Jay Lavee, the Israeli transplant surgeon behind some of Israel's new legislation (and who I met in person for the first time at Duke), recently returned from Taiwan, and forwarded these links:
The first is to this story in the Tapei Times:
"Two issues surrounding organ transplants in Taiwan were spotlighted by foreign experts and Taiwanese legislators: using executed prisoners as organ donors and post-transplant medication insured by the NHI.
Jacob Lavee, director of the heart transplant unit at Israel’s Sheba Medical Center, said he used to hold up Taiwan on various occasions as a prominent example of a nation that had stopped taking organs from executed prisoners, who are considered unwilling donors, until he regretfully discovered Taiwan had resumed using such organs two years ago.
"The Department of Health’s Bureau of Planning head Shih Chung-yuan (石崇原) said in response that “although there is no law banning the use of organs taken from executed prisoners, the government does not encourage it and has stopped soliciting organ donations in the prison.”
"Concerning the current lawless state of organ transplants performed abroad, Shih said that in 2009, an amendment to the Organ Transplant Act (人體器官移植條例) was proposed that would require all organ recipients, in Taiwan or abroad, to register with local authorities, but it was not passed.
Tien also called for stricter regulation for organ transplants performed abroad, saying that since the majority (88.6 percent) of Taiwanese organ recipients went to China for organ transplants that are often from questionable and unethical organ sources, but continue to be insured by the NHI for post-transplant medication, “it almost seems like all Taiwanese who contribute to the NHI are complicit with the illegal and unethical organ-harvesting crimes perpetrated in China.”
***********
Here's a related story from NTD news: Taiwan's Health Department Wants to Criminalize Organ Trade
Taiwan’s health department said on Thursday it plans to modify its organ transplant laws to criminalize organ trade and brokerage.
The main concern is illegally obtained organs in China, where authorities have been accused of killing prisoners of conscience for their organs. China is the main destination for Taiwanese patients who obtain organs overseas.
[Hsu Ming-neng, Director, Bureau of Medical Affairs, Department of Health]:
“We want to minimize the occurrence of using organs with questionable sources. We plan to discuss the amendment of organ transplant laws [during the upcoming legislative period] and we want everyone’s support.”
Hsu Ming-neng spoke during a forum in Taipei on Thursday organized by the Department of Health. On the panel was a group of five doctors and investigators from around the world. They visited Taiwan this week to highlight transplant abuse in China.
Dr Jacob Lavee from Israel discovered his patients were going to China for rapid transplants. Some were promised an organ on a certain day—something that suggests China has an “on-demand” organ supply.
He has since worked to get Israel to stop transplant tourism to China.
[Jacob Lavee, MD, Advisor, Doctors Against Forced Organ Harvesting]:
“Those brokers who intermediate between local candidates and overseas [donors in China], that should be taken care of. That’s what we’ve done in Israel and that’s the way we’ve succeeded in Israel to stop completely the flow of Israeli patients to China.”
US-based doctor, Jianchao Xu, says a combined effort is necessary to stop forced organ harvesting in China.
[Jianchao Xu, MD, Medical Director, Doctors Against Forced Organ Harvesting]:
“I think the public, medical community, the political field and the legal community all need to take action, because this isn’t something that doctors alone can accomplish.”
Independent investigators and human rights activists have accused the Chinese regime of profiting from forced organ harvesting. The largest groups of victims identified are persecuted Falun Gong practitioners. Detained House Christians and Uyghur minorities are also believed to be amongst those killed for their organs.
NTD News, Taiwan
Showing posts sorted by date for query Lavee. Sort by relevance Show all posts
Showing posts sorted by date for query Lavee. Sort by relevance Show all posts
Monday, April 1, 2013
Sunday, March 31, 2013
Organs and Inducements at Duke
I was talked into going to what turned out to be a wonderful conference. The modal participant was a law professor, but here's a photo of economists and a surgeon:
Kim Krawiec posts about the conference at the Faculty Lounge: I reproduce her post below...
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| Judd Kessler, Jay Lavee, Al Roth, Avi Stoler |
Kim Krawiec posts about the conference at the Faculty Lounge: I reproduce her post below...
"Organs & Inducements
I, of course, meant to post this in advance of the symposium, but underestimated the amount of time and attention last minute details would consume (what’s that phrase about older but not wiser?). So I’m just getting to it now.
Anyway, I think that the event was a big success and I will have more to say about it in the coming days. For now, I’ll just post the symposium abstract, along with a thanks to all the many wonderful participants who made this event a success.
More to follow . . .
