Selling organs

[wunky]

From the London Times:
A paper by two American doctors, published today in the journal Kidney International, suggests that the medical profession should consider setting up a regulated market in organs from live donors.

Would this work? Would we want it to? Would we stop at just kidneys?
There are not enough donor organs to meet the demand. It is not just kidneys. Maybe if people were paid for their organs that would increase the list of available organs.
Imagine if you could get $5,000.00 (US) for your liver, $20,000.00 (US) for your heart or $60,000.00 (US) for your lungs. You would get the money before you died. Would that make the body a commodity?

That would allow several more people to live, or live longer/better.

Or are the ethics tied to the concept more than we could stomach (pun)

[Earthborn]

Imagine if you could get $5,000.00 (US) for your liver, $20,000.00 (US) for your heart or $60,000.00 (US) for your lungs. You would get the money before you died.A person cannot live without these organs, so I assume that you mean that people will be paid for promising that their organs may be used after they died.

The problem with this scheme is that there is no shortage of people willing to donate their organs after death, even if they are not paid for it. There is a shortage of people willing to donate their organs dying under the right circumstances that their organs can actually be used: they must be braindead, but otherwise healthy. This happens almost exclusively in car and particularly motorcycle accidents. Even if paying people to become donors makes more people willing to become donors (and I'm not convinced that's true), these people still need to die under the right circumstances. If they die in old age, they have been paid for nothing.

If a liver is worth $5000, and the chance someone dies in the right circumstances is 1:1000, you'll only be able to offer each potential donor $5 as you would have to pay 1000 potential donors to get one liver. That's not much more of an incentive than appealing to people's emotions by telling them they can "help others" by signing up on a donor registration list.

[jj]

Somebody does that all the time:
http://www.imagin.net/~rredman/

[wunky]

Somebody does that all the time:
http://www.imagin.net/~rredman/


I would imagine that would be quite a production.

[wunky]

The problem with this scheme is that there is no shortage of people willing to donate their organs after death, even if they are not paid for it.


Where are all of these people? Are they on the UNOS lists?
According to the article over 3,000.00 people a year die waiting for a kidney.

[Mongrel]

The problem with this scheme is that there is no shortage of people willing to donate their organs after death, even if they are not paid for it.


Where are all of these people? Are they on the UNOS lists?
According to the article over 3,000.00 people a year die waiting for a kidney.


As I understand it whilst a lot of card carrying, organ donors die each year it's a) The donors age and lifestyle, b) Nature of death c) Timing of death and d) Suitability. Apologies in advance if the following seems ghoulish.

For example I smoke, therefore my lifestyle choice will probably preclude someone getting my lungs if I get knocked down by a bus tomorrow. Age is important because even with todays medical knowledge transplanting a pair of 75 year old kidneys will only be of marginal benefit.

Nature of death takes into account that the donor died with all the transplantables in good condition. Timing of death means organs whipped out of my still warm body won't stay in a good condition for very long - ideally they're looking for the donor to be brain dead\no hope of recovery but on life support, that way the person recieving the transplant can be moved nearer to the location and in a hospital bed before they flick the switch.

Finally suitability, even with advances in immuno-suppressants there's no point putting a my fresh kidney into someone if their body rejects it. At best it's done no good and it's wasted a perfectly fine kidney and at worse you've just killed the recipient.
Combining all these factors means that, unfortunately, people who need a transplant do have a wait ahead of them :(

[wunky]

I also realize that we are harvesting organs from other animals for possible donation. Pigs- come to mind right off the bat.

Is any medical institution cloning organs? Has that been raised as a possibility?

[richardm]

In the past trade in organs has been tainted by people nipping over to the Third World and helping themselves for fun and profit.

You can remove this risk by insisting that anyone who dies has to donate their organs. If they don't like the idea then they can carry a "Leave my bits alone" card. I think this opt-out would result in a much livelier range of body parts than the current opt-in.

[HopkinsMedStudent]

I also realize that we are harvesting organs from other animals for possible donation. Pigs- come to mind right off the bat.

Is any medical institution cloning organs? Has that been raised as a possibility?

Cloning individual organs is, as of right now, science fiction. No way to do that currently without cloning a whole human being.

However I think in the future cloning organs without cloning a full human will be possible. But I'd say we're at least 20 or 30 years away from that.

[luchog]

A person cannot live without these organs, so I assume that you mean that people will be paid for promising that their organs may be used after they died..
Only if they're insisting that any organs I sell be my own. Without that little restriction, I would have no problems selling as many organs as are needed. I can guarantee quality and condition.

[SteveGrenard]

Only if they're insisting that any organs I sell be my own. Without that little restriction, I would have no problems selling as many organs as are needed. I can guarantee quality and condition.

Sounds like the theme from The Organ Grinders by Bill Fitzhugh which if you haven't read, I recommend anyone interested in this try it.....it will have you in stitches.

