Organ donation concerns thousands of people who need transplantation for a new lease of life. Regrettably, our media often gives it a lopsided portrayal, ignoring ground realities and the paradigm shift taking place in the world’s perception of its ethical aspects. News outlets naively applaud the police when they catch lawbreakers working at covert transplant centers - not appreciating that these incidences indicate the system’s failure rather than its success; the media’s treatment of the subject camouflages the deeper, complex human issue at hand.

The following narration by a doctor, one of many, provides an example of the problem. “I saw a young girl in the ER, screaming with pain, running a fever and prostrated. She had a kidney transplant at an unauthorized center a couple of days back and then had to leave it because it lacked facilities to manage her further and had a looming danger of a police raid as well. The hospitals she visited later one after the other refused to entertain her because for them it was unethical to manage an illegally transplanted patient. By the time she reached our hospital, her infection in the blood collected around the transplanted kidney had advanced to septicemia and graft dysfunction. She required an urgent operation but before it could be undertaken, it was too late and she succumbed!

The episode was shocking for me - a young girl dying mercilessly, after running pillar to post, begging for her treatment, and being persecuted for her ‘sin’ of desperately seeking a remedy for her devastating illness. I wondered whether the life of a human being is the supreme or blind pursuit of law or self-proclaimed ethics!

Sadly, tragic happenings like above in the aftermath of the imposition of a strict ban on paid donation receive minimal attention from our media and policymakers. Atop that is the failure of the legislation in controlling rampant sale and purchase of donor organs. Its impact has only been on the black market’s rates and standards - the first rising sky high and the latter declining rock bottom!

Human experience tells us that the crimes committed from sheer desperation never get eradicated through legal prohibitions and harsh punishments alone; they require a holistic approach. To curb illegal transplants, we must first understand their dynamics. Amongst its players - the transplant center and the patient, the former exploits the patient’s helplessness and is thus the harbinger of the crime. Conversely, patients are to be little blamed as their going for the transplant at all costs is a natural human response to a life-threatening situation. Pushing them to the wall through the tightening of regulations means increasing their desperation and easing exploitation and profits for the black marketers. Any policy that overlooks patients’ needs or sees them through a prism of skewed morality is a recipe for the burgeoning of illegal practices.

To repeal the above atrocious situation, the way forward is putting the main focus on promotion rather than restriction of organ donation and replacing disincentives to it with incentives, like the rest of the world. A proposed model is a government controlled institutionalized mechanism of compensating donors for their lost wages, travel expenses, relocation and long term social security in the form of regular stipends. The benefits of such a policy are: allowing transplants - in abeyance due to the non-availability of donors, cutting treatment costs, helping destitute patients, improving the quality of transplants and their outcome, and eradicating the black market. These gains are not speculative but are unequivocally proven in countries like Saudi Arabia and Iran where the model is already in place.

Putting partisan ethical concerns aside, it is high time that we in Pakistan follow a progressive policy that alleviates the suffering of people in need of transplantation, and puts their demands first in its list of priorities.