The regulatory challenges of international transplant medicine

Abstract

Transplant tourism is spurred by the global shortage of organs and the potential for regulatory arbitrage in purchasing an organ in jurisdictions that do not prohibit sale or lack effective regulatory mechanisms to enforce prohibition. Various nations once identified as transplant tourism hotspots have since enacted legislation prohibiting organ sales and emplaced regulatory oversight. However, concerns persist that the legitimization of altruistic unrelated living donor transplants conceals underlying commercialism and unethical practices. These concerns are heightened when transplant candidates travel across borders in search of international transplant medicine. This article examines the regulatory challenges associated with differentiating international transplant medicine from transplant tourism, and various regulatory mechanisms that have been developed to address them from the domestic perspective – in particular, those recently implemented in the Singapore. It seeks to identify the strengths and weaknesses of the Singapore system and what lessons this has for international standards and practices.