“I have encountered this once in my career. The patient obtained an organ from Korea and came to Australia for aftercare… The treating team knew what happened but nothing was said or reported, as it wouldn’t change management – are they going to remove the organ and leave the patient to die? I don’t know what the answer is – if there is any.”
In the 1990s “transplant tourism,” a form of organ trafficking in which an individual travels to a different country and pays for an organ transplant in cash, began to increase in frequency. As the recipient crosses national borders following surgery, this form of organ trafficking is especially difficult to catch and prevent.
Countries have responded differently to organ donor shortages and the increase in organ trafficking. In Iran, it is legal to buy organs. In the U.S., states are exploring ways to increase donations: Michigan increased donations from 2 million in 2010 to 3 million in 2013 with relatively simple changes. Still other nations have made a compulsory role for physicians. We asked our global physician community about such laws: Do you think your country should adopt the law already in place in some nations, and make it mandatory for physicians to report the recipient of an organ purchased abroad if follow-up care is requested?
Over 800 doctors from 23 different countries replied to this question. 8 percent of respondents reported living in countries that already have this law. Of the remaining respondents, 85 percent want their countries to adopt this law. Alongside the poll, physicians offered commentary…
Such a law exists in Spain, and Spanish doctors commented in support of it. A cardiologist believed that legislation is necessary, and others noted the value of the Spanish law for other countries:
“The Spanish system carried out and created by the National Transplant Organization is a model worldwide.”
“We are pioneers in transplants worldwide, and our system allows [transplants] to be done rigorously [and according to a list.”
“I find it very striking that there is a portion of respondents that it opposes the creation of laws to prevent illegal trafficking of organs. Any serious country should legislate about it”
A South African surgeon provided a commonsense response in support of the majority finding:
“There was a huge South African organ trafficking scandal about 15-20 years ago. I think it is correct: every organ transplanted outside your borders is suspect. Why on earth would a wealthy British businessman have his kidney transplant in Thailand? Every overseas organ transplant should be investigated.”
The most poignant commentary, at the top of this piece, shows the complexity of facing this question in real-life. SERMO exists to offer physicians a protected place to hash out nuanced, difficult cases – and while the community may not always have the same perspective on an issue, they can offer each other a type of support and advice that others simply cannot.
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