Kidney black markets and legal transplants: are they opposite sides of the same coin?

OBJECTIVES: This study investigates why the illegal traffic of kidneys exists and remains resilient in the Philippines. It also evaluates the efficacy of the legal and regulatory framework for kidney (and organ) transplantation, and the corresponding implications for health policy. The experiences o...

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Publicado en:Health Policy Vol. 94; no. 3; pp. 255 - 266
Autor principal: Mendoza RL
Formato: research Journal Article
Publicado: Elsevier B.V. Mar2010
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Kidney black markets and legal transplants: are they opposite sides of the same coin?
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        au: Mendoza RL
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          Kidney Transplantation Economics
          Kidney Transplantation Legislation and Jurisprudence
          Kidney Transplantation Statistics and Numerical Data
          Organ Procurement Administration
          Adolescence
          Adult
          Age Factors
          Aged
          Costs and Cost Analysis
          Educational Status
          Female
          Government Regulations
          Surveys
          Health Policy
          Human
          Male
          Marital Status
          Marketing
          Middle Age
          Philippines
          Sex Factors
          Transplant Donors Statistics and Numerical Data
          Organ Procurement Economics
          Organ Procurement Legislation and Jurisprudence
          Organ Procurement Statistics and Numerical Data
          Young Adult
          Adolescent: 13-18 years
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: OBJECTIVES: This study investigates why the illegal traffic of kidneys exists and remains resilient in the Philippines. It also evaluates the efficacy of the legal and regulatory framework for kidney (and organ) transplantation, and the corresponding implications for health policy. The experiences of comparable countries are noted. METHODS: Three surveys were employed in this study: 1) a review of related literature on kidney black markets; 2) questionnaire-based interviews of a multi-stage probability sample of 131 kidney vendors from the two largest supplier regions in the Philippines; and 3) a comparative content analysis of pertinent legal and regulatory measures to address the underground kidney trade. RESULTS: Survey results, based on a 4.0 percent statistical margin of error, indicate that kidney vendors are typically males (98.4 percent) who belong to the lower income classes/groups D and E (88.5 percent). The vast majority of vendors (89.2 percent) were unrelated to kidney recipients, many of whom were of foreign descent (60.3 percent). The study finds that certain key elements underpin the kidney black market in the Philippines: an open, brokered and compensation-based contractual system between unrelated donors and sellers. These elements are sustained and reinforced by a robust supply-and-demand interface anchored on brokerage pricing, government incapacity, policy contradictions and public tolerance or indifference. CONCLUSION: The study suggests that the relative ambiguity of, and continuity between, the legal and underground kidney transplant systems be carefully addressed prior to enacting more specific reforms. The study also calls attention to the unintended consequences of various reform efforts, which are often neglected in formulating health policy and evaluating its costs and benefits.
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    language: English
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