off work. But he said the organization did not have the money to cover the costs of "14 more people, Jews and non-Jews, who want to go to Israel and donate a kidney to an Israeli who needs it."

Moshiko's mother Rachel had asked Health Minister Dan Naveh if the government would help fund further transplant operations. Israel Transplant, the ministry's organ transplant coordination center headed by Shaare Zedek Medical Center director-general Prof. Jonathan Halevy, says the government rejected the idea.

Halevy told the Post: "In general, I think that to bring in foreigners to give their organs poses a moral problem and is in bad taste. It could even arouse hostility in the country they come from, which has its own donor organ shortage. Every year, about 60 or 70 Israeli donors altruistically donate a kidney, most of them to close relatives. There are hundreds of Israelis waiting for kidneys, and we can mobilize more if relatives of Israelis who die donate them, or if people here donate their own. We must not depend on foreigners to do this."

Medical costs are covered by the health funds, as with all organ transplants performed here. Halevy added that, despite Israel Transplant's organizational and informational efforts and due to cultural, religious, and psychological reasons, the rate of consent to donate organs of deceased loved ones among Israelis is among the lowest in the world.

"There is almost no American Jew who hasn't heard about HODS; Moshiko benefited. But it is shameful for Israelis," said Halevy. "If an altruistic American wants to donate a kidney to an Israeli at his own initiative, that is all right. But it is unacceptable for Israelis to solicit organs from American live donors. The lesson should be that we have to depend on ourselves to solve our problems. Many more Israelis should sign consent cards as potential organ donors for the ADI organization."

Berman replied via e-mail: "I can't comment as to [Halevy's] opinion about this being morally objectionable because he doesn't state why. I agree, however, that more Israelis should sign organ donor cards and obviate the need for live donation. Israelis have a much lesser chance of getting a cadavaric donation than Americans do. In order to offset those odds, there are Americans who want to save Israelis from certain death and donate their kidneys."

Berman noted that "the HOD Society doesn't actively solicit live donation from Americans to Israelis, but for those who are set on doing so, we are happy to help them in this mitzva of saving lives. Because of our exposure on the Yair Lapid [TV show], I am getting half a dozen calls a day from Israelis desperately looking to get a kidney."

Halevy said Israel Transplant promotes a special cross-donation arrangement for families whose loved one needs a kidney, but do not have a donor with a compatible blood type. Instead, a family member gives a kidney to a patient from another family; a member of this second family who has a suitable blood type donates a kidney to the patient from the first family.

"This arrangement greatly increases the ability to make a live kidney donation," added Berlovich. "We always suggest that a family member donate an organ, but you can't force a family to give."

Prof. Avraham Steinberg, a pediatric neurologist and Jewish medical ethics expert who is an Israel Prize laureate, also argues that the state covering the expenses of a foreign donor is problematic. "This almost makes it commerce in organs," he said.

He also worries that an emotionally charged publicity campaign in the US soliciting live donors of kidneys for Israeli patients, such as that run by HODS, could encourage people with weak personalities who seek the limelight and a hero's welcome in Israel. Potential donors could be swept up emotionally and not understand what they were getting into, he said.

Steinberg heads one of the Health Ministry's two public committees that receive the applications of the few dozen altruistic live organ donors each year who volunteer to give kidneys to non-relatives (not all of them actually go through with it). Among them are tourists and foreign workers. Such donations were made possible by a change in the law in the late 1990s that required psychological and medical assessment of the potential donor and is charged with ensuring that money does not pass illegally from the organ donor to the recipient.

The ministry contracts a private assessment company to conduct psychological testing of the would-be donor, and tries its best to prevent those with unsuitable motivations from donating. Swim passed such a battery of tests both here and, according to Berman, in the United States.

Halevy has suggested passage of a Knesset bill that would give monetary compensation for time, pain, and medical expenses – but not a profit – only to altruistic Israelis who want to donate one of their organs for transplant. Such a bill would explicitly rule out foreign donors in such an arrangement.