Should Donated Organs be International Property?
Today’s blog looks at health tourism focussing on organ transplantation. Recent reports in the media have been criticising the increasing numbers of foreign patients undergoing private transplant operation in the UK. However at the same time, the media often ignores the impact of people from industrialised countries visiting developing countries for cheaper healthcare. We also have posted a very interesting new article on the healthcare related faced by asylum seekers, who are interestingly often attacked by the British media for apparently moving to Britain with the sole intention of getting free healthcare.
Reports over the weekend in The Times has highlighted public dissatisfaction with the current EU rules surrounding organ transplantation.
European law currently enables patients from member states to seek treatment in other European countries. In reference to our previous blog from the European Regional meeting of the IFMSA, this means that an average patient in Europe waits 3 years for an organ. However this has also resulted in 50 foreign patients receiving the organs of British National Health Service donors over the past two years. This is despite the fact that the UK is suffering from a shortage of organs, with 8000 Britons currently on the NHS organ waiting list. Therefore the ethics of using organs to treat foreign patients, rather than using them for local patients, has been questioned by various UK residents, many of who are awaiting life-saving transplants themselves.
The situation is further complicated by the fact that forty-one of the overseas patients given British organs came from Greece or Cyrus with the governments of these countries paying the British hospitals for the operations at private rates on behalf of their citizens. The payment of £75,000 per operation was paid by the governments to overcome shortages in their own country. Apparently private foreign patients are currently given the same access to British organs as private British residents, with the recipient selected according to the severity of their condition and their blood group, but it unclear whether they have priority over NHS-treated British residents.
Interestingly, Britain is not obliged to treat these patients and the decision is left to individual hospital trusts. Some trust have decided not to perform transplants on patients from outside the UK however there are two main departments performing these international transplant operations, King’s College Hospital NHS Foundation Trust and Royal Free Hampstead NHS Trust, both in London. Though the practice has been reported to the Department of Health, the operations continue as trusts are not breaking any rules.
There is increasing debate in among medical communities about whether each countries organ pool should be reserved for the countries own members, or whether organ pools should be shared internationally. International organ registers such as The Anthony Nolan Trust are often championed due to their success in providing suitable donors and recipients for organs. However in this case both UK departments have been criticized by medical colleagues and patients, including calls for a similar system to Australia and New Zealand to be set up. In these countries, there are two waiting lists for organ allocation. This enables native residents to be allocated organs in priority to foreign patients. At the moment, no consensus has been drawn but it will be interesting to see how the debate develops as The Department of Health becomes involved in talks with the European commission to clarify the correct procedure. Furthermore, how does this debate fit in with the debate about whether to make organ donation compulsory in the UK, using the system of presumed consent modeled by Croatia?
This problem also ironically coexists with the global problem of health tourism. Health tourism normally involves people from industrialised countries, such as the UK, visiting developing countries, such as India, for cheaper healthcare. This specific type of tourism has been blamed for the establishment of an unequal two-tier system of healthcare countries and an ‘internal brain drain’ (involving professional moving from public to private hospitals) within developing countries.