Taiwanese singer Lu Jian-zhong (呂建中), also known as Tank, recently traveled to Hangzhou, China, to undergo a simultaneous heart and liver transplant. Beneath surface-level astonishment, I feel a deep sense of unease over ethics and the fairness of resource allocation.
When I was a child, I remember seeing a news report about the police discovering an unidentified body. I blurted out: “How sad, I sure hope it is not her.” My mother dispassionately replied: “Then who do you hope it is?”
That response has stayed with me to this day. People often feel sympathy for familiar names, yet are completely desensitized to the deaths of strangers.
That emotional mechanism is particularly evident in organ transplants. It is much more likely that the survival of celebrities or high-status individuals is celebrated. However, hidden behind their new chance at life is a fundamental question. Organs are an extremely scarce resource — who, then, is more likely to be prioritized to undergo a prompt transplant?
Cases involving simultaneous heart and liver transplants are extremely rare. It is more than just a matter of finding a medical match — that case raises significant concerns over the transparency of the organ allocation system and potential resource bias. If we cannot ensure that the organ distribution system is based on the principles of medical urgency and fairness, then access to healthcare could be in danger of becoming a transaction where survival is determined by wealth and social status.
What is more concerning is that Lu’s transplant was not conducted in Taiwan, but in China. The source of organs in China has long been a subject of international controversy. Although China promised in 2015 that it would shift to a completely voluntary donation system, there have continued to be questions over transparency. Not only was the country previously exposed for harvesting organs from executed prisoners, but international human rights organizations continue to say that there is a high likelihood that organ harvesting is still occurring in China.
When society applauds a successful organ transplant such as Lu’s, perhaps we should also pause to reflect — who was the “donor” who simultaneously gave up two vital organs? Did that person give their consent? Might they have had a chance to live? Did their family mourn a decision they might or might not have made? If the source of organ donations in a country cannot be trusted, should all transplant operations performed within its system not be subject to even stricter scrutiny?
Organ transplantation has always been more than just a medical issue — it involves ethics, law and social justice. As a society, we must never allow our enthusiasm for saving one person overshadow the cost of losing another. When organ transplants become a tailor-made treatment allowing privilege to cut the line between life and death, the foundations of medicine have already begun to crumble.
Of course, everyone hopes for patients to be saved — but the fairness, transparency and integrity of organ allocation systems is even more essential. Taiwan must uphold that principle and not allow its resources to flow into less transparent environments. Otherwise, the hopes of so many nameless people waiting behind the scenes could be sacrificed for more glamorous and seemingly miraculous stories of revival.
The sanctity of medicine lies in its commitment to treat all lives equally. Organs are not commodities, and lives are not bargaining chips. Only by respecting every donor and every patient in wait, and by adhering to the foundations of medical ethics can healthcare return to its original essence — saving lives, regardless of wealth or status.
Lu Chun-wei is a dermatologist and an assistant professor at Chang Gung Memorial Hospital.
Translated by Kyra Gustavsen
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