Organ donation in Israel: the good, the bad, the depressing, the options

Helping hand(s)So… what happens after we die?

One thing we know for sure – (ok, two things, for starters, our bodies decompose after some awkward nail and hair growth) – one sure thing is that we leave behind the living.

The healthy living. The barely living. The newly living. The next in line.

Organ donation is not a glamorous topic. The word organ: ugh. Way to reduce the miracle of human physiology to such a crude-sounding word. org-un.

But it is truly miraculous that we humans have figured out how to take the heart, liver, kidney, womb from one body and place it in another, so that the latter human can continue to beat, think, thrive.

Consider that.

This week I heard of a tragic scenario in which an immigrant-Israeli needs a transplant to survive, but is battling the complications she’s encountering due to the priority criteria in this country. It’s consumed me since I started researching (48 hours ago) how organ donation works in Israel, why it’s complicated, and the preparatory options available.

The situation

As we’re all painfully aware, Israel is a tiny country with a tiny population. We’ve got around 7.7 million residents. That’s not ideal news for those in need of organ transplants. Less people, less possibility. Drill down further, and there are significant sectors of the demographics committed to theology that doesn’t jive with organ donation.

So when it comes to ‘homegrown’ organ donation, not every person waiting makes it to seeing the other side of living.

As a country and culture and people that place life as sacred over all else, it’s a hard pill to swallow – according to the numbers, not everyone in need of a life-saving transplant can or will be saved.

I found this to be a painful revelation. It’s obvious-sounding. But take into account: what if you’re the one in the middle of the waiting list, with the clock ticking? How many more visits from your kids do you have left? Will the support system in place pick up where you left off?

How do you even begin to grapple with that?

And does it need to be the story’s ending as much as it is?

How it works here

I don’t know how organ donation law works abroad; I can only assume that in a place as populous as the States, it’s based on urgency, matching, survival chances, location, and other factors, probably including financial implications. Way more people, way more potential donors, way more organs to go around.

Here’s how the allocation of organs works in Israel, according to ADI, the National Transplant Center.

Since 2008, a priority law has been set to encourage people to sign up as potential donors and help prioritize who receives organs, when. Considering the gaping lack of organs for the necessity, this seems like a bold (and positive?) move:

The Organ Transplant Law was formulated after comprehensive and in-depth discussions by a forum of ethicists, philosophers, jurists, clergymen, psychologists, and physicians. The Law grants priority on the waiting list to the organ transplant candidate holder of a donor card before other candidates with similar medical data who do not hold such a card.

Then, the next part, where the donor priority details get broken down:

The new Law grants priority on the transplant waiting list in the following cases:

  • To a transplant candidate whose first degree relative (parents, siblings, children or spouse) has signed the donor card.
  • To a transplant candidate whose first degree relative died (in Israel) and his/her organs were donated for life saving.
  • To a transplant candidate who has donated, or whose first degree relative has donated an organ (kidney, liver lobe or lung lobe) to a non-specified recipient, i.e. to a stranger, from the transplant waiting list.

Here’s more on donor rights in Israel. Law nerds: You can read the organ donation details here. And the numbers… how many have signed ADI cards in Israel:


There was this rite of passage, growing up in the Modern Orthodox day school world, when we high school students entered drivers license age and were told organ donation is against Jewish law. Then again, I also heard from teachers and rabbis that it was pikuach nefesh, or saving a life, which is pretty much the most sacred Jewish value.

Mixed messages, yes. ADI lays out the Jewish take on organ donation on a page broken down into much-appreciated detail.

Even further, the Halachic Organ Donor Society (HODS) is an organization campaigning for more Jews to get involved. Their mission: “To save lives by increasing organ donations from Jews to the general population (Jews and non-Jews alike).” 

I promised depressing (and uplifting) so here’s the people-side testimonial.

Do what you need to do
Read more. Talk to your partner. Make your call. Sign the card.

Another extremely important (and of course, possibly life-saving) option to consider if you’re an Israeli resident: private health insurance.

Israelis are all entitled to the national (socialized) health insurance agencies. Going further, many people decide to add a layer of protection and security by opting in to private health insurance plans. They can add a basic layer of extra coverage, or go the whole way.

The option here is to adopt a plan where after obtaining the medical sign off that you need a transplant, you contact the insurance company to make a claim. From there, you’re traveling the private route, with no Israeli national (and highly limited) organ wait list. In that case, the organs are typically flown in from abroad, or patient is flown abroad (depends on your plan); it’s a completely independent system, where the insurance company is a player.

For more on private health insurance options in Israel, start here (disclaimer: I live with the guy who wrote this).

Yeah. So. It’s an uncomfortable, depressing topic. But just like setting up a Will, it’s something you just have to consider. For myself I view it as some kind of parenthood rite of passage.

Do you know more about organ donation in Israel? Please leave comments and share your info… Still so curious.


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