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Fortean Times Message Board :: View topic - Call to allow body organ selling
Quote: :
Call to allow body organ selling
Two US doctors have suggested the sale of organs such as kidneys should be legalised to meet the rising demand.
They said bids to increase the donor pool were failing, and a black market in organ sales was booming.
Writing in Kidney International the pair said, while it remained a taboo, legalisation should be considered.
But experts in the UK - where selling organs is illegal - said such a move was unnecessary and would exploit the poorest sections of society.
It is a tragedy that the critical shortage of organs donated for transplant means this question arises at all
UK Transplant spokesman
About 400 people a year die in the UK because they are left waiting for a donor, despite the fact that 13m people are signed up to the register.
UK Transplant, the NHS body responsible for the register, said in many cases organs were prevented from being donated because the families were unaware of the donor's intentions.
A spokesman said efforts were being made in the UK to encourage people to join the register and talk about it with their families.
And while refusing to take a position on selling organs, he said: "It is a tragedy that the critical shortage of organs donated for transplant means this question arises at all."
Eli Friedman, a kidney specialist, at the State University of New York, and Amy Friedman, a transplant specialist, of Yale University, said the case for legalising kidney purchases hinged on the fact that individuals were entitled to control their own body parts.
'Exploitative'
They said: "Strategies to expand the donor pool - public relations campaigns - have been mainly unsuccessful.
"Although illegal in most nations, and viewed as unethical by professional medical organisations, the voluntary sale of purchased donor kidneys now accounts for thousands of black market transplants."
The doctors suggested a figure of about £23,000 for a kidney, with an agency being set up to regulate the market.
But Dr Michael Wilks, chairman of the British Medical Association's ethics committee, said there was universal opinion against selling organs.
"It is exploitative, particularly for the third world, if you had an unfettered global market, and what is more it is not necessary.
"If we had more investment in transplantation services and intensive care and changed the law so we had presumed consent we could meet need."
Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/1/hi/health/4719374.stm
Published: 2006/02/16 11:59:48 GMT
© BBC MMVI
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Quote: : Tsunami victims 'selling kidneys'
BY TN Gopalan
BBC News, Madras
Many fishermen say they cannot make ends meet
The government in the Indian state of Tamil Nadu has launched an inquiry into reports of the sale of kidneys by the families of poor fishermen.
Local newspapers say that a number of fishermen's wives in the state have been forced to sell their kidneys because of financial pressures.
Those selling their kidneys are believed to have been displaced by the tsunami of December 2004.
Kidney sales are prohibited in India, but donations by relatives are allowed.
Deep distress
While analysts say that the rehabilitation of tsunami survivors has generally been satisfactory in Tamil Nadu, for some the pace has been relatively slow.
Displaced fishermen have been put up in temporary camps which in places are some distance from the sea.
Much of Tamil Nadu's fishing fleet was destroyed in the tsunami
That adds to their transportation costs and means they have less time in their vessels.
The construction of permanent houses closer to the coast line is way behind the schedule earlier announced by the government.
In some families, where the men folk have suffered permanent injuries from the tsunami, women are forced to bear the brunt of running the household.
Many of these families say they are now in deep distress.
Now the women in these families are resorting to selling their kidneys.
A few have already done so, and others say they intend to follow suit.
Fishermen's families living in a temporary camp near Madras told the BBC they had no other way of offsetting a financial crisis.
Lured
Aid groups working in the area say at least 50 people may have sold away their kidneys so far, and many more are waiting in the queue.
The District Magistrate in Madras, R Jaya, told the BBC's Tamil service that the trend was disturbing, particularly when the government had gone all out to provide relief to all tsunami survivors.
She said the government was collecting the details of all such illegal kidney sales.
She said new initiatives targeting tsunami-stricken families were now on the cards.
Kidney sales by poor people have been reported in the past, but this is the first time that tsunami survivors are reported to have been lured into the trade.
A human kidney can fetch a price of 100,000 Indian rupees (around $2,200), but sellers get only 50% of that money - intermediaries are believed to walk away with the rest.
