If it's up to Health Minister Danny Naveh, Israelis will soon be able to sell organs for transplant and women will be able to sell their ova (eggs) in return for compensatory payment from the state. In addition, Israelis will be able to buy medicines in supermarkets, gas stations and kiosks as well as in drugstores. This is part of the medical vision being espoused by Naveh. He is now promoting legislation on these issues - in fact, he began pushing these ideas before becoming health minister - which he sees as the forefront of his activity. Naveh believes that legislation along these lines will enhance health and well-being and increase the possibilities of creating and saving life.
However, in the view of many senior figures in the health system, Naveh's move is dangerous and is liable to further worsen the condition of medicine, and indeed of the society in general, in Israel. Naveh notes that a few dozen people die every year in Israel because of an ongoing shortage of organs for transplant, and that the law that forbids trade in organs will help the authorities fight merchants who peddle them.
The new bill calls for the establishment of a state entity that will pay financial compensation to living donors of organs. However, even the Health Ministry concedes that it will be impossible to curb a phenomenon that the new law will generate, in which poor people will agree to donate organs for money at the price of risking their health, and the state will thus become a trader in its citizens' organs.
The solution to the organ shortage is to publicize the situation among both the public and medical personnel (some of whom, contrary to expectations, flinch from the subject), encourage organ donations from both the living and the dead, and to take intensive action against medical personnel who trade in organs, instead of the forgiving attitude and blind-eye approach the Health Ministry has so far taken.
The ministry is displaying a similar look-the-other-way approach in the area of ova. In recent years there has been a shortage of eggs for in vitro fertilization, largely because of the publicity about the commerce in eggs - an affair in which some of the country's top gynecologists are accused of engaging in a medical manipulation that induced women to produce a very large number of eggs for sale, even though the women's lives were endangered. The reports generated a crisis of confidence, and since then women have been apprehensive about donating eggs for fertilization purposes. To solve the problem, the health minister is now promoting a law that will make it possible for every woman - not only women undergoing fertility treatment, as was the case until now - to sell ova in return for compensatory payment from a state body.
In this case, too, the health minister is choosing the easy - and dangerous - way, which is liable to create a situation in which the state will find itself trading in the eggs of poor citizens while causing a serious risk to their health. Instead, action should be taken to restore the trust of women in the gynecological community, not least by taking harsh measures against those involved in the commerce in eggs.
In another reform being promoted by Naveh, the Health Ministry is proposing new regulations under which medicines will for the first time be able to be sold in drugstores without a pharmacist and also in places other than drugstores. This will constitute a major change in the medicines market in Israel, but it is being promoted despite the medical dangers to the public, which are described in a report prepared by a ministry commission. That panel, headed by Prof. Hillel Halkin, dealt thoroughly with the subject and in 2001 recommended not to permit medicines to be sold outside drugstores. Rather, in the first stage it would permit, as in most countries in Europe, the sale of medicines in drugstores without the assistance of a pharmacist, and after a time to examine the implications of the change in policy.
The commission noted the danger to the health of the public as a result of incorrect and excessive use of medicines and in late self-treatment for illnesses. The organization of pharmacists in Israel has written to Naveh stating that some of the items the ministry wants to include in the reform constitute a health risk to the public. But what is the connection between the Health Ministry and the health of the public? The commission's recommendations were never made public and have been shelved, and the ministry continues to look the other way.
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