Speech by Prof. Katrina Bramstedt in the NSW Parliament

Speech by transplant ethicist Prof. Katrina Bramstedt in the NSW Parliament, Sydney

Nov. 4, 2015


“Forced.  Organ.  Harvesting.  This was the title given to me for our session.  But as you can see, I have created a new one.  But, nonetheless, think about those 3 words for a moment…. “FORCED.   ORGAN.    HARVESTING.”     The phrase gives me great unease, physical and moral discomfort.  Organ transplantation is supposed to be a medical marvel, which pivots on the positive event of “organ donation,” not “forced organ harvesting.”
FORCE…it means not voluntary, unnatural.  HARVEST…this comes from the Latin word, carpere “to cut, divide, pluck.”  These are NOT the concepts that spring to mind when one thinks of “organ donation.”  Organ donation is a gift, not something plucked out from involuntary victims.  From an ethics perspective, organ donation is the very opposite of forced harvesting because organ donation has the premise of voluntariness, and the procedure itself is not a rough and tumble harvest, but rather the careful, skilled, gliding of many hands in perfect sequence to reveal a beautiful treasure.
Involuntariness, un-naturalness, plucking of organs —  this is most definitely unethical, a violation of human rights.  Yet, some patients with organ failure are ready recipients for such organs.  Their desperation to save their life, potentially fueled by Australia’s severe under-performance in the area of organ donation, can lead them to unethical decisions such as organ tourism and organ purchasing.
The questions are many: Do our patients have an ethical obligation to receive only gifted organs?  YES.  Our bodies are not meant to house stolen valuables in any form.
Do surgeons have an ethical obligation to refuse to participate in organ harvesting? YES.  Their hands are not made for torture.
And what about the ethical obligation of healthcare workers as a community?  What is their duty in all of this?  We need to get our act together.  In Australia, under-performance in the area of donor referrals is one of the many problems that contribute to low rates of organ donation.  Removing conflict of interest and benchmarking against proven, successful organ donation systems can move Australia forward and help shrink the gap between organ need and organ availability.
The “no worry” attitude, common in Australia can set a reckless standard of complacency by patients and providers, where benchmarking and innovation are set aside.
We suffer as a society when we fail to protect the vulnerable.  We also suffer as a community when we allow our talents to be wasted.
So I am asking you to indeed worry.  Be very worried.  Be worried about our reputation as a medical community who is too idle.  Be worried about the people robbed of their organs.  But also, commit to make a difference.  Use your hands as they were made to be used.
Thank you.”