Here's part of a brief review from the Library Journal:


If there's anybody currently working hard at resuscitating the art of political incorrectness, it's Fitzhugh, first in Pest Control (LJ 3/1/97) and now in The Organ Grinders. Jerry Landis, the driving force behind the pharmaceutical concern Landaq, plots to use baboon organs to fill the demand for human hearts, lungs, and tissue. Aiding him is Arty, whose discovery of his own rapid-healing ability has led him (for a price) to the head of the organ donor line, leaving him at this point little more than a human stump in a motorized wheelchair.

It's probably out of print but widely available via used booksellers on the net.

[Capsid]

I also realize that we are harvesting organs from other animals for possible donation. Pigs- come to mind right off the bat.

Is any medical institution cloning organs? Has that been raised as a possibility?

Transgenic pigs were being produced for the purpose of xenotransplantation. Unfortunately, pigs have endogenous retroviruses and the uncertainty of a zoonotic infection with these viruses has required some further research.

[rjh01]

Imagine you are a doctor telling someone that their relative is on life support and their is no hope of recovery. You recommend that life support be turned off. This is a unpleasant, stressful situation for yourself. Not add in the extra bit about asking for their relative's organs. I am sure many doctors will not do this. Hence their is a shortage of organs.

[geni]

Imagine you are a doctor telling someone that their relative is on life support and their is no hope of recovery. You recommend that life support be turned off. This is a unpleasant, stressful situation for yourself. Not add in the extra bit about asking for their relative's organs. I am sure many doctors will not do this.

Really. It seems to be pretty standard practice.

No the shortage is still largely due to all those selfish 20 somethings wearing seatbelts.

[Ducky]

I support regulation on organ sales.

9 grand for a pristine Hammond B3 is just rape.

[Soapy Sam]

I think it's time we started tissue typing convicted criminals.
As a moral reason to behave in a civilised fashion, the knowledge that next time you break the law your left lung will go on an organ donor list might be quite effective.

[rjh01]

That is what they do in China. Capital punishment by shooting in the head is the common punishment for serious crimes. The organs of the deceased are then sold.

[IIRichard]

In the past trade in organs has been tainted by people nipping over to the Third World and helping themselves for fun and profit.

You can remove this risk by insisting that anyone who dies has to donate their organs. If they don't like the idea then they can carry a "Leave my bits alone" card. I think this opt-out would result in a much livelier range of body parts than the current opt-in.

I'd carry the idea bit futher. Implement laws that make the opt-out or in decision binding on the deceased's survivors. If hubby didn't sign and carry his opt out card then the widow can't block his apparent willingness to be a donor. Also, anybody who has opted out for whatever reason, goes to the back of the line for organs if he/she needs one. That would effectively deny donor organs to the opt-outs but screw 'em.

In the interest of full disclosure, I was the beneficiary of some donated scleral
tissue some years ago.

IIRichard

[Soapy Sam]

Listened to a discussion about likely increases in NHS prescription charges and other medical / dental procedures widely believed to be " free" in the UK.

It occurred to me that supermarkets issue "loyalty" cards to customers. How's about a discount off NHS bills for people who are blood donors or carry an organ donor card? Or a two for one hip transplant?

[Mercifull]

If i got paid that kind of cash for my organs then id gladly let go of a kidney.
The problem with offering stuff like this is that the poorest get hit, they are the ones who will most likely be selling these organs and are likely to not be as healthy as a result of this. Theres also the issue of people perhaps being forced to sell their organs by other people and then taking the money for themselves. Theres a lot of vulnerable people out there and almost as many people willing to abuse their position for their own gain

[SteveGrenard]

The story that started this discussion has been picked up by a few papers in recent days and is an argument IMHO both for and against the “sale” of body parts.

While many doctors discount financial transactions for organs as wholly unethical, others have suggested that it is not such a large moral distance from selling semen or ova.

Eli Friedman, of the State University of New York, and Amy Friedman, of Yale University, the authors of the paper, say that the case for legalising kidney purchase hinges on the key premise that individuals are entitled to control of their body parts, even to the point of inducing risk of life.

more at:

http://www.dispatch.co.za/2006/02/17/Foreign/abody.html

In a related, somewhat older story, a firm in NYC was called up on charges that they conspired with undertakers to harvest body parts for implantation into living humans in need of them. What looked like a fully legitimate and legal business turned out to be anything but as authorities charged the company and undertakers with harvesting withOUT permission, failure to check the tissues for infectious diseases such as HIV or hepatitis and sloppy paperwork involving mix-ups, deliberate or accidental in death certificate records … e.g. the wrong deceased credited with a tissue specimen that came from another. The Biomedical Tissues saga prompts the question for the kidney doctors "Who's going to guarantee the organs are infection free?" Would I buy a used kidney from this person (Mercifull..) without safeguards? No.


