Authors
Vasudevan S, Department of Urology, Government Medical College, Trivandrum; Chief Editor, IMA, Kerala Medical Journal
Abstract
Background: Organ transplantation offers a new lease on life for patients with untreatable diseases. Despite its success, particularly in India, the field has been plagued by ethical dilemmas, commercialism, and exploitation, prompting legislative efforts like the Transplantation of Human Organs Act (THO Act). This editorial explores the complex ethical landscape of organ transplantation.
Discussion: The article delves into core ethical principles (autonomy, beneficence, non-maleficence, justice) and critical issues. Key concerns include challenges around consent (presumed, informed, coercion), organ procurement mechanisms (donor registries, expanding ‘near relative’ definitions), and the persistent problem of organ marketing and commodification, particularly exploiting the poor. Allocation disparities, the controversial role of financial incentives (undue inducement, commodification, crowding out altruism), and significant religious and cultural barriers to donation are also discussed. The text highlights the failure of existing regulations to curb illegal trade and increase deceased donation.
Conclusion: Addressing these ethical challenges requires multi-faceted interventions. Suggestions include promoting cadaveric donation, ensuring clear standard operating procedures for authorization, revising medical curricula, restructuring governance, and potentially re-evaluating regulated incentive models while upholding altruism. Increased public awareness through community leaders, media, and NGOs is crucial to foster an ethical and effective organ donation program.