Payment for donated kidneys is ethically indefensible

Somehow or other I missed this very thoughtful editorial on the above subject which appeared in Lancet early in 2011, but better late than never! The editorial was stimulated by an announcement by the Minister of Health in the new Philippine government stating the ban on foreigners receiving transplants from Filipinos was to lifted and he would allow organ donors to be compensated by gratuity packages as large as US$2,300. The authors quite rightly argue that this is unacceptable for a variety of reasons and conclude that “although the three fundamental principles of bioethics – beneficence, respect for autonomy, and justice – to not support organ sales, proponents still argue that a regulated market should be established because organ trading is going to happen anyway. This would also allow arguments to be advanced that slavery and human trafficking of women, for example, would also be acceptable in a regulated market.

The authors conclude that there is no justification for retreating from the World Health Assembly’s recent affirmation that “voluntary, non remunerated donation of organs helps to ensure a vital community resource”.  Thus countries need to develop robust systems for organ donation, which does not allow for any form of payment to donors. The Istanbul Declaration of 2010 arrives at the same conclusion.