Organ transplants: Your part or mine?
AS MARKETS in human organs go, the one which flourishes on Tehran’s Vali Asr street, where Iran’s main transplant hospital is located, is not the cruellest—and there is no lack of people willing to discuss their transactions. Gholamreza, a 44-year-old man from northern Iran, explains what he did when his dialysis started to fail. “I put an advertisement in the paper for a kidney, and a donor came straight to me. We reached an agreement on the price quite quickly. In these cases, the recipient usually takes care of the donor afterwards. So I still visit my donor and help him out.”
Another man wandering round the district, aged around 30 and wearing torn, cheap clothing, is hoping he can find a buyer as decent as Gholamreza claims to be. He expects to get between $3,000 and $4,000 for one of his kidneys. “I need the money because I lost out in a pyramid investment scam. After the operation I won’t be able to lift heavy things, but I can still live with only one kidney.”
Iran’s Association of Kidney Patients, a non-government organisation which obviously enjoys official favour, is responsible for all legal kidney transplants: it insists that commercial deals are the exception, not the rule. For one thing, it says, the religious authorities encourage voluntary gifts: in other words, cases where a patient receives a kidney freely offered by a friend or relative. Pious Muslims may also offer up a kidney to anyone who needs it.
For surgeons, patients and medical economists alike, the shortage of kidneys seems frustrating, because no organ lends itself better to transplant. As long as they receive decent after-care, kidney donors suffer only the tiniest increase in their own risk of dying of kidney disease. And transplants make economic sense: the cost of one kidney operation and a lifetime’s supply of antirejection drugs equals that of three years’ dialysis. Kidneys donated by a living person last for a median 22 years in another body; when they are taken from a fresh corpse, the figure is 14 years.
Whatever solution they propose to the shortage of kidneys, nobody doubts that the black market, as it now works, has grotesque effects, both for donors and recipients. Rich westerners who go to South Asia or Africa in search of kidneys often receive organs that are diseased or unsuitable.
Nancy Scheper-Hughes, an American professor of medical anthropology and campaigner against organ trading, says the way poor Brazilians were induced to travel to South Africa is typical of the abuses a market in body parts, especially an international one, is bound to cause. She says donors in the Brazilian slums were given false promises about the money they would make, the care they would receive and the after-effects of the operation.
Some senior figures in the medical world draw a different conclusion: as long as some people are determined to obtain kidneys and others are desperate enough to sell them, the trade will be impossible to stop—so it makes better sense to regulate the business than drive it underground.
考研詞匯：
flourish[ˈflʌriʃ]
v.繁榮，茂盛，興旺
[真題例句] It’s theory to which many economists subscribe, but in practice it often leaves railroads in the position of determining which companies will flourish and which will fail.[2003年閱讀3]
[例句精譯] 這種理論得到了多數經濟學家的認同，但在實際操作中，它使鐵路公司獲得了一個決定誰敗誰榮的權利。
transaction[trænˈzækʃən]
n.①辦理，處理;②交易，事務;③[pl.]會報，學報
[真題例句] Conrails net railway operating income in 1996 was just $427 million, less than half of the carrying costs of the transaction (②).[2003年閱讀3]
[例句精譯] 聯合鐵路公司1996年鐵路運營純收入為4.27億美元，這還不足這宗交易運作成本的一半。
recipient[riˈsipiənt]
a.容易接受的，感受性強的;n.①容納者，容器;②接受者 [真題例句] This kind of support, like all government support, requires decisions about the appropriate recipients (n.②) of funds.[1996年翻譯]
[例句精譯] 這種資助就像所有的政府資助一樣，需要決定資金的合適的接受對象。
voluntary[ˈvɔləntəri]
a.自愿的，志愿的
[真題例句] Downshifting—also known in America as “voluntary simplicity”—has, ironically, even bred a new area of what might be termed anti-consumerism.[2001年閱讀5]
[例句精譯] 具有諷刺意味的是，“放慢生活節奏”——在美國也稱“自愿簡單化”——甚至孕育了一個嶄新的、可稱之為反消費主義的生活方式。
bound[baund]
v./n. 跳(躍);a.①被束縛的，理應……的，必定的，一定的;②準備(或正在)到……去的，開往……的;③(be bound up with) 與……有密切關系
[真題例句] The innovator will search for alternate courses, which may prove easier in the long run and are bound (a.①) to be more interesting and challenging even if they lead to dead ends.[1994年閱讀5]
[例句精譯] 創新者則會探尋另外不同的道路，而這樣的道路將會最終被證實更簡單、也一定更有趣、更富挑戰性，即使它們通向絕境。
[真題例句] (72) Furthermore, it is obvious that the strength of a country’s economy is directly bound (a.③) up with the efficiency of its agriculture and industry, and that this in turn rests upon the efforts of scientists and technologists of all kinds.[2000年翻譯]
[例句精譯] (72)再者，顯而易見的是一個國家的經濟實力與其工農業生產效率直接相關，而效率的提高則又有賴于各類科技人員的努力。
desperate[ˈdespərit]
a.①絕望的;②不顧一切的，拼死的
[真題例句] 59. Which of the following best defines the word “aggressive” (Line 1, Paragraph 7)?[2002年閱讀4]
[D] Desperate (①)
[例句精譯] 59.下面的哪個詞最好地解釋了“aggressive”一詞(第七段第一行)的意思?
