A ética do bazar de órgãos: debate na Harvard School of Public Health

The Ethics of the Organ Bazaar The event, entitled "Markets for Kidneys? The Ethics of the Organ Bazaar," was held on February 8 in Snyder Auditorium. Speakers presented the often harsh realities of the international organ trade. Ethicists, economists, and audience members struggled to define the compelling issues and circumstances that could make selling organs palatable. The event was organized by HSPH Professor Daniel Wikler. The latest headlines showcase some of the problems with the international organ trade. In India, for example, there appears to be an illicit organ market, despite being outlawed, that includes the participation of some doctors. Some donors appear to be abducted or conned, and many of their organs are sold to people from other countries. Demand for organs vastly outpaces the supply, said Luc Noël, coordinator of the Clinical Ethics Team for the World Health Organization. The total number of annual kidney transplants, for example, estimated at 66,000 worldwide, far from meets the needs of the 1 million people suffering from end-stage renal disease, even if only one-half of them meet surgical criteria. The critical shortage of organs has led to "transplant tourism," a term that describes patients, donors, or physicians who travel to other countries to obtain organs through commercial transactions, typically from the poor and vulnerable. "We must have a global consensus of objection to commercialization of transplantation," said Francis Delmonico, a surgery professor at Massachusetts General Hospital and Harvard Medical School and director of medical affairs for the Transplantation Society. In the 1990s, the WHO drafted guiding principles on human organ transplantation that prohibited giving or receiving payments for organs. Taking it further, a 2004 World Health Assembly adopted a resolution where delegates agreed to "take measures to protect the poorest and vulnerable groups from ‘transplant tourism' and the sale or trafficking of tissues and organs." Even with global censure of a commercial organ market, the ultimate solution lies in the willingness and ability of each country to become self-sufficient in organ transplants, providing a fair system within its borders to satisfy the medical demand there, several speakers said.