Though this happened more than two years ago, Mr. El-Sheikh's story is still much too common and the problems of transplant tourism continues to prevail. Between 2004 and 2006, more than 300 tourism transplants occurred among American patients, yet there has still not been a complete consensus regarding possible solutions to the problem. Recently, a 46-year old American accountant traveled to China for a liver transplant and returned with a condition much worse than what he had when he left. He needed to be hospitalized and received a replacement transplant in the United States.
This situation highlights one of the biggest problems of transplant tourism. Many organ transplants in 3rd world countries are from executed prisoners, are poorly matched to the donor, use unhealthy or unexperienced doctors, fail to use proper surgical techniques, and do not provide the donor with proper records or education about the procedure--all of which breed the possibility of re-infection and possibility of necessary re-transplantation.
But many doctors are incredibly skeptical when it comes to providing care for individuals who participated in transplant tourism. Is it really fair that they take away an organ from someone who waited to give it to someone who did the transplant elsewhere? This patient was treated, but many ethical concerns still remain.
It is imperative that better procedures and guidelines be put in place to prevent this problem to begin with. Though many organizations have issued statements about their position on transplant tourism, there are no international laws in place that truly regulate this practice. For example, the International Transplant Society and the American Association for the Study of Liver Diseases both have "positions against the exploitation of donors, the recovery of organs from executed prisoners, and condemned the sue of paid living donors", but there needs to be firm international guidelines and better local policies put in place to regulate transplant tourism--these statements are not enough.
With what is currently in place, doctors are forced to make difficult decisions regarding their patients that received organ transplants in unsafe environments. There needs to be an organization in place to regulate these practices and stricter guidelines need to be in place in 3rd world countries that participate in transplant tourism. But, the fact that so many people turn to this practice highlights another problem. 40% of the 300 donors participating in transplant tourism between 2004 and 2006 were from New York and California (the two most populated parts of the country). Before being forced to turn elsewhere for there transplants, they should be referred to other parts of the country for their procedure, because often less populated places have much shorter transplant lists. Furthermore, the United States needs to increase education about the dangers of transplant tourism and the benefits of organ donation. To solve the ethical dilemmas that result from transplant tourism, there needs to be better international regulation of these procedures and better alternatives available at home.
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Sources:
http://www.eturbonews.com/2373/transplant-tourist-sees-one-way-out
http://www.sciencedaily.com/releases/2010/01/100126133354.htm
http://dmmsclick.wiley.com/share.asp?m=s8gib7hywostp6rgw2mh&f=h
http://abcnews.go.com/Health/transplant-tourism-hidden-risks/story?id=9702948
2 comments:
Another issue with transplant tourism is that the people who sell their organs not likely to benefit from the transaction. Most people who offer to sell their organs do so because they are in debt. Of the 305 surveyed people who sold their kidney in India, three quarters were still in debt six years after the donation, average family income declined by one-third, 86% of them reported a decline in health, and 76% would not recommend others to sell a kidney. As such, not only are the transplant tourists putting themselves at risk of a badly performed operation, the organ sellers are also harmed by this transaction, and ultimately, the only net beneficiary is the clinics that offer the service.
Therefore, I agree with you that the solution to this is to increase the number of organs available for transplant within the US. Another possible solution is to adopt an opt-out system for organ donation, where all people who have not indicated that they do not wish to donate their organs upon death are presumed to have given consent and are placed on a list of the organ donors. Countries with an opt-out system have, on average 22.6 transplants per million as compared to 13.9 per million in countries that require expressed consent. While there are concerns about whether we can really presume that most people would choose to donate their organs upon death, as long as people are informed and opting out is not made excessively difficult, there are great potential benefits to people waiting for organs, and more lives can be saved.
Sources:
http://en.wikipedia.org/wiki/Organ_donation
http://jama.ama-assn.org/cgi/content/full/288/13/1589
http://www.reuters.com/article/idUSTRE6AH0BH20101118
I completely agree with Cece's final points and the issues that Yak raised regarding increasing the number of organs donated in the first place so as to prevent the need for anyone to seek organs from other countries, and the considerations that need to be taken regarding the foreign organ "donors" who transplant tourists seek to gain their new organs from.
In some cases, the source of these foreign organs is the forceful large-scale seizure of organs from victims and prisoners of oppressive regimes, for example in China, for the purpose of profit. By not doing its best to prevent transplant tourism, the US government is inadvertently supporting these corrupt and morally condemnable human rights violations. We ought to feel a greater responsibility to alter and control those elements which we have the power over, for example education in the US and better communication across different States. For while it would theoretically be effective to attempt to alter regulations and conditions in foreign countries, this is highly impractical and unrealistic. Instead, we can certainly promote our ideals and preserve human rights globally by better controlling our own conditions, and preventing the need for patients to seek organs from foreign sources in the first place.
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