http://ijme.in/index.php/ijme/article/view/2391
Unrelated renal transplantation: an ethical enigma
Gaurav Aggarwal, Samiran Adhikary
Abstract
End-stage renal disease (ESRD) is a condition better discussed than suffered. People suffering from ESRD are at a disadvantage not only financially, but also emotionally and in terms of the quality of their lives.
The majority of their productive time is spent in hospital, on dialysis machines, or in the search for a suitable kidney donor, so that they may be able to improve upon the quality of their remaining lifespan. Only a “lucky few” are able to find a suitable matching donor, be it living (related) or a cadaver, whilst the others are left to fend for themselves.
As the supply fails to cope with the demand, people go to the extent of exploring the pool of “unrelated donors”. Though not legalised yet, this is one domain yet to be explored in its entirety, both on humanitarian as well as ethical grounds.
Our current work hopes to highlight this scenario and also provides a few options that may well become “ethically acceptable” in the not-so-far future.
http://www.issuesinmedicalethics.org/index.php/ijme/article/view/2391/4963#.VzH8aj1lccE.linkedin
Ethical enigma in renal transplants the current scenario. We have tried to look at all existing issues in this short essay published online
The commentary done by D Martin in the same issue Home > Online First > Martin
http://ijme.in/index.php/ijme/article/view/2392
Trade in kidneys is ethically intolerable
Dominique E Martin
Abstract
In India, as in most countries where trade in human organs is legally prohibited, policies governing transplantation from living donors are designed to identify and exclude prospective donors who have a commercial interest in donation. The effective implementation of such policies requires resources, training and motivation on the part of health professionals responsible for organ procurement and transplantation. If professionals are unconvinced by or unfamiliar with the ethical justification of the relevant laws and policies, they may fail to perform a robust evaluation of prospective donors and transplant candidates, and to act on suspicions or evidence of illicit activities. I comment here on a recent paper by Aggarwal and Adhikary (2016), in which the authors imply that tolerance of illicit commercialism in living kidney donation programmes is not unreasonable, given the insufficiency of kidneys available for transplantation. I argue that such tolerance is unethical not only because of the harmful consequences of kidney trafficking, but because professional tolerance of commercialism undermines public trust in organ procurement programmes and impairs the development of sustainable donation and transplant systems.
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And his email to us
Thank you so much for your email. I was very pleased to have the opportunity to provide a commentary on your article. You and Dr Adhikary are to be congratulated on a thoughtful paper that brings to the fore a number of ideas that are shared by many professionals working in transplantation across the world. In doing so, I think it helps to encourage open discussion of and reflection on some important issues, in particular that of financial incentives for donation.
I am glad to know you are opposed to trade in kidneys – your leadership on this is so important not just in India but in the region. I hope to have the opportunity to visit India in the next couple of years and would be delighted to meet you and Dr Adhikary. I will certainly stay in touch and hope you will in turn share with me any of your own further work in this field.
Warm regards,
Dominique
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Dr Dominique Martin MBBS, BA(Hons), PhD
Senior Lecturer in Health Ethics and Professionalism
School of Medicine, Faculty of Health
Deakin University
Geelong Waurn Ponds Campus, Locked Bag 20000, Geelong, VIC 3220
+61 3 5247 9482
Dominique.martin@deakin.edu.au
www.deakin.edu.au/medicine
Deakin University CRICOS Provider Code 00113B
