My friend and I revisited this topic today and I asked if she was for or against organ trading. Her answer was quite straight forward; she was for it – only if no lives are being sacrificed in the process because it is pointless to sacrifice a life just to save another one. Some people might be thinking – it couldn’t be that the donor would want to sacrifice his life in exchange for money that he couldn’t spend, would he?

Well, not exactly. However, we do know that there are already syndicates which are harvesting organs (legal or otherwise) for sale in the black market. Yes, that darkens everything, doesn’t it – the existence of syndicates that goes round harvesting for organs. Remember all those chain emails that you used to get that warns you about being drugged in a pub and waking up only to find yourself in a tub of cold water and a note that tells you to call 911 (or 995 in Singapore) immediately because your life is in danger? Yes, these emails depict of the dark scenario that may happen if syndicate activities were to go up. They warn of people getting drugged and having their organs stolen from them.

Of course, many of us shrug them off as being urban legends, but these could jolly well be true one day. However, just before you think that I am trying to convert you to be against organ trading, you might want to think through a few questions first.

Now, imagine if you are on dialysis, 3 times a week, 4 hours each time. Imagine if you have to be on the waiting list for an average of 9 years. Imagine spending 12 hours each week on the dialysis machine, over 600 hours a year and more than 5400 hours over 9 years. If you are a regular graduate paid about $150 for a 10 hours work-day, that’s about $15 per hour, which means your opportunity cost is about $81000. If your dialysis costs $1200 per month, that works out to be about $14400 per year and $129600 for that 9 years. Adding that up, that’s about $144000 (that’s one hundred and forty-four thousand) in total costs just waiting for a donor kidney; meaning, there’s no guarantee that you don’t have to wait beyond 9 years, and providing nothing happens to you while waiting on that dialysis machine.

Someone comes up to you, makes an offer of $30000 for someone else’s kidney excluding his medical well-being. Let’s put in another $20000 for hospitalization and medical fees for both of you. $50000 for a kidney – will you take it?

Perhaps you have integrity and feel that you are young and can wait. You feel that the time spent on the dialysis machine is nothing compared to someone losing his kidney over money. Moreover, you don’t know the circumstances leading to the donor giving up his kidney. Now, let’s assume that the donor himself comes up to you, and makes you an offer. Same figure, but no middle man. Every single cent you give him goes to his pocket.

Still not convinced?

Let’s just say without your money, the potential donor might just starve. He has a sick mother to take care of and needs money for the medical treatments. Your money will do him good. Even if you are half way into the waiting list, $50000 is still much less than how much you’d have to spend and that gives you and him a new leash of life. If you don’t take his kidney, he may never find another suitable recipient. His family suffers and you continue your wait. A wait that may see no end.

Instead of putting things in such a morbid light, let’s look at it from the pure economic aspect. Organ trading is now illegal because money is involved. If you take the money out of the equation, then it becomes "an act of kindness". Do you, as a waiting organ recipient, really expect to receive an organ for free? Would you be "thick-skinned" enough to receive an organ for free even if you have the means to compensate the donor for it but are not doing it because "organ trading" is against your morals? How about taking a back seat and rethinking about the whole thing again.

Of course, if organ trading becomes legalised, the syndicates may have more business and perhaps what’s said in the earlier chain emails might come true. People might really start waking up to find one or two of their kidneys, or their liver, or any other harvestable (editor: there’s no such word as "harvestable", but you know what I mean) organs missing. That is over the line, but if syndicates are involved, then there’s nothing to stop potential recipients from hunting down organs through the syndicates; legal or not. Of course, some will think that if organ trading is legalised, potential recipients will not feel that bad paying for an organ. There is, however, a difference between paying and seeing the donor, and just buying an organ.

That’s where legislation should step in.

With the recent upheaval on the organ trading cases, some countries such as India are toughening laws on organ transplants, requiring recipients to bring along their donors when seeking treatment in India. As in the article below, farmers are being duped of their organs by syndicates for small amounts of money. While I am not in any position to comment, at the end of the day, a holistic approach has to be taken. What’s written here is just meant to provide different perspectives to a problem that will continue to run its own course in the black market.