Although doctors say some people can lead a relatively normal life with just a single kidney, it is an area fraught with medical complications.
http://news.bbc.co.uk/2/hi/south_asia/6266641.stm
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Quote: : Friday, 2 February 2007
Pay Organ Donors, Stop Dangerous Organ Trade
Topic: Organ Donation
Maybe organ donors should get paid?
Not by shady brokers who abandon donors without medical care, but by governments or health insurance organizations.
Payment could come in the form of free healthcare for life (after all, organ donation creates a patient that could have chronic medical problems), or possibly cash.
These are some suggestions from Jim Warren, a journalist who covers the world of organ transplantation closer than probably anyone.
He puts out a weekly and monthly version of his newsletter Transplant News.
He's heard all of the arguments for and against payment for organ donation, and comes out believing that we have to at least test a payment system.
Because, obviously, just telling people they can't do it isn't working, as evidenced by the situation in India.
Warren related an anecdote to me from an Indian surgeon to put the issue in perspective.
The surgeon was at a conference in the United States, and had been badgered repeatedly by American transplant surgeons on the point that payment for organs in India just had to be stopped.
Finally, the Indian surgeon had his say.
He said he understood what the American surgeons were saying, but that they had to understand that getting paid $5,000 (or similar amount) for an organ for poor Indian person meant they could educate their entire family and live off of that money for the rest of their lives.
There's just too much incentive.
What do you think?
Should organ donors get paid?
If not, how do we stop the shady brokerage of organs?
Posted by Kristen Philipkoski 12:29 PM
http://blog.wired.com/biotech/2007/02/pay_organ_donor.html
More comments at link above.
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Quote: : Indians Buy Organs With Impunity
By Scott Carney
08:00 AM Feb, 08, 2007
CHENNAI, India -- Police raids here last month that led to the arrests of at least three alleged dealers in human kidneys have thrown a spotlight on lapses by local medical regulators and recharged the global debate over legalized organ sales.
More than 500 people across the state of Tamil Nadu say they've sold their kidneys to organ brokers, in violation of a ban enacted in 1994.
Since then, however, the agency responsible for enforcing the ban has frequently turned a blind eye.
"We do everything in accordance with the letter of the law on paper, but we know that almost all of the documents we see are false," said a member of Tamil Nadu's Transplant Authorization Committee, who spoke to Wired News on condition of anonymity.
"It is an open secret.
It is either, approve a transplant with forged documents, or a patient is going to die."
Humanitarian arguments excusing black-market organ sales may seem a stretch given the stark danger of exploitation that led to the ban in the first place.
Given the failure of India's official system, however, some medical policy experts say some form of legalization may be the best solution.
Under India's 1994 legislation, a state-appointed ethics committee must approve all transplants.
The committee must interview all prospective donors before approving each transplant.
On average the committee hears 20 requests a week and approves 15.
The anonymous committee member said brokers routinely produce forged documents so that the transaction takes on the appearance of legality.
"The major issue as far as India is concerned is getting rid of the brokers.
This would mean government regulation or administration of any compensation policy that would be developed," said Transplant News editor Jim Warren, who advocates compensating people at a standard rate and providing state-sponsored health insurance for life.
Such a system, however, might not work if the state is offering less than the global market, says Nancy Scheper-Hughes, a medical anthropology professor at the University of California at Berkeley and founding director of Organs Watch.
"Free health care sounds good on paper, but the problem is that when a country goes legal then it enters into competition with the international market in organ transplant tourism," says Scheper-Hughes.
"When the state offers incentives along with a lesser pay scale, but a broker from another country offers slightly more cash without the medical benefits, most people opt for the cash and you run into the same problems you had before legalization."
The Tamil Nadu agency has unofficially sanctioned the illegal organ trade for the past 13 years, the unnamed committee member said.
Without illegal organ trade, he says, patients have no hope because in India, organ donation after death is extremely rare.
Without incentive, donors are practically nonexistent.
