The increase in critical medical conditions has led to increased demand for organ transplants. Transplantation of organs is continuously being practiced worldwide. The demand for human organs has been on the rise leading to organs shortage in supply to the extent of patients traveling overseas where the organs are available (Shimazono, 2007). In countries like India, organs are readily available for sale commercially (Shimazono, 2007). However, the cost of some human organs is way beyond the financial capabilities of many individuals. Such situations have triggered the emergence of black markets that deal with human organs. This paper reviews an article titled Organ transplants: ethical, social and religious issues in a multicultural society by Robson, Razack, & Dublin (2010). This paper will summarize the authors' ideas in the article and make a critique of the same article. By doing so, it will help the readers understand organs transplantation ethical, socio-cultural and religious issues.
Organ transplantation occurs after the failure of a critical organ in the human body and has been practiced globally (Shimazono, 2007). According to WHO records, organ transplantation is being carried out in over 91 countries (Shimazono, 2007). The determinants for the transplantations are; technology capabilities in such countries, costs of medical care as well as the laws governing this exercise (Shimazono, 2007). This trade creates a global network in which the patients travel to where the organs are commercially sold for transplantation. However, trading of organs has resulted in issues such as the rise of black markets for organs. Such illegal markets have led to the ban of organ trade in some countries including the US.
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In the article, the author discusses issues that are related to organs transplantation as far as multicultural societies are concerned. The author in this article discusses ethical, social and religious issues that affect organs transplantation. His work is based on reference to Malaysia, which is a multicultural society. The author argues that inadequate availability of organs is forcing Malaysia to seek support from other nations.
When discussing ethical issues surrounding organs transplant, the authors argues from the following factors; One, they are concerned with the factors that determine the priorities given when organ transplantation is carried out. They highlight the ethical controversies surrounding organs transplantations in Malaysia. The authors also mention on the individual's social status as well as their political influence that determines the priorities people get when it comes to organs transplantations.
The authors also highlighted on the ethical issues surrounding the donors. They argue that the donors hold the rights of voluntary donation of organs ( Robson, Razack, & Dublin, 2010) . From their point of view, the ethical issues surrounding the donors is that they are exposed to manipulations and coercion. The authors also argue that the donor's origin also plays a role in how organ transplantation is carried out. Racial discrimination as the authors argues limits the freedom of the donors to donate their organs ( Robson, Razack, & Dublin, 2010) .
Another ethical issue that the authors mentions pertains the definition of the word death. The author wonders whether death is defined as " when the heart and lungs stop, or when the entire brain ceased to have activity, or when the higher functions stop? " ( Robson, Razack, & Dublin, 2010). Some organs are required while the patient is still alive. As the authors argue, this raises an issue of concern since the doctors have to decide whether to take out those organs while the patient is half death or extract the organs when the person is deceased that would render such organs unusable.
When the authors are discussing social and religious issues surrounding organs transplantation, they look at the different religious perspectives. They first look at the Islamic aspects and argues that in most of the Arabic nations, transplantation of organs is prohibited except for few countries that include Saudi Arabia and Iran ( Robson, Razack, & Dublin, 2010) . Despite the efforts by Muslim scholar by teaching the Muslims on the need to save human lives by seeking medical interventions, their teachings have not been adopted in most Islamic regions. Other religions such as Christianity advocates for saving human lives by donating of human organs.
The authors advocate for medical practitioners to understand the different donors and patient's socio-cultural and religious backgrounds ( Robson, Razack, & Dublin, 2010) . Through such understanding, the procurement of organs becomes easier. The author supports saving human lives through organs donations irrespective of the socio-cultural and religious beliefs. They urge medical practitioners and communities to appreciate organ donations positively.
Despite the positive impacts of organs transplantations on saving lives as the authors have discussed, I feel that a lot is to be explored in this concept of organs transplantations. There have been controversies surrounding organs transplantations which are increasing at an alarming rate. The shortage of organs around the world has led to people engaging in illegal activities of trading organs in the black markets. As Scheper-Hughes (2004) discusses, " there are outlaw surgeons, kidney hunters and transplant tourists involved in ‘back-door' transplants in the global economy. " By referencing her work of exposing the secrets of how human organs are harvested, sold and distributed in the market, it will help in forming the basis of cementing the review of the article by Robson, Razack, & Dublin (2010) and for the making of a personal stand as far as organs transplantations is concerned.
