September 17 was held the World Medical Association Scientific Session. Let us remind, that the Scientific Session took place within the WMA General Assembly, Cordoba, Spain 2020 and was in online mode. It was attended by the representatives of the medical associations from all about the world including the WMA President David Barbe and the Presidium member of the All-Russian public organization Society of Doctors of Russia, the WMA AM Stepan Firstov. The Scientific Session is always held within the General Assembly and devoted to this or that discussions. The topic of the current Session was physicians in the organ donation and transplantation process: ethical challenges.

The event began with a welcome speech of the WMA President. Then, it was followed by presentations of invited speakers. The Scientific Session consisted of two parts with a traditional break. The main topics for discussions were organ trafficking and transplant tourism as well as donation as a part of end-of-life care. The participants recognized the growing problem of illegal organ trafficking, especially in countries such as Africa, Brazil, Uruguay, China, Iran, Philippines, Pakistan, Turkey, Peru, Egypt and Thailand. Kidnapping is just on the streets. Some of the reasons for such actions are the lack of regulatory framework on donation processes, significant expensiveness of donation surgeries ($ 70000- $ 160000 per organ), lack of a single international data base for recording of all patients sent for surgery as well as people donated this or that organ. It is common knowledge, that doctors participate in a process of organ trafficking. Thus, ethical principles and medical duties should prevail over criminal activity. Donation and transplantation are complex issues, that require non-single approach. Methods and measures of regulation processes must include a legal aspect, an equivalent exchange of data from the unified world register, medical control for patients sent for surgery abroad as well as cooperation efforts with transplant centers and government agencies to strengthen the control.

During the discussion of the second issue, the speakers told us about the fact of the death from a medical point of view. According to Prof. Francis L. Delmonico: "Death is the loss of possibility of awarness of situation and termination of all neurons activity.» According to the clinical trials, the death is understood as the result of stop of blood circulation in organism or significant damage of neurons, which includes traumas, growths, insults, anoxia and encephalitis. In opinion of many specialists, an act of death is stated, when during 5 minutes a circulatory system of a patient does not active any more, thus, it leads to stop brain functioning. Approaches are applied based on the mortality projections of a patient, and further treatment seems to be impossible physiologically, because hemodynamics, respiration, kidney functioning and other metabolism processes fail without external support; or a patient is able to survive, however, doctors or guardians come to conclusion, that the quality of life will be dramatically lower under the burden of regular medicial care; or in case, when a doctor reports on an advance directive of a patient, that he/she refuses life support medicial care. In these situations, organ and tissue samplings imply obtaining consent from the deceased or his/her relatives/guardians. In general, the issue on transplantation in patients at the end-of-life is tolerable, assessing it as an altruistic gesture of life saving and leaving a good memory. But you should not forget about the presence of ethical contradictions and difficulties of legal aspect.

The Session finishes with the speech of the Spanish medical association representatives and a wish for health.