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肾病患者从世界上的贫困人口那里购买肾脏是否符合伦理道德?

Is it ethical for patients with renal disease to purchase kidneys from the world's poor?

作者信息

Bakdash Tarif, Scheper-Hughes Nancy

机构信息

Bioethics at Damascus University, Damascus, Syria.

出版信息

PLoS Med. 2006 Oct;3(10):e349. doi: 10.1371/journal.pmed.0030349.

Abstract

In many countries, the number of patients waiting for a kidney transplant is increasing. But there is a widespread and serious shortage of kidneys for transplantation, a shortage that can lead to suffering and death. One approach to tackling the shortage is for a patient with renal disease to buy a kidney from a living donor, who is often in a developing country, a sale that could--in theory at least--help to lift the donor out of poverty. Such kidney sales are almost universally illegal. Proponents of kidney sales argue that since the practice is widespread, it would be safer to formally regulate it, and that society should respect people's autonomous control over their bodies. Critics express concern about the potential for exploitation and coercion of the poor, and about the psychological and physical after-effects on the donors of this illegal kidney trade.

摘要

在许多国家,等待肾脏移植的患者数量正在增加。但用于移植的肾脏普遍严重短缺,这种短缺可能导致痛苦和死亡。解决短缺问题的一种方法是让肾病患者从活体供体那里购买肾脏,而活体供体通常来自发展中国家,这种交易——至少在理论上——可以帮助供体摆脱贫困。这种肾脏买卖几乎在全世界都是非法的。支持肾脏买卖的人认为,既然这种做法很普遍,那么对其进行正式监管会更安全,而且社会应该尊重人们对自己身体的自主控制权。批评者则对穷人可能受到剥削和胁迫以及这种非法肾脏交易对供体的心理和身体后遗症表示担忧。

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本文引用的文献

1
Payment for donor kidneys: pros and cons.捐赠肾脏的报酬:利弊
Kidney Int. 2006 Mar;69(6):960-2. doi: 10.1038/sj.ki.5000262.
2
Israel considers paying people for donating a kidney.以色列考虑向捐肾者支付报酬。
BMJ. 2003 Jan 18;326(7381):126. doi: 10.1136/bmj.326.7381.126/c.
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Lancet. 2002 Mar 16;359(9310):971-3. doi: 10.1016/S0140-6736(02)08030-3.
6
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JAMA. 2000 Dec 13;284(22):2919-26. doi: 10.1001/jama.284.22.2919.
8
The National Organ Transplantation Act.
Bull Am Coll Surg. 1985 May;70(5):18.

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