The government is pressing ahead to pass a bill on organ transplants that has been pending for seven years in Parliament, hindered by controversy over the precise definition of death.
Hamdi al-Sayed, head of the Egyptian Doctors’ Syndicate, believes that approval of the law will combat the trade in human organs that currently blights Egypt, which rates fourth in the list of countries illegally trading in organs. He warned that delay in passing the law would move Egypt to the first ranking in organ trade, now that India and Bangladesh have passed laws to regulate organ transplant, while China has stipulated strict conditions thereon. Some experts, however, argue that the law would give the green light for those who can afford it to exploit the susceptibility of the poor and will by no means put a stop to the organ trade. Last week the Grand Imam of al-Azhar, Sheikh Mohammed Sayed Tantawy announced approval of al-Azhar of the transplant of organs from a dead person to a living one, pending the agreement of doctors on the definition of clinical death.
Definition of death
Proponents and opponents of the law argue on four main topics; defining physiological death; approving organ transplantation from and to non-Egyptians; regarding a deceased person as a donor if he or she did not state it in a will; and finally the concept of undergoing organ transplantation only if necessary. These points still have to be debated.
The bill bans organ donation unless from someone alive and fully aware of the risks or, in the event of being on the deathbed as in case of accidents, someone fully conscious. Organ donation would be allowed only between relatives up to the fourth degree, a stipulation that came under fire since critics said it would be placed in order to ban donations to non-Egyptians or individuals of a different religion.
To ensure the legality of the operation, Mohamed Ghoneim, manager of the Kidney Centre in Mansoura says that organ transplant may only be conducted in State hospitals by medical consultants, since private hospitals may act as a backdoor to organ trade.
Exploiting the poor
MP Khalifa Radwan says that the contentious issue is the definition of death, with opponents, mainly Islamists, refusing to accept it as brain stem death. Dr Radwan is wary that the law might be exploited to the detriment of the poor, where poor comatose patients may be considered dead and their organs seized. And it must be remembered, he says, that the poor can in no way afford organ transplant when they need it, while the State in turn cannot sustain the full expense of such procedures. In case of liver transplant the State pays EGP50,000 while the operation costs between EGP300,000 and EGP700,000.
If the law is not passed, Ahmed Nasr, researcher at the Egyptian Institute of Democracy, says, it would mean that Egypt’s law is unable to protect Egyptian patients. “How come that there are more than 85 countries over the world, including the Islamic countries Saudi Arabia, Tunisia and Iran, that have laws regulating organ transplant, while Egypt alone does not?” Dr Nasr wondered.