Organs at any price? Gestating for donating

Is transplantation medicine losing its way? Organ transplantation has been one of the great medical advances during the past half-century or so. However there have been several episodes of public loss of confidence in organ donation during that time. After the notorious Wada heart transplant scandal, heart transplants in Japan virtually ceased for decades and the case of Sim Tee Hua in Singapore is part of the reason that donation rates remain low there. These scandals have all involved adult patients —  up to now.

New questions arose for me however about the ethics of organ donation from a paper given by a paediatric intensivist at London’s Great Ormond Street Hospital at a recent conference in Glasgow.  Dr Joe Brierley, who has tirelessly campaigned to increase the availability of organs for children, stated in the Daily Mail that “Given that three people a day die waiting for an organ transplant, I welcome anything that improves the number of donors.”

His general enthusiasm to increase available organs is understandable. However the particular idea that Dr Brierley is now advocating is that women carrying babies identified on antenatal screening to have lethal abnormalities such as anencephaly, should be asked if they would allow organs to be taken from the baby for transplantation after birth should they choose to continue with the pregnancy.

From a utilitarian perspective this makes perfect sense – these children have hopeless prognoses and will die anyway so why let their organs simply go to waste?  Though exact details of the proposal are unclear there are enough elements in what has been reported to raise some serious questions.

Read here