Author Topic: Selling Kidneys in Singapore  (Read 14135 times)

Offline zuoom

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Selling Kidneys in Singapore
« on: June 30, 2008, 12:56:02 AM »
Quote from: cuxyz;5489830
June 27, 2008   
By Elena Chong
 
IN the first case of its kind, two Indonesians admitted in court on Friday to selling their kidneys to two persons for substantial sums of money.

One of the intended recipients was retail company CK Tang's executive chairman Tang Wee Sung, 56, who is suffering from kidney disease.

His potential donor, Sulaiman Damanik, 26, was found out before the transplant could be carried out.

The other Indonesian, Toni, 27, underwent a successful operation in March and transplanted his kidney to a woman named Juliana Soh.

On his return to Medan, 186 million rupiah (S$29,390) was transferred to his bank account.

Both men pleaded guilty in a district court to charges under the Human Organ Transplant Act and Oaths and Declarations Act. Sentencing is expected next Wednesday.

Sulaiman had arranged with several people earlier this month to sell his kidney to Mr Tang in return for about 150 million rupiah (about S$23,700).

On June 17, he lied that there was no financial gain in the kidney living donor surgical operation. He also lied that the brother-in-law of Mr Tang's niece's was married to his aunt.

Toni's role was to act as a liaison between Sulaiman and Mr Tang.

He flew here on May 29 and was put up in an apartment at Lucky Plaza.

Sulaiman gave false information to the committee panel who approved the application for a live kidney transplant.

Source:  The Straits Times

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Two plead guilty to human organ trading in first such case in S'pore

By Hasnita Majid, Channel NewsAsia
Posted: 27 June 2008 2235 hrs

   

 
 
SINGAPORE: In the first case of its kind, two Indonesian men have been convicted of organ trading. 26-year-old Sulaiman Damanik and 27-year-old Toni, both Indonesians, are due to be sentenced next week.

Both men also pleaded guilty in a Subordinate Court on Friday to making false declarations to a hospital transplant ethics committee.

The court heard that Sulaiman Damanik had agreed to donate his kidney for 150 million rupiah or about S$23,700 in an arrangement made with several people earlier this month.

He had lied that there were no financial gains involved in the living donor transplant and that he was related to Tang Wee Sung, the intended recipient named in court documents.

Channel NewsAsia is unable to confirm at this point if Mr Tang is CK Tang's 56-year-old executive chairman, who is known to be suffering from kidney disease.

Sulaiman said that his aunt was married to the brother-in-law of Mr Tang's niece. But Sulaiman was found out before the transplant could be carried out.

The transplant operation involving Toni went ahead with his kidney going to a woman named Juliana Soh.

Toni, who admitted to acting as a middleman between Sulaiman and Mr Tang, received 186 million rupiah or about S$29,390 for his kidney. The operation took place in March.

Both men will be sentenced next week.

The Ministry of Health (MOH) said that a number of Singaporeans are assisting with the investigation.

Speaking to reporters on the sidelines of a community event, Health Minister Khaw Boon Wan said his ministry will take action against anyone engaging in illegal human organ transactions.

He said he understands that some patients may be desperate because it's a life and death situation. But, still, he stressed they should never break the law.

Mr Khaw said: "It is wrong to do so. But of course there are people who are desperate and they may push the boundary. So I think we have to be alert and each time we hear of such an allegation, we have to investigate and if people break the law, then they have to face the law."

He added that if Singapore wants to be a regional hub for organ transplantation, it not only needs high clinical standards but also ethical standards.

Mr Khaw said the ethics committee in hospitals was set up to thoroughly interview and counsel patients as well as donors to ensure proper consent. Otherwise, cases of exploitation will occur.

He added: "It's either your relative who wants to donate (their organ) to give to their relative or for various other reasons. But it must be purely altruistic and not as a result of exchange of money."

Under the Human Organ Transplant Act, it is a criminal offence to enter into a contract or arrangement under which a person agrees to the sale or supply of any organ or blood for valuable consideration.

Those convicted can be jailed for up to 12 months, or fined S$10,000, or both.

In a statement, MOH said that it takes a serious view of such illegal acts.

It added that organ trading often involves the exploitation of the poor and socially disadvantaged donors who are unable to make an informed choice and suffer potential medical risks.

Organ trading is largely prohibited around the world. - CNA/vm

Source: CNA

Quote from: cuxyz;5492527
Tangs chief named in kidneys-for-sale case 

Elena Chong
Sat, Jun 28, 2008
The Straits Times 
 
IN THE first case of its kind, two Indonesian men who agreed to sell their kidneys to patients here for over $20,000 each have pleaded guilty to offences linked to organ trading.

Court documents cite Mr Tang Wee Sung, executive chairman of retail company CK Tang, as one of the patients who had offered to pay for an organ.

