Reciprocal Altruism—the Impact of Resurrecting an Old Moral Imperative on the National Organ Donation Rate in Israel

Israel’s organ-transplantation history dates back to 1964, when the first kidney transplantation from a living related donor was performed. In 1965, the first kidney transplantation from a deceased donor was successfully accomplished. Currently six Israeli medical centers perform kidney, heart, lung, and liver transplantations. The Israel National Transplant Center (INTC) coordinates all donors and transplantations. INTC coordinators are in every medical center in the country. Despite this, the deceased-organ-donation rate in Israel has traditionally been among the lowest in Western countries, ranging between seven and eight deceased donors per million population. There are numerous past and present causes of the low donation rate. One major cause is the refusal of some ultraorthodox religious groups to recognize brain death as a valid determination of death. These groups may refuse organ donation from individuals who are brain dead but do not meet other criteria. Many mainstream rabbis accept brain death as a valid determination of death