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Ethics in Biology, Engineering and Medicine: An International Journal
SJR: 0.123

ISSN Print: 2151-805X
ISSN Online: 2151-8068

Ethics in Biology, Engineering and Medicine: An International Journal

DOI: 10.1615/EthicsBiologyEngMed.2015014034
pages 287-300

Ethical and Current Issues with Organ Transplants in Developed and Developing Countries

Mariane Espitalie
SUNY Downstate Medical Center, Department of Orthopedic Surgery & Rehabilitation Medicine, Brooklyn, New York
Subrata Saha
University of Washington, Department of Restorative Dentistry Affiliated Faculty, Department of Oral & Maxillofacial Surgery School of Dentistry, University of Washington, Seattle, WA


There is a worldwide gap between the number of transplant donations and patients waiting for them. However, challenges vary depending on countries and their educational level, poverty rate, and health insurance. Thus, different solutions have to be considered depending on laws and policies to overcome the low rate of organ donations and the ethical issues linked to them. In developing countries, due to poor diet, aging populations, and no health insurance, diseases affecting organs are common, and there is a particularly high demand for kidney transplants. For instance, in India and Nepal, transplants are mostly taken from living donors and family members to ensure emotional attachment from the donor instead of monetary goals. However, many poor people give their kidney for pecuniary gain due to massive financial pressure. Thus, there is a real need for more donors to reduce this opening to illegal organ trafficking. To overcome the gap between the demand and supply of organs, there is a need to educate the population about cadaveric donations. In developed countries such as the United States, the same gap exists. Transplants are taken from brain-dead individuals if they are identified as consenting donors on their car licenses. However, because of the aging population, fewer donors are available and the waiting list is increasing. One possible solution is to adopt the "consent statute" as Spain and 24 other countries in Europe did, which presumes that everyone is a donor once brain dead unless they indicate otherwise. There is a need to consider living donors as well; thus, the main issue is whether we should be free to donate organs for money because our body is our property. Is it fair to get an incentive for a generous act? Shouldn't medicine prevent people from harming themselves? This could be relevant in developed countries because policies and laws could control procedures and the goodwill of people. However, this regulation seems impossible in developing countries. Despite the increase of donations, organ sales in developing countries would only favor rich individuals and drastically reduce poor donors' lifespans due to inadequate medical follow-ups. In a distant future, we may be able to overcome the gap between supply and demand by engineering tissue reconstitution and developing artificial organs.

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