There were two articles recently about kidney transplants.
The first was a heartwarming one about a 5 way swop of kidneys so that 5 needy patients with 5 willing but otherwise non-compatible donors, would be able to receive suitable kidneys. With the shortage of donors, this unconventional method of transplanting kidneys was a great success. Although it must have been a logistical nightmare, all came together with a resulting happy ending.
The second is about the legalisation of sales of kidneys in Iran. This is undeniably controversial. The question of ethics comes up. But if you were the patient, & had the means to pay for such a procedure, would you do so? Having said that, would this mean that only those who can afford it will get the kidneys they need while the poorer patients will have to wait till an available donor comes up, or till they die?
As doctors, our first response to such commercialisation of organ transplantation would most likely be that of disapproval. The idea of selling organs for money is a distasteful one. Whenever money comes into play, there is always the chance that eventually, the bottom line will become more important than the patient's health (IMHO, this is already happening - look at how aesthetic medicine is booming & how MHC's have affected the way medicine is practised).
But as humans, how do we condemn someone who only wants to live to see his/her children grow up & grow old with the one they love?
This is a complicated issue indeed, & something that we need to step back & look at from different perspectives...no easy answer to it.