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Last Updated: Thursday, 22 May, 2003, 11:13 GMT 12:13 UK
Should people be paid for organ donation?
A leading transplant surgeon has called on the government to license the sale of human organs in the UK.

Professor Nadey Hakim, a surgeon based at St Mary's Hospital, London told BBC Radio 4's File On 4 programme that regulated control of donors would reduce so-called "transplant tourism".

Do you agree with Professor Hakim? Is it time that the sale of human organs was allowed in the UK? Tell us what you think.


This debate is now closed. Read a selection of your comments below:

SUGGEST A DEBATE
This topic was suggested by Peter S. F. Chan, UK
I would like to know what people think of Professor Nadey Hakim's proposal to legalise the live organ trade?

I think it is a very good idea. Living donors obviously aren't forced into giving away part of themselves and in the long run it will help the people who are waiting to lead a normal healthy life, as well as cutting waiting list times. At the end of the day it's a huge benefit to the donee and the donor has something to gain from it. I don't know a lot of people that give an organ for FREE!
Nikki P, England

The very idea of selling organs is abhorrent. On the one hand, only the wealthy will be able to pay to live longer and, on the other, the poor will be giving up their longer term lives for short term financial gain.
JohnM, LyneMeads,UK

Are we going back to the days of Burke & Hare? Are we setting ourselves up for a new crime wave where people are murdered, not for their possessions, but for their organs?
Simon, UK

The organs should be paid for by the NHS
Matt, UK
I have a friend who is in need of a kidney transplant but the waiting list means his transplant could be years away. If money would allow him get the treatment he needs, I would support this.

The one thing I believe is that it should not be a private purchase though. That would lead to a medical system where the rich can afford new organs while the poor cannot. Instead, the organs should be paid for by the NHS using the money that is saved by not having people on dialysis or expensive drugs to cope with their existing failing organs.
Matt, UK

I'm concerned that payment for organs is being considered as the best way to institute regulated control of donors. A number of respondents have pointed out that this may give those living in poverty a reason to sacrifice their own future health and well-being for a temporary monetary gain. I agree that this is problematic, although I think it is paternalistic to suggest that perhaps people in poverty are either too irrational or too unintelligent to be able to make a free and educated trade-off. The "free funeral" option is, I think, the only acceptable monetary option, since it is less likely to result in coercive decisions regarding living donors. However, why consider monetary incentives at all? Why not regulate control of donors by having a system that assumes universal consent, but allows for a centralized "opt-out" database that all hospitals must check when a patient dies? This very option is being considered currently in Texas in the United States. I think it is far less fraught with the risk of coercion than is any monetary compensation scheme.
Alison Crane, USA

There is one very simple fact upon which virtually every human surely agrees: Everybody has the right to life. If people agree with this, I think that the only logical conclusion is to donate your organs, the result of which will be another persons life. Therefore, if you do actually want the person to live, you should be helping them to live out of kindness, not out of greed for money. I think that anyone with this opinion should give their organs away, not sell them. Truly, no price can be put on another persons life.
AWW, England

I see no reason for why people insist organs should be given for altruism only
Jane, London
I see no reason for why people insist organs should be given for altruism only. Doctors and nurses profit financially by getting paid to transplant them, why should the donor be the only one not getting paid? There are plenty of ways of making money by risking your health (eg firemen) - is it unethical to pay them too? Of course not!
Jane, London

I don't have a problem with the sale of organs - for example, I think the organs of the deceased should be seen as part of their estate and so could be sold after death, to the benefit of the deceased's children. I don't really have that much problem in someone choosing to sell an organ before they're dead either - the problems are likely to arise where there is coercion involved, and maintaining the quality of the donated organs.
David Moran, Scotland/Australia

When I die, I hope that my family will follow my wishes and donate my organs for transplant. However, I would like to think that they do this because its what I want, not because they want the money. It is to my understanding that in some countries it is automatic that organs will be taken for donation unless the person carries a card which specifically states they do not want their organs used for that purpose.
Sarah Parkes, England

