Should organ-ised trade be legalised in India?

Tue, Jan 29 08:15 AM

New Delhi: The illegal organ trade racket unearthed in Gurgaon has been found to be spread across five states. The doctors involved in the racket were catering to demands for organs even from overseas. Police investigations revealed that the doctors had received as many as 48 requests for kidneys.

But if organ transplant is legal, shouldn't organ trade also be a legalised practice? Are the archaic laws on human organ donation to be blamed for giving rise to such exploitative and widespread organ trade in the country?

That was the topic of debate on CNN-IBN show Face the Nation on Monday night where a panel of experts, including the Editor, Indian Journal of Medical Ethics, Dr George Thomas; family friend of a patient who has had a kidney transplant, B Bhattacharyya; and senior lawyer %26 executive director, Human Rights Law Network, Colin Gonsalves took part. The show was moderated by Senior Editor, Sagarika Ghose.

Organ transplants are the subject of a quietly growing global drama. There are many benefits of legalising the trade of human organs. Many lives would be saved and there are only a few health risks of donating a kidney. Regulated market would destroy the black market and mafia. Money generated could be used for charitable transplants. Many people believe that the government has no right to forbid freedom of choice.

However, the flipside of legalising the organ business is that it would cannibalise the poor and only the rich would get transplanted kidneys. This could lead to terrible social costs, crime and violence.

Kill black market and legalise organ trade?

Initiating the argument, Sagarika said if there is demand for a product and the product is banned in the market, it leads to a black market. The argument is to legalise it so that the black market and mafia operations seize.

"No where in the world there is legalisation in trade of organs or body parts. The arguments are made in favour of donations and not for buying and selling of organs," said Colin Gonsalves.

However, Sagarika quoted The Economist , "The right to life becomes meaningless when the law forbids you to buy an organ that protects your life."

Disagreeing with the argument, Gonsalves said that paying for organs is banned under the Transplantation of Human Organs act 1994.

Is that not the cause of the rise in the black market?

"If you legalise the organ trade, then can you imagine people buying and selling parts of their body because they are too poor. What a horrific situation," said Gonsalves.

But what surrogate mothers? They usually rent out wombs for money.

Colin explained the issue was different from trading in organs. "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," he said.

Towing a similar strain of thought, Dr George Thomas said, "The fact is that we certainly should not sell organs, not only because it is horrific, but also if you subscribe to a civilization, and you believe that all people are equal. You should not allow sale of a body part as the poor people sell their organs because of poverty.

He also adds that the argument that organ trade will continue in the black market, and it is a reason to legalise it, then one may land up legalising most illegal activities, such as commercial sex work and sale of dangerous drugs.

"People sell their organs because of poverty. The western countries have perhaps already gone to the extent of cadaver transplant. However, Indians have not even touched the tip of cadaver transplant. So unless, one reaches that level or strives to reach there, talking about legalizing of organ trade is not right," he said.

There should be a centralised donation bank and organ donation should be controlled. Organ donation should be a voluntary effort and should be coordinated in a better manner.

However, for someone who suffers from a kidney failure, legalising organ trade may be the answer to all problems.

Sagarika from CNN-IBN asked B Bhattacharyya if he supports buying and selling of organ trade.

Living life: A fundamental right

"I believe that living life is a fundamental right of everyone and if with one kidney one can easily lead ones life, then I don't think there should be any issue, provided there is a clear understanding between the donor and the donee," said Bhattacharyya.

He questioned the other panelists and asked, "If there is a problem like tissue matching or such medical issues and the family cannot donate, then what is the solution?"

However, Gonsalves debated that the law permits to take a kidney from family and the circle of friends. Despite this, many people prefer buying it from a poor laborer. "It is sad that your family and friends do not want to give it to you," he added.

Public Campaign?

Do we need a public campaign and greater awareness to send the message across that one should donate organs and not buy them?

Dr Thomas argued that there can be no situation where body does not accept chemo-dialysis. Throughout the west, patients are kept on dialysis, till an organ becomes available. However, we have not even tried this. "Though you have a facility for cadaver transplant, but the number of transplants are very few because a social movement to make it possible has not yet come into being. It is essential to make the idea of donation of organs nationally acceptable," said Thomas.

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.

But don't people buy blood? "Blood donation is not like taking a part of your body away. It does not effect you that severely," he explained and asked, "Can you imagine that with money power, I can go out and buy organs of poor people?"

He said not only is organ trading a morally repugnant thing to do, it is also legally wrong. "The statute in the country does not allow you to trade in organs or pay for organs."

But if the poor are getting a sizeable sum by selling a body part, why shouldn't they have the freedom to do so?

"In any civilised society for a person to be put in a position, where he or she sells a body part for money, it is because of necessities like food," he explained, "and that is the most horrific and uncivilised society you can be a part of."

What should India do to handle this situation? Like the US, should India too have a national register which keeps a record of all the accidents that happen throughout the country, so that depending on availability, organs can be provided to people?

Dr Thomas agreed with the idea of implementing a national database. He also suggested clearing organ donation-related doubts among people. "When a person is brain dead and you are taking the organs out, you are not mutilating the body in any way," he said.

However, India does not seem to have proper infrastructure to support a sturdy organ donation mechanism. If someone dies and the relatives call to donate the organs, the ambulance wouldn't arrive and proper procedures might just not be carried out.

To which Thomas said that the situation is "dicey" because the infrastructure just does not exist. "Unless you strengthen the public health system, where there are enough ventilators, where there are enough possibilities of keeping the people alive in hospitals, it will not improve," he said.

Moral Crisis?

Are Indians faced with a moral crisis?

Explaining the situation, Dr Thomas said, "It is a case double standards." He said that even though people say that they should be allowed to donate their kidneys, because there are two of them, they never really do. Everyone is aware of the risk involved, which no one is willing to take.

Final results of the question of the day:

Yes - 64 per cent

No - 36 per cent

CNN-IBN Editorial:

Rather than allow buying and selling of human organs it is important to set up a centralised organ donation bank. There is also need for a vigorous public awareness campaign on the need to donate organs and the setting up of an infrastructure for the legal availability of donor organs. Permitting organs to be paid for, however might lead to widespread crime and big social costs.

RECOMMEND THIS STORY