Policy and legal review of organ transplantation in six countries

Background

Global regulatory frameworks such as the WHO Guiding Principles on Human Organ Transplantation (1991) and the Declaration of Istanbul on Organ Trafficking and Transplant Tourism (2008, 2018), formulated by professional organisations led by The Transplantation Society (TTS) and the International Society of Nephrology (ISN), provide an ethical framework for organ transplantation to combat the universal shortage of organs, organ trafficking, financial inducements, and coercion in donation.

While these global principles, coupled with domestic regulatory landscapes, have had positive impacts, unethical practices continue to be reported, especially from low- and middle-income countries.

Aim

To identify the intersection of international ethics principles and guidelines with the domestic regulatory frameworks of select developing countries.
To understand the barriers and facilitators to the implementation of international ethics principles and guidelines in the domestic laws and policies of select developing countries.

Research Methodology

This study uses a qualitative case study approach to analyse how organ transplant policies are implemented in six countries: India, Pakistan, the Philippines, Costa Rica, Colombia, and Egypt. The results were examined in light of the global ethics principles outlined in the Declaration of Istanbul, focussing on four main areas: equity, self-sufficiency, combating crimes, and financial neutrality.

The study involved reviewing international guidelines on organ transplants, local laws and policies, and existing research on how these laws are put into practice. Based on this review, in-depth interviews were conducted online with key informants using a semi-structured interview guide. Throughout the research, a group of 5-6 experts from India, Australia, Philippines, Costa Rica and Pakistan provided guidance at each stage.