The committee member denies that brokers bribed members of the transplant committee.
But local police believe there's more behind the Tamil Nadu organ trade than altruism.
"These brokers are not rich people," said police superintendent Chandrabasu (his only name) of the Crime Branch Central Investigation Department in Chennai.
"Out of the (several thousand dollars) they took as their commission from the operation, most of that went to bribes.
They would only make about ($300) per transaction in the end."
Flouting the law may have saved lives;
But, by allowing brokers to operate with impunity, the Transplant Authorization Committee has allowed poor people to fall victim to organ brokers -- the same problem that was rampant before the 1994 organ donation law.
In January, a group of poverty-stricken women living in a tsunami refugee camp 7.5 miles north of Chennai confessed at a public meeting that they sold their kidneys through brokers.
"When I went to the ethics committee, there were four other women sitting next to me who had also been arranged by the broker," said one of the refugees, known as Rani (her only name), in an interview with Wired News.
She said she received only about $900 of the $3,300 she was promised by the broker who arranged her transplant.
"We went up one at a time and all (the committee) did was ask me if I was willing to donate my kidney and to sign a paper.
It was very quick."
With no viable solution in sight, the Tamil Nadu Transplant Authorization Committee took matters into its own hands, and authorities are scrambling to respond.
The police have three brokers in custody for forgery, according to superintendent Chandrabasu.
The director of Medical Services says his division is investigating reports that 52 hospitals may have been involved in illegal transplants.
Tamil Nadu's health minister last week suggested possible ways of strengthening the government ethics committee.
He did not return phone calls requesting comment for this story.
- - -
Scott Carney is a freelance contributor to Wired News and writes for the Bodyhack blog.
www.wired.com/news/technology/medtech/0,72675-0.html?tw=wn_index_17
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Quote: : Why a Kidney (Street Value: $3,000) Sells for $85,000
Scott Carney 05.08.07 | 2:00 AM
The overcrowded municipal slums in Aynavaram, India, on the north side of Chennai form one of the nicer kidneyvakkams in the city.
View Slideshow
CHENNAI, India -- Aadil Hospital in Lahore, Pakistan is one of the top medical facilities in the region, rated on par with any hospital in the West, according to the International Organization for Standardization.
Kidney-transplant candidates stuck on a 10-year waiting list in the United States might happily pay a consultant $35,000 or more to book an operation here.
Or, they could arrange it themselves for less than half that price.
These days, Aadil openly advertises two packages for transplant patients at steep discounts to the brokered rate: $14,000 for the first transplant, $16,000 for people who need a second organ after the first has failed.
Surgeons, Slums and Money: Organ Trafficking in India
Black-Market Scandal Shakes India's Ban on Organ Sales
Inside 'Kidneyville': Rani's Story
Why a Kidney (Street Value: $3,000) Sells for $85,000
The Case for Mandatory Organ Donation
Portrait: A Land Ravaged by Tsunami and Kidney Brokers
Infographic: Where in the World Can I Buy a Heart?
"You do not have to worry about the donor.
We shall provide a live donor arranged through a humanitarian organization, which has hundreds," said Abdul Waheed Sheikh, CEO of Aadil Hospital in an e-mail interview with Wired News.
Scarcity has long been a key driver of the global kidney market, but in regions like India, Brazil, Pakistan and China, sellers are dealing with signs of a surplus.
Operations that once set back patients tens of thousands of dollars on the black market can now be had for a fraction of the cost in some places.
The price of a kidney transplant at one of the best hospitals in the Philippines, where organ sales are legal, was recently just $6,316, according to a 2005 report by the Philippine Information Agency.
That compares to prices as high as $85,000 charged by professional organ hunters who place Western patients with donors from the slums of Manila.
Yet, legalization has seemingly not worked to alleviate the supply shortage for the patient.
Legal confusion, fear and an information gap have created a classic arbitrage scenario for connected vendors, and the vast profits available to the middlemen have entrenched market inequities and dented reform efforts, experts say.
Falling prices have hit the lowest end of the chain hardest.