But the 55-year-old kidney patient, who is on dialysis, did not get the transplant. Investigations into the organ trading allegations put a stop to it this month.

But an earlier transplant, in March this year, went ahead at Mount Elizabeth Hospital for an Indonesian patient, Ms Juliana Soh.

Both patients were treated by renal physician Dr Lye Wai Choong, president of the Society of Transplantation (Singapore), who runs a clinic in Mount Elizabeth Medical Centre.

And in both cases, the donors had lied about being related to the patients and also about not being paid for their organs.

Ms Soh's donor, known only as Toni, 27, pretended to be her adopted son since he was 10 years old.

On his return to Medan after the operation, 186 million rupiah (about S$29,390) was banked into his account.

He was back in Singapore on May 29, this time as a 'runner' escorting Sulaiman Damanik, 26, who was preparing to donate his kidney to Mr Tang.

Sulaiman had agreed to sell his kidney to Mr Tang for about 150 million rupiah. His alleged connection to Mr Tang - his aunt was married to Mr Tang's niece's brother-in-law.

Both men pleaded guilty in a district court to charges under the Human Organ Transplant Act and Oaths and Declarations Act.

The duo are expected to be sentenced next Wednesday. Investigations into others connected to the cases continue.

Organ trading is banned here and in most countries worldwide, the Health Ministry (MOH) said yesterday, because poor and socially disadvantaged donors who cannot make an informed choice can be exploited.

But the practice continues to take place and over the years more than 300 Singaporeans have gone overseas for transplants.

The main reason for this - a transplant gives a kidney patient a better chance of survival than dialysis, where 38 per cent of people die within a year.

With a transplant, only 7 per cent die within 12 months.

Long-term survival is also better, with 89 per cent of transplant patients living for more than five years, compared to only 36 per cent of those on dialysis.

There are about 600 people waiting for a kidney here, with an average waiting time of nine years.

Some patients do not survive the wait. Others get too old and are taken off the waiting list.

Despite several calls over the years to reconsider the ban on organ trading, the Singapore authorities have remained dead set against it.

Instead, MOH has progressively expanded the list of possible organs for transplant to include the liver, heart and corneas. The organs can also be harvested from patients left brain-dead after an illness, and no longer only from accident victims.

At a community event yesterday, Health Minister Khaw Boon Wan said: 'There is always more demand than supply, so I can understand why some patients become desperate because it is about life and death.

'But no matter how desperate the situation is, we must never break the law.'

He added that only by protecting the interests of both the patients as well as the donors, can Singapore maintain the high ethical standards needed to be a transplant hub.
 
Source:  AsiaOne News

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Some comments from AsiaOne readers:
Quote
Some comments from AsiaOne readers:

Quote:
Why are just these 2 men hauled before the Court? Aren't both the sellers & buyers equally guilty & responsible in these illegal transactions? Why doesn't the law addressed this part of seemingly lop-sided situaition? Or are the Laws & Justice mean different things to ppl from different backgrounds & level of society. It seems that the rich & wealthy usually got away if crimes of this nature are committed.
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It would seem that fairness would demand that the individuals who solicited to purchase the kidneys are also guilty of breaking the law . . . or does the law only apply to the poor, and the wealthy are live by a different rules?
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There is no shame & of course is morally right to save lives but don't be confused as to how & whose lives shld be saved. These ppl did an immoral & illegal thing by exploiting the human greed, needs, etc. so that they can live & enjoy a luxurous life a several more years. Btw what make them so superior & special that their lives are worth more than those ordinary ppl who daily struggles with the cost & efforts to survive each day..human lives shld never be equate with dollars bec it were then it cheapens & dehumanise life & therefore means nothing...
Quote:
Got money got cure. Why don't these rich peoples donate and help the poor and in these manner they might be blessed.

We are in this world once only, and why should we take advantage of the poor.

Mr. Tang, please be more charitable and die with a good heart.
Quote:
You got it wrong. It is not buyer and seller. Rather it is rich and poor. Face it. The rich always get away and always right. The poor is always responsible. Who dare to charge him in court? Hmmm.. Police Force suddenly become quiet over this? Thought the scholars used to say a lot of things one?
Quote:
Must punish those who sell or buy kidney illegally according to the law no matter how rich they are. Let them be a lesson to others too. Government should send a strong signal to others too. I think should punish the doctor too because he should know that the recipient and donor are not related. He just doing it for $$$, what else.
Quote:
I empathised with Mr Tang. I saw up close how my mother died due to kidney failure. Before her death, she had to undergo dialysis 3 times per week; each session lasting 4 hours and it was torture for her. As for Mr Tang, he has to do it every day - I don't envy him. Of course, we are not rich enough to look for and buy a kidney.

