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Towards a new transplant scheme in the US

Four states in the USA have recently adopted a revision of the human organ donation law. This should facilitate donations and help fight both the shortage and the traffic of human organs.

Transplantation is an increasing problem in rich states where waiting lists are growing faster than donors' lists. For instance only 25 000 kidney transplants are performed every year in the US on the 95 000 people who are waiting for such transplants.

The shortage of donors has fuelled a global black market in human organs which threatens the traditional legal framework for organ donation. Whereas selling human organs is illegal in the US and in Europe, the world traffic in organs is booming. Poor people sell their organs for very little money to intermediaries who often sell them again with a very high profit margin. "A New Yorker paid $60,000 to receive a kidney in a South African hospital from a Brazilian who was paid $6,000 for it,"** explains Francis Delmonico of Harvard Medical School.

Ending this "medical apartheid" is not easy. The idea to create a regulated market for human organs has been rejected so far as it would be a step towards the commercialisation of human organs. "If kidneys have a [monetary] value, all organs have to have a value. But nobody can sell his heart."** said Bert Vanderhaegen, ethicist at University Hospital in Ghent, Belgium.
Organ donation is a sensitive and intricate issue, both ethically, emotionally and legally. The revision of the organ donation law tackles many tricky problems but not all. "The idea behind this is to facilitate organ donation as much as possible,"* according to Robert M. Sade, the American Medical Association's representative to the committee that drafted the measure. For instance, it makes clear that if someone wants to become a donor, his or her family cannot override his or her decision, i.e. when a donor's family refuses to allow the removal of organs on the dead donor, the revised law imposes to respect the decision of the donor.

The idea is to get this revision adopted nationwide. "What we're trying to do is come up with a set of uniform rules that will encourage more donations,"* says Sheldon F. Kurtz, a University of Iowa law professor. About 20 states are interested in the new donation system. Virginia, Idaho, Utah and South Dakota have already adopted the measure but the signatures of other states like Arkansas, Indiana, Iowa and New Mexico are shortly awaited.

Sources: * "States Revising Organ-Donation Law," The Washington Post 4 April 2007.
** "Human organ trafficking threatens donation schemes," The Washington Post 2 April 2007.

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