Magazine article New Internationalist

Is It Ever Right to Buy or Sell Human Organs?

Magazine article New Internationalist

Is It Ever Right to Buy or Sell Human Organs?

Article excerpt

A leading medical think-tank, The Nuffield Council for Bioethics in London, is currently examining this thorny issue. They are due to report their findings in 2011. In the meantime we have asked two experts to argue the case for and against.

YES

Sally Satel:

The global organ shortage has spawned illegal and unregulated organ markets. The World Health Organization estimates that five to ten per cent of all kidneys transplanted annually - perhaps 63,000 in total - are obtained in the organ bazaars of Africa, Asia, Eastern Europe and South America. Thus, we face a dual tragedy: on one side, thousands of patients who die each year waiting for a kidney; on the other, a human rights fiasco in which corrupt brokers deceive indigent donors about the nature of surgery, cheat them out of payment and ignore their post-surgical needs. Altruistic appeals to organ donation have not yielded enough organs for transplantation. Not all developed countries have made the most use of posthumous donation, and of course they should. Unfortunately, much of the world transplant establishment - including the World Health Organization, the Transplantation Society and the World Medical Association - focuses exclusively on obliterating organ trafficking. While at face value this may seem reasonable, in reality it is a lethally one-sided prescription, because trying to stamp out underground markets either drives corruption further underground or causes it to flourish elsewhere. Government-sponsored compensation of healthy individuals who are willing to give one of their kidneys to save the life of a dying stranger is the best short-term solution.

Jeremy Chapman:

So we start on common ground: illegal and unregulated organ markets are reprehensible consequences of individuals driven to seek transplantation therapy. The tragedy has played out across the world. The drive for survival is a very strong human instinct and one that overcomes feelings and common bonds between people. It overthrows decency and humanity and it requires consequentially strong and united laws and regulations. 'I must leave the country tonight because they are shooting my donor tomorrow,' was said by a patient to one of my colleagues recently. Such opportunistic human cannibalism has no place in healthcare.

Organ donation after death is the only practicable solution for heart, lung, pancreas, intestine, composite tissue and most liver recipients. There can be no solution that ignores the reality of people with these needs. By focusing on kidneys alone, where the solutions must embrace both the deceased and the living donor, you seem to have discarded the broader needs for transplantation. I thus seek more from you than a throw- away line on 'the need to make the most use of posthumous donation'.

NO

Sally Satel:

Let me say a few words about myself. In August 2004 I became one of those whose 'drive for survival' became very strong. That's when I learned I had idiopathic renal failure. After a year of searching for a donor among people I knew well - and coming up empty - a casual (but now very dear) friend stepped in to spare me vears of life-draining dialysis and premature death.

I am well aware of my good fortune. Many people without a donor are tailing on dialysis, and some have no access to dialysis at all. And they will follow that survival instinct to foreign lands, despite the sickening knowledge that their new organ might come from an executed prisoner in China or an illiterate labourer in India. I, for one, had considered it. Your reference to Opportunistic human cannibalism' took me aback. The tragedy we face is symmetric: hapless donors and wretched patients are locked in a morbid embrace. I outlined one model for disentangling them - a governmentregulated programme of in-kind benefits to well-informed donors, offered by a third party and distributed to the next ill person, not the wealthiest. What innovations have you offered? …

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