Ethical questions arose over Mr Tang's attempt to buy a kidney. But as long as there is a willing buyer and a willing seller, then who are we to decide that it is wrong? In buying a kidney, the buyer hopes to prolong his life, and the seller gets a monetary payment for it. If it is not ethical, then look at why countries, including Singapore, produces weapons/ammunition for sale knowing that it could be used to kill? Isn't this worse than selling a kidney?

As for the attempted sale of the kidney, why are both the sellers being prosecuted? What about the buyers and the middleman? Though I empathised with Mr Tang, I am surprised that for a man of his position, the sum paid for a kidney is almost negligible to him.

I believed that there will be more of such cases. Why not the government legalise the sale of kidney if there are people who are willing to sell it? They can set-up a committee, charge a minimum fee to both buyers and sellers, ensure safety checks are in place and that there is no exploitation.
Quote:
Let me see, worst case scenario is a fine & jail sentence to the seller. The seller is poor so he cant pay fine so increased his jail sentence. He will rot in jail.

Worst case scenario, the buyer also recieved fine & jail sentences. He is spared jail sentence bcos he is sick. Since the buyer is rich he paid the fine & go back to his big home.

Hurray, the law is divine & justice has prevailed

Quote from: cuxyz;5492739
MOH to examine if there are any lapses in living donor transplant programme

By Hasnita A Majid, Channel NewsAsia
Posted: 28 June 2008 1943 hrs

   

Mr Khaw Boon Wan (file picture)
   

SINGAPORE: Health Minister Khaw Boon Wan has said his ministry will review the living donor transplant programme to see if there are any lapses, after a current case of organ trading wraps up in court.

He is confident that this episode will not dent Singapore's reputation as a medical hub.

In the first case of its kind, two men - both Indonesians - have been convicted of organ trading.

One of them had his kidney transplanted into Indonesian woman Juliana Soh. This was done at the Mount Elizabeth Hospital.

The other had planned to sell his kidney to 55-year-old Tang Wee Sung, the executive chairman of retail company C K Tang. But the operation never took place, after the authorities intervened hours after the Mount Elizabeth Hospital ethics committee gave the go-ahead.

The doctor who handled both cases was Dr Lye Wai Choong, the president of the Society of Transplantation (Singapore). He has a clinic at Mount Elizabeth Medical Centre.

Digging for more information will help shed light on the current kidneys-for-sale case, said Minister Khaw at a community event in Sembawang on Saturday.

Until the facts are clearer, Mr Khaw said, there should not be any speculation on whether the Transplant Ethics Committee involved in the case is negligent.

"Let's find out first how they reach their conclusion, how they do their job," he said.

The minister noted that the donors in both cases had lied about being related to the patients and also about not being paid for their organs.

"They were misrepresenting, so a lot depends on the interview (when the donors appeared before the Transplant Ethics Committee)...." Mr Khaw said, adding that sometimes it may not be easy to detect the misrepresentation.

"But, if they (committee) were doing their job too casually, to allow even a clear-cut misrepresentation to pass through, then I'll be very disappointed. We also have to review, from the minutes of the meeting (interview), what actually happened in this case and whether there were lapses. If there were, we hope that the hospital ethics committee will learn from this, so that there will be no repeat of such lapses," added the minister.

Mr Khaw said that the law is "crystal clear" about the buying and selling of organs. But he acknowledged that although laws are in place, there will always be those who will break them.

"How you enforce the law makes a difference....If we do it robustly, it enhances our reputation rather than weakens it," the minister said.

Mr Khaw also acknowledged that organ trading is a global phenomenon but added that except for Iran, most countries have largely banned the illegal trade. - CNA/ir

Source: CNA

Quote from: Asimof;5492768
i heard lots of patients travel to india to buy organs for transplant. apparently, the poverty there and the lack of enforcement are encouraging a fledging transplant industry.

i am sure you have heard of thieves stealing organ from unsuspecting victims who were drugged.

via : http://forums.vr-zone.com/showthread.php?t=294391

Offline zuoom

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Re: Selling Kidneys in Singapore
« Reply #1 on: June 30, 2008, 01:16:13 AM »
looking from a very 3rd party POV.

it's very obvious that there's demand for transplant. and there's a "shortage" of supply.

why is that so? the hospital unable to find "donors"?

as for Mr. Tang's case of 20K ++ for the kidney. i would pay that money too if it helps me get off dialysis. that's cheap compared to the among of time n pain on dialysis. if it would improve the quality of life, YES.

it is illegal to sell/trade body organs. hence, this "underground"/under the radar ops.
but the poor will continue to suffer as they are often under-the-radar. ie: ignored, forgotten. by the main bulk of the society. often, just one of the many face in the crowd, just a number, a statistic.

the demand will definitely stay, in fact i will reckon it to increase more/faster. people are living longer, more unhealthy lifestyle, more polluted air/water etc.  people will want "replacement" parts for themselves (and they are willing n able to pay.)

the extremely rich n poor gap will continue to pull further apart.

the poor will need money. the rich will want "donors".

classic case in the making.

perhaps it time to consider legalizing selling of body parts? but it too will face the problem of enforcement, and those that seep thru the net.

demand n supply. how to curb demand? how to increase supply?

how to strike a balance?

what do you think?

