Israelis seeking a transplantation abroad because of the severe shortage of organs inside the country can no longer get financial help from their health insurer unless they can prove the donated organ was not illegally purchased or taken under duress.
New regulations to that effect have been issued by the director general of the health ministry, Avi Yisraeli, who sent them to the four public health funds operating under the national health insurance system.
Until now health funds have given members—especially those with optional supplementary health insurance policies—between $35 000 (£20 000; €29 000) and $70 000 to help cover the cost of transplantations done abroad without asking for any documentation concerning the source of the organ.
Israel’s National Transplant Centre said that last year 126 citizens underwent organ transplantations abroad. Of these people, 87 received kidneys, 21 livers, 15 hearts, and three lungs. Over the same period 260 organ transplantations were carried out in Israeli medical centres.
Israel has a lower proportion of cadaver donors than other developed countries for a variety of reasons, including the beliefs of many traditional Jewish and Muslim people, who prefer that their dead be buried whole.
Various go-betweens in Israel and abroad have taken advantage of the country’s dearth of organs and arranged for them to be provided by live donors in China, Eastern Europe, and South America. Israel has received bad publicity in recent years from foreign media reports of kidneys and other organs being supplied by prisoners for a fee, and allegations have even been made that organs have been removed from people kidnapped in developing countries.
Recently the health ministry presented a government bill to regulate organ transplantation and prohibit the sale of organs from cadavers and from live donors. The bill was passed by the Knesset (parliament) on its first reading, but its final passage will probably be delayed by national elections at the end of March.
The new prohibition against referring patients for transplantations abroad that involve organs obtained by illegal sale or force was accompanied by detailed requirements. These lay down that the identity and nationality of the potential live donor and of the agent who arranged the deal must be revealed, and depositions must be signed by the donor and recipient and authorised by a lawyer obtained by the insurers.
Organisations representing desperate patients reacted angrily to the new regulations, saying they have ruined their hopes.
“People go abroad for organs because they can’t get them in Israel, and they have no choice. Now the queue in Israel for organs will double, and the number of dialysis patients will grow,” said Amos Canaf, head of the Israel Kidney Transplant and Dialysis Organization.
Jonathan Halevy, director general of Jerusalem’s Shaare Zedek Medical Centre, who last month ended six years as unpaid chairman of the Israel National Transplant Centre, welcomed the new regulations, “because illegality must be prevented.” But he said that the regulations would not solve the “greater problem of inadequate organ donation and the fact that only 300 000 Israelis have signed donor cards.”
Professor Halevy added, “If two million [of seven million] Israelis were registered as potential donors, there would be no queue, as there would be enough brain dead donors to supply the needs. A massive educational effort must be launched to change Israelis’ views of organ donation.”