Organ transplants: Your part or mine?
AS MARKETS in human organs go, the one which flourishes on Tehran’s Vali Asr street, where Iran’s main transplant hospital is located, is not the cruellest—and there is no lack of people willing to discuss their transactions. Gholamreza, a 44-year-old man from northern Iran, explains what he did when his dialysis started to fail. “I put an advertisement in the paper for a kidney, and a donor came straight to me. We reached an agreement on the price quite quickly. In these cases, the recipient usually takes care of the donor afterwards. So I still visit my donor and help him out.”
Another man wandering round the district, aged around 30 and wearing torn, cheap clothing, is hoping he can find a buyer as decent as Gholamreza claims to be. He expects to get between $3,000 and $4,000 for one of his kidneys. “I need the money because I lost out in a pyramid investment scam. After the operation I won’t be able to lift heavy things, but I can still live with only one kidney.”
Iran’s Association of Kidney Patients, a non-government organisation which obviously enjoys official favour, is responsible for all legal kidney transplants: it insists that commercial deals are the exception, not the rule. For one thing, it says, the religious authorities encourage voluntary gifts: in other words, cases where a patient receives a kidney freely offered by a friend or relative. Pious Muslims may also offer up a kidney to anyone who needs it.
For surgeons, patients and medical economists alike, the shortage of kidneys seems frustrating, because no organ lends itself better to transplant. As long as they receive decent after-care, kidney donors suffer only the tiniest increase in their own risk of dying of kidney disease. And transplants make economic sense: the cost of one kidney operation and a lifetime’s supply of anti?rejection drugs equals that of three years’ dialysis. Kidneys donated by a living person last for a median 22 years in another body; when they are taken from a fresh corpse, the figure is 14 years.
Whatever solution they propose to the shortage of kidneys, nobody doubts that the black market, as it now works, has grotesque effects, both for donors and recipients. Rich westerners who go to South Asia or Africa in search of kidneys often receive organs that are diseased or unsuitable.
Nancy Scheper-Hughes, an American professor of medical anthropology and campaigner against organ trading, says the way poor Brazilians were induced to travel to South Africa is typical of the abuses a market in body parts, especially an international one, is bound to cause. She says donors in the Brazilian slums were given false promises about the money they would make, the care they would receive and the after-effects of the operation.
Some senior figures in the medical world draw a different conclusion: as long as some people are determined to obtain kidneys and others are desperate enough to sell them, the trade will be impossible to stop—so it makes better sense to regulate the business than drive it underground.
显然受到官方支持的非政府组织“伊朗肾脏患者协会(Iran’s Association of Kidney Patients)”负责所有合法的肾脏移植事务：该组织坚持称，商业交易是例外，而不是常态。它表示，首先，宗教权威鼓励自愿捐献;此外，患者通常接受的是由朋友或亲戚免费提供的肾脏。虔诚的穆斯林也会将肾脏捐献给任何需要的人。
南希·谢柏?休斯(Nancy Scheper?Hughes)是一名美国医学人类学教授，也是一名反对器官买卖的活动人士，她说，劝诱巴西穷人前往南非旅行的方式是人体器官市场，特别是国际性的市场，所必然促生的典型弊端。她表示，巴西贫民窟的捐赠者只得到有关可挣钱款、所获照顾以及手术后果的虚假承诺。 #p#副标题#e#
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