Rigorous Rules for Medical Grafts : Skin Becomes Divisive Issue for Israeli Jews

The deep and often-rancorous split between religious and secular Jews in this Jewish state widened a bit this week in a dispute over human skin.

The issue led to the temporary expulsion of right-wing Rabbi Meir Kahane from the Israeli Parliament on Wednesday after he called a fellow member a “hypocrite,” a “Jew hater,” and a “foul creature.” The object of his wrath, a woman, had just branded as “stupid” a law the religious parties pushed through eight years ago.

The cause of the name-calling is the unlikely issue of skin grafts, and the dispute reveals at least as much about religious tensions in Israel as it does about law or medicine.

It all began on Tuesday, when Jerusalem’s Hadassah Hospital issued a public appeal for the bodies of people who had just died so the skin could be grafted onto two badly burned Israeli soldiers. The soldiers were among 14 wounded last Sunday when a suicide truck bomber crashed into an Israeli troop transport in southern Lebanon. Twelve Israelis were killed in the terrorist attack.

Living Bandage

It is common practice in other countries for hospitals to keep a reserve of human skin on hand, preserved in liquid nitrogen, to be used in burn emergencies. The grafted skin acts like a living bandage to prevent infection of the burned area and to allow new skin to form.

However, according to a Hadassah news release issued Tuesday, it has no “skin bank” “because of opposition in some Orthodox circles to the storage of organs for transplantation.” As a result, skin was ordered flown in from a skin bank in Holland.

Specifically, said Hadassah’s director, Dr. Shmuel Penchas, the problem is a 1976 “Law on Anatomy and Pathology” that prohibits “desecration of the dead for scientific purposes.” The law was pushed by Israel’s religious political parties, which, because of the inability of either of the big secular political groupings to win a parliamentary majority, enjoy disproportionate influence as necessary allies in a ruling coalition.

Religious Jews here agree that in case of emergency it is acceptable to graft skin from corpses onto a patient, but only under rigorous conditions of family consent. Moreover, the ultra-Orthodox insist that skin and other organs can be removed only when required immediately to save a life.

Skin ‘Banking’ Banned

“Banking” of human skin for future emergencies is not allowed in this most rigorous interpretation of Jewish religious law.

Hadassah spokeswoman Ruth Mekel said Friday that the hospital banked skin for about a year, but that the “experiment” did not work. Other sources here said the bank was closed under pressure from ultra-Orthodox religious groups.

The hospital’s call for donors caused an immediate furor. The left-wing newspaper Al Hamishmar said it was filled with “anger and pain at a society which values corpses more than it does living, breathing human beings.”

The day before, Citizens Rights Movement and Knesset (parliament) member Shulamit Aloni made the same point in branding the pathology and anatomy law “stupid.” At that point Kahane insulted her and was ordered out of the Knesset chamber. Aloni is a well-known crusader against what she sees as undue religious influence over Israeli laws.

On Friday, the newspaper Maariv carried three articles on the dispute, including one that quoted extensively from death threats made by a bereaved son against a doctor who pleaded that he be allowed to take some skin from the body of the man’s mother, who had just died in the hospital.

Death Threat Reported

“I want my mother to reach heaven in one piece,” Maariv quoted the son as saying. “And if you touch her, that’s the end of you.”

Rabbi Menachem Porush, a Knesset member from the religious Agudat Israel party, which was a prime mover behind the 1976 legislation, said he opposes any changes in the law and charged that the whole affair has been blown out of proportion to stir up antagonism against religious Jews.

He also lashed out at Aloni in Wednesday’s Knesset confrontation. “How long will you incite the nation against religion, with your unbridled hatred?” he demanded. “Since the anatomy and pathology law was passed, there was no case in which skin was needed and the rabbis did not approve its removal,” Porush said.

By Thursday, officials of the Health Ministry were saying that there had never been a skin shortage because one of the country’s chief rabbis had ruled within 12 hours of Sunday’s suicide truck bomb attack that the situation was an emergency and that skin from dead bodies could be used even without the consent of the deceased’s family.

Nonetheless, the chief rabbinate announced Thursday that it has established a commission of rabbis and doctors to look into the question of a skin bank.

And Penchas, for one, will not be satisfied until the law is changed. As it stands, he said, “Whenever we have a situation in which many square meters of skin are required, we have to . . . start hunting around for immediate possible donors. And this is not a very easy situation to live with.”