Organ Donation

Ethics: What is a kidney worth?

Ñ"Ю Every day, 17 Americans die of organ failure.

Ñ"Ю In Israel, the average wait for a kidney transplant is four years.

Ñ"Ю In response, a global gray market has bloomed.

Ethical issues

Ñ"Ю Who owns our bodies?

Ñ"Ю Should it be illegal to sell an organ if it could save someone's life?

Ñ"Ю Utilitarian point of view

Ñ"Ю What is the government's role in protecting two vulnerable groups - the poor, who are willingly exploited, and the sick, who are desperate for healing?

The story of a Brazilian guy

Ñ"Ю Hernani Gomes da Silva is 32 years old and still lives in his mother's two-room house. Rain comes in through the roof, and cockroaches and rats scuttle across the cement floor. He has three kids, a wife who loathes him, and a mistress 20 years his senior. He is unemployed with no money, no skills, and a criminal record. The future is bleak.

The story of an Israeli man

Ñ"Ю Arie Pach, a stout Israeli lawyer in failing health, sees his future flash before him.

Ñ"Ю In February 2002, Arie's doctors told him his kidneys were beginning to falter.

Ñ"Ю By early 2003, he has had minor surgery to prepare for dialysis

Contradiction

Ñ"Ю The expense of dialysis to the healthcare system - about $45,000 to $50,000 per year.

Ñ"Ю Only some 10 percent of dialysis patients live more than 10 years, according to the US National Center for Health Statistics.

Ñ"Ю Arie has too many things left to do in life. He loves to travel abroad with his wife. One of his two sons will marry this summer. To see any grandchildren, he's got to stick around. But the doctors warn him that his blood could soon start to become toxic. They give him two choices: dialysis or a kidney transplant.

Meeting

Ñ"Ю Arie starts surfing the Web, looking at clinics in the United States that do transplant surgery.

Ñ"Ю A friend suggests a medical-advice hotline run by an aide to an influential rabbi.

Ñ"Ю Soon, Arie put in touch with a broker who tells him a transplant, done in South Africa, will cost $100,000, with 10 percent paid up front.

Ñ"Ю Aug./Sept., 2002 - Hernani Gomes da Silva first connects with the kidney-donor syndicate in Recife, Brazil.

Ñ"Ю October, 2002 - Hernani flies to Durban, South Africa

Ñ"Ю November 26, 2002 - Hernani's left kidney is removed and implanted in Arie Pach, an Israeli. Hernani is listed as a "live related" donor. He was paid 6000$.

The state of organ trafficking in key countries

South Africa: Human Tissue Act

Ñ"Ю Sect. 1: "[T]issue means ... any flesh, bone, organ, gland, or body fluid...." Sect. 28: "No person ... may receive any payment in ... the ... acquisition ... of any tissue...." Section 33: Violators "shall be ... liable ... to a fine not exceeding 2,000 Rand or to imprisonment for a period not exceeding one year....ÐŽ§

Ñ"Ю One year in jail or a fine of about $300.

Ñ"Ю Under South Africa's 1983 Human Tissue Act, Arie and his donor have broken the law.

Ñ"Ю But the organ brokers and doctors are the ones making the biggest profits - and are the real targets of the police.

Ñ"Ю Buying and selling kidneys across three continents is, in some ways, the perfect 21st-century crime.

Facts

Ñ"Ю Donors are getting $6,000 to $18,000 for their kidneys. They're coming from Israel, Brazil, and maybe Russia and Romania, given the Eastern European-sounding names on the hospital records.

Ñ"Ю Doctors have put in the pocket as much as $450,000 after 2 years doing more than 107 operations in South Africa

General figures

Ñ"Ю In India, about 2,000 people sell a kidney each year.

Ñ"Ю One study there in 2002 found 86 percent of organ sellers saying they had significant declines in their health in the three years after surgery.

Ñ"Ю In the eastern European nation of Moldova, some 300 peasants sold their kidneys between 1999 and 2002.

Ñ"Ю A study by Organs Watch found 79 percent of Moldovan donors with health problems in the months and years after the procedure.

Consequences

Ñ"Ю For recipients:

Ñ"Ю Paying $70,000 for one kidney transplant is far cheaper than $50,000 a year for life in dialysis bills.

Ñ"Ю The transplant recipient is healthier, and has a better quality of life than a dialysis patient.

Ñ"Ю For donors:

Ñ"Ю According to the study in India, organ selling actually increased poverty.

Ñ"Ю Some 54 percent of sellers were extremely poor before losing a kidney.

Ñ"Ю A year later, 74 percent were still in debt, and the average family income had declined by about 30 percent.

ETHICS

Ñ"Ю "If the rich are free to engage in dangerous sports for pleasure ... it is difficult to see why the poor, who take the lesser risk of kidney selling ... should be thought so misguided as to need saving from themselves," says Dr.