In South Asia, sellers work through organ brokers who on average pay only a few thousand dollars for a healthy kidney, assuming they pay at all.
And that's despite booming demand.
The World Health Organization in 2002 pegged the global number of people suffering from diabetes at 171 million.
By 2030 the number will climb to more than 366 million.
"Each country and each region therein has completely different situations than the next one," explained a Los Angeles-based organ finder doing business online at the website liver4you.org, who asked to be identified only as Mitch.
"Since most overseas transplants are doctor-controlled, like (from) private medical practice in the United States, there is a wide range in prices ...
The donors are in such huge supply where it's legal, like the Philippines, so they have to accept the average of $3,000 (for selling their kidneys)."
Savings are rarely passed on to the buyer.
Once the organs move from the streets into the medical supply chain, their value inflates quickly.
Mitch said he typically charges between $35,000 and $85,000 for kidney transplants.
Depending on where those operations take place, Mitch could clear $25,000 or more per transaction.
"When Iran legalized live donations, they bought the argument that the short supply of kidneys was really only a marketing problem," said Nancy Scheper-Hughes whose nonprofit Organs Watch monitors organ trade around the world.
"But by making the government responsible for managing the black-market kidney trade, the so-called transplant coordinators were turned into brokers and kidney hunters -- or more accurately into thugs who troll the streets and homeless shelters for people to donate on the cheap."
In Chennai, K.
Karppiah is widely considered one of the most active players in the kidney trade, having been fingered by dozens of organ donors from the slums north of the city.
He declined requests to be interviewed for this story.
When a reporter visited his house, a man outside was laying asphalt.
"Everyone knows Karppiah," he said.
"On this street, all the houses are his."
- - -
Scott Carney is an investigative journalist based in Chennai, India.
www.wired.com/medtech/health/news/2007/05/india_transplants_prices
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Sadly things are as bad as ever.
Quote: : Desperation behind Pakistan's kidney trade
By Ayesha Akram
BBC News, Lahore
Muhammad Amjad, 34, takes out his rosary during a five-minute-break between shuttling customers around Lahore in his auto rickshaw.
These noisy machines, which can be heard from afar revving their four stroke engines like buzzing locusts, are usually decorated with brightly coloured motifs or poetic verses.
But the back of Amjad's rickshaw, which he has been driving for almost a decade, is completely covered by a white cloth banner with an advertisement sprawled across it in black and red painted letters.
The advertisement has been put there by Amjad who is eager to sell his kidney (blood group A+) to the highest bidder.
'Helpless'
"I don't have any other options," he says.
"My family can't help me.
The government doesn't help me.
What can I do?"
Amjad is one of many poverty-stricken Pakistanis driven to desperation by the recent escalation in the prices of food and oil, caused by the global food crisis and the coalition government's inability to provide sufficient state-subsidies.
It's just not possible to live on this amount
Muhammad Amjad
Almost one-third of the Pakistani population - about 40 million people - lives below the poverty line, according to the World Bank.
Amjad's greatest problem is the loan of $4,200 he took out two years ago to take care of hospital expenses during his mother's illness.
Almost daily, Amjad's creditor knocks on his door and screams at him.
"He (my creditor) insults me all the time," he says.
"I am tired of feeling helpless."
Desperate times are prompting many Pakistanis to adopt dangerous measures.
In three villages near Gujranwala, located about 75km (47 miles) from Lahore, one member from each of the 300 families living there has sold a kidney.
Atta Chohan, a resident of the area, says the stories of many kidney sellers are similar to Amjad's tale of woe.
Breaking point
"Often the kidney seller is a brick kiln worker who has taken a loan from a landlord and is unable to pay it off," he says.
"Sometimes men sell their kidneys to pay for the weddings of their daughters or hospital bills."
Besides Gujranwala, the kidney trade is also flourishing in southern Punjab especially in cities like Sargodha.
Here, more than half of the people living there have sold a kidney.
The reasons for the flourishing kidney trade are simple - the poor are reaching their breaking point according to economist Dr Qais Aslam.
