cohen - Sharon Bukov - December 30 2010
Mourners at a memorial service for Avi Cohen in Ramat Gan yesterday. Photo by Sharon Bukov
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The family of soccer star Avi Cohen has refused to donate his organs despite the fact that he signed a donor's card - something that has happened only once before in Israel's history.

Cohen, 54, was declared brain dead Tuesday afternoon at Ichilov Hospital in Tel Aviv, where he had been in critical condition since suffering a motorcycle accident on December 20. The determination was made by a medical committee as required by law.

Pursuant to Health Ministry regulations, Ichilov then asked his family for permission to use his organs. The family initially agreed, since he had signed the donor's card. But shortly before they were to sign the necessary forms, hospital staffers said, they were contacted by rabbis, some of whom even came to the hospital, and the rabbis dissuaded them.

Though the Chief Rabbinate was involved in drafting the law on determining brain death that passed two years ago, some rabbis still do not recognize brain death, holding that death occurs only when the heart stops - at which point, most organs become useless.

The hospital sources said that Sephardi Chief Rabbi Shlomo Amar personally called the family to urge them to approve the donation. But they ultimately sided instead with the rabbis who urged them to leave Cohen intact until his heart stopped, which happened yesterday morning.

It was Amar - with approval from the Sephardi community's leading halakhic arbiter, Rabbi Ovadia Yosef - who issued the halakhic ruling that held brain death, rather than heart stoppage, to be the true moment of death, and enabled the brain death law to pass.

Some 600,000 Israelis have signed donor's cards, but the cards have no legal force: When a signatory dies, family permission is still needed to donate organs. Still, the only previous case in which a signatory's family refused occurred over a decade ago.

"The organ donor's card is very important, because it makes it easier for the family to make the decision to donate the organs," the National Transplant Center said in a statement. "But organ donation can't be compelled, and no doctor would agree to remove organs for donation from someone without the family's consent."

Currently, Israel has one of the Western world's highest rates of refusal to donate organs, mainly due to ultra-Orthodox rabbinical objections to brain death.

Though Amar's ruling is widely accepted in the Sephardi community, non-Hasidic Ashkenazi Haredim, led by Rabbi Yosef Shlomo Elyashiv, still adamantly reject brain death and deem it murder to disconnect someone from life support before his heart stops beating.

According to the transplant center, 46.4 percent of families refused consent for organ donation in 2009. But that was an improvement: In every previous year, the figure was over 50 percent.

Nevertheless, both medical workers and legislators are frustrated that the brain death law has not done more to increase organ donation.

A European Union study published in the journal Transplant found that Israel's refusal rate in 2007, at 57.9 percent, was the third-highest among the 24 countries surveyed. Only Britain (60.2 percent ) and Turkey (58.7 percent ) were higher; the lowest refusal rate, in Hungary, was a mere 4.3 percent.

Earlier this month, Haaretz reported on plans to increase kidney donations, both by creating donor chains - in which people who aren't a match for their own relatives donate to someone else, whose relatives donate in turn, until a match is found for every patient in the chain - and by keeping road accident victims' hearts beating until their families can be asked to donate their organs.

In addition, MK Otniel Schneller (Kadima ), who drafted the brain death law, has been trying to get rabbis to publicly back organ donation. He said that while most rabbis do support it, many fear opponents' wrath by going public.