End the organ trade racket

The lid has just been blown off an organ racket, which has led to the arrest of several high-powered doctors engaged in organ transplant work at a top private hospital in Mumbai. This is not the first time that organised illegal trade in organs has surfaced. It keeps persisting underground and periodically surfacing overground for two reasons. There is a huge unmet demand for organs by people suffering from organ failure that puts their life under threat. Such people will procure organs by whatever means possible. On the supply side, as it were, there are a lot of poor people who are lured into selling their organs to earn, what to them are, substantial sums of money. So, a market for organ trade is as real as the occurrence of organ failure. The choice is whether to leave it underground or to regulate and legitimise it and turn it into an essential non-commercial exchange system. This involves putting in place a cadaver policy that retrieves organs from dead voluntary donors, who have pledged their organs, or those killed in accidents, and quickly makes them available for transplant.

The key facilitators in this process are the doctors. They have rightly said they cannot stop illegality. But, doctors are critically placed to demand a legitimate and working system, and towards such a goal, exert greater influence over policymakers than most other players in this process. The trusted medical specialist that a minister or legislator consults has his ear. But, both doctors and the Medical Council of India, the official body charged with overseeing their professional and ethical conduct, have let everyone down.

It is vital that doctors at private hospitals stop pretending not to know how or from where an organ has come while happily pocketing the high fees that a transplant operation typically fetches. The reputation of private doctors and hospitals is already in the mud for their widely perceived role in fleecing patients by recommending and performing unnecessary diagnostic tests and procedures. This racket brings down the reputation of private healthcare providers even further. Clearly self-regulation by doctors' associations has not worked, and MCI has made virtually zero effort over the decades in bringing unethical doctors to book. To remedy the overall low ethical levels in private healthcare, it is worth considering stopping the practice of paying doctors commissions per procedure. Exceptional private healthcare providers known for maintaining high ethical standards, in fact, use only salaried full-time specialists. It is also high time the government cleaned up MCI and ensured that the council made a difference in doctors' ethical levels.

As for organ transplants, there is now an organ registry to record donors, and the government has decided to fund two transplant coordinators at every hospital that undertakes retrieval and transplant. But, enormous ground still needs to be covered in this regard. For organ retrieval to work, the country has to be dotted with good public hospitals with the necessary skills and facilities. The government has to play a strong role in coordinating public and private facilities that make up the entire chain of organ retrieval and transplanting.

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