Martin Dominique E
Senior Lecturer in Health Ethics and Professionalism, School of Medicine, Deakin University, Geelong Waurn Ponds Campus, Locked Bag 20000, Geelong, VIC 3220, Australia,.
Indian J Med Ethics. 2016 Jul-Sep;1(3):180-3. doi: 10.20529/IJME.2016.049. Epub 2016 May 9.
In India, as in most countries where trade in human organs is legally prohibited, policies governing transplantation from living donors are designed to identify and exclude prospective donors who have a commercial interest in donation. The effective implementation of such policies requires resources, training and motivation on the part of health professionals responsible for organ procurement and transplantation. If professionals are unconvinced by or unfamiliar with the ethical justification of the relevant laws and policies, they may fail to perform a robust evaluation of prospective donors and transplant candidates, and to act on suspicions or evidence of illicit activities. I comment here on a recent paper by Aggarwal and Adhikary (2016), in which the authors imply that tolerance of illicit commercialism in living kidney donation programmes is not unreasonable, given the insufficiency of kidneys available for transplantation. I argue that such tolerance is unethical not only because of the harmful consequences of kidney trafficking, but because professional tolerance of commercialism undermines public trust in organ procurement programmes and impairs the development of sustainable donation and transplant systems.
在印度，如同大多数法律禁止人体器官交易的国家一样，关于活体器官捐赠移植的政策旨在识别并排除那些对捐赠有商业利益的潜在捐赠者。这类政策的有效实施需要负责器官获取和移植的卫生专业人员具备资源、培训和积极性。如果专业人员不认同或不熟悉相关法律和政策的伦理依据，他们可能无法对潜在捐赠者和移植候选人进行严格评估，也无法对非法活动的怀疑或证据采取行动。我在此评论阿加瓦尔和阿迪卡里（2016年）最近的一篇论文，作者在文中暗示，鉴于可用于移植的肾脏不足，对活体肾脏捐赠项目中的非法商业行为持宽容态度并非不合理。我认为这种宽容是不道德的，不仅因为肾脏交易的有害后果，还因为专业人员对商业行为的宽容会破坏公众对器官获取项目的信任，并损害可持续捐赠和移植系统的发展。