India gets tough on organ transplants

It will toughen laws so that foreigners seeking treatment must find donors from their own country

By P. Jayaram, India Correspondent

NEW DELHI – INDIA plans to tighten its organ transplant laws and put more curbs on foreigners who come for such operations.

Under proposed amendments to the Transplantation of Human Organs Act, foreigners, who make up 30 per cent to 40 per cent of these transplants – mostly kidney and liver – would need to find donors from their own country.

India has also proposed enhancing jail terms and fines for violations of the Act.

The move comes six months after a multi-million-dollar kidney transplant racket was busted in Gurgaon, an affluent Delhi suburb.

The racket involved a network of doctors, nurses, a clandestine hospital run from a three-storey house and mobile testing labs.

Health Minister Anbumani Ramadoss said then the government would amend the organ transplantation Act to enhance penalties for the illegal organ trade.

Under the Act, only immediate relatives – parents, siblings, spouses – can donate an organ to the patient. It also allows a person to donate organs ‘by reason of affection or attachment towards the recipient or for any other special reasons’, a clause that experts say is grossly misused.

The amendments propose doubling the jail term for doctors, donors and recipients involved in illegal organ transplants from five to 10 years, and raise fines from 10,000 rupees to 500,000 rupees (S$315 to S$15,800).

For others involved in running transplant rackets, the amendments propose to increase the jail term from seven to 10 years and the fine from 500,000 rupees to 1 million rupees.

According to health experts, the proposed amendments will make it mandatory for foreigners having the transplant operations in India to get donors from their own country, with proof that the organs are from their relatives, in line with India’s laws.

Experts say that one out of every 10 Indians – or about 100 million of the country’s one billion population – suffers from some form of kidney ailment, creating a huge demand for such transplants.

But the Gurgaon kidney racket showed that many foreigners were also coming to India for illegal transplant operations.

Investigations point to the involvement of politicians, bureaucrats and police, besides doctors, nurses and other hospital staff, in the racket.

It was also found that many poor labourers and farmers were duped into parting with their kidneys for 10,000 to 20,000 rupees each, and that the organs were then sold for 1.5 million to 2 million rupees.

pjay@sph.com.sg

Source: Straits Times Interactive, http://www.straitstimes.com/Asia/Asia/Story/STIStory_255581.html

Article extracted on 8th July 2008



Reader's Comments

  1. Jwong | July 9th, 2008 at 8:43 am

    But imagine if the hospital were to be the middle man, who actually pays for your kidney, and then sells it to the next compatible person-in-waiting. The person ‘selling’ his kidneys would have to be there in person to sign up, and would have no say in who it finally goes to.

    I mean, donations? I dare say most of us aren’t that altruistic. It’s only fair that someone pays. After all, we have been brought up to believe that nothing in this world comes for free.

  2. Onlooker | July 9th, 2008 at 12:04 pm

    Actually, One of of the way mention by Dr Lee (the daughter) is feasible as we are a small country so enforcing that will be much simpler for us.
    But the thing will get messy when there is a lapse or when complacency sets in. We have taken a recent doses of such bad service.
    Come to think of it Dr Lee is PM material.Her view/ suggestion is to the point and it does solve the problem for both side donor and recipient.
    A solution with equilibrium.
    There are also alternative to human organ transplant though like animal transplant. But people (recipient) are squeamish.

  3. ricE | July 9th, 2008 at 3:48 pm

    middle man = property agent, stock broker, insurance agent = all legal.

    why not kidney broker? they only charge too much ‘cos its illegal. if its legal, price will go down and everyone will benefit, but of course the government wants to benefit too and the money made from matching demand and supply, they claim they will do a better job in redistribution of income.

  4. auntieblog | July 10th, 2008 at 11:26 am

    I’m all for buying an organ. Those who are against it probably do not want to imagine how they would feel if they were staring death in the face due to kidney failure.

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