ISRAEL: Soccer legend’s death puts organ donation debate in center field

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One of Israel’s favorite winners, soccer legend Avi Cohen, lost the battle for his life last week, after
a critical injury in a motorcycle spill.

The 54-year-old athlete was a childhood hero of many, after making local history in 1979 as the first Israeli soccer player to sign with a big international team as defender for Liverpool and later with the Glasgow Rangers.

His son Tamir -- himself a promising footballer now playing in England -- had rushed home to be at his father’s bedside.

Pray for him, he and the family asked supporters waiting for good news at the hospital and at home. They sought higher help too, meeting with rabbis who came to the hospital to give their blessings.

A week later, Cohen was pronounced brain dead. His heart stopped the following morning.

Fans observed a minute of applause on soccer fields on both sides of the ocean. Liverpoolers wished him a final farewell with their trademark ‘YWNA’ -- ‘you’ll never walk alone.’

Cohen’s death united fans but also divided people in a debate about a sensitive issue: organ donation.

Brain death is the point at which relatives are approached for their consent to organ donation. The medical window of opportunity isn’t always wide, around 12 hours in this case. Cohen had an organ donor card but his family couldn’t bring themselves to act on it.

Initially, they agreed. Chief Rabbi Shlomo Amar reportedly called the family, personally urging them to approve; other rabbis discouraged them. Finally,the family decided against it.

The cards are legally recognized but families’ consent is still required. Overwhelmingly, they agree. This is only the second case of families overruling the card, say medical officials.

Avi’s brother Haim told Israel Radio the family was at peace with their decision. Some in the family knew about the card. But in the pull between emotion and rationale, the former prevailed. ‘We waited for a miracle,’ he said.

That’s human, said Avinoam Reches, a neurology professor and chairman of Israel Medical Assn.’s ethics committee -- but there’s no medical precedent.

Jewish law allows live donations; it’s the other kind that is problematic.

Attempts were made to reconcile the religious aspect, though rabbis were -- and remain -- divided. Part of a twofold legislative move to encourage organ donations instituted a new and detailed protocol for determining death, making brain death not only a medical definition but a legal one.

The chief rabbinate was involved in the bill and accepted brain death as the defining criterion, which makes donating organs at this stage compliant with Jewish law. Heralded as groundbreaking, the 2008 bill, it was hoped, would encourage donation and save lives. The waiting list for transplants and donations exceeds 1,000 patients.

Medicine has advanced to the point that technology can essentially keep dead people alive, and Jewish law needs to address this, Reches said on radio. He was disappointed the rabbinate hadn’t made enough of a clear, public statement accepting brain death as the defining criterion, saying the rabbis had ‘betrayed their public duty.’ (There is an organization dedicated to increasing organ donations among Jews in keeping with religious law.)

A Health Ministry survey found that 62% of adults in Israel are willing to donate organs after death. Fifty-six percent are willing to sign a donor card, but only 10% have. Among 24 countries surveyed by the national organ transplant center, Israel is 3rd in refusal rates, after Britain and Turkey. Around 50% of families approached in hospitals consent. A third of those who decline cite religious reasons.

Some criticized rabbinical intervention and others the family, though no one wants to be in their place.

Now, lawmaker Ilan Gilon is advancing legislation to give donor cards people sign the legal validity of a will.This will free families from the dilemma and protect them from pressure from ‘charlatans and magi.’

Dr. Gil Siegal, who chairs the Center for Health Law and Bioethics at the Ono Academic College, believes consent to organ donation must become the legal default. Families may refuse, but should understand the connection between giving and getting. After all, few would turn down receiving a donation.

He too says the card is like a will. It is a pity that a man’s wish to give others life wasn’t respected, when no one would have dared overrule a will, Siegal said, even if he had asked to be buried in his Liverpool shirt or leave all his money to Prime Minister Benjamin Netanyahu.

-- Batsheva Sobelman in Jerusalem.

Image: Avi Cohen/Liverpool Football Club website