ETHICAL PRINCIPLES AND ORGAN DONATION

Prevention of human organ trafficking

Many reasonable fears abound about the illegal and clandestine practice of human organ trafficking. However, these fears should not be held against the scientifically and institutionally controlled legal practice of organ transplantation.  In 2014 the Committee of Ministers of the Council of Europe adopted the Convention against Trafficking in Human Organs, representing a historical milestone in the fight against the illegal organ trade. The efforts and successes of organizations like Eurotransplant will surely lead to more transparent and fair organ allocation practice.

Currently, the most hotly debated ethical questions in the organ trade are concerned with distributive justice in the face of an organ shortage. There are more people in need of an organ than donors.  How can we fairly divide available resources to accomplish distributive justice? The Eurotransplant organization has developed an efficient and transparent organ allocation system which aims to make a perfect transplant patient to donor match generated by a complex software engine. The criteria taken into consideration for matching a patient to a donor are urgency, expected outcome, national organ balance (the quantity of organs available) and waiting time.

A serious ethical issue is the organ trade. As the Council of Europe secretary Thorbjoern Jagland said, the organ trade is the “most exploitative trade on the planet”, generating over 1.1 billion euros per year. The organ trade is illegal worldwide, and some highly developed countries have considered legalizing it to prevent organ extraction without an individual’s consent. There are more negatives than positives regarding the organ trade. Organ trade legalization would mean more control over this trade area, but arguments against it are often stronger. Poor, vulnerable and uneducated people who often live in deprived and marginalized territories would be more likely to undertake organ donation out of desperation, even if this donation is medically ill-advised. On the other hand, wealthy people would have easier access to the needed organ and the donator’s safety could become ques­tionable.