Before it slips from the news, take a look at a scandal in India that illustrates one of the biggest bioethical challenges we face in a globalised world. Last weekend, Nepal handed over to Indian authorities an Indian man arrested on suspicion of running a huge illegal kidney transplant racket. It seems this ring duped poor Indians into selling kidneys that could be transplanted into rich Indians and foreigners at many times the fee that the unwitting donors received. At least five foreigners — two U.S. and three Greek citizens — were found in a luxury guesthouse run by the racket in a city of high-tech companies just outside New Delhi.
Demand for cheap kidneys has skyrocketed in recent years in rich countries, mostly because people there are becoming more obese and suffering from kidney failure. This has led to “transplant tourism” where patients from rich countries travel to the developing world to receive new kidneys. It has led to serious proposals to set up a global kidney market to meet the demand.
This black market in kidneys for transplants is widely denounced as illegal and immoral because it exploits poor people. But would creating a worldwide organ trade make the practice any more moral? Is the danger of exploitation of the poor so strong that lawmakers should ensure that money doesn’t end up deciding everything?
This is one of those bioethical challenges that are multiplying as science and technology create situations that were unthinkable not so long ago. Ethics councils, churches and philosophers develop guidelines to keep up, but reality has a way of pulling ahead of them. Globalisation means agents in one country can arrange for patients in a second country to have the transplant performed in a third. We will probably see more rather than fewer cases like this one in Nepal and India.
We’ve written on this issue from several datelines over the past year. Here are a few that give an idea of the problem: