The Transplant in UK - Essay Example

Though the shortage of organs for transplant is a global problem, the UK currently has measures in place that prohibit donor organ trade, specifically donor kidneys. Some concerns are legitimate. The World Health Organization has concerns of black market sales, transplant tourism, where the weakest and least protected in society may be vulnerable to victimization of this type of trade. However, kidneys typically come in pairs. A major obstacle is that many countries prohibit the sale of human organs for donation. There are plenty of willing donors, though tissue matching is another challenge. Often potential recipients die waiting for ‘a match.’ Currently live kidney donations are only accepted from relatives and close friends of patients. Those wishing to donate kidneys and other organs upon death must register with the NHS. The current policy is an ‘opt in’ policy where specific consent must be given prior to death, to use organs for transplant. The UK is considering an ‘opt out’ program, where it is presumed that those who die wish to donate their organs unless otherwise specified. Nations that have adopted this policy have had great success with it. With the cost of transplantation estimated at roughly £250,000, there are some unscrupulous physicians who have stolen kidneys from patients as they undergo surgical procedures for other health problems. Where demand is much greater than supply, or where cost is prohibitive for many needing transplant, theft and other abuses will occur. One of the measures that could reduce these types of incidents is to open up an international trade on donor organs. Increases in supply should bring down costs. However, when the supply increases, those who supply organs receive less compensation. There is also risk of contamination of organs that could possibly be Hepatitis B or HIV positive. There are a host transport issues as well. Donor organs must be kept on ice and used within a short time frame, to be considered optimal transplant material. “Organs such as kidneys and livers have to be taken and transplanted within 48 hours of death; typically they are transplanted within five hours” (Siddle, 2001). There are several European nations within a 2-3 hour flight of the UK, depending on the location. This type of limitation may be necessary to ensure quality and viability. The time constraint would eliminate possible trade between nations who frequently trade in other industries. For instance, with a 8-9 hour flight from the east coast of the U.S. to London, this would not be viable. In terms of suppliers and transporters, increases in donor organs could translate into increased need for transport services, creating more jobs. It would also require more nurses and support staff to accommodate increases in transplant procedures. This is certain to stimulate growth in the health care industry. However, insurance companies are still hesitant to pay for such procedures. This limits the number of patients who can actually afford to pay the current costs for transplantation. However, if supply increases, cost to the patient should be reduced, given that there are fewer possible recipients vying for the same kidney. The removal of the legal bar to the trade in human organs would allow such trade to be regulated, though the legal aspect of organ donation is highly regulated in many countries. This would remove the financial incentives for the worst abuses and also permit people in the developing countries the choice of selling an organ for a price that could, for them, be life changing “ (The University of Oxford, 2006). However, those who are compensated the least are typically the most vulnerable physically and financially. There is little incentive to prevent other developed nations from taking advantage of this. In many developing nations, its citizens can quickly become victims of political and leadership unrest. The more advantages they are given, they more they are robbed or stripped of their wealth, often by forcible means. In countries like the UK, where physician salaries are paid by the government, there is little monetary incentive to perform more procedures. Those who are skilled at such procedures may be forced to work longer hours, greatly increasing the risk of medical error or malpractice. This then increases costs of health care for facilities, the government and its suppliers. Those who manufacture and supply medical monitoring and surgical care devices will then be prompted to include additional error prevention features, to prevent physician error. It is not just the patient that pays the cost of malpractice. Everyone involved in health care is affected in one way or another. Technology has made it possible for donors and possible recipients to submit DNA information into a databank or database. On one hand, this might make finding a kidney from sources outside the UK a bit less daunting, and therefore less costly to NHS. Issues in trade with other nations become problematic when those with universal health coverage, like the UK, trade with those who do not have universal coverage. Nations without