Canada's medical profession is the first in the world to develop stringent new guidelines on organ trafficking, aimed at deterring prospective transplant tourists.
Stringent new guidelines aimed at deterring prospective transplant tourists set an important precedent. Canada's medical profession is the first in the world to develop an official policy statement on organ trafficking. It is an appropriate, if long overdue, directive.
The policy, by the Canadian Societies of Transplantation and of Nephrology, is to be discussed Monday in Vancouver at an international meeting of The Transplantation Society. It allows doctors to refuse to treat patients who participate in the lucrative trade, which exploits the world's most vulnerable. It also directs doctors to counsel their patients about the treatment of people who sell their body parts; in some cases, sellers have been taken by force, or even killed for their organs.
Buying and selling livers, hearts, kidneys and other body parts is illegal in Canada and most countries, but the enterprise continues in many developing countries. From 2000 to 2008 in B.C. alone, 93 Canadians, 90 per cent of them ethnic minorities from countries such as China, India and Pakistan, bought kidneys overseas.
Transplant tourists are exposed to a higher risk of complication and organ failure. They often receive sub-optimal care back in Canada because little is known about the donor.
If patients are determined to become transplant tourists, it is appropriate that doctors may choose to terminate their relationship with them, and refuse to provide pre-transplant screening or prescriptions. But physicians must, as the guidelines note, still treat emergency needs: They can refer patients to someone else for ongoing care.
This is not to minimize the frustration of patients who languish on wait lists that stretch as long as eight years. With an aging population and increased incidence of hypertension and diabetes, Canada has a chronic organ shortage. Every year, 60 people on the kidney wait list die.
However, patients have other options. They may, for example, approach a loved one to consider being a live kidney donor.
Dr. John Gill, a transplant nephrologist at Vancouver's St. Paul's Hospital, says one prospective transplant tourist recently changed his mind and decided not to fly to China to buy a prisoner's kidney, after his Vancouver doctor warned him he would terminate their relationship. The patient found a family member willing to be a donor.
If a living relative is not a blood or tissue match, they can donate their kidney to someone else, allowing their loved one to receive a kidney from another donor whose intended recipient is also incompatible.
The Societies should be applauded for upholding the nobility of organ donation, and dissuading Canadians from exploiting those who feel they have no choice but to put their livers, kidneys and corneas up for sale.