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Re: Selling Kidneys in Singapore
« Reply #2 on: June 30, 2008, 01:29:53 AM »
http://www.sgh.com.sg/ForPatientsnVisitors/PatientEducation/HealthGlossary/KidneyTransplant.htm
Quote
Kidney Transplant
(Renal Transplant)
   

Article Sections

    * Introduction
    *
    * Different forms of Transplantation Possible Risks


Introduction

A renal transplant can perform all the functions of a normal kidney by removing waste products and water as well as producing the hormones produced by the normal kidney, and is a solution for patients with severe or irreversible kidney failure. Dialysis is another option of therapy for such patients.  However, not all patients are suitable for both forms of therapy. The choice of one treatment over the other for any individual patient is based on many factors including medical and social factors, as well as the availability of these options for the individual patient. Thus some patients with heart disease are not suitable for kidney transplantation, and will need to remain on dialysis. Some patients with severe heart disease or other debilitating illnesses may not even tolerate dialysis. Every patient will need to be evaluated individually to decide whether he or she is suitable for either form of treatment.

Renal transplantation usually remains the most ideal option of renal replacement therapy. With a functioning renal transplant (also called allograft), the patient is freed from the need of having to do dialysis, can have a normal diet, and can in almost all respects have a normal unimpeded lifestyle.

http://www.annals.edu.sg/pdf/36VolNo3Mar2007/V36N3p157.pdf
Quote
Twenty-five Facts about Kidney Disease in Singapore: In ...
File Format: PDF/Adobe Acrobat - View as HTML
donor kidney transplant in Singapore. 16. The average waiting time for a. deceased-donor kidney transplant in Singapore is 7 years. ...

http://www.asiaone.com/Health/News/Story/A1Story20080504-63210.html
Quote
Their blood types don't match, but he's getting her kidney

A Singaporean renal patient will be the first person in South-east Asia to receive a kidney donation from someone with a different blood type.

Mr Khairul Anwar Ibni, 46, whose blood type is O+, will be getting a kidney from his wife, Madam Radiyah Mohamad Som, 43, whose blood type is A+.

The transplant will be done by Dr Lye Wai Choong, a renal specialist in private practice, at Mount Elizabeth Hospital at the end of this month.

Under normal conditions, the transplant would have been impossible.

In standard kidney transplants, both donor and recipient must belong to a common blood group. If not, the kidney will be rejected automatically by the recipient's body. This also applies when other organs such as the heart or liver are transplanted.

The procedure, known as the ABO incompatible kidney transplant, allows for a kidney to be accepted by the recipient even when blood types do not match.

The ABO transplant was first done in Sweden in the 1970s and, later, more commonly carried out in Japan in the 1980s. It caught on in the United States and Europe only in 2000, although just a handful of hospitals carry out the procedure.

ABO incompatible transplants were unheard of in Singapore because of high risks, extensive preparations and exorbitant costs, Dr Lye told The Sunday Times.

'Normal kidney transplants have a 98 per cent success rate. But in ABO incompatible transplants, the success rate is 85 to 90 per cent. Given a choice, not many patients may want to take the risk,' he said.

But Dr Lye recommended the procedure to Mr Khairul as it is his only chance. Mr Khairul's heart is so weak that if he does not get a kidney soon, he will not live beyond 18 months.

Dr A. Vathsala, director of the adult renal transplantation programme at the National University Hospital (NUH), said transplant nephrologists have been talking to patients about exploring the possibility of an ABO incompatible transplant over the past few years.

But many are reluctant to be the first patient to undergo such a transplant here.

Although the surgery is carried out the same way as normal kidney transplants, extensive preparation is needed beforehand to remove antibodies from the recipient and prepare him for the transplant.

This involves highly sophisticated and expensive machinery and medicines. This is why ABO incompatible transplants are so expensive.

While a standard kidney transplant can cost about $60,000, an ABO incompatible transplant can easily cost two to three times as much. Mr Khairul's transplant is expected to cost $120,000.

Also, few doctors have the expertise to carry out and monitor this process. The Sunday Times understands that there are only four such doctors in Singapore, one of whom is Dr Lye.

There were 555 renal patients in Singapore waiting for a kidney last year. The average wait is nine years.

In 2006, 139 patients were taken off the kidney waiting list, mostly because they were no longer fit to undergo surgery even if a suitable kidney donor came along.