such policy may believe the foreign government is unrealistic about the price of donor organs. Nations with universal coverage may set limits on the amount of compensation to nations without. This could leave those nations with the view that they are being cheated because of policy unlike theirs. They may become more unwilling to participate in organ donor trade. Society often becomes more fearful and hesitant to take action, when negative stories surrounding a specific industry abound. If too many abuses or violations of trade agreements flood the news headlines, they will likely react as they have during the downturn of the stock markets. They will play it safe or withdraw from involvement. Removing trade restrictions may cause a more negative reaction among potential donors and therefore, less supply for donor organs, such as kidneys. There are increased costs associated with monitoring of donor organ trade. Additional law enforcement is required of all countries involved. Such costs may translate into increases in shipping or transport costs. It also may involve increases in government taxes or health care costs. Many developed ‘westernized’ nations have been unable to successfully rein in health care administration costs thus far. Taxpayers may be sympathetic, but given the current global economic conditions, they would be less willing to pay more taxes to fund kidney and other organ transplantation costs. Organ donation, like other enterprises, may indeed provide a means for some families to escape poverty. But in developing nations where lack of sanitation, clean water and other needs vital to proper health are abundant, the risk of donation poses serious threats to individual donors and their families. “In a survey of Indian people who had sold a kidney, it was found that their average family income declined by one third after the operation and the number of participants living below the poverty line actually increased” (True Vision 2007). Infection and other complications of surgery are greater in developing nations. It may sound good to say that paying for a donated kidney to help someone out of poverty is the ideal situation. It can actually incur increased cost not only for the donor, but to the transplant recipient as well. Accepting a kidney from an individual in a developing nation comes with its own risks. Infection, virus and a host of other diseases may be present in the blood and in the organ tissue of the donor kidney. Ultimately, the recipient will spend more fighting off additional infections. This makes kidney transplantation less cost-effective than it currently is, should regulations change to allow international trade in donor organs. Business decisions are often based on costs versus benefit. In terms of human life, it becomes more difficult to place a value. A cost-benefit analysis though, may show that global trade in donor kidneys does not prove more beneficial to human life. “Even were all the technical problems to be solved, there to be an unlimited supply of parts, it has been estimated by Richard Nicholson, editor of the Bulletin of Medical Ethics, that life expectancy would be extended by 0.003% (less than a day in a lifetime)” (Scheper-Hughes, 2001). International trade in donor Kidneys may not provide as much benefit as we would like to believe. Less than a day is an extremely small and insignificant amount of time, even for those who are extremely ill. Most people, if they were informed that being put on life support would only extend their lives by this small increment, would likely choose to forego the medical assistance. People now choose to forego life support with much more time that a portion of a day. Removing restrictions on donor kidneys seems like a great idea. It appears to solve many current problems surrounding the shortage of donor organs and crimes linked to organ procurement. However, it is unlikely to bring down costs. It also may not produce the desired effect of increasing supply. Additional challenges include increasing costs for some donors and recipients, while posing greater health risk. There are additional costs associated with global monitoring, for many nations involved. Removing restrictions may also lead to inequities in trade. It is possible to reduce costs if costs of health care were to be addressed prior to removal of trade bans. It is also possible to perform less costly procurement and transplantation, but not very likely, given the history of the health care industry. References Scheper-Hughes, N. (2001). The Organ of Last Resort. The Courier. Retrieved 26 March 2009 from http://www.unesco.org/courier/2001_07/uk/doss34.htm. Siddle, J. (2001). Global Demand Fuels Human Organ Trade. BBC News. Retrieved 26 March 2009 from http://news.bbc.co.uk/2/hi/asia-pacific/1412348-stm. True Vision. (2007). The Transplant Trade. Retrieved 26 March 2009 from http:// www.truevisiontv.com/documentary/index.htm The University of Oxford. (2006). A Market in Human Organs. Retrieved 25 March 2009 from http://weblearn.ox.ac.uk/site/conted/biosci/ethicsbiosci/eb_content/BioethicsAndTheDevelopingWorld/AMarketInHumanOrgans.html. Read More