Transplant tourism is routinely denounced by influential voices such as the World Health Organization, the Declaration of Istanbul and the Madrid Resolution as an unethical solution to worldwide organ shortages. Instead, it is suggested that national deceased donor schemes and multinational organ-sharing programs are the only acceptable avenues for addressing the organ shortage crisis. The present demand for self-sufficiency in organ supply responds to risks such as poor clinical outcomes, and exploitation of the poor through the various commercial practices of transplant tourism. However, opponents of transplant tourism say little about what governments should do to ensure that their citizens have real and comprehensive access to all forms of transplantation. To address this complex question, we describe a current practice of international transplant medicine in Singapore. It addresses salient concerns with transplant tourism and supports the principle of national self-sufficiency in organ supply, even as its health care system thrives and expands comprehensive transplant services to its citizens by catering to international patients. We offer a critical appraisal of the Singaporean system, and some suggestions to minimize the risk of abuse by international patients or operatives of illegal organ markets. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.

Medical tourism National self-sufficiency Risk regulation Transplantation policy Ethics Organ trafficking

organ transplantation health care policy follow up health insurance human professionalism Internationality medical ethics priority journal health status transplant tourism conflict of interest organ donor transplantation Humans welfare Review patient education health care access medical tourism Singapore medical care patient autonomy