New York senator pushes for legislation
Jan. 30, 2006. 01:00 AM
PREMA OZA
SPECIAL TO THE STAR

WINDSOR—The district attorney's office in Brooklyn, N.Y., is investigating the illegal sale and acquisition of body parts while high-ranking officials at Windsor's Hotel-Dieu Grace Hospital react to the intense media and legal scrutiny from the use of some of those cadaver parts in surgeries.

While the district attorney's office would not comment, New York sources say the crux of their case appears to fall under fraud-related charges involving the forging of death certificates and other paperwork pertaining to a New Jersey cadaver tissue bank known as Biomedical Tissues Services Ltd.

more at:

http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_Type1&c=Article&cid=1138575010125&call_pageid=968332188774&col=968350116467


There is a real problem allowing the unregulated sale of tissues when it comes both to permissions and the presence of communicable diseases …. By doing so surreptitiously without the involvement of the donors’ hospitals, doctors and family in the chain of supply, it is much too easy for infected tissue to slip into the inventory. By involving family and health care givers a patients history would or should be known and this is an important safeguard. This company overlooked the need for universal precautions and now a lot of recipients of their “product” are worried.

Here is the FDA’s statement on this subject:


Under its comprehensive framework for ensuring the safety of human tissue products, the U.S. Food and Drug Administration (FDA) today ordered Biomedical Tissue Services, Ltd. (BTS), of Fort Lee, N.J., a human tissue-recovery firm, and its CEO and executive director of operations, Michael Mastromarino, DDS, to immediately cease all manufacturing operations. All tissue products initially recovered from human donors by BTS were recalled. FDA is carefully monitoring these recalls to account for all of the tissue distributed."FDA's investigation of BTS revealed serious and widespread deficiencies in their manufacturing practices that provide the agency reason to believe that allowing the firm to manufacture would present a danger to public health by increasing the risk of communicable disease transmission," said Margaret O'K. Glavin, FDA's associate commissioner for regulatory affairs."FDA's current regulatory framework for Human Tissue and Cellular and Tissue Based Products (HCT/Ps) provides strong measures that the agency can utilize to prevent the introduction, transmission, or spread of communicable diseases by HCT/Ps, and require firms to screen and test donors for relevant communicable disease agents and diseases and to ensure that HCT/Ps are processed in a way that prevents communicable disease contamination and cross-contamination," added Jesse L. Goodman, MD, MPH, director of FDA's Center for Biologics Evaluation and Research. The FDA order to cease manufacturing and to retain HCT/Ps requires BTS to suspend any and all manufacturing steps, including but not limited to the recovery and shipment of HCT/Ps. FDA's inspection of BTS uncovered serious violations of the regulations governing donor screening and record keeping practices, as well as failures to follow their own standard operating procedures (SOPs), failure to recover HCT/Ps in a manner that does not cause contamination or cross-contamination during recovery, and failure to adequately control environmental conditions. Despite records maintaining otherwise, the firm had inadequately screened donors for risk factors for, or clinical evidence of, relevant communicable disease agents and diseases. In addition, FDA found numerous instances where death certificates maintained in BTS' files were at variance with the death certificates FDA obtained from the state where the death occurred, on important information such as cause, place, and time of death, and the identity of the next of kin. After initially focusing efforts on assessing the safety of distributed tissues and facilitating the appropriate recalls, the agency has determined that these violations, because of their serious nature, constitute a danger to health and is taking this unprecedented action.FDA continues to investigate BTS' activities and to work cooperatively with tissue processors and appropriate federal, state and local authorities, and will take further actions as needed.

Source:FDA
http://www.infectioncontroltoday.com/hotnews/62h61003920082.html

[SteveGrenard]

Here's a follow-up on the story mentioned above which is from today's NY POST...pretty gruesome stuff:



http://www.nypost.com/php/pfriendly/pfriendly_new.php


4 INDICTED IN 'BODY-SNATCH'
By LARRY CELONA

The four ghouls who allegedly ran a body-snatching ring were indicted yesterday by a Brooklyn grand jury, The Post has learned.
Michael Mastromarino, a former dentist from Fort Lee, N.J., and Joseph Nicelli, an embalmer, face a 100-plus count indictment on a slew of charges - including grand larceny, forgery and fraud - in connection with a ring that harvested the body parts of more than 1,000 cadavers, sources said.

The men allegedly stripped bodies of tissues, bones and organs, then sold them for a profit without the permission of the bereaved families. The body parts were taken from corpses at funeral homes across the city, New Jersey and Pennsylvania.

Investigators who examined the body of an 82-year-old woman discovered that half her bones were missing -and had been replaced with plastic plumbing pipes.

"Masterpiece Theater" host Alistair Cooke, who died in his Manhattan home in March 2004, was among those whose bones were sold by Mastromarino, authorities said.

larry.celona@nypost.com



complete story at:

http://www.nypost.com/php/pfriendly/pfriendly_new.php