It is ironical to many people that the medical facilities they invest their trust in are used to run illegal selling of human organs. The author accuses the international organizations responsible for regulating transplants of their hypocrisy (Scheper-Hughes, 2004) . These bodies provide the public with statistics of the progress but never allow any outsider to have a hand in the confidential documents these organizations hold (Scheper-Hughes, 2004) . Some medical practitioners act is deliberately unprofessional to conceal the truth of transplantations. Documents are concealed, or their tracing reported impossible by the individuals in power in medical facilities conducting the donations and transplantations of organs (Scheper-Hughes, 2004) . These influential individuals are among a ring of cartels involved in the trafficking of organs in the black market, and I believe that their acts of concealing documents are meant to save their images.
Since surgeons hold the highest ranks in the world of medicine, they may be undisputed in participating in the dark world markets of humans trafficking for their organs. However, it should be noted that not all medical practitioners are evil. Some medical practitioners are honest in their work and come clean when audited. For donors with fears of being robbed of other organs if they volunteer to donate, these medical practitioners act professionally in the manner they handle such donors. Adding to the ethical issues reviewed above, some surgeons, on the other hand, rob the donors of their organs for sale in the black markets. For those donors participating in the black markets, the surgeons recruit them in their programs of being a hunter (Scheper-Hughes, 2004) . These programs involve manipulating other people to donate their organs for quick cash which are then traded in the black market (Scheper-Hughes, 2004) a claim that I strongly agrees with as far as ethics are concerned .
Some of the surgeons participating in organs trade black markets are reckless to the extent of leaving the donors with medical complications after the surgeries. Other consequences to the donors who illegally donate their organs include; since they fear their secrets of donating to be known, they fear to be medically examined by medical practitioners (Scheper-Hughes, 2004) . Such fears put their lives at stake when they get ill. It is also apparent that most people who donate their organs illegally are after quick cash. Therefore, this implies that most cannot cater for hospital bills in the future if they get ill.
I also believe that these surgeons participate in human trafficking and after extracting their organs, they kill them to hide any evidence. Such surgeons recruit kidney hunters who coerce people from poor regions into parting with their kidneys. These recruits make enticing offers to the people from poor regions which they cannot turn down. Once these people are moved abroad, they are coerced to donate their kidneys which are then sold in the black markets. These are the same persons that patients trust their lives during surgeries for transplantation. Greed for riches and corruption has marred the progress made in the organ's transplantation health practices. As the authors discusses above in their article, I strongly agree with their view of ethics in organs transplantations.
When it comes to cultural diversities and religious beliefs regarding organs transplantation a lot of opinions are expressed. The reality is that cultural diversities and religious beliefs pose a challenge to medical practitioners when it comes to organs transplantations. As discussed by the authors above, these factors influence the way individuals make decisions of donating organs for transplantation. There are no set laws that govern how individuals should donate their organs in religions and cultural beliefs (Churak, 2005). Some cultures and religious beliefs are against the donation of organs. In some cultures, transplanting organs from a donor to the recipient transfers spirits. Some traditions such as in Black Minority Ethnic (BME) also believe that for a deceased to rest in peace, their body organs must be retained (Churak, 2005) . BME is an example of cultural diversities that deem organs transplantation as a taboo in their communities. It is ironical to find that; these communities consist of 30% of individuals that require kidney transplant (Churak, 2005).
To add to the authors' claims on religions, Religious leaders are very crucial in influencing the decisions made by the donors. Religious leaders have been used to convince people of the purpose of saving lives. However, cartels have used the influence of religious leaders on the congregations in convincing people to donate their organs to save lives. Such compelling is used maliciously by manipulating people into donating their organs which are then traded in the black markets. The masses need to know when religious leaders influence is getting manipulative.
Conclusions
Organs transplantation has helped and is still helping many patients by saving their lives. When practiced ethically, organ transplantation has many benefits to people's lives. However, the existence of organs black markets has tarnished the excellent work this exercise has achieved. Despite the measures put in place to curb this trade, the demand for organs has exceeded leading to the cartels coming up with ways to bed these measures. I strongly agree with the views of the author, and by adding some views, it helps in strengthening the existing research., I believe that this it is high time the state governments employed more strict laws that would see heavy penalties imposed on such cartels.
References
Churak, J. M. (2005). Racial and ethnic disparities in renal transplantation. Journal of the National Medical Association , 97 (2), 153.
Robson, N. Z. M. H., Razack, A. H., & Dublin, N. (2010). Organ transplants: ethical, social, and religious issues in a multicultural society. Asia Pacific Journal of Public Health , 22 (3), 271-278.
Scheper-Hughes, N. (2004). Parts unknown: Undercover ethnography of the organs-trafficking underworld. Ethnography , 5 (1), 29-73.
Shimazono, Y. (2007). The state of the international organ trade: a provisional picture based on integration of available information. Bulletin of the World Health Organization , 85 , 955-962.
