Tuesday, October 28, 2008

Human Organ Trade - a necessary evil?

Another round of public venting of views is going round the press circles.

Inside information is that the HOTA (Human Organ Transplantation Act) [see here also for more readings on HOTA] is being further tweaked. I'm not sure what the amendments are going to look like, but it seems like the legal eagles in the Ministry of Health are going through the process of preparing a draft amendment. This despite Salma Khalik reporting in Oct 6 Straits Times that "Health Minister Khaw Boon Wan said that there was no possibility of legalizing organ trading any time soon.".

So we'll wait and see.

It seems like the issues around which the organ trading controversy revolves are,

a] sanctity of the human body...that somehow it is degrading to trade in human spare parts.

b] the problem of exploitation.

Quite frankly, I am personally not so convinced about [a]. The biologist in me says it's just a lump of flesh. If someone wants to sell his kilogram of flesh...what's the big deal? The human body (the whole and parts of...) has been bartered and traded since the beginning history. We've had slavery (of various degrees), prostitution, menial labourers (no minimum wages), paid volunteers for human experimentation (sanctioned as ethical by institutional review boards), etc. Hospitals and research centres hoard spare parts for their research efforts which bring fame and fortune (and patents) to the researchers and institutions....this seems to be pretty acceptable! All in the name of altruism and science!

It is true that the christian in me balks a little since our bodies are supposed to be the 'temple of the Holy Spirit'. But I think this idea has been over represented. No where in the Bible does it say that our physical bodies are worth very much. In fact the Bible tends to be rather deprecative about our physical bodies.

"In the sweat of thy face shalt thou eat bread, till thou return unto the ground; for out of it wast thou taken: for dust thou art, and unto dust shalt thou return." Genesis 3:19

Issue [b] is a much weightier problem. How can one allow trading....in such a way as to prevent exploitation. I am not sure it can ever be done in a perfect way. Exploitation occurs in all forms of trading. One buys, and another sells...Is there ever a fair deal where both parties truly 'wins'. Trading is always a matching pair of trade-offs. Some one is always 'exploited' in some way. Who will ever voluntarily sell his/her organ? Obviously the poor. Who will engage in high risk work, if not for the lure of money? Who will prostitute her body, unless she so desperately needs the money? We've accepted all these unfair trades in our society without a blink, haven't we?

This I guess is the ultimate challenge in dealing with the organ trading issue. I can't see any way to prevent it from happening. If a wealthy s.o.b. wants to purchase an organ to save his own wretched life, he will do it some way or other...if not in Singapore, then it will be elsewhere. Much as it may sound unpalatable to some, it may be the lesser of two evils to legalize it, and manage it rationally so that we can ensure, a reasonably fair deal for the seller....and ensure the buyer takes on his/her legal and moral responsibilities for the transaction.

A necessary evil, for an imperfect world. sigh...

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