Human organ trade - a necessary evil? Let's get it correct....

Well, it certainly looks like we have to accept the reality that human organ trading will be legalized in Singapore. Perhaps, there isn't much of an option. I don't think we can will it away, or pretend the problem doesn't exist. It may start off with the kidneys, but will quickly extend to other organs.

Minister Khaw was actually reported in August 2008 (The New Paper) as having said that, "...SINGAPORE may have an acceptable model of organ trading in the next one to three years."

This fairly mobile time frames which change from reports to reports may just reflect the uncertainty on the Minister's part. It is a rather difficult issue to deal with...and to his credit, he has been consistently trying to deal with it up front. I am not sure though, that I agree with him that, ..."...while the debate rages on, patients are dying and the poor are being exploited to part with their kidneys at a low price.....If we don't do anything about it, we will be guilty ourselves." Sometimes inaction is better than a wrong (though well intended) act.

I was thinking through this issue through the weekend, and I think if we are determined to go down this road, we will need to seriously deal with the problem of exploitation. The entire process must be stripped of any commercial potential, which to my mind provides a fertile ground for abuse.

I suggest the following be put in place, as part of the regulatory environment if organ trading is to be allowed.

a] Organ trading to be limited only to buyers and sellers who are domiciled Singaporeans. This will better limit any socio-economic disparity between different buyer-sellers, as well as exploitation of sellers from extreme regions of poverty in neighbouring countries. It is vital that the program clearly and unambiguously distances itself from any activities that are related to developing Singapore as a medical hub.

b] Run the organ-trade-transplant service as a not for profit activity. The intention here is to discourage over-servicing by transplant surgeons and profiteering.

c] Appoint a special organ-trade-transplant ethics review committee at a national level, so that the review process is fully independent of domestic institutional interests.

d] Strict adherence to price controls.

e] Above all, reasonable and appropriate reimbursements to the seller, with long term medical insurance covering organ failure.