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This article is background to the story The saintly, the martyred and the depraved
By Jennifer Woods
(March 1, 2004)
Although Israelis are living in a time of war and violence, willingness to donate organs remains unaffected by religious and ethnic tensions, a recent study found - suggesting that generosity and altruism cut across the boundaries of religion.
Tamar Ashkenazi, transplant coordinator at the National Transplant Center in Israel, led a study that found that the number one reason given by Israeli families for consenting to organ donation was altruism.
Ashkenazi and a team of researchers collected data from 22 hospitals in Israel from September 2000 - April 2003. The researchers concluded that kindness is a universal trait that has proven to prevail over politics.
Ideally, organ donation is an altruistic act, not influenced by race, religion, ethnicity or financial gain. "If you look at altruism in its purest sense, it's the idea that you do something to benefit another without regard to yourself and without expecting any benefit to yourself," said Mark Fox, chair of United Network of Organ Sharing's ethics committee, located in the United States. Yet, altruistic donation can have different meanings for different people. "Altruism fundamentally comes back to a value question," he added.
Israel works to ensure that organ donation is objective. Dr. Michael Friedlaender, a kidney specialist and associate professor of medicine at Hadassah University Hospital in Jerusalem, said, "We don't allow families to specify to whom the organs should go." Recipients of organs have no knowledge of the ethnicity, race or religion of the donor, he explained.
Occasionally, Israeli donors will ask that their organs be given only to a person of the same faith. Ashkenazi recorded that four out of nine Jewish families who lost a loved one from a terrorist attack made such a request. But, after the individuals were informed that they could not decide who qualifies as a recipient, they still decided to become donors. Six of the recipients were Arabs.
The idea of donating organs to a specific group of people is controversial. For example, some might argue that an individual who only wants to donate to children is justified, Fox said. The problem is, he continued, "We'd have to accept the downside or the dark side of it." If restrictive donation is accepted, "You also have to allow the 'I only wanna donate to KKK members' or a sort of restrictive class,'" he said.
Ashkenazi found that organ donation in Israel has been unaffected by the tensions created by the ongoing conflict. Studies show that organ donation rates among Arabs and Jews are proportional to their representation in Israel's population. Friedlaender added, "We still get donations across the borders of ethnicity."
Both Judaism and Islam support the idea of donating organs to save a life. Islamic traditions allow transplants from brain-dead and living donors if the donors or their families freely agree. Islam recognizes death when the heart and lungs no longer function or when there is complete loss of brain function.
Those of the Jewish faith believe a person is obligated to save another's life if able to do so. Living donation of kidneys or part of the liver is allowed because there is minimal danger to the donor, but it is not obligatory.
Judaism's definition of death is not as clear. David Perry, a professor of philosophy at Dickinson College, said, "There are some in the Orthodox Jewish community, I believe, who believe that brain death is not an acceptable legal determination of the death of a person." He added, "That particular view is very old, but it was challenged by the modern development of the brain death."
Despite religious beliefs that might deter donors, researchers fear it is possible that the willingness of Muslim Arabs to donate in the future may be influenced by the current religious and ethnic hostility. "There is more animosity now than perhaps when all the bombing started, from both sides," Friedlaender said.
Since the Palestinian Intifada in September 2000, there has been a slight decrease in the number of consenting Arab donors. Ashkenazi found that roughly 28 percent of Arab families agree to become donors while about 53 percent of all Jewish families are donors. Ashkenazi attributes the change in the number of Arab donors to the fear being rejected by their community for "cooperating" with the Jews.
Friedlaender believes fewer Arabs may be willing to donate because, "Arabs in the West Bank have more or less been cut off by us in the last four or five years. Not by us so much, but by their own administration." Muslim Arabs do not have the proper resources and money to reach the hospitals, he explained.
The organ shortage in Israel is serious. According to the Israeli Ministry of Health, the general consent rate for cadaver donation is only about 45 percent. The nonliving consent rate in the United States from August 2001 - November 2002 was 51 percent, studies show.
The situation in Israel is unique in comparison to many other countries. "People don't think everyday or every week about death," the way they do in Israel, Friedlaender said. Patients sometimes have to wait five years for transplants, and "If we don't have enough kidneys here, they're finding their solutions abroad," he said.
While it is possible there may be future changes in donation numbers, Ashkenazi said, "It is rather surprising to see that the number of kidney living-donor transplants in Israel has not changed in recent years, including 2003."
Although the conflict in Israel is religiously based, science may be the one area that brings Jews and Arabs together to affirm life. Medical procedures, such as organ transplantation, may allow a people divided to come together as human beings. "If you look from a long way away you will not see the big divide in medicine that you will see in the streets," Friedlaender said.
Jennifer Woods is an editorial intern at Science & Theology News.
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