MedBlogs

24 Apr 12
1:12 PM

'Regulating the commercial sale and purchase of organ can benefit medicine and do away with illegal sale of organs' - this was tried in Iran where the Govt tried to regulate and failed. When informed consent has monetary consideration, it is not truly an informed consent it becomes coercion. The traffic of flow of organs was always from poor to rich. In most instances, the money ran out because it was reqd to pay off a debt etc. and once their little pot of gold disappeared - depression would set in and with this a feeling of lost health. Loss of health meant loss of work and loss of daily wages. When money is the driving force instead of altruism in organ donation, it always causes problems with health and quality of life issues. The complexity of these issues can only surface if you experience these different models in healthcare and have worked in this field for many years. While there are no perfect models and vitamin M is a grt motivator to make you do things which are not necessarily right but it comes with its own chain reaction and in the end there is greater price to pay for the small price that u get. So in life keep it 'simple silly' as some would say... thnxs anyway for your significant contribution on this topic, more so if you happen to be a non-medico.

24 Apr 12
11:05 AM

Hi, Thank you for your comments and information. I really appreciate it. Here is what I wish to say about them: Firstly, I understand that donating organs for money is illegal and punishable in India. I endevoured to discuss the reason behind it - that is: the fear of Commercialization. Hence, I paint a picture where regulating the commercial sale and purchase of organ can benefit medicine and do away with illegal sale of organs. Its a policy issue and needs some thought and pondering. I also understand that proposing this might be too long a stride to take given the present medio- legal policies in India. Secondly, with respect to allowing the 'next of kin' - I look at the meaning of the word 'kin' and further analyse if giving possession of the body (that is considering it property) - should imply dealing with the organs and further more donating them without the will of the owner (who is dead). That is where I draw the debate of personal autonomy and relational autonomy. Thirdly, I understand that India follows the model of 'Informed Consent' which demands fulfillment of three things a) Information is given b) The capacity to understand the information and c) Information understood and decision delivered. I question the model on two pretexts - 1) Where the person is dead and the next of kin has to take an informed decision - will it be categorized as 'informed consent' or 'proxy consent' or 'presumed consent' or 'consent in the best interest of the patient'. The fact that it can be all of this or none raises issues to the form of consent we follow. And finally, I completely agree with your thoughts on Organ Donation in your last point. Very well said, especially, the thought that '...we come into existence with a big bang and will end with another...'Thanks again. Best -Rimali

24 Apr 12
10:29 AM

Your post has some interesting points but also has some misinformation. Maybe some clarification would help to keep you better informed -a. Donating organs for money is illegal and punishable offense in India. Fines can be as much as one crore besides getting a jail sentence.b. Possession of body after death is with the next to kin and their decision to donate is valid in India and other part of the world.c. The person who donates can also carry a donor card expressing their desire to donate after death - even so consent from next to kin is required.d. In India we followed informed consent so at least a consent is taken . In some countries that follow presumed consent - the state presumes that you are an organ donor unless otherwise expressed. e. In India we do about 3000 kidney transplant from living and 300 from cadavers. We do close to 1000 liver transplants of which about 100-150 are from cadavers. f. The need for kidneys are over 150,000 but only 5000 maybe able to afford it as transplants are expensive As they say - ' don't take your organs to heaven for heaven knows they are needed here'Being possessive about ourselves, our body, our rights etc makes no sense to mother nature because she recycles us all the time. we are eventually made up of atoms that came into existence with the big bang and they will end perhaps with another big bang when this universe comes to an end. So recycling your organs a bit to give someone very sick a second chance in life makes perfect sense.