If I ask whether you would trade your kidney for an iPad2 and perhaps another iPhone, what would you say? This news report about a 17 years old teenager in China must have left many people feeling amazed and frustrated about what is going on there. Giving away your kidney for iPad? Really?
If true, the issue highlights a major weakness in policy and law enforcement on organ transplantation in the country. The Lancet, as summarized in our HealthSpace.Asia blog, has just published a news article by Ted Alcorn describing how a migrant worker was forced to sell his kidney or how renal failure patients are still going to China to get their 'new' ones. The Ministry of Health and the Red Cross are planning to respond by implementing a national policy to address such issue.
The Economist, a popular news magazine, had long argued for an open market for organ transplantation. It highlighted the Iranian model to legalize the sell of kidneys where regulated kidney market became, arguably, better at protecting organ donors, reducing long queues of waiting recipients given serious global shortages, and making the system more efficient. It also argued that banning organ selling ends up driving the business underground with more harms to both sides as in the Indian case. It is estimated that at least 2000 kidneys are still being sold in the Indian black market each year.
The Economist's articles may grossly neglect the ethical and social implications of such market activities. Poorly informed individuals and vulnerable groups may be lured or coerced into the trade exploitatively. It may also be debatable whether it will create increasing overall organ availability or it may instead reduce living related donation. Nevertheless, the news about this Chinese youth reminds me further that having an outdated policy or poorly enforced law could be even worse. And the problem certainly is not limited to China where reported scandals on illegal organ transplantation can be found all over the world from Northern Ukraine, Northeast America, Central Manila or South Africa. The increasing epidemic of noncommunicable and chronic diseases such as diabetes and hypertension will likely drive the demand for organ transplantation much higher. Without proper policy and incentives for disease prevention, encouragement of legal donation, and enforcement of legislation, we may have to continue to read more similar stories in the future.
If you have time, I would love to hear more whether organ trafficking is also an issue of concern in your country? What's your view on the extent of the problem and the existing policy/laws in your country? Please leave your comments below.
Note: below are some academic papers I found useful
- Shimazono's article, "The State of the International Organ Trade", in the Bulletin of WHO
- Jafar's article, "Organ Trafficking: Global Solutions for a Global Problem", in the American Journal of Kidney Diseases
- Voo et al.'s article, "The Ethics of Organ Transplantation", from Annals Academy of Medicine