Angry Doctor

Tuesday, February 06, 2007

How much is that kidney in the window?

(source: http://caglecartoons.com/)

angry doc could almost hear Prof Lee's sardonic voice in his head as he read her latest letter on the ST Forum page today.

An organ is no different from a life-saving drug

THE debate about allowing the sale of organs has revealed an amusing aspect of human nature: 'If my welfare is not compromised, I can afford to espouse the politically correct view', human organs are sacred and should not be traded like a commodity.

However, the cold reality is that there are people suffering and dying because no organ is available in Singapore. These patients do not think it wrong that they buy an organ.

A similar situation is where pharmaceutical companies require strong laws upholding their patents to survive and make a profit. This is a major incentive for them to set up factories and do R & D in Singapore. They spend millions, and sometimes billions, to create new drugs. Patents allow them to make back their money. Otherwise, new cures may not be found.

On the other hand, the patients who can benefit from but cannot afford these new drugs which are still protected by patents rant, rave and, in certain countries, riot because they feel their health is more important than economic justice.

I suggest that we be cool- headedly but compassionately logical. What makes an organ more sacred than a medical device or medicine that can save a life? The supplier of the organ or the pharmaceutical company producing the new drug must be appropriately remunerated or there would be no incentive to part with the organ or undertake the R & D required to produce a safe and effective drug.

Whether the public and patients like it or not, these are the facts. Everyone stands to lose if we choose to ignore these facts and use arbitrary moral arguments to support a certain stance and enforce the illogical stance by law.

Assoc Prof Lee Wei Ling

Prof Lee summarises angry doc's view on the whole organ-for-sale debate succintly in her first paragraph.

angry doc's first response to Prof Lee's comparison between drug patents and organs was that one involved direct risk to a human being while the other didn't. But of course he is wrong - drug trials involve human test subjects, and occassionally adverse effects and deaths do result from them.

angry doc admits that he is squeamish about the whole idea of a living-donor organ transplant, let alone a transplant where the donor is paid to undergo the surgery. It comes from an old belief that healthy persons should not be subject to surgical risks. Of course, how much donor mortality and morbidity is considered acceptable is a subjective judgement.

As an exercise, do ask yourself how much donor mortality and morbidity risk in a liver transplant you would consider acceptable, and then compare your answers with the figures in this article.

So is it safer, or riskier than you had thought?

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