Renal specialists said this first ABO incompatible transplant would be a significant breakthrough for Singapore's medical scene.

Said kidney transplant surgeon James Tan: 'In the past, many patients stood no chance of getting a kidney. Every kidney is so precious that it's given only to the person with an exact match. But now with ABO incompatible transplants, we can have a bigger donor pool.'

Renal specialist Pary Sivaraman agrees. 'About 20 to 30 per cent of kidney donors are usually rejected because their blood types don't match. This transplant pushes the limits.'

Restructured hospitals are also gearing up and preparing themselves to perform future ABO incompatible transplants.

The Singapore General Hospital renal transplant programme has set up a special team to perform such transplants.

Said Dr Vathsala from NUH: 'Our restructured hospitals have the facilities and expertise to carry out such high-risk transplants. However, it is not a standard therapy and is still experimental. The risks and benefits must be properly weighed.'

ndianah@sph.com.sg

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Re: Selling Kidneys in Singapore
« Reply #3 on: June 30, 2008, 01:31:47 AM »
http://www.zimbio.com/Singapore+Travel+and+Expats/articles/55/Need+Cash+Fast+Not+Sell+Kidney+Singapore+Black
Quote
Need Cash Fast? Why Not Sell A Kidney On The Singapore Black Market? - Going Rate About $22,000!
Email
Written by AussiePB on
From:  www.aussiepete.com
Selling an organ in Singapore is strictly against the law and protocols, under the Human Organ Transplant Act (Hota) and Oaths and Declarations Act. So how did two Indonesians almost get away with selling their kidneys to recipients in Singapore. In fact, one of the transactions were complete, before any charges were laid.

This is the first time that the current laws banning organ trade have been invoked since they were introduced twenty years ago.

The Ministry of Health (MOH) are still investigating the transactions, with assistance from several Singaporeans.

The first Indonesian charged, 26-year old Sulaiman Damanik, pleaded guilty in a district court and was convicted on Friday. Sulaiman was apprehended before he could have the surgery to remove his kidney. He had previously arranged with an executive chairman, 54-year old Tang Wee Sung, to sell him the organ for around $22,000 (150 million rupiah).

Under the current protocols in Singapore, organ donation is not entirely illegal, and the guidelines allow for close relatives of the recipient to donate. In the case of unrelated donors, the MOH makes a determination on a 'case by case' basis, depending on things such as medical emergency and the donor's motives (which cannot under any circumstances, be motivated by money or profit).

So on June 17th, Sulaiman was brought before a private hospital's ethics commitee, at which time he purported to be a close relative of Mr Tang - he claimed that Mr Tang's niece was married to his aunt. He further claimed that by making the donation, he would achive no financial gain or payment for the kidney. These claims have later proven to be false.

The second Indonesian convicted is known as Toni and is 27-years of age. He had already given his kidney to Ms Juliana Soh in March this year, for a payment of 186 million rupiah which he received upon his return to his home in Medan. He then acted as the 'go between' for Sulaiman and Mr Tang's transaction. He returned to Singapore to assist the former on May 29th.

Toni and Sulaiman are likely to be sentenced for their respective crimes on Wednesday of this coming week.

MORE ARRESTS PENDING?

As the investigations have been unfolding, MOH have met the ethics panel of a particular unnamed private hospital, and some lawyers have been contacted by some of the people who have been assisting with police investigations, looking for legal counsel to act on their behalf. This seems to be a very strong indication that more people are likely to be charged under Hota.

ISSUE WITH CURRENT GUIDELINES AND PROTOCOLS

The biggest problem for authorities in detecting breaches of the laws, is the fact that it is often difficult to prove a relationship between the donor and the recipient. Both parties must make statutory declarations and present their cases to the ethics committees, but there is no 'exhaustive' way of proving the parties are related.

CROSS-BORDER BLACK MARKET

The cross-border blackmarket demand is seemingly quite large, with Dr Pary Sivaraman (consultant kidney and transplant physician at the Singapore Clinic for Kidney Diseases) stating that he gets at least two emails a week from foreign organ buyers looking for a donor, while also receiving emails from potential organ sellers (usually from Indonesia or India) advising their health condition, age, and placing a price on their 'offered kidney' - anywhere between US$10,000 to US$30,000.

Reports today in the media, have cited that more than 600 Singaporeans have sought out donors overseas throughout the last 20 years. Most of these potential recipients have tried to eke out opportunities in China or India, where it is easiest to buy the organs.

On average, kidney patients wait approximately nine years for a transplant, dependent upon whether or not a suitable kidney can be found.

The petient at the heart of the recent controversy, Mr Tang was interviewed in 2006, and had said that he needed a transplant soon, and rather than approaching family members, was considering taking his search for an organ abroad and having the operation performed in Beijing, where he had friends who are doctors.

