Buying an organ

The front page news of The Straits Times of Singapore (28/06/2008) was about two Indonesian men arrested for offering their kidneys in exchange for money in a private hospital. In both cases, the man pretended to be a relative of the recipient and offered to ‘donate’ it to a loved one. When the donor returns home, an agreed sum of money is deposited into the bank account. The first man ‘donated’ his kidney in return for S$29,390. The second man was to get S$20,000 but the operation was stopped by the Ministry of Health one day before it was due. Both cases were reviewed by the ethics committee of the private hospital and were cleared to proceed. In the second case, the alleged relationship was that the donor’s aunt was married to the recipient’s niece’s brother-in-law. Were these the first 2 cases of organ trading in Singapore? I do not know. Is organ trading only limited to Singapore? Definitely not.

It can be difficult to make a decision on whether an organ donor is truly related to a recipient based on testimonies only. Precisely for this reason, in the United Kingdom as part of the workup, all living related transplantation cannot go ahead unless both donor and recipient have had a genetic test in UK to prove their relationship. This is an objective test and unlike an interview, cannot be ‘coached’. Having a genetic test to establish kinship before allowing an organ transplant operation to go ahead will certainly help to reduce the number of organ ‘donation’ for money.

The issue of organ trading has plagued the medical community for many years. Society has a responsibility to protect the weak and poor from exploitation. As doctors we too have a responsibility to protect the potential donor from exploitation. We have to be convinced ourselves that the donor is genuinely giving his organ out of love and not out of monetary consideration. If we are not convinced, we must desist from being involved. That is our job too.

The organs in our body do not normally fail for no reasons. In the case of diabetic kidney failure we know that diabetic patients who have poor glucose control will have a much higher risk of developing kidney failure. Therefore it is important that diabetic patients are taught to strive for near perfect sugar control. By having long-term tight glucose control, this will either prevent a patient from developing or delay the onset of kidney failure. Remember, prevention is better than cure.