Prioritizing registered donors in organ allocation: An ethical appraisal of the Israeli organ transplant law

Jacob Lavee*, Dan W. Brock

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

37 Scopus citations


PURPOSE OF REVIEW: A new organ transplant law in Israel, which gives priority in organ allocation to candidates who in various ways support organ donation, has resulted in a significant increase in organ donation in 2011. We provide an ethical analysis of the new law. RECENT FINDINGS: We note that by continuing to require opt-in consent, the Israeli law has an ethical advantage over opt-out laws, which may result in some use of organs from donors who have not consented. We discuss the fair response to 'free-riding' candidates who, usually for religious reasons, are opposed to donation, but nevertheless seek a transplant, who will not receive any priority over candidates who have been registered donors for at least 3 years before listing. We spell out several reasons why it is potentially unfair to prioritize patients whose first-degree relatives are registered donors, whereas it is fair to prioritize candidates who have been living directed or nondirected donors. Finally, we note the difficulty of ensuring public awareness of the priority system, which is necessary for its fairness. SUMMARY: Athough needing some modifications, the new Israeli law is based on sound ethical approach that seems to begin already to bear fruits.

Original languageEnglish
Pages (from-to)707-711
Number of pages5
JournalCurrent Opinion in Critical Care
Issue number6
StatePublished - Dec 2012


  • opt-in vs. opt-out consent
  • organ allocation
  • transplantation law
  • wait list priority


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