Dr. Jameela George, MB BS: Black Market Organ Transplantation & Medical Tourism

Dr. George is a Christian bioethicist in India speaking today on medical tourism, those who are in pursuit of cost efffective, faster or better private medical care. In India there is medical tourism in many areas including cardiology, joint replacement, organ transplants, etc.Reasons for medical tourism include availability and low cost of services.With the cost of a heart valve replacement costing $10,000 as opposed to the $200,000 in the US. The following are some highlights from her presentation:

Surrogacy tourism - Wombs for Rent
Often contracted through hospitals in India.Surrogates live in dormatories or "baby farms."
Ethics issues: Exploitation, concept of family, comodification of physiological process.
Surrogates are paid $5000 - $7000, a relatively low cost.

Kidney Tourism
Donors enticed to go abroad for removal and subsequent tranplantation of their kidneys.
The first human kidney transplant - Boston 1954
Transplantation of the liver followed in 1963 and heart in 1967
The kidney is the most wanted organ for transplantation

Worldwide about 1.2 million suffer from kidney failure. In Israel the average wait is 4 years. Worldwide 50k transplants are performed annually.About 285k people are on dialysis in the US.

Laws about Organ Transplantation
Brazil - illegal to sell organs (1997)
1998 law -all Brazilian adults are organ donors at death

Iran
Kidney sales are legal and regulated

India
Transplantation of Human Organs Act of 1994
Altruistic donation of organs from close family members
Donation b y those who are emotionally attached to the recipients
The Act permits transplantation of various cadaver organs including kidneys

Countries practicing Black market organ trans
India, China, Russia, Turkey, Moldova, Romania...

Partners in Black Market Organ Transplant Business in India

• Surgeons and medical teams
• managers of hospitals
• organ brokers
• jobless people
• tourism industry

Kidney donors can earn up to $2500
Recipients pay as much as $25k in India

Measures to decrease organ gap

• Prevention of renal failure
  
• Increase of domestic supply

Controversial solutions

• Routine recovery from cadavers-implied consent
• legalising sale of organs
• legalizing rewarded gifting of unrelated donors
• upgrading facilities to harvest and transport organs from resource poor settings

Ethical Issues in BMOT

• Lack of respect for person
• Coercion
• Exploitation
• Social Justice
• Violation of Human Dignity