Personal Commentary - Organ Trading

This commentary is in response to the article: “Why not allow organ trading?" posted below. Summarising briefly, the article primarily examines the objections and criticism of the people against organ trading.

If Bill Gates were to suffer from kidney failure, he would be able to hire the best doctors, buy the most effective equipment, but he would not be able to buy a kidney for kidney transplant, not legally at least. Even with all the money he has, he would still have to undergo dialysis. Yet, if an ordinary person in Iran suffers from kidney failure, if he has the money, he would be able to buy a kidney, and spare himself of the pain of dialysis. Now, why does Bill Gates, one of the richest men in the world, lose out to an ordinary person from Iran, if they were to suffer from kidney failure? The reason is that organ trading is illegal in the US, but legal in Iran.

In almost all countries around the world, the buying and selling of organs, also known as organ trading, is banned.

Currently, with organ trading being banned, the only way of obtaining organs for patients who need them is through altruistic donations and donation of organs from deceased people, and perhaps even underground transactions of buying and selling of organs. However, in many countries, including Singapore, the supply of organs is simply unable to satisfy the demand, and many patients die because they are unable to carry out receive a transplant in time. But if organ trading were to be allowed, would the situation improve?

Yes it would! With the permitting of organ trading, people would be able to offer monetary incentives to potential donors, motivating them to donate their organs, thus increasing the amount of supply of organs. In the article, it is stated that there is a considerable amount of risk when carrying out organ transplants using bought organs. Indeed, the chance of success for a perfect tissue match, and hence easier acceptance of the organ and fewer complications is much greater for that of donations from relatives compared to that of donations from non-relatives. But hey, if patients are completely unable to receive a transplant, their chance of success would be zero. If relatives are unable to, or even unwilling to, then patients have no choice but to turn to donations from non-relatives, despite the lower rate of success.

The scenario examined in the article, stating that six out of eight experienced complications, was that of underground surgeries being carried out, as they had to avoid being caught by relevant authorities. The standard of surgery in those situations is much lower than if transplants were to be carried out in a regular hospital. If organ trading were to be legalised, the operation need not be kept secret, and the quality of the surgery would be better, coupled with proper checking and matching of donor and patient, the rate of success would be greater and more patients would be able to avoid the fate of death, for a longer time at least.

Well, if organ trading is able to improve the situation, then why is it still being banned around the world?

One criticism is that organ trading is merely exploitation of the poor by the rich and middle class. After all, the rich and the middle class, who are not in desperate need of money, would probably never sell their organs. Permitting organ trading only serves to allow the richer people a means to obtain the organs they need from the poorer in exchange for money, and hence they are exploiting the poor people’s situation to obtain the organs they need.

However, is it not a win-win scenario for both parties? The poor receive financial aid, and the rich are able to receive the organs needed for the transplant. The poor may be exploited, but it does not necessarily harm them. In fact, this provides them an outlet to get financial aid. Moreover, the rich and middle class are not the ones who directly cause the impoverished situation of the poor, and they do not force the sale upon the poor. The poor still hold the power to decide if they wish to sell their organs.

Another weakness is that it would be harder for the poor to receive organ donations, since are less able to afford buying organs, and altruistic organ donations from non-relatives would be greatly reduced since selling their organs would be more profitable than donating them. The poor would be disadvantaged, but this applies for other situations as well. In healthcare, being unable to afford certain medication or operations, the poor would also be disadvantaged. Shall we change the way other facets of healthcare work as well? I think not. The poor being disadvantaged is stems from the capitalist beliefs embedded deep in society, and it is hard to change. Nonetheless though, introducing organ trading is what causes the matter of organ donation to be ‘capitalist’, and it would not be beneficial to the poor.