"There are both short-term and long-term affects of the grinding poverty," he says.
"In the short term, criminalisation is increasing, people are selling their children and in some cases parts of themselves.
The tragedy of Pakistan is that a majority of the population is being forced to scavenge themselves."
Suicide
Amjad, who spends a good 10 to 12 hours a day ferrying customers around Lahore, says that despite the long hours he pulls at work he can only afford one meal a day for his family.
On good days, he makes about 1,000 rupees (about $14) to 1,200 rupees (about $16), out of which 200 rupees (approximately $3) is spent on petrol and another 200 rupees is paid to the owner of the rickshaw from whom he leases the vehicle.
"It's just not possible to live on this amount," he says, beads of sweat glistening on his forehead and worry etched on his face.
Abdul Sattar Edhi, popularly referred to as the Mother Teresa of Pakistan, says that stories like those of Amjad are proof that Pakistan is at the worst stage in its history.
"I fear that we will soon come to a stage where the poor will start dying of hunger," he says.
"I have never seen such depressing conditions in Pakistan before."
But Amjad still considers himself to be fortunate.
His friend recently committed suicide after he was unable to raise finances for his daughter's wedding and his mother's illness.
Many of Amjad's neighbours have started mobile-snatching or indulging in other petty crimes, he says.
"At least I'm earning my living honestly," he says.
Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/south_asia/7613235.stm
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I think this best fits here.
Quote: : Organ Trafficking Discussed By Transplant Experts At ASN Renal Week 2008
10 Nov 2008
With the number of patients in need of organ transplants on the rise, an increasing number of patients are turning to unconventional sources for organs.
Individuals are willing to donate their kidneys for financial incentive, particularly in developing countries where the poverty rate is high, resulting in numerous reports of human trafficking as a source of organs.
This troubling issue was the topic of a session during the American Society of Nephrology's 41st Annual Meeting and Scientific Exposition in Philadelphia, Pennsylvania.
In April 2008, The Transplantation Society and International Society of Nephrology convened an international summit of more than 150 representatives of scientific and medical bodies from around the world to address unethical practices related to transplantation.
Practices include organ trafficking (the illicit sale of human organs), transplant commercialism (when an organ is treated as a commodity), and transplant tourism (when organs given to patients from outside a country undermine the country's ability to provide organs for its own population).
The Declaration of Istanbul was born from this meeting and sets forth recommendations to help eliminate organ trafficking.
The Declaration advises countries to implement programs to prevent organ failure and provide organs to meet the transplant needs of its residents from donors within their own populations.
Maximizing deceased organ donation is also recommended.
ASN published The Declaration of Istanbul in the September 2008 print issue of the Clinical Journal of the American Society of Nephrology (CJASN).
During the Renal Week session on this topic, members of The Declaration of Istanbul Steering Committee presented the background, rationale and recommendations from the summit.
National and international leaders in the field will discuss the implications of the Declaration.
"We are concerned about this issue and feel it's important for Renal Week attendees to understand the severity of organ trafficking and the implications of the Declaration of Istanbul," says William E.
Harmon, MD, of Children's Hospital in Boston, MA, and a co-moderator of the session.
Article adapted by Medical News Today from original press release.
The session, entitled "No to Organ Trafficking and Tourism: An In-Depth Discussion Regarding the Declaration of Istanbul," was presented as a Basic and Clinical Science Symposium on Saturday, November 8, 2008.
ASN understands the importance of this issue and is publishing an article in the November 2008 issue of the CJASN, which finds that people traveling to other countries to receive kidney transplants experience more severe post-transplant complications and a higher incidence of acute rejection and severe infections.
The article, by Jagbir Gill, MD, of the David Geffen School of Medicine at the University of California, Los Angeles (UCLA) in Los Angeles, CA, and his colleagues, entitled "Transplant Tourism in the United States: A Single Center Experience," is currently available online at http://cjasn.asnjournals.org/, and in the November 2008 print issue of CJASN.
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