The Negative Impact of Paid Organ Donation

The enormous advances that have taken place in transplantation during the past decade and the increasing demand by patients to reap the benefits of these advances have created a widening disparity between organ demand and organ supply. This situation has led to a flourishing international trade in human organs which is rapidly increasing, particularly in those areas of the world where cadaver organs are not available and where there is marked disparity in wealth among the different segments of the population such as India and the Far and Middle East. As a consequence, a new and deplorable kind of medical practice has emerged where human kidneys are bought from the poor and the destitute for transplantation into a wealthy clientele with soaring profits for brokers, private hospitals and physicians. According to Dr. CE Vas of India, the current President of the Geneva based International Commission of Health Professionals (ICHP), more than 1000 kidneys were sold in India in 1988 to wealthy recipients, of whom 56% came from wealthier countries of the Middle East, the Far East, Europe, and America. Also, since 1986, more than 400 patients from the Arabian Gulf countries received paid kidney transplants in India, Egypt, and more recently Iraq. Trading in human organs has also taken place in Europe and the Americas, albeit on a smaller scale, and recently in England, where some of the physicians involved in this practice were duly reprimanded. It is not surprising that such practices have alarmed both the medical profession and the public and have been rightly condemned by international medical societies and organizations including the International, the European, the American, and, more recently, the Middle East Societies for organ transplantation [1, 2]. In order to get around this professional and public outcry and in an attempt to make this abhorrent practice less disagreeable, a new and more attractive label was recently introduced. It is called “rewarded gifting” [3, 4], which is not only a contradiction in terms, but in our view and from our experience is only another more subtle form of trading in human organs and has the same negative impact on many of our moral, medical, and ethical values. In this paper, we shall illustrate and explain some of the negative consequences of organ sale in the light of our observations and experiences in the Middle East.