Should organ trade be legalised?

Should organ trade be legalised?

Rishabh Srivastava, 09 February 2008, Saturday

While organ trade is mushrooming in India, one question lingers – can legalisation of sale of organs curtail such rackets? Though it is morally wrong, but isn’t it amoral at the same time to let one die when something can be done to save a life?

HUMAN ORGANS Transplant Act was enacted in 1994 and it put some curbs on the commercial trading of kidney. But it resurfaced in 1998 after discovery of organised rackets in Noida and Karnataka that year.

The organ trafficking is not new to the world and India is considered to be one of the biggest centres. The number of renal transplants has increased manifolds in last decade and has led to a number of ‘unrelated’ transplants in the name of ‘altruistic donation’. Kidney is a paired organ in the human body and one of the kidneys can be removed from a live person and thus, is most preferred organ in trafficking business. The donors are poor people, who are lured by very lucrative offers for jobs but are paid a meagre sum by brokers involved in the racket, while hefty financial gains are enjoyed by the person at the higher level of hierarchy.

The Gurgaon kidney racket kingpin, Dr Amit Kumar, has been arrested and very soon will be deported to India from Nepal. Kumar has been on the run for few weeks. Only time will tell whether the arrest of kingpin would have any effect on the kidney trade going on in the country and worldwide. This incident has surely led to a debate as to whether organ sale should be legalised.

Consider a hypothetical situation, where the person X is living on dialysis for couple of years but could not find a donor for himself. One day, person Y, who is in dearth of money, approaches X and offers to donate his kidney for a certain amount. X can pay that much but knows that law does not permit him to do so. What should he do now? No guesses, he will go for it, whether legal or illegal!

There is a yawning gap between the demand and supply of kidneys worldwide and this leads to black marketing of kidney. Whenever one law is broken, there will be a series of illegal activities such as exploitation of recipient and donor, human rights violation. The rich people are ready to pay huge sum of money to save their lives, and there is a set of donors that donates for the sake of money only, or is made (forced) to donate the organ. In a last year’s report, World Health Organisation (WHO) estimated that ten per cent of all transplants involved patients from developed countries to poor countries to buy organs. This was the case in this racket too, and Dr Kumar conducted 500 transplants in a few years, mainly involving the foreign recipients.

The various policies and strategies to boost the donations have not been successful. Till date, the supply of transplant organs is left to altruism but now we need some more imaginative strategies. We need to encourage a law of ‘presumed consent’, which authorises the doctors to remove organs from a ‘brain dead’ individual if there are no objections from the family members. Several European countries including Austria, Belgium, France, and Italy have legalised this law and they have witnessed increase in the number of donations.

We can also have a policy, where kidney sale is legalised and the recipient has to obey some pre-set rules such as health insurance cover for donor, no exploitation at any level, no commerce involved, etc. A review committee consisting of responsible persons can formulate these rules.

I think that we should now seriously look at this alternative because the current black market is accessible only to those people who have resources.

Many moralists will not agree with this point of view. Ethically thinking, we may feel that buying and selling of organs is wrong, but is it morally wrong to let a patient suffer and die on dialysis when something can be done to save his/her life? Why not legalise the sale of organs then?

Unless and until we bridge the ever-widening gap of demand and supply, such rackets will continue to flourish. The efficacy of the legal system is also questionable and very soon, we may see Dr Kumar on bail and the never-ending trial leading to nowhere.

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