Friday, 24 July 2009

Two Major Scandals This Week - One Major Issue


Scandal One: Romania: Israeli physicians arrested on suspicion of egg trafficking

Tel Aviv (YNet) 21st July 2009 -- Father, son who run Sabyc Medical Center in Bucharest arrested for allegedly trafficking in human eggs, stem cells; both remanded for 29 days. Romanian authorities order two other Israeli doctors not to leave country, confiscate passports of five other Israelis involved

Scandal Two: New York man accused of trying to broker kidney sale

NEW YORK (CNN) 23rd July 2009 -- One of the sweeping criminal complaints unveiled Thursday in New Jersey against 44 public officials and others includes a New York man accused of trying to arrange the private sale of a kidney from a donor in Israel.

Levy Izhak Rosenbaum, who lives in Brooklyn and is not a licensed physician or medical professional, faces charges of acting as a human organ broker. He offered to obtain a kidney for an undercover FBI agent and a confidential witness working for authorities, the criminal complaint says. The price was $160,000.

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Often referred to as "trading in body parts" or "trafficking organs", providing financial reward to donors of organs is now illegal in most developed countries.

Several years ago, I was approached by a man in Israel, "Yaakov", who suffered from chronic kidney disease, and was on dialysis for many years. Yaakov's arms were thickly scarred and little suitable space remained for the dialysis to continue. The doctors had told him Yaakov needed a kidney transplant to ensure he would see his next birthday.

"There are very few kidneys donated in Israel," Yaakov explained to me, "so the doctors have to prioritize who gets to receive them. Given the choice between saving the life of a middle aged man like me – I'm 56 - or saving a teenager, who would you choose? So practically speaking, I will never receive the kidney I need to live, by waiting in line. I'll be waiting in line for the grave-yard."

The alternative to "waiting in line" in Israel, would be to go privately. The transplant operation would cost around $70,000 and would be carried out in a third country. The top-notch Israeli surgical team would fly out with Yaakov to that country, where the live donor of the kidney was also located, for the transplant operation. In that third country, the procedure was legal*.

He asked me to help him and his family raise the money for the operation.

I had successfully raised funds and made arrangements for other major life-saving procedures several times – so I had few doubts I could help this man also.

My only hesitation was, even if the operation was legal, was it kosher?

Before I could ask people to donate to saving Yaakov's life, I needed to know if halachikally it was the correct thing to do.

So I called up Rabbi M* (by coincidence I was staying by his son, who put me through to his father); Rabbi M is a leading international authority on medical halacha.

I explained the issue and Rabbi M replied (I paraphrase):

"The medical profession are hypocrites about this issue.

"At a transplant operation, will the surgeon be paid?" he asked me. And answered his own question "Of course he will!"

"And will the anesthetist be paid? Of course… And the nurses? The hospital itself? Even the cleaning staff! Everyone will be paid!"

"The only person who is not even 'allowed' to be paid, is the guy who's giving part of his very body for this operation – the organ donor. He's not just giving his time, he's giving his kidney – and he's not allowed to be compensated?!!"

Rabbi M went on to explain how paid kidney donors are typically poor people, from third world countries.

" You should understand that we are over-endowed with kidneys – we need just 10% of one kidney to function normally – but our Creator gave us each two. The second one is an insurance policy, in the case the first one fails. These kidney donors are cashing-in their insurance policy. They get paid between $10-20,000 for their kidney. And for them, it's a good deal. Instead of working as cheap labor, for a fee rupees per hour, to struggle a life-time to feed their families on rice, they receive enough money for their kidney to enable them to purchase some land. Once they have land, they and their families are no longer considered serfs, but move into a higher class. The organ donors are not being abused – they do this with full understanding and willingly.

"And above all, there are not enough organs to meet the needs, so this is saving a life. Pikuach nefesh. And there is no alternative."

Rabbi M concluded that, where the transaction is legal, it is also kosher, and encouraged me to participate in this important mitzva.

I therefore proceeded to raise the funds needed for Yaakov's life-saving kidney transplant operation.

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The connection between my story, and the two scandals which have come to light this week – one in Romania and one in New Jersey – is the issue of obtaining organs or other biological material from live donors for payments.

The tragic truth is that there are not enough people willing to donate organs for love alone, to save all the people who need them. And every day people do die, "waiting in line". However there are people willing to donate for money.

By placing a blanket ban on giving ANY compensation to live organ donors, as is the case in most western countries, we create a situation which is comparable to "Prohibition". The Prohibition of alcohol in many countries during the early 20th Century did not succeed in stopping the production and trading of alcohol. It merely succeeded in taking it from a controlled environment to an uncontrolled one – where the mafia filled the vacuum, and made plenty of ill-gotten-gains.

Today, the still-new technology which enables seriously ill patients to live longer by obtaining kidneys and other organs from live donors – has generated blanket legislation banning compensating organ donors.

This has not stopped the practice of compensating organ donors – but merely driven it underground, into the murkey world of illegal transactions, ,money laundering, document forging – and this week – Chilul Hashem B'rabim (the public desecration of G-d's Name).

In my opinion, a smarter way of addressing this issue, would be for the US and other Western Governments to regulate, not ban, the reasonable and fair compensation for live organ donors.

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* Note 1: I have called the Rabbi "M", because I have not yet asked him for his permission to publish his name. I do not know if he would agree or not, so I am "playing safe".

* Note 2: Since the events described in my story, the laws have changed in Israel, making it now illegal to make arrangements in Israel for any medical procedure which would be illegal in Israel, even if the surgery is legal in the location where it will be carried out.

2 comments:

  1. Slippery Slope25 July 2009 22:36

    Isn't the main reason that governments ban selling "body parts" that they are worried about the 'slippery slope' - ie some Indian guy sells his kidney for $20,000 today (the way you tell it in your story about Yaakov), and tomorrow someone else sells their SISTER's kidney for $20,000 (but to you $19,000), or the disappeared hitch-hiker resurfaces in parts in the local meat market... ??

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  2. Whew! David you've made a convincing case for governmental regulation of organ donations. My concern, though, is government's tendency to fail on the job (I can imagine some countries cheating all the time or failing to ever supervize things, other countries merely cheating less often).

    Perhaps the World Health Organization, the Centers for Disease Control and some other integrity-based body could be involved in forming and enforcing such international regulations.

    Let me know if you'd care to do a "Guest Editorial" at my "Cope with Medical Crises" blog.

    Sh'koach! More power to you! Kol hakavod for having the courage and good sense to address this problem with shrewd insight and integrity.


    Yocheved Golani http://www.linkedin.com/in/yochevedgolaniink
    http://twitter.com/yochevedgolani and
    http://itsmycrisisandillcryifineedto.blogspot.com/

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