Organ Donation in Israel—Achievements and Challenges

Ashkenazi, Tamar; Lavee, Jacob; Mor, Eytan

doi:10.1097/tp.0000000000000591

Cited by 34 publications

(30 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Shewmon ( 2007 ) has convincingly argued against the biological equivalence of brain death and physiologic decapitation. Despite the biological flaw of the analogy of brain death with physiologic decapitation, some Jewish, Christian and Islamic scholars have accepted brain death as human death (Albar 2012 ; Ashkenazi et al 2015 ; Fins 1995 ; Napier 2009 ; Tonti-Filippini 2012 ). Referring to the statement from Pope Pius XII that it “remains for the doctor to give a clear and precise definition of ‘death’ and the ‘moment of death’ of a patient who passes away in the state of unconsciousness” (Pope Pius XII, The Prolongation of Life, The Pope Speaks 4; 393, 396 [1957]), 1 the PC argued that the theological position that the “human essence or soul departs at the moment of death is not inconsistent with the establishment, through neurological examination, of the time when death occurs” (The President’s Commission 1981 p. 11).…”

Section: Implications Of Neuroscientific Findings On the Debatementioning

confidence: 99%

Neuroscience and Brain Death Controversies: The Elephant in the Room

2018

View full text Add to dashboard Cite

The conception and the determination of brain death continue to raise scientific, legal, philosophical, and religious controversies. While both the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research in 1981 and the President’s Council on Bioethics in 2008 committed to a biological definition of death as the basis for the whole-brain death criteria, contemporary neuroscientific findings augment the concerns about the validity of this biological definition. Neuroscientific evidentiary findings, however, have not yet permeated discussions about brain death. These findings have critical relevance (scientifically, medically, legally, morally, and religiously) because they indicate that some core assumptions about brain death are demonstrably incorrect, while others lack sufficient evidential support. If behavioral unresponsiveness does not equate to unconsciousness, then the philosophical underpinning of the definition based on loss of capacity for consciousness as well as the criteria, and tests in brain death determination are incongruent with empirical evidence. Thus, the primary claim that brain death equates to biological death has then been de facto falsified. This conclusion has profound philosophical, religious, and legal implications that should compel respective authorities to (1) reassess the philosophical rationale for the definition of death, (2) initiate a critical reappraisal of the presumed alignment of brain death with the theological definition of death in Abrahamic faith traditions, and (3) enact new legislation ratifying religious exemption to death determination by neurologic criteria.

show abstract

Section: Implications Of Neuroscientific Findings On the Debatementioning

confidence: 99%

Neuroscience and Brain Death Controversies: The Elephant in the Room

2018

View full text Add to dashboard Cite

show abstract

“…Priority points act as a tie breaker by giving an advantage to consented donors over non-donors in cases of similar medical need [ 9 ]. Second priority awards a small number of points to individuals with first-degree relatives who are registered as an organ donor [ 10 ]. …”

Section: Background: Israel’s 2008 Organ Transplant Lawmentioning

confidence: 99%

“…Second priority awards a small number of points to individuals with first-degree relatives who are registered as an organ donor [ 10 ].…”

Section: Background: Israel’s 2008 Organ Transplant Lawmentioning

confidence: 99%

Israel’s 2008 Organ Transplant Law: continued ethical challenges to the priority points model

Berzon

2018

Isr J Health Policy Res

View full text Add to dashboard Cite

In 2008, responding to a widening gap between need and availability of transplant organs, Israel’s Ministry of Health adopted a program of incentivized cadaveric organ donation. The Organ Transplant Law rewards individuals with prioritized access to organs on the condition that they participate in procurement efforts. Priority is awarded in the form of additional points allocated to the individual’s organ recipient profile. Although Israel has experienced moderate gains in the years since the law’s implementation, these have not been sufficient to satisfy the demand. Furthermore, the law faces logistical and ethical challenges. These challenges could potentially be resolved by shifting the organ procurement default to routine retrieval rather than the current default of presumed refusal to organ retrieval.This paper examines philosophical and practical challenges to the priority points policy and weighs whether Israel should consider an alternative policy of routine retrieval of transplant organs with the option to opt out of the donor pool.

show abstract

“…These individuals see full moral standing as inherent to any breathing human, regardless of sentience. Ultraorthodox adherents to this interpretation of Jewish law reportedly constitute approximately 8% of the Israeli population 21. It is unclear how many in the USA actually do carry or would act on those objections.…”

Section: Honouring Requests For Sustained Physiological Support In Brmentioning

confidence: 99%

Is there a place for CPR and sustained physiological support in brain-dead non-donors?

Brown

2017

J Med Ethics

View full text Add to dashboard Cite

This article addresses whether cardiopulmonary resuscitation (CPR) and sustained physiological support should ever be permitted in individuals who are diagnosed as brain dead and who had held previously expressed moral or religious objections to the currently accepted criteria for such a determination. It contrasts how requests for care would normally be treated in cases involving a brain-dead individual with previously expressed wishes to donate and a similarly diagnosed individual with previously expressed beliefs that did not conform to a brain-based conception of death. The paper first focuses narrowly on requests for CPR and then expands its scope to address extended physiological support. It describes how refusing the brain-dead non-donor's requests for either CPR or extended support would represent enduring harm to the antemortem or previously autonomous individual by negating their beliefs and self-identity. The paper subsequently discusses potential implications of policy that would allow greater accommodations to those with conscientious objections to currently accepted brain-based death criteria, such as for cost, insurance, higher brain formulations and bedside communication. The conclusion is that granting wider latitude to personal conceptions around the definition of death, rather than forcing a contested definition on those with valid moral and religious objections, would benefit both individuals and society.

show abstract

Organ Donation in Israel—Achievements and Challenges

Cited by 34 publications

References 9 publications

Neuroscience and Brain Death Controversies: The Elephant in the Room

Neuroscience and Brain Death Controversies: The Elephant in the Room

Israel’s 2008 Organ Transplant Law: continued ethical challenges to the priority points model

Is there a place for CPR and sustained physiological support in brain-dead non-donors?

Contact Info

Product

Resources

About