Update: here's a further post today by Kim K., on the origins of the conference (and why they chose the word "inducements" rather than "incentives": More Organs & InducementsSymposium Abstract:The need for human organs for transplantation far outstrips supply. As a result, a large literature has developed debating possible means to address the gap. Suggestions range from procurement system improvements and changes in the consent regime, in the case of cadaveric organ donation, to inventive exchange systems (such as swaps and NEAD chains) and financial incentives of various sorts, in the case of live organ donation.In Organs and Inducements, contributors build on existing debates on mechanisms designed to bridge the gap between organ demand and supply, to address deeper questions regarding inducements to donate. Among the varied possible mechanisms of persuasion and incentives at society’s disposal, what are the relative advantages and disadvantages of each? What are the larger ethical, economic, sociological, and psychological issues raised by these different types of inducements, including non-financial inducements? Why are some accepted by the law and society at large, while others are not? Do the lines we’ve drawn among permissible and impermissible inducements make sense, given the concerns those rules are meant to address?"*************************************************
Friday, October 26, 2012
"Kidney ethics" in Hebrew and in Israel
The phrase "מוסר כליות" (musar claiot) in Hebrew could be literally translated as "kidney ethics," but is an idiom that means something like "a guilty conscience" or maybe "remorse". It's the headline of this story in Haaretz magazine, about the grey market for organs in Israel...
This is the kind of thing that Jay Lavee wrote about trying to fix, in his op-ed that I blogged about yesterday.
Ht: Ran Shorrer
This is the kind of thing that Jay Lavee wrote about trying to fix, in his op-ed that I blogged about yesterday.
Ht: Ran Shorrer
Thursday, October 25, 2012
Jay Lavee on organ transplantation policy in Israel
An op-ed by Jay Lavee, the Israeli transplant surgeon at the heart of recent dramatic revisions of transplant law and policy in Israel: Saving lives locally
Tuesday, December 22, 2009
Israel revamps its priority system for deceased donor organs
In an effort to increase the number of deceased organ donors, Israel has revamped its allocation system to give priority to those who have themselves signed up to donate, and to their relatives and the relatives of previous donors.
New Law For Organ Donation In Israel: Increased Priority For Those Who Are Prepared To Donate
"An article published Online First and in The Lancet reports that a unique new law comes into effect in Israel in January 2010. It states that people who are prepared to sign donor cards themselves receive priority when they are in need of an organ transplant. In addition, increased priority is given to first degree relatives of those who have signed donor cards, to first degree relatives of those who have died and given organs, and to live donors of a kidney, liver lobe or lung lobe who have donated for as yet undesignated recipients. The article is the work of Professor Jacob Lavee, Director of the Heart Transplantation Unit, Sheba Medical Centre, Ramat Gan, and the Israel Transplant Centre, and colleagues. "
...
"There are different levels of priority concerning the different situations. A transplant candidate with a first-degree relative who has signed a donor card would be given half the allocation priority that is given to a transplant candidate who has signed his or her own donor card. Then again, a transplant candidate with a first-degree relative who donated organs after death or who was an eligible live non-directed organ donor would be given allocation priority 1.5 times greater than that given to candidates who have signed their own donor cards. Among candidates with the same number of allocation points, organs will be allocated first to prioritisation-eligible candidates. Regardless of the new law, patients in urgent need of a heart, lung, or liver transplant due to their serious condition will continue to receive priority. However, in the event that two such people are eligible for the same organ, their priority status under the new law would decide who receives the organ. Candidates under 18 and those unable to express their wishes due to physical or mental disability will retain their priority status versus an adult who merits priority."
This priority system is more nuanced than the one enshrined in Singapore law (see the bottom of this post). And of course legislation on a national scale gives donors a priority for all deceased donor organs, not just those from like-minded donors, which is the path being taken by Lifesharers, an interesting organization about which I posted here.
HT: Steve Leider
Update: here's a YNet followup from March 2010 Radical way to boost organ donation.It discusses, among other things, political obstacles to implementing the new law...
New Law For Organ Donation In Israel: Increased Priority For Those Who Are Prepared To Donate
"An article published Online First and in The Lancet reports that a unique new law comes into effect in Israel in January 2010. It states that people who are prepared to sign donor cards themselves receive priority when they are in need of an organ transplant. In addition, increased priority is given to first degree relatives of those who have signed donor cards, to first degree relatives of those who have died and given organs, and to live donors of a kidney, liver lobe or lung lobe who have donated for as yet undesignated recipients. The article is the work of Professor Jacob Lavee, Director of the Heart Transplantation Unit, Sheba Medical Centre, Ramat Gan, and the Israel Transplant Centre, and colleagues. "
...
