BMJ 2003;327:1009 (1 November)

liver411

European parliament tries to stamp out trafficking in human organs
Rory Watson
Brussels

The European parliament has overwhelmingly supported wide ranging moves to
stamp out the growing phenomenon of trafficking in human organs.

The measures include proposals to make it a criminal offence for European
Union citizens to go abroad and pay for kidney transplants, and to introduce
a minimum 10 year prison sentence for anyone caught trafficking individuals
into the union so their organs can be removed without consent.

The draft legislation says that the penalties would apply especially where
force, violence, threats, deceit, or other forms of coercion (in particular
psychological or physical) are used.

Although all 15 EU countries, apart from Austria, outlaw payments for
organs, there are differences in the way that national penal legislation is
applied.

Robert Evans, the British Labour MEP who is leading the campaign, explained:
"We need EU action now to close gaps in the existing law which would allow
further development of what is an abhorrent trade. We need to put a clear
definition of illegal organ trafficking in place across the EU and set
minimum penalties which are tough enough to act as a deterrent."

But Mr Evans wants to go further and tackle the root of the problem: the
shortage of legal donors. With 30 000 kidney patients in England-and their
numbers expected to increase to 45 000 by 2010-the issue is becoming
increasingly serious.

The Labour MEP wants to shift the balance from a donor system, as in the
United Kingdom, where people carry a card and opt in, to one where they may
opt out if they decide to say no. The BMA and the UK's Kidney Patients
Association are just two organisations that support a move to presumed
consent-a policy used in Belgium, Finland, France, Greece, Italy,
Luxembourg, Portugal, and Spain.

However, the British government has no intention of abandoning its current
system of informed consent with its encouragement of people to donate their
organs. Over the past two years, it has taken various initiatives, including
the appointment of 35 new donor liaison nurses working in hospital care
units, to boost organ donation rates.

The European parliament backed a call for the creation of two EU-wide
databases. The first would contain details of patients waiting for
transplants so that newly available organs could be matched quickly with
potential recipients.

The second would provide information on legally available organs.

The package of measures approved by MEPs, with just 20 abstentions and no
votes against, will put further pressure on EU governments to tighten up
existing legislation. The only opposition to the move has come from the
Libertarian Alliance, which describes itself as a "free market and civil
liberties think tank" and pressure group.

Its director, Dr Chris Tame, described the measures as "morally obscene as
well as economically harmful."