New Israeli law about organ transplantation

Lifetime probabilities of needing an organ transplant versus donating an organ after death

The lifetime probabilities of becoming a deceased organ donor and requiring or receiving an organ transplant are unknown. An actuarial analysis was performed in a representative Canadian sample. Using Canadian organ donation data 1999-2007, provincial waiting list and population census data, actuarial rates were produced that provide the probabilities, by age band and gender, of (1) becoming a deceased organ donor, (2) needing an organ transplant and (3) receiving all organs needed. Regardless of age, the lifetime probability of needing a transplant for males is approximately twice that of females. Depending on age, Canadians are five to six times more likely to need an organ transplant than to become a deceased organ donor. The lifetime probabilities of not receiving a required organ transplant, expressed as a percentage of individuals on the waiting list, ranges from approximately 30% at birth, 20 years and 40 years to approximately 40% at 60 years. Across provinces and genders, Canadians at all ages are much more likely to need an organ transplant than to become an organ donor. Approximately one-third of those in need of a transplant will never receive one. How this information may influence organ donation decisions is currently under study.

Laypeople's ethical concerns about a New Israeli organ transplantation prioritization policy aimed to encourage organ donor registration among the public

A new policy recently enacted in Israel promises preferred status in receiving organs for transplantation to individuals who register to be organ donors and to their close family members. Proponents believe it will increase the supply of organs for transplantation from the deceased. Ethical issues were raised in government committees appointed to discuss the policy before its approval, but discussions among laypeople were not solicited. This study aimed to elicit laypeople's views about the policy by conducting thirteen group interviews and thirty-six individual interviews. Participants included religious and nonreligious people, immigrants, and Arabs. Some participants thought the law would contribute to fairness by prioritizing those willing to give, but others articulated ethical concerns that were not emphasized by scholars, in particular that the policy would add to the erosion of social solidarity, increase divisiveness, and enable people to abuse the system. Mistrust in the health care system emerged as a prominent reason for not registering as an organ donor. Implications about the importance of transparency in the organ transplantation system as a basis for an information campaign, social norms regarding organ donation, and the public's involvement in policy issues on organ donation are discussed.