"There are different levels of priority concerning the different situations. A transplant candidate with a first-degree relative who has signed a donor card would be given half the allocation priority that is given to a transplant candidate who has signed his or her own donor card. Then again, a transplant candidate with a first-degree relative who donated organs after death or who was an eligible live non-directed organ donor would be given allocation priority 1.5 times greater than that given to candidates who have signed their own donor cards. Among candidates with the same number of allocation points, organs will be allocated first to prioritisation-eligible candidates. Regardless of the new law, patients in urgent need of a heart, lung, or liver transplant due to their serious condition will continue to receive priority. However, in the event that two such people are eligible for the same organ, their priority status under the new law would decide who receives the organ. Candidates under 18 and those unable to express their wishes due to physical or mental disability will retain their priority status versus an adult who merits priority."
This priority system is more nuanced than the one enshrined in Singapore law (see the bottom of this post). And of course legislation on a national scale gives donors a priority for all deceased donor organs, not just those from like-minded donors, which is the path being taken by Lifesharers, an interesting organization about which I posted here.
HT: Steve Leider
Update: here's a YNet followup from March 2010 Radical way to boost organ donation.It discusses, among other things, political obstacles to implementing the new law...
Monday, July 27, 2009
Corruption and kidneys in New Jersey and Brooklyn
The NY Times reports on a corruption investigation resulting in 44 arrests in New Jersey and Brooklyn: In New Jersey Case, Nervous Jokes and a Cereal Box of Cash
Almost as an aside, the story reports that a broker for transplant kidneys was caught in the net:
"Another man in Brooklyn, Levy-Izhak Rosenbaum, was accused of enticing vulnerable people to give up a kidney for $10,000 and then selling the organ for $160,000. Mr. Dwek pretended to be soliciting a kidney on behalf of someone and Mr. Rosenbaum said that he had been in business of buying organs for years, according to the complaint."
Part of the repugnance to the transaction seems to be the buying and selling prices. (Would we/should we feel differently if the kidneys were bought for $100,000 and sold for $115,000?)
Steve Leider points me to an Indiana Jones connection: Anthropologist's 'Dick Tracy moment' plays role in arrest of suspected kidney trafficker. (The anthropologist in question, Nancy Scheper-Hughes, writes frequently about black markets for kidneys, and apparently indentified Mr Rosenbaum some years ago, although the story doesn't suggest to me an immediate connection to the recent arrest.)
Parag Pathak points me towards Benyamin Cohen's story in Slate, following up on the Jewish connection: The arrests of rabbis who trafficked body parts uncover more complicated issues, that suggests some of the nuances of Jewish religious jurisprudence about organ donation and sales.
Trying to figure out Jewish law directly from the Bible skips a couple of centuries of subsequent interpretation. Here's what I wrote about kidney sales in a footnote of my paper Repugnance as a constraint on markets:
3 While there is no central authority on the application of Jewish law to modern concerns such as transplantation, the most authoritative opinions are contained in various “responsa” or answers to particular questions by rabbis acting as legal “deciders” (poskim), whose authority arises from the respect of their peers. The consensus on the matter of live kidney donation, for example, seems to be that live donation is allowed (since it saves lives), but it is not required (since the donor becomes wounded and takes some risk to his own life), and hence it falls into the category of things for which compensation could be offered and accepted (unlike actions that are either forbidden or required). See, for example, Eisenberg (2006), Grazi and Wolowelsky (2004), Kunin (2005), and Israeli (1997) who cite eminent modern poskim such as Rabbi Shlomo Zalman Auerbach and Rabbi Moshe Feinstein."
"For example, Avraham (2004, p. 271–2) reports the opinion of the eminent Rabbi Shlomo Zalman Auerbach that someone who sells a kidney with the intention of saving a life does a good deed “even if he would not have donated his kidney only to save life.” But he goes on to note, “[I ]n spite of all that has been said above, it seems to me that it is the community that needs soul-searching for allowing a person to reach such a depth of despair that he must sell a kidney, either because of poverty, debts, or the inability to pay for a relative’s medical expenses.”
Although mainstream Jewish authorities support organ donation, some streams of ultra-orthodox Judaism do not: here's a disturbing article brought to my attention by Miran Epstein, from Yediot: Heart recipient's father: We'll never donate organs
It goes on to note
"The father's words angered Prof. Yaacov Lavee, director of the Heart Transplantation Unit at the Sheba Medical Center. "This is outrageous," he said. "I've heard such statements from many of my candidates (for a transplant), who weren't ashamed to admit they wouldn't donate organs.