LEGAL TRANSPLANTS - IMPORTANT INFORMATION!!

The Human Organ Transplant Act (Hota) was enacted in 1987 because there was a growing number of patients with renal failure but a lack of donors. The act, which allows organs to be removed when a person dies, was initially limited to the kidneys as there were no heart or liver transplant programs then.

Doctors may now also remove the liver, heart and cornea of ALL Singaporeans and Permanent Residents upon their deaths, following the amendment to the act in January, 2004. Organs may be removed from anyone who is brain-dead, unless the person has opted out os is a muslim who has not opted in.

A transplant ethics commitee at each hospital will decide whether to allow a transplant from a living donor. Donating organs for money and organ trading remains illegal. Offenders face a fine of up to $10,000 and/or imprisonment for up to one year.



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wiki on Organ donation
« Reply #4 on: June 30, 2008, 01:32:27 AM »
http://en.wikipedia.org/wiki/Organ_donation

Organ donation
From Wikipedia, the free encyclopedia
Jump to: navigation, search

Organ donation is the removal of the tissues of the human body from a person who has recently died, or from a living donor, for the purpose of transplanting. Organs and tissues are removed in procedures similar to surgery, and all incisions are closed at the conclusion of the surgery. Steps are taken to provide a traditional funeral viewing. People of all ages may be organ and tissue donors. See "organ transplant" for discussion of the mechanics and history of organ transplantation.

In numerical terms, donations from dead donors far outweigh donations by living ones. The laws of different countries allow either the potential organ donor to consent or dissent to the donation during his life time, or his relatives to consent or dissent. Due to these different legislative possibilities, the number of donations per million people varies substantially in different countries.
Contents

    * 1 Organs and tissues which can be donated
    * 2 Recipient protection
    * 3 Legislation regarding organ donation
    * 4 Bioethical issues in organ donation
          o 4.1 Deontological issues
          o 4.2 Teleological issues
    * 5 Political issues
          o 5.1 Organs for prisoners
    * 6 Organ shortfall
    * 7 Scandals
    * 8 See also
    * 9 Sources
    * 10 External links

[edit] Organs and tissues which can be donated

Organs that can be procured include:[1] the heart, intestines, kidneys, lungs, liver, pancreas. These are procured from a brain dead donor or a donor where the family has consent for donation after cardiac death, known as Non-heart beating donation.

The following tissues can be procured: bones, tendons, corneas, heart valves, femoral veins, great saphenous veins, small saphenous veins, pericardium, skin grafts, and the sclera (the tough, white outer coating surrounding the eye). These are only procured after someone has died.

Organs that can be donated from living donors include part of the liver or pancreas and the kidney.

[edit] Recipient protection

To protect the person receiving an organ, various health and safety tests are conducted. Because an organ transplant requires immune suppression, it is important that the organ not be infected with a disease that could harm the recipient. These tests are not perfect, but organ-related infections are relatively rare.[1]

Precise regulations vary by country or even hospital to hospital. In most countries, organs are not accepted from a person who has an active or recent case of cancer (except a brain tumor which has not spread or certain mild kinds of skin cancer), who has ever had a blood cancer, or who has certain infectious diseases, including HIV or severe bacterial or fungal infections at the time of death.[2] People with these conditions may be able to donate their bodies or tissues for lab research or education, but not to a living donor. Because most people die from infections, cancer, or organ failure, only 1% of people who die at a hospital will be able to donate their organs.

At least one case of a brain tumor being spread through liver transplant has been documented.[3] However, transplant officials are reluctant to shrink the supply of organs because of this rare risk.

Some countries have proposed that HIV+ people be able to donate organs to other HIV+ people under some circumstances and has been passed into law in Illinois.[4]

[edit] Legislation regarding organ donation

There are four different legislative approaches to the donation, if the donor has not explicitly dissented. The least restrictive approach is the dissent solution, according to which the donor has to explicitly dissent to donation during his lifetime. According to the extended dissent solution, relatives may dissent in the event the potential donor has not consented.

The different legislative approaches are the main reason that countries like Spain (27 donors per million inhabitants) or Austria (24 donors per million inhabitants) have higher donor rates than Germany (13 donors) or Greece (6 donors). In most countries with the dissent solutions, there is no waiting list for donations, or the list is short, while most countries with consent solutions have substantial organ shortages. The reason for this is that, in both situations, most people do not explicitly state their wishes. Thus, in a country requiring dissent, most people will not have dissented, while in a country requiring consent, most people will not have consented.