Why not provide a free funeral for the people who donate organs when they die to encourage the relatives to allow the wishes of the dead relative. For those who live donate this could be in the form of a voucher redeemable when needed.
pat long, UK

It is a very ethical problem of exploiting the poor of the third world to part with their human body such as kidney or liver or whatever to support the unhealthy life style of some in the rich and mostly affluent nations.
Vijay k Vijayaratnam, united kingdom

Transplants do not always mean a better quality of life
Mary H (Renal Nurse), Scotland
Transplants do not always mean a better quality of life, the huge list of drugs to be taken is quite horrendous, rejection is always a possibility unless a very close tissue match is found. The side effects from the drugs are very difficult to live with. The idea of paying for organs is perhaps on the surface alright but in reality it will be a disaster. Complications from any surgery are real and do happen, and many who are left with one kidney may themselves end up in kidney failure... I have seen it happen on more then one occasion. Organ donation is a very difficult topic and not easily handled, for more organs to become available more deaths of young fit healthy people need to occur.. very sick indeed, what a sad world we live in.
Mary H (Renal Nurse), Scotland

Yes. This is a VERY GOOD idea because at the moment, homeless, poor & vulnerable people are easily lured, kidnapped and butchered by unscrupulous organ thieves in big cities like London. If people can openly sell their organs on the NHS, at least we can be sure that they will be operated upon by qualified people in a hygienic environment and that they get a fair price for their body parts. It may sound distasteful to mocha sipping middle class socialists but I can assure you, it will save many impoverished peoples lives. If you saw some of the horrors of organ theft cases (which I have) you would fully back this idea. Dismissing it because it offends bourgeois values won't make the very real and horrific underground market go away.
Amoroso Gombe, Kenya

That's the sickest idea I've heard in a long time
Christine, UK
I agree we need more donor organs, but to pay for it? That's the sickest idea I've heard in a long time. We're already living in a society where the size of your wallet determines what kind of care you get when you're ill. If we allow this to happen there'll soon be a bidding war for the available organs, and I don't believe for a second that NHS patients will be the winners.
Christine, UK

If someone is willing to pay for an organ to save their life, and someone else is willing to sell an organ then why not? It would clearly cover the costs and physical pain involved for the donor as well as placing some kind of market value on an organ. People who complain that the rich could buy a longer life miss the point - the rich can afford to travel abroad and do this anyway, and of course a poor person could charge pretty much what they liked if an extremely rich person was close to death. As for alternatives suggested by others, the minute the government introduces an assumed consent to organ donation I will tear up my existing donor card and visit the tattoo studio to get an opt-out tattooed on my chest. I will decide what happens to my remains, not the government.
John B, UK

No one is forced to sell their organs, just as no one is forced to sell their house to pay off their mortgage. There is too much of a need of organ transplants to moralise about it.
Richard Murray, UK

These people should be rewarded, but money should not be the way
J.Kelleher, UK
Anyone that is willing enough to donate an organ free of charge, is an extremely brave person. These people should be rewarded, but money should not be the way. It should be the reward of the mind, knowing that it has done a courageous, and benevolent thing. Anyone that is willing to sacrifice one of their organs just for a small bit of money is truly in need, of some money, but surely there are better ways of getting it?!
J.Kelleher, UK

This is just one solution to the growing problem of replacement organ demand. In my opinion a more sensible option would be for the government to change the donor card system to an active "opt out" rather than one which requires individuals to actively "opt in" to the donor system.
Mike Kenrick, UK

This is sick. Society seems to continually think that everything does and should have a price. This is nothing more than the buying and selling of humanity and the exploitation of the developing world. There is a huge difference between the demand for and supply of organs for transplant but there must be a morally acceptable way.
Mike, UK

Regulation and more regulation within an international framework agreement is necessary in this case to make sure the poor are not exploited as Paul has mentioned. It's obvious that there are not enough organs in the UK to provide for those who need them. At the same time, we need a drastic solution to help to clear the backlog of cases and reduce the strain on the NHS. If people can live without a kidney or a lung and want to sell one, why shouldn't they?
Khaled Shivji, UK