"Such statements led me to initiate the bill that prioritizes transplants for people who have signed an organ donor card. This is clearly immoral behavior," he added.
The new transplant law, which will go into effect in May, states that any person in need of a transplant and who has had an organ donor card for at least three years will be given priority on the organ transplant waiting list. "
This makes some aspects of Israeli transplant law resemble parts of Singapore's transplant law, which also gives priority for organs to those who are registered as donors. (I wrote about this near the end of an earlier post.)
Update: Sally Satel's take is in the WSJ: About That New Jersey Organ Scandal It’s not surprising when 80,000 Americans are waiting for kidneys, and a background piece from Time magazine: How Does Kidney-Trafficking Work?
Almost as an aside, the story reports that a broker for transplant kidneys was caught in the net:
"Another man in Brooklyn, Levy-Izhak Rosenbaum, was accused of enticing vulnerable people to give up a kidney for $10,000 and then selling the organ for $160,000. Mr. Dwek pretended to be soliciting a kidney on behalf of someone and Mr. Rosenbaum said that he had been in business of buying organs for years, according to the complaint."
Part of the repugnance to the transaction seems to be the buying and selling prices. (Would we/should we feel differently if the kidneys were bought for $100,000 and sold for $115,000?)
Steve Leider points me to an Indiana Jones connection: Anthropologist's 'Dick Tracy moment' plays role in arrest of suspected kidney trafficker. (The anthropologist in question, Nancy Scheper-Hughes, writes frequently about black markets for kidneys, and apparently indentified Mr Rosenbaum some years ago, although the story doesn't suggest to me an immediate connection to the recent arrest.)
Parag Pathak points me towards Benyamin Cohen's story in Slate, following up on the Jewish connection: The arrests of rabbis who trafficked body parts uncover more complicated issues, that suggests some of the nuances of Jewish religious jurisprudence about organ donation and sales.
Trying to figure out Jewish law directly from the Bible skips a couple of centuries of subsequent interpretation. Here's what I wrote about kidney sales in a footnote of my paper Repugnance as a constraint on markets:
3 While there is no central authority on the application of Jewish law to modern concerns such as transplantation, the most authoritative opinions are contained in various “responsa” or answers to particular questions by rabbis acting as legal “deciders” (poskim), whose authority arises from the respect of their peers. The consensus on the matter of live kidney donation, for example, seems to be that live donation is allowed (since it saves lives), but it is not required (since the donor becomes wounded and takes some risk to his own life), and hence it falls into the category of things for which compensation could be offered and accepted (unlike actions that are either forbidden or required). See, for example, Eisenberg (2006), Grazi and Wolowelsky (2004), Kunin (2005), and Israeli (1997) who cite eminent modern poskim such as Rabbi Shlomo Zalman Auerbach and Rabbi Moshe Feinstein."
"For example, Avraham (2004, p. 271–2) reports the opinion of the eminent Rabbi Shlomo Zalman Auerbach that someone who sells a kidney with the intention of saving a life does a good deed “even if he would not have donated his kidney only to save life.” But he goes on to note, “[I ]n spite of all that has been said above, it seems to me that it is the community that needs soul-searching for allowing a person to reach such a depth of despair that he must sell a kidney, either because of poverty, debts, or the inability to pay for a relative’s medical expenses.”
Although mainstream Jewish authorities support organ donation, some streams of ultra-orthodox Judaism do not: here's a disturbing article brought to my attention by Miran Epstein, from Yediot: Heart recipient's father: We'll never donate organs
It goes on to note
"The father's words angered Prof. Yaacov Lavee, director of the Heart Transplantation Unit at the Sheba Medical Center. "This is outrageous," he said. "I've heard such statements from many of my candidates (for a transplant), who weren't ashamed to admit they wouldn't donate organs.
"Such statements led me to initiate the bill that prioritizes transplants for people who have signed an organ donor card. This is clearly immoral behavior," he added.
The new transplant law, which will go into effect in May, states that any person in need of a transplant and who has had an organ donor card for at least three years will be given priority on the organ transplant waiting list. "
This makes some aspects of Israeli transplant law resemble parts of Singapore's transplant law, which also gives priority for organs to those who are registered as donors. (I wrote about this near the end of an earlier post.)
Update: Sally Satel's take is in the WSJ: About That New Jersey Organ Scandal It’s not surprising when 80,000 Americans are waiting for kidneys, and a background piece from Time magazine: How Does Kidney-Trafficking Work?
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