Sunday, September 06, 2009

organ failure

Slate | With the right ingredients of salaciousness and scandal, the news appeared to be straight out of a Hollywood screenplay: corrupt politicians, money laundering, people being arrested by the busload, raids on synagogues, an Apple Jacks cereal box stuffed with $97,000 in cash, and rabbis trafficking organs. Allegedly, one paid $10,000 to an impoverished Israeli for his or her kidney and tried to sell it for upward of $150,000 in the United States. The criminal complaint quotes the rabbi as saying he was in the organ business for a decade. (And in a you-can't-make-this-stuff-up twist, it wasn't even the day's only story on Israelis trafficking human body parts.)

The rabbis' organ trafficking was only one of their many indiscretions. In addition to being against the law, it raises a complex bioethical issue for Jews, one laced in a culture of moral imperatives. Is illegally buying an organ really wrong if it's saving someone's life? Is paying for altruism, by definition, counterintuitive? Jews have been battling this quandary for a long time, especially when you consider how little they themselves actually help the cause of transplantation.

"Jews don't like to donate organs," says Rabbi Michael J. Broyde, one of the founding members of the Beth Din of America, the equivalent of the Supreme Court of the Jewish justice system. "They don't donate at the rate of other social groups." This imbalance—of taking more from organ banks than they are putting in—has put Jews around the world at odds with transplant technology. Israel has suffered for years with an organ shortage, forcing its residents to engage in "transplant tourism" in places across Europe and, most notably, in China. According to statistics from Israel's transplant authority and the United Network of Organ Sharing, the number of people who hold an organ donation card in Israel is at a paltry 8 percent. Most Western countries hover closer to 35 percent.

In an attempt to repair the disparity, Israel passed a law last year that made it easier to become an organ donor. But it took a while. Earlier versions of the bill failed because people feared it would lead to "rabbinical supervision" of the time of death: They thought doctors and rabbis might conspire to hasten a patient's death if they knew they could harvest organs. An Israeli organization called Adi, formed by a family who lost their son while he was waiting for a kidney transplant, has worked tirelessly to try to promote awareness among the Israeli populace of the moral imperatives of being an organ donor. But for a religion that prides itself on being a "light unto the nations," it's an oddly uphill battle. Some in the ultra-Orthodox community oppose the Adi initiative so fiercely that they have actually created "life cards" that state explicitly that the cardholder does not want to donate organs under any circumstances.

There are a whole host of reasons why Israelis—and Jews in general—don't wish to part with their anatomy even after they die. For some, it's simply taboo, yet another guilt-laden stigma in an already guilt-laden religion. Others believe it is a biblical commandment to be buried whole without any missing organs.

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