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