"Organ donation raises religious doubts in Israel"

by Ari Rabinovitch (Reuters, November 08, 2006)

Jerusalem, Israel - Tani Goodman was just 17 when he died and his organs were used to save the lives of four people.

It did not occur to his mother Maggie, an Orthodox Jew from Jerusalem, that her religion might get in the way of donating his organs after he was crushed to death by an automatic gate while attending an orientation session at a seminary in 2002.

"Saving a life is the most important thing. You don't have to be a rabbi to see that," she said. "It was the only positive thing that came out of that black day."

Many people in the Jewish state feel differently, and as a result, the waiting list for organ transplants is a long one.

Although Israel has an advanced health care system and is a world leader in medical advancement, only 260 organ transplants were conducted in 2005. In the United States, about 73 are carried out per day.

"It hurts knowing that even though we have all the technology, there are still people dying every week waiting for organs," said Tamar Ashkenazi, director of Israel's National Transplant Center.

One problem is that, while most Israelis are secular Jews, they often identify with religion on issues of death and refuse to donate organs, she said.

Rabbi Daniel Sperber, president of the Institute of Advanced Jewish Studies at Bar Ilan University near Tel Aviv, said many families refused to allow organs to be removed because the Bible prohibits the desecration of bodies and delay of burial.

However, he said, Jewish law clearly stated that the concept of "Pikuach Nefesh", or saving a life, overrode such concerns.

"If the patient was a donor and the family consents, of course taking an organ is allowed," he said.

LOWEST PERCENTAGE

The Halachic Organ Donation Society, comprising rabbis and doctors from around the world, said on its Web site that Jews had the lowest percentage among ethnic groups worldwide of carrying organ donor cards.

"There remains a widespread misperception in Israel that Jewish law categorically prohibits organ donation," the society said.

More than 10 percent of the people on the transplant waiting list in Israel died last year, nearly double the figure in the United States provided by the U.S. Organ Procurement and Transplantation Network.

Part of the reason for the long wait is that only 4 percent of Israelis are registered organ donors, far fewer than the 15 to 35 percent in other Western countries.

As a result, more than half of the Israelis who received transplants paid for their new organs abroad.

Groups in Israel promoting organ donations have launched a campaign within the Jewish Orthodox community, hoping that once religious leaders embrace the concept, secular families will follow suit.

They must overcome some long-held beliefs, such as fears that signing a donor card invites the "evil eye", or death, or that organs must be kept in the body to await resurrection when the Messiah comes.

Some scholars suggest that, for some Israelis, a decade of watching Palestinian suicide bombings on television and religious workers collecting scattered body parts for burial may have exaggerated the importance of ensuring the corpse is buried in its entirety.

One sticking point in organ donation is the determination of death.

"In the Western world, in cases of brain death, it is permissible to use the heart and lungs for donation. The rabbinical community in Israel is hesitant to recognise brain death," said Frieda Horwitz of the Unity Council for Ultra-Orthodox, Religious and Secular Relations.

There is no data showing how many organs are lost because of the disagreement over when it is permissible to remove one for transplant.

The Unity Council arranges joint committees of doctors and rabbis in an effort to deal with the confusion and cultivate a level of trust.

"Because of the confusion, a family may call up their rabbi from the hospital to ask what to do. This takes time, and by the time they get a response, the patient may no longer be able to donate," Horwitz said.

One project being developed by the Unity Council involves a network of trained rabbis, on call throughout the country, who can provide immediate guidance to religious families contemplating organ donation.

To further encourage religious donors, included on the donor card is the option to donate organs "only on the condition it is confirmed by a religious person chosen by my family".