The greatest objection to organ trading is that the act of buying of selling of organs is equivalent to treating the human body like goods, defying the sanctity of humanity, and is hence something immoral and should be disallowed. Yet, to respect this sanctity of humanity, we potentially sacrifice the life of a patient who could survive if given the organ. Does the respect for the human body take priority over the life of a human? As stated in the article by Janet Radcliffe Richards, Reader in Bioethics at University College London, we are protecting our own squeamish sensibilities, namely the notion of not allowing the human body to be commodified, while other people die. Does human life not take precedence over the respect for the human body? Are we to let patients, suffering from organ failure, waiting in pain and agony for an organ transplant, to continue suffering and even die, just to maintain the sacredness of the human body? Is that what is moral?

In conclusion, I feel that organ trading, despite having its flaws, is still ultimately beneficial towards patients waiting for an organ transplant, and hence should be allowed. It provides patients a new ray of hope, allowing them to take action to find a suitable donor and offer them incentives to motivate them to donate their organs, instead of passively waiting for a suitable donor to appear, or rather, die, so that his organs can be used.

Why not allow organ trading?
Friday, 30 August, 2002, 09:10 GMT 10:10 UK
by Chris Hogg
BBC Health correspondent

Is it wrong to buy a kidney to save a life, or to sell one to help yourself out of poverty?

In Britain and much of the rest of the world it is illegal.

On Friday, a retired GP accused of trading in human organs was found guilty of the charges made against him by the General Medical Council.

The GMC heard that Doctor Bhagat Makkar had promised undercover journalists that, for a fee, he could obtain a kidney from a living donor - charges he denied.

Now it has emerged that a second doctor, from Coventry, will appear before the GMC on similar charges in October.

So why not legitimise the practice and allow free trading of human body parts?

The idea of a market for human organs is grotesque to many. But doctors in Britain say because it is banned in this country some people take desperate measures.

Risks 'considerable'

Geoff Koffman, a transplant surgeon at Guy's Hospital, believes patients who were on his waiting list have paid for new kidneys donated by strangers - a practice he finds unacceptable.

"A number of my patients who are on dialysis treatment in London have sought a transplant from an unrelated donor out of this country - strongly against our advice.

"If they were going back to India or Pakistan and having a transplant from a relative, then that would be understandable and reasonably acceptable.

"But if they go over to have a transplant from an unknown donor then I think there's an issue there that we're very unhappy with."

The risks are considerable. Research carried out by doctors in Coventry shows that of eight of their patients who travelled to India or Pakistan for treatment, six returned suffering from serious complications.

Indian market

In Delhi, however, Dr P C Bhatnagar from the Voluntary Health Association of India says odds like that do not seem to have harmed the business.

"Presently it's a flourishing market. On average, around 2,000 sales of kidneys are taking place in this country, and this figure doesn't include all the donations and operations which are taking place under the proper procedures."

The demand is driven by shortages. The British government has responded with recruitment drives for donors, especially from among the Asian community where there is a particular problem. But with little effect.

And so some now believe it is time for us to abandon our reluctance to trade organs for cash.

Janet Radcliffe Richards, Reader in Bioethics at University College London, accepts this is not an attractive option.

But she rejects the argument that it is corrupt to sell or to buy the means to save a life.

"The question is not whether you find this repugnant, it's a question of what the cost of going along with this feeling of repugnance is.

"And my fear about this is we're protecting our own squeamish sensibilities while other people die or have their best options taken from them - and this strikes me as morally outrageous."

Altruistic donation

Others go so far as to suggest how the practicalities might work.

Robert Elms, a transplant surgeon at the Royal Liverpool Hospital, believes the principle of compensation would be more acceptable to many than payment.

He said it was very odd that the act of giving someone a kidney is considered "wonderful, a noble act" - yet as soon as an exchange of money is involved it becomes "so outrageous as to be intolerable".

He points to the examples of injuries compensation in the courts, "where thousands of pounds may be given to the individual who is damaged by an accident".

This, he said, provides a legal and a moral precedent for considering the "extra pain and discomfort and trouble to which someone is willing to go in order to give a kidney to someone they like or they love."

The government is currently considering whether to relax the rules and extend the principle of altruistic donation, allowing people to donate organs to strangers in need.

But the issue of payment is still taboo and is not mentioned anywhere in the proposals. That, it seems, is a step too far.

Source: http://news.bbc.co.uk/2/hi/health/2224554.stm