Organ Selling

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Leading surgeons are calling for the Government to consider the merits of a legalised market in organs for transplant. A public discussion on allowing people to sell their organs would, the doctors say, allow a better-informed decision on a matter of such moral and medical significance. At stake are the lives of thousands of people who may die before a suitable donor can be found. Eight thousand people are on the transplant waiting list, more than 500 of whom die each year before they obtain an organ, and the numbers are rising by 8 per cent a year. But there are serious concerns that introducing payments for people who donate their organs would result in poor and vulnerable people coming under severe pressure to alleviate their financial problems by selling a part of their body. Professor Nadey Hakim, a Harley Street surgeon, and one of the world's leading transplant surgeons, believes that a properly regulated market should be permitted so that the black market in organs is, if not destroyed, at least dramatically reduced. He sees the effects of the black market in patients so desperate to have a transplant operation that they travel abroad for an organ. This "transplant tourism", he said, often results in botched operations requiring further surgery when the patient returns to Britain. It would make better sense for organ sales to be allowed in the UK under a strictly regulated regime, he said, adding: "Let's have a system that doesn't allow organs with HIV or whatever." Professor John Harris, an ethicist at the University of Manchester, believes a debate and the introduction of an organ market are long overdue. "Morality demands it," he said. "It's time to consider it because this country, to its eternal shame, has allowed a completely unnecessary shortage for 30 years. Thousands of people die each year [internationally] for want of organs. That's the measure of the urgency of the problem. "Being paid doesn't nullify altruism – doctors aren't less caring because they are paid. With the current system, everyone gets paid except for the donor." Professor Harris has developed proposals for an ethical market in organs in which donors would be paid as part of a regulated system. Such a system, he said, would have to be controlled within a strictly defined community, probably the UK but possibly extended to the EU, so every organ could be accounted for. No imports would be allowed. The NHS would be the sole supplier and would distribute organs as it does other treatments – ability to pay would not be a factor. Consent would be required for every donation and would have to be rigorously carried out to ensure no donor was subjected to untoward pressure. Professor Sir Peter Bell, former vice-president of the Royal College of Surgeons but now retired from practice, wants a public debate because there is such a shortage of organs for transplantation: "It is time to debate it again. There is a great shortage of organs." Recent medical advances, he said, now make it reasonable to allow a kidney market and perhaps the sale of liver donations, although other body parts remain too risky, he argued. "If someone wants to alleviate a financial problem why shouldn't he do that? It's his choice," he said. Professor Bell suggested a fee of £50,000 to £100,000 for each kidney, the equivalent of one or two years on dialysis, and added: "Kidney donation has now become so safe it's something you could ethically justify and it would stop all this illegal trafficking." There remains stiff opposition to liberalising the market, not least from the British Transplantation Society (BTS). Opponents agree there should be a public debate about the merits and flaws of a market in organs. "The British Transplantation Society opposes this view, however it is prepared to debate this issue as the theoretical and empirical literature evolves," said a spokesman. Keith Rigg, the transplant surgeon and BTS president, said: "I'm happy to debate it. There are pros...
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