Examentrainers

		Just how vital are				were going to come along not speaking the same
		your organs?				language before you were going to ask the
						question?!’ one member of the General Medical
		… but kidney doctoring is bad				Council asked a doctor.
		by Barbara Gunnell		5		Unabashed, the dog now returns to its vomit.
				6		‘The best way to address such problems would be
						by regulation and perhaps a central purchasing
1		A delicate business, medical ethics, and the				system, to provide screening, counselling, reliable
		International Forum for Transplant Ethics was wise				payment, insurance and financial advice,’ write the
		to observe a long period of silence on the sale of				ethical experts, concluding with a flourish that
		organs for transplant after the Turkish kidney donor				‘feelings of repugnance cannot justify removing the
		scandal of the Eighties. But time is a great healer				only hope of the destitute and dying.’
		(though less so if you’ve had one of your kidneys		7		The logic here is a bit assailable (we could, for
		stolen), and the Forum now wants to re-examine the				example, look for better ways of helping the
		rights and wrongs of rich people buying the kidneys				destitute than dismantling them). None the less the
		of poor people.				doctors are right that a shortage of kidneys for
2		‘Most people will recognise in themselves the				transplant is causing suffering and death - as well as
		feelings of outrage and disgust that led to an outright				a substantial loss of profits, with an estimated 38,000
		ban on kidney sales … Nevertheless, we need better				patients waiting for kidneys in the United States
		reasons than our own feelings of disgust … if we are				alone.
		to deny treatment to the suffering and dying,’ wrote		8		So what have we, the squeamish, to offer as a
		members of the Forum in The Lancet3) last week.				solution? Human rights considerations militate
3		Let’s just recall the disgust and outrage that are				against regularising the illicit but flourishing trade in
		not good enough reasons. A lucrative trade in the				the organs of executed Chinese prisoners: livers for
		kidneys of impoverished Turks was exposed in our				$40,000, kidneys for $20,000, guaranteed non-
		very own Harley Street 4). The gaff was blown when				smoker lungs, etc. One might find the number of
		one poorly Turk had to carry his even more poorly				executions rising uncannily.
		compatriot out of the private clinic that had		9		But consider: the destitute and dispossessed, with
		purchased their kidneys for £3,000 and resold them				their inadequate diets and degraded environments,
		for at least 10 times that.				need both their poison filters. The rich, with their
4		Called before the General Medical Council to				sanitised lives and Perrier water, can easily get by on
		defend their trade, doctors said they had thought all				just one. Doctors seem confident that removal is a
		the impoverished Turkish donors they saw were				simple risk-free operation. We suggest they lead the
		volunteer relatives of the wealthy recipients, who,				way - make donating a kidney part of the rite of
		strangely, were Greek, Israeli, Libyan - every				passage for all doctors entering private practice.
		nationality but Turkish. ‘One almost has to make an		10		No cash, no ethical dilemma.
		effort to be as unwitting as this. How many Turks
						‘The Observer’, June 28, 1998

noot 3 - The Lancet: a British medical journal

noot 4 - Harley Street: a London street with a large concentration of private medical practices