If you wish to be helped by the NHS when you are sick then you should be expected to contribute your organs when you die. For those unprepared to contribute there should be an opt out but this must be conditional on holding private medical insurance to cover you for any illness. Let's see how many 'socialists' actually believe in socialism.
B. Essada, UK

I do not want to live in a state where people can sell their organs legally. Is this the only way to stop underground human organs selling? Are the rich determined to live longer while the poor simply die naturally because they are not wealthy enough? Organ donation should be a purely sincere reflection of humanity. We must preserve this.
Iven Cheung, Hong Kong

It seems that this is just a natural extension of the free market system. It probably goes on now anyway so why not let us be honest about it?
Roland Pascoe, UK

I would not want a kidney from a paid live donor
Paul Fitchett, England
I am a fifty year old man working as a civil engineer for a water company. Five years ago I had a kidney transplant and it has allowed me to carry on a near normal life. I was lucky because I was on dialysis for a relatively short time. At some time in the future it is probable that my transplanted kidney will fail and that I will need another transplant, but I would not want a kidney from a paid live donor. The best way to increase the supply of kidneys from transplant would be to change the law so that the default position is that people carry a card if they do not want to be donors.
Paul Fitchett, England

The professor is being pragmatic. I'm sure that unofficially we Brits benefit from organs bought and sold in poorer countries. So we need to create and/ or enable the appropriate forms of legislation to protect our benefactors, the 'donors' from the 'businessmen' who trade now and will continue to trade in the future. Perhaps then we could see our way to enabling a more level playing field.
Katie, UK

Yes, they should. I will need a kidney transplant in about two years and would welcome the chance to save my own life.
John Backhouse, UK

What kind of example is it sending to patients and donors alike?
Jitinder Hari, UK
This is truly a stupid idea, selling organs for money. What next - 2-4-1 deals on a new set of lungs? Clearly this is further exploiting people who are in already tough times financially. Also what kind of example is it sending to patients and donors alike?
Jitinder Hari, UK

This idea absolutely sickens me. It is a sad, sad day when people demand money in order to save another human being's life!
James McEnaney, Scotland

The idea sickens me and I'm curious to know how Professor Hakim sees his duty as a doctor to protect human health in light of his view that people should be paid to donate their healthy organs. I'm with Jacqueline on her views that the donor card system should provide an "opt-out" rather than the present "opt-in" approach. But under no circumstances should money change hands. What next? Bankrupts being forced into donorship to clear their debts?
Kathy, UK

Charles of Scotland, we do not have a perfectly adequate system as it stands otherwise people would not still be dieing as they await a transplant. I am very much against the selling of organs. Make organ donation an automatic opt in unless you are a card carrying "opt out".
Jacqueline, Scotland

We have a perfectly adequate system based on altruism and human decency. This proposal would very quickly result in poor people selling a kidney or bequeathing organs in order to pay the rent. It is an abhorrent idea and goes against every principle of civilisation.
Charles Moore, Scotland

I am against the idea of selling organs for transplant for all the reasons already stated and was appalled at Paul's idea of taking away the need for consent for removal of organs, especially from children. As a mother, I hope that I am never put in a position where the doctors can ask for consent to remove my son's organs, although I carry a donor card and would give my consent. If I thought though that I had no say over what happened to my son, it would make a tragic situation almost unbearable. Also, who is supposed to pay for these organs, the already overstretched NHS or the recipients? Surely this is going to add to the problems with healthcare in this country and create a 2-tier system with the poorer community losing out again.
Cherry, UK

A morally repugnant idea. Those on the poverty line would end up selling kidneys and other body bits simply to live. The rich would quite simply be able to 'buy the life of the poor'. More people should sign up for organ donation after their death, with doctors having the automatic right to remove organs from a deceased, should they provide a chance for someone else to live. Do away with the consent idea from relatives, especially when it comes to children.
Paul, UK




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