[D] 不顧一切的
背景常識介紹：
1936年俄國人Voronov為一急性腎功能衰竭的病人進行了尸體腎臟移植,雖然只存活了48小時,但卻揭開了腎臟移植的序幕,腎臟移植是迄今為止世界上根治腎功能衰竭最有效的辦法。
參考譯文：
器官移植：你的還是我的?
就人體器官市場而言，活躍于德黑蘭瓦里阿瑟(Vali Asr)大街的市場還不算是最悲慘的，這里坐落著伊朗主要的移植醫院——也從不缺愿意討論交易的人。來自伊朗北部的44歲男子古拉姆瑞扎(Gholamreza)解釋了他在腎臟透析治療開始不起作用之后所做的事：“我在報紙上刊登了一則尋求腎臟的廣告，就有一名捐贈者直接同我聯系。我們很快就談好了價格。在這類情況下，接受捐獻者以后通常會照顧捐贈者。因此，我常看望我的捐贈人，并幫助他解決困難。”
另一名年約30歲、身穿破爛而便宜的衣服的人，則正在該區徘徊，希望能找到一個如古拉姆瑞扎所自詡的那種大方的買主。他希望自己的一只腎臟可以換得3000至4000美元。“因為我在傳銷騙局中失利，我急需錢用。盡管手術之后我不能干重活，但我還可以憑一只腎活下去。”
顯然受到官方支持的非政府組織“伊朗腎臟患者協會(Iran’s Association of Kidney Patients)”負責所有合法的腎臟移植事務：該組織堅持稱，商業交易是例外，而不是常態。它表示，首先，宗教權威鼓勵自愿捐獻;此外，患者通常接受的是由朋友或親戚免費提供的腎臟。虔誠的穆斯林也會將腎臟捐獻給任何需要的人。
對外科醫生、患者及醫療經濟學家而言，腎臟的匱乏似乎令人沮喪，因為沒有比腎臟移植更適合的器官移植了。只要接受適當的病后護理與治療，腎臟捐獻者死于自身腎病的風險只有微小的增加。此外，移植也有經濟學意義：一次腎臟手術以及終生抗排斥藥物的供應與三年透析治療費用相當。活人捐獻的腎臟在另一人的體內平均可以維持22年;而從新鮮尸體上獲得的腎臟則可以維持14年。
無論對腎臟短缺提出怎樣的解決方案，沒有人懷疑黑市對捐獻者和接受者雙方帶來怪誕的結果，正如目前的情形那樣。去南亞或非洲尋找腎臟的西方富人們通常得到的都是帶疾病的或不適應的腎臟。
南希·謝柏休斯(Nancy ScheperHughes)是一名美國醫學人類學教授，也是一名反對器官買賣的活動人士，她說，勸誘巴西窮人前往南非旅行的方式是人體器官市場，特別是國際性的市場，所必然促生的典型弊端。她表示，巴西貧民窟的捐贈者只得到有關可掙錢款、所獲照顧以及手術后果的虛假承諾。
醫學界一些資深人物則給出了不同的結論：只要一些人決心獲得腎臟，而另一些人鋌而走險地販售，交易就很難被阻止——因此，更理智的處理是規范交易，而不是消除它。
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