The
amendment to the Human Organ Transplant Act (HOTA) allowing for
reimbursement of living kidney donors was passed in Parliament with
heated debate recently.
It generated such heat that MPs from the ruling party were
given authorisation to vote in accordance to their religious or
moral convictions.
The obvious objection seems to centre on the possible
abuse from those donors who may do so for profit as well as how
ethics committees can discharge duties responsibly.
Whatever the objections or concerns may be, it does seem
that the primary focus is on the donor rather than the
recipient. In this sense, would it not be
expedient to discuss this issue from a systemic perspective, taking
into consideration the needs of recipients, consequences for donors
as well as the larger health system.
It is certainly beyond the health system to meet demands
for kidney transplants. The fact that there is such a long waiting
list for kidneys, must definitely spur us to think of the burden of
our health system to ensure that kidney patients do not need to
experience undue suffering.
There is also the need to consider ways to ease the burden
of having to deny those in grave danger not only from further
incapacitation or death. If laws are too
stringent and kidney donation becomes restrictive, one wonders if
our health system would have the reputation in being an illness
system.
If our health system is to provide healing and enhancement
of health, then the onus is on the administrators of the system to
explore every avenue to ensure that this is made available to all
in need.
It is always tragic to learn of those who have to endure
extended suffering from kidney failure, far worse to witness those
who die prematurely due to lack of access to kidney
donors.
We only need to recall the very heart-rending experience
some years ago of the family of the Indian woman who experienced
severe pain and suffering till her death because her life could not
be saved due to restrictions prevailing at that
time.
Her family was traumatised and the health of her mother
and sister were so badly affected that within a year or two, they
too met their death. The surviving sister
needed help with her trauma that took a while to
heal.
Such an experience should not be repeated if we could
consider the needs of kidney patients. If we value life, then
surely saving lives must take precedence over laws and
procedures. And if easing the restrictions
and making donation more readily available can be a way to promote
living, then laws would need to be amended to make this
possible.
If we were to have this expanded perspective, then it is a
little easier to uphold the need to consider how best to make
donation more accessible. This is where the
amendment to provide for reimbursement can make sense.
There must be a place for care of the donor as
well. For one, we are aware of the risks
involved. Donors have encountered complications to their physical
well-being including deaths, although the latter has been
infrequent.
As the Health Minister asserted in Parliament, suffering
from financial consequences is a major risk involved. Furthermore,
during the recovery from the procedure, disruption to work and
life, as well as the need to live with the loss of an internal
organ are other risks that have often been overlooked.
To this extent, the amendment to allow for reimbursement
can pave the way for reluctant donors to offer their
kidneys.
Of course there will be possible risk of abuse of the
system but that should not deter us from a very humanitarian
approach to this matter. Likewise, those
who are concerned about the administration of reimbursement and
procedures to be put in place to prevent abuse can be assured that
these are operational matters that can be dealt with
responsibly.
This confidence comes from the way our government has been
functioning, ever cautious and
prudent. Sometimes they tended to be unduly
vigilant to the point of stifling possibilities for change. If they
continue to function as they probably would, then we can be hopeful
that measures would be put in place to prevent abuse.
There are already ethics committees in place for approving
organ transplants and we can rest assure that fine-tuning will be
executed accordingly.
Hence, there should be optimism despite concerns
expressed; support for greater flexibility in the midst of existing
laws and public support for making kidney donation more readily
available.
Hopefully our health system will be life-enhancing,
life-preserving and life-extending with this amendment passed in
Parliament.
