Thursday, January 31, 2008

The Organ Trade Debate on IBNLive

In light of the ongoing illegal kidney trade scandal, CNN-IBNLive had a debate on the question of organ trade. Some interesting points were made by the anchor in support of legalizing it including the right to life of the recipient. Several of the panelists held a contrary view.

Reading the transcript, I was intrigued by some of the Q&As between the anchor Sagarika Ghose and Colin Gonsalves. Here are some excerpts:

“Ghose: But what about surrogate mothers? They usually rent out wombs for money.

Gonsalves: That is not donation of an organ. In the case of surrogate mothers, the organ is taken out and transplanted in someone else's body. The hospitals are registered both for removal and transplantation simultaneously. On the contrary, there is seven years of imprisonment for sale of organs in this country.

…Why couldn’t a person dying of kidney failure go to the open market and purchase it?

To which Gonsalves replied saying that if someone needs an organ and his friends and family are not willing to step forward then it is too bad for him.

Ghose: But don’t people buy blood?

Gonsalves: Blood donation is not like taking a part of your body away. It does not affect you that severely.”

There are two questions here. (1) Does an egg, sperm or blood constitute an organ? The definition under the Transplantation of Human Organs Act, 1994 states: “"human organ" means any part of a human body consisting of a structured arrangement of tissues which, if wholly re- moved, cannot be replicated by the body”. Egg, sperm and blood could not be termed ‘structured arrangement of tissues’, so he is right that they would not constitute organs. However, with regard to blood, its status has nothing to do with severity.

(2) Does the time gap between removal from the donor and transplantation affect the legality of the procedure? The relevant provision is cited below:

"Punishment for commercial dealings in human organs: Whoever (a) makes or receives any payment for the supply of, or for an offer to supply, any human organ; (b) seeks to find a person willing to supply for payment any human organ; (c) offers to supply any human organ for payment; (d) initiates or negotiates any arrangement involving the making of any payment for the supply of, or for an offer to supply, any human organ:, (e) takes part in the management or control of a body of persons, whether a society, firm or company, whose activities consist of or include the initiation or negotiation of any arrangement referred to in clause (d); or (f) Publishes or distributes or causes to be published or distributed any advertisement,-- (a) inviting persons to supply for payment of any human organ; (b) offering to supply any human organ for payment; or (c) indicating that the advertiser is willing to initiate or negotiate any arrangement referred to in clause (d), shall be punishable..."

Though he is right that organs are not stored except for very short periods owing to technical reasons, there is nothing here to suggest that the sale would become legal if only the entire procedure were to be executed in one go.

The moral arguments against it were that the thought of people selling their organs is quite repugnant and if allowed to do so, only the poor would be selling their organs for money. The first is a matter of sentiment (imagine donors hawking their kidneys on eBay!) but the second is debatable. Are those selling them for money going to suffer more than those donating it currently for altruistic motives? If not, how is the ban going to help the poor? Ghose did not however ask these questions.

Today’s HT has an op-ed by Lalita Panicker on the same issue. She notes a number of details of this sordid affair but strangely ends up berating the government for not raising healthcare spending. Huh? I am still trying to figure out what the connection is.

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