Under United States law, the regulation of organ donation is left to states within the limitations of the federal National Organ Transplant Act of 1968. Each state's Uniform Anatomical Gift Act seeks to streamline the process and standardize the rules among the various states, but it still requires that the donor make an affirmative statement during her or his lifetime that she or he is willing to be an organ donor. Many states have sought to encourage the donations to be made by allowing the consent to be noted on the driver's license. Still, it remains a pure consent system rather than an extended consent system or even a dissent opt-out system. Curiously, though, relatives can still dissent even in the presence of evidence of explicit consent by the potential organ donor (driver's licence, living will, registry information, etc.). As such, many organ donation campaigns in the United States encourage family communication about one's decision to donate or not to donate.

In the United Kingdom organ donation is always voluntary and no consent is presumed. There is however a national database called the Organ Donation Register where those individuals who wish to donate their organs after death can register. All NHS hospital have access to this database so that in the event of a death it can be seen if someone was a donor or not. It is also usual for hospital staff to ask relatives directly, in the event of a patientís death if they would be willing to donate their organs or not. Some members of the public in the UK also carry Donor Cards in their wallets, which are credit card sized and state that the person wishes to be a donor in the event of their death. In patients who require kidney or bone marrow transplants and in some cases a lobe of liver it is common as in other countries for the patientís relatives to be tested to see if they are a match. All transplants in the UK are carried out on the NHS to ensure that the whole population has access to potential donors in the event of them needing a transplant.

On June 27, 2008, Indonesian, Sulaiman Damanik, 26, pleaded guilty in Singapore court for sale of his kidney to CK Tang's executive chair, Mr Tang Wee Sung, 55, for 150 million rupiah (S$ 22,200). The Transplant Ethics Committee must approve living donor kidney transplants. Organ trading is banned in Singapore and in many other countries to prevent the exploitation of "poor and socially disadvantaged donors who are unable to make informed choices and suffer potential medical risks." Toni, 27, the other accused, donated a kidney to an Indonesian patient in March, alleging he was the patient's adopted son, and was paid 186 million rupiah (20,200 US). Upon sentence, both would suffer each, 12 months in jail or 10,000 Singapore dollars (7,300 US) fine.[5][6]

[edit] Bioethical issues in organ donation

Since the mid-1970s, bioethics, a relatively new area of ethics, has emerged at the forefront of modern clinical science. Many philosophical arguments against organ donation stem from this field. Generally, the arguments are rooted in either deontological or teleological ethical considerations.

cepheus

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Re: Selling Kidneys in Singapore
« Reply #5 on: June 30, 2008, 02:51:33 AM »
For those who even think of going overseas for a transplant, eg china, indon etc, where kidneys might be easy to come by, butthe QC might be a big question mark. Eg. Hep B in China, they might be able to provide u with a kidney which is functioning, the risk of getting hep B is also much higher.

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Re: Selling Kidneys in Singapore
« Reply #6 on: June 30, 2008, 05:21:18 AM »
Siow bo..20k-30k wana buy kidney.. ::) ::) US$20-30million I may consider lar..hehehe.. ;D :P


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Offline zuoom

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Re: Selling Kidneys in Singapore
« Reply #7 on: July 01, 2008, 01:06:12 AM »
Quote from: MinMin
Docs say strict measures in place to prevent organ trading
 




SINGAPORE: Doctors say strict measures are in place to prevent people from donating organs for money.

Getting to the operating theatre for a kidney transplant can take up to three months of checks when a living donor is involved.

At the National University Hospital (NUH), donors go for repeated interviews, medical checks and psychiatric assessments to ensure they are aware of the risks and are donating for altruistic reasons.

Doctors and organ transplant coordinators pay particular attention when screening for non-related transplants or when the donor is a foreigner.

All transplant cases need to seek the hospital's ethics committee's approval.

Professor A Vathsala, director for adult renal transplant programme at NUH, said: "There are a lot of subtle clues and we look for stories that gel. We look for that emotive input between donor and recipient and sometimes that care and the concern comes through in conversations and we repeat ourselves many times. And when you do that, an inconsistent story does come out."

3,500 people in Singapore have kidney failure. Of these, 600 are on the transplant list, but will have to wait up to nine years for a cadaveric donation.

However, trading in organs is not a solution, said Professor Vathsala.

"Organ trafficking tourism for transplantation will all become rampant and the poor and the disadvantaged will become donors of the wealthy ill," he said.

Last week, two Indonesian men were convicted of organ trading in Singapore. One man intended to sell a kidney to C K Tang's executive chairman Tang Wee Sung for S$23,700.

Lawyer Palaniappan Sundararaj said a patient could face a fine of up to S$10,000, jail of up to 12 months or both if he or she knowingly accepts a sold kidney for transplant.

"The prosecution would have to prove the patient knew the kidney was sold. This is not always the case, for example, when the recipient is a child or when an adult patient has an over-enthusiastic relative who sources the organ," he said.

The lawyer said it is up to the prosecution to decide whether to press charges against a patient for buying an organ.

