Angry Doctor

Saturday, June 28, 2008

Medicine and Morality

It's been a long week and angry doc lacks the energy to write separate entries for two very interesting articles in the newspaper today, so he decided to lump them together.

The first article is a news article on illegal organ trade in Singapore.

Despite the known benefits of transplant to recipients and the very low risk to donors, the ministry's position on organ donation between unrelated persons is that "organ trading often involves the exploitation of the poor and socially disadvantaged donors who are unable to make an informed choice and suffer potential medical risks".

The second article is an interview with Professor Roy Chan, president of Action for Aids, who had this to say about the fight against HIV/AIDS in Singapore:

"We have to see Aids as a disease. Clouding the issue with the morality aspects only impedes the treatment and prevention of the disease."

Together, these two articles show how much morality affects the ministry's health policies. Whether that is a good thing or not will probably depend on whether you share the same morality.

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posted by angry doc at 7:15 pm

13 Comments:

  • "organ trading often involves the exploitation of the poor and socially disadvantaged donors who are unable to make an informed choice and suffer potential medical risks".

    Yes this is true. And we should try as hard as possible not to allow such things to happen.

    However the flip side is that many transplant patients die because they cannot find donors. What about them? Too bad?

    It is not impossible for the authorities to come up with guidelines to ensure legal organ donation with compensation.

    Morality issues aside, in today's society MONEY TALKS. I feel the medical world is way too @!$# to continue thinking otherwise.

    So can't we have some guidelines that ensure that only well to do (we've got means testing) and socially advantaged donors who are able to make an informed choice will be allowed to donate their organs with compensation?

    It is possible. And it will save lives.

    By Anonymous Anonymous, At June 30, 2008 11:15 am  

  • My view on organ donation is actually more extreme. I think we need to ask ourselves whether it is at all ethical to subject a person to surgical risks when there is nothing wrong with him physically, whether or not he is related to the recepient and whether or not money changes hands.

    Proceeding from that, I would say that for a donor to die during surgery is a tragedy, but for a donor to die during surgery because he needed money is an injustice.

    By Blogger angry doc, At June 30, 2008 4:52 pm  

  • Those are risks that would be made known to the donor.

    Some of these educated people who are in need of money may die anyway if they don't get the money.

    have you read Mr Wang's blog?

    By Anonymous Anonymous, At June 30, 2008 6:51 pm  

  • "Some of these educated people who are in need of money may die anyway if they don't get the money."

    So they may. But we don't necessarily have to have a hand it that, do we?

    People who support organ transplant and trading look at the lives of patients we stand to save. I look at the lives of healthy people we stand to lose. Donor risks are very low, and benefits to recepients are substantial. However, I don't think this issue should be just one of numbers, but a fundamental one about whether doctors should subject the lives of healthy people to risk for no physical benefits to them.

    By Blogger angry doc, At June 30, 2008 9:12 pm  

  • "whether doctors should subject the lives of healthy people to risk for no physical benefits to them."

    Well then how do your deal with the moralities of drug trials? Are the risks any higher in those? And for the matter more of these drug trials end up with nothing in terms of benefit for others (failed trials).

    I don't understand the point. Is the point that we should not have donors at all simply because it is too dangerous and we cannot AFFORD to lose any healthy people? (Certainly not so because you can donate for free)

    Or is it an issue of the morality of people receiving compensation?

    By Anonymous Anonymous, At July 01, 2008 9:43 am  

  • "Well then how do your deal with the moralities of drug trials?"

    I can't, actually. Any argument I can make for drug trial can probably be applied to organ donation too.

    That's why I merely state my view and do not promote it.

    By Blogger angry doc, At July 01, 2008 10:19 am  

  • This comment has been removed by the author.

    By Blogger Cyke, At July 01, 2008 1:59 pm  

  • Cyke,

    I think your criticism is valid.

    The only argument I can make is that we have no reasonable choice but to use human volunteers for drug trials, whereas we have the option of non-living donor when it comes to organ transplantation (which does not endanger the donor). However, at the same time I must acknowledge that living donors can provide more timely intervention and better outcomes.

    I don't think I am morally-consistent on this issue: I will probably donate an organ but not receive one from a living donor, and I have no issue with donating an organ when I die or receiving an organ from a non-living donor.

    By Blogger angry doc, At July 01, 2008 2:39 pm  

  • Hi angrydoc,

    Actually the whole point in the end is that our world stinks.

    Money talks lah. No money incentive, nobody wants to help.

    So for the patients they are just waiting to.....

    It's one of those very last bastions where even if you had tons of money you cannot buy your way out.

    But I personally think it is about to change.

    By Blogger Cyke, At July 01, 2008 3:58 pm  

  • Well, if it's any comfort I suspect the ethical issues revolving around a human donor will all be moot in our life-time with the advent of first human-compatible animal organs and then "test-tube" organs grown from stem-cells on a scaffolding.

    By Blogger angry doc, At July 01, 2008 4:27 pm  

  • "Well, if it's any comfort I suspect the ethical issues revolving around a human donor will all be moot in our life-time with the advent of first human-compatible animal organs and then "test-tube" organs grown from stem-cells on a scaffolding."

    Yes. But what will be the price of such treatments? Probably priced way beyond the reach of the average man.

    So in the end, it's the same. The rich will get the organs. But instead of the donor receiving $$$ it is the medical corporation/pharmaceutical that gets the $$.

    Might as well save some people right now.

    By Blogger Cyke, At July 01, 2008 4:37 pm  

  • Medical technology 'trickle down'. In the first few years and maybe decades after they become available "grown" kidneys will probably be beyond the reach of many, but they will later become available due either to competition between suppliers or government subsidy.

    By Blogger angry doc, At July 01, 2008 5:01 pm  

  • Well what's the morality in denying a life saving treatment to someone because they cannot afford it, vs denying a life saving treatment that someone can afford?

    By Anonymous Anonymous, At July 01, 2008 5:14 pm  

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