An ethics panel has called for a reopening of the debate over whether people should be allowed to sell their kidneys.
In the June 27 issue of The Lancet (1998;352:1950-1952), the International Forum for Transplant Ethics outlines the reasons it refutes common arguments against organ sales, particularly as applicable to the sale of kidneys by live donors. The group, which includes physicians from the United States, Canada, England, and Oman, says that the trade should be regulated rather than banned.
They reject the notion that legal kidney sales promote exploitation of the poor and cite the low medical risk that accompanies removing a kidney. "If the rich are free to engage in dangerous sports for pleasure, or dangerous jobs for high pay, it is difficult to see why the poor who take the lesser risk of kidney selling for greater rewards--perhaps saving relatives' lives, or extricating themselves from poverty and debt--should be thought so misguided as to need saving from themselves," they write.
In addition, the authors argue that "there is much more scope for exploitation and abuse when a supply of desperately wanted goods is made illegal." They suggest that perhaps a central purchasing system could be developed to oversee the selling of kidneys and to provide counseling, screening, and other related services.
"It is entirely feasible to have laws and professional practices that allow the giving or selling only of non-vital organs," the authors state.
The group also questions the assertion that organ donation must be altruistic to be acceptable. They ask why, for instance, if it is acceptable for a father to give a kidney to his daughter, it would be less acceptable for him to sell his kidney to be able to pay for another operation that could save his daughter's life.
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The Lancet article (requires registration):
http://www.thelancet.com/newlancet/reg/issues/vol351no9120/ethics1950.html
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