In Japan last year, a husband and wife were found guilty of buying a kidney for transplant. They received a one-year jail term which was suspended for three years. - CNA/ir

http://www.channelnewsasia.com/stories/singaporelocalnews/view/357386/1/.html

via : http://forums.vr-zone.com/showthread.php?t=295584

klumpkeTT

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Re: Selling Kidneys in Singapore
« Reply #8 on: July 01, 2008, 02:59:41 PM »
Siow bo..20k-30k wana buy kidney.. ::) ::) US$20-30million I may consider lar..hehehe.. ;D :P

Are you sure?? Considering you only need about 20% of One kidney to survive! If you're desperate, like some of the really poor, $20k is a lot.

klumpkeTT

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Re: Selling Kidneys in Singapore
« Reply #9 on: July 01, 2008, 03:09:13 PM »
Here's what i think - just to sum it up...
More sedentry lifestyle -> Obesity -> Insulin-resistance -> Metabolic syndrome -> Diabetes Mellitus -> End-Stage Renal Failure.

So you ask, why the demand is so much? Look at the above. Tell me where the problem lies...

Not to mention the attitudes of some diabetic patients that i have encountered who just plain "Bo Chap"....
What happens to poorly controlld diabetics? Renal / Kidney Failure....
The rich will just 'buy' a new kidney. The poor go to NKF for dialysis...

Some more lots of Singaporean want to opt out of HOTA (Human Organ Transplant Act) Obviously demand will always be more than supply... How???...
« Last Edit: July 01, 2008, 03:25:31 PM by klumpkeTT »

klumpkeTT

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Re: Selling Kidneys in Singapore
« Reply #10 on: July 01, 2008, 03:15:51 PM »
What is HOTA?

HOTA (Human Organ Transplant Act) refers to the law that covers the removal of any organ from the body of a dead person into the body a living person. A short section also covers transplants between two living persons. In short, it covers transplantation of human organs.

Who is covered by the act?

Singapore Citizens and Permanent Residents
Non-Muslim
Aged between 21 and 60 years
Of sound mind (i.e. not insane)
AND
Who had not opted out while he was alive (by default, if you did not opt out)

What are the organs covered?
Kidneys
Liver
Corneas (the transparent front part of the eye)
Heart

When does the act kick in?

When a person has died in hospital
Death is defined legally in Part I, Section 2A of the Interpretation Act
Death may mean cardiac death (heart stops beating), or brain death (heart is still beating, but brain does not function)


--------------------------------------------------------------------------------
About opting out I strongly DO NOT recommend
How to opt out


You can opt out by filling in a form from the MOH website.
You can opt out completely, or for specific organs (e.g. donate your kidney and liver but not cornea and heart)
You must opt out yourself, while you are alive and able to do so.
    (i.e. your family cannot opt out on your behalf once you are in a coma).
What happens if I opt out

You will receive lower priority on the organ transplant waiting list, if you ever need a transplant.
This rule also applies to those not covered by HOTA (i.e. Age < 21 or > 60, and Muslims who have not opted in)

How to opt-in / cancel opt-out / donate other organs?

If you have opted out, you can cancel your objection(i.e. opt back in) at any time by using a similar form.
Other organs can be pledged under the MTERA
Non-Singaporeans can also do the same.
Muslims can opt-in, in the presence of two male Muslim adults, and receive equal priority on the transplant waiting lists.


from http://www.geraldtan.com/medaffairs/hota.html#intro

klumpkeTT

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Re: Selling Kidneys in Singapore
« Reply #11 on: July 01, 2008, 03:18:23 PM »
My own personal opinion - If i die, i hope every part of me can be used to save another.

Offline zuoom

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Re: Selling Kidneys in Singapore
« Reply #12 on: July 02, 2008, 12:31:09 AM »
*touch wood.

=================

there's a discussion on making it legal to sell kidneys. something along the line of "willing buyer, willing seller".

what do you guys think?

iirc, Iran is the few country that's legal to sell kidney.

klumpkeTT

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Re: Selling Kidneys in Singapore
« Reply #13 on: July 02, 2008, 01:31:24 AM »
You start selling kidneys you open a flood gates for illegal sales, black marketering. not to mention ILLEGAL harvesting.... (they steal your kidneys witout you knowing...)

Offline zuoom

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Re: Selling Kidneys in Singapore
« Reply #14 on: July 02, 2008, 02:21:30 AM »
i was thinking more along the lines of with it being legal, the proper method, test etc can be administered. ie: proper records, tracking etc.

leaving it illegal (or grey) as it is will probably be the action we will be taking.

the willing n rich will definitely continue to find ways to bypass/exploit the current laws. ie: receiving organs bought from overseas.

the stealing of your kidneys will continue to happen, be it illegal or legal. that's another problem to solve. ie: policing.