A National Survey of Attitudes of the Zionist Ultra-Orthodox Community in Israel to Organ Donation

Abstract

Background: The Council of the Chief Rabbinate formally accepted neurologically declared death as an indication of death for all legal and religious purposes following changes made to practice parameters in order to comply with Jewish Law (halacha). This removed Jewish-legal barriers for organ donation. We surveyed the Zionist ultra-Orthodox community to identify the reasons for their continued reluctance to donate. Methods: A questionnaire was designed to assess personal, cultural, religious, and system-related considerations relating to organ donation. A telephone survey of persons identifying themselves with the Zionist ultra-Orthodox community was conducted to include 300 respondents (150 males and 150 females). Results: The response rate was 5.5% (300 of 6799 approached). While most participants (79%) agreed that organ donation improved or saved lives, a minority (25%) expressed willingness to donate. The most important inhibiting factors were related to religion, namely, importance of being buried intact (84%) and donation being against halacha (46%). Most respondents (67%) would approach a religious figure for advice, and willingness to donate increased when informed that donation was permitted (68%) and supported (63%) by orthodox religious authorities. Finally, a minority (37%) perceived the allocation process to be fair and adequately supervised (36%). Conclusions: This study identified religious and system-related constraints as important inhibiting factors to donation, factors which were potentially modifiable. Since this community relies on their religious leaders for guidance, public support by authoritative and accepted religious leaders is required to reassure the community of the legitimacy and positive aspects of organ donation.