Organ transplantation is certainly one of the “miracles” of modern medicine. Organ donation is founded on the pillars of altruism. Despite many obstacles, the era of transplantation has begun and was everywhere hailed as an extraordinary leap in medicine and surgery. Yet, almost immediately, ethical problems were noticed lurking in the miracle.

Body:

Ethical principles involved in organ donation:

• Medical integrity: Patients and  the  public  must be able to trust  their  doctors  not to sacrifice  the interest  of one  to that of another,  from  whatever 
• Scientific validity: the basic biology and technology must be sufficiently assured to offer a probability of beneficial outcome, case by case.
• The ethical basis of donation is in consent, based upon information adequately   presented,   weighed   and understood, and unbought, unforced. The adjective ‘informed’ is often used with ‘consent’ but the term is differently interpreted.
• State governments, which have responsibility for health care provision, are expected to ensure that the organs that are altruistically donated by families of brain-dead people are given to recipients ethically, and as mandated by law.
• Priority for citizens enrolled in the State and national waiting lists over foreign nationals is laid down in the Transplantation of Human Organs and Tissues Rules.
• There should be no invasion of a healthy body to obtain an organ for another, this goes against the bodily integrity of a human.

Importance of Regulations for success of organ transplantation policy:

• There is a huge gap between demand and supply of organs.
• Unregulated cost of transplant surgeries; cost out of reach of poor people
• Instances of Hospitals and professionals who engage in commerce shows the unethical behaviour.
• Preferential treatment to the rich and wealthy: Instances where preferential allotment of hearts and lungs has been made to foreign patients in Tamil Nadu — in 2017, foreigners accounted for 25% of heart transplants and 33% of lung transplants, show the inequality.
• Instances of organ trafficking from abducted persons are on the rise, especially the destitute and orphans.
• False proclamation of “scandals”; organ rackets; News of improper practices of organ collection breaks public trust and is impediment to the entire process of organ donation
• Religious beliefs hinder deceased organ donation. Superstitions prevalent such as being born (rebirth) with a missing organ (that has been donated), being tangled in the life-death-rebirth cycle

Conclusion:

The Declaration of Istanbul outlines principles against organ trafficking and transplant tourism. World Health Organization’s Guiding Principles on Human Cell, Tissue and Organ Transplantation aim at ensuring transparency in organ procurement and allocation. The ethics of financial incentives and non-financial incentives such as incorporation of non-medical criteria in organ priority allocation should be incorporated in the regulations.