Saudi Electronic University Pioneer Hotels Financial Statements Audit Paper In this assignment, you are required to create formal quality audit report to evaluate pre-identified area at company, the topic covered in chapter 10 .
The following points should be included :
1- Introduction
Name of the Auditee (unit audited)- Identify the company business nature ( manufacturing , service ).
Duration of Internal Audit ( how long will take).
Brief description of the current process under audit , type of udit ( process , system . product ).
Budget / Expenditure of the auditee unit.
2- Objective and Scope( why )
Elaborate on the objective ( two ) , and scope of the audit engagement
3- Methodology used during the audit engagement ( qualitative , quantitative )
4- Audit Observations , your opinion about the current process ( situation) .
5- Consequence / Effect / Impact: What effect did it have?( cause , effect analysis )
6- Corrective Action / Recommendation: What should be done to fix the issues (two enough)?
Assignment Regulations :
This assignment is an individual assignment.
All students are encouraged to use their own word.
Student must apply Harvard Referencing Style within their reports.
A mark of zero will be given for any submission that includes copying from other resource without referencing it
No more than two pages , use the attached example for more information about the sections . Black Market Bodies: How
Legalizing the Sale of Human
Organs Could Save Lives
by Kristin Houser on November 6, 2017
Trafficking in Body Parts
When a failing heart, liver, or other vital organ proves resistant to all available
forms of treatment, a dying patient’s only shot at survival may be an organ
transplant. Unfortunately, there aren’t enough donor organs to save all the
patients who need one. Feeling desperate with precious time running out, some
patients may attempt to purchase an organ illegally. In fact, thousands of sales or
purchases of black market organs take place every year, according to the World
Health Organization.
In the 1980s, Iran had both a shortage of legally donated kidneys and subpar
dialysis equipment to treat the growing segment of the population with end-stage
renal disease (ESRD). It did have highly trained surgeons capable of performing
organ transplants, though. So in 1988, the nation decided on a bold (and
somewhat controversial) new strategy to eliminate the dangers that come with
procuring or receiving an organ illegally: they made it legal for a living person to
sell their kidney.
Nearly three decades later, Iran is one of the few nations without an organ
shortage— every Iranian who needs a kidney can receive one. Should other
nations follow suit?
In 2014, 4,761 Americans died waiting for a kidney transplant.
In 2016, legally donated organs met less than 10 percent of global need,
according to a report from ONT-WHO Global Observatory on Donation and
Transplantation, the world’s most comprehensive source on transplant-related
data. In 2014, 4,761 Americans died waiting for a kidney transplant, and another
3,668 dropped off the list because they became too sick to receive one, notes
the National Kidney Foundation (NKF), an organization dedicated to the
awareness, prevention, and treatment of kidney disease.
Given this substantial need, perhaps it’s not a surprise that people turn to the
black market to save their lives. While exact figures are hard to come by (the
black market doesn’t exactly have any official ways to track it), the illegal trade of
all organs generates between US$840 million and $1.7 billion annually and
accounts for an estimated 10 percent of transplanted organs, according to a 2017
report from Global Financial Integrity (GFI), a non-profit research and advisory
organization focused on illicit financial flows.
Kidneys are the most-frequently sold organs for a fairly simple reason: humans
have two and can live a healthy life with just one. Selling kidneys, then, might
seem like a simple matter of supply and demand — the demand for kidneys is
high, so willing donors should, in theory, be able to negotiate their price from a
position of strength.
However, the population supplying the organs is nothing like the people receiving
them. GFI researchers found that kidney buyers are usually middle- to high-
income individuals from developed countries, while kidney sellers are typically
from the world’s most vulnerable populations. For poor and uneducated citizens
of developing countries, selling a kidney may seem like the only way to escape
poverty or settle a debt.
Recipients may pay upwards of $200,000 for a kidney, but the donor may receive
as little as $5,000 of that (a broker pockets the rest), according to the WHO.
Some donors aren’t paid at all, and because the sale is illegal, they have little
recourse to obtain the money they are owed.
Even worse, inadequately trained surgeons may perform the surgeries under
unhygienic conditions. Donors may be left with dangerous, painful complications
that could force them to miss work or require expensive follow-up care, leaving
the donor in a more financially precarious situation than prior to selling his or
her organ.
A Market Unlike Any Other
By legalizing the sale of kidneys from living donors, Iran has been able to avoid
these pitfalls of a black market, and today, about 55 percent of all kidneys
donated in the nation are from living donors, according to government
statistics obtained by the Associated Press. For comparison, only about 38
percent of kidney donations in the U.S. are from living donors. The rest come
from deceased donors, and those organs aren’t as likely to keep recipients healthy
in the long term.
The process of buying or selling a kidney in Iran is fairly straightforward, a 2011
paper shows. A doctor writes a letter stating that a patient needs a kidney, and
the patient then brings that letter to an office of the Kidney Foundation of Iran, a
nonprofit organization that facilitates the nation’s kidney transplants. The
organization adds the patient to a list and sorts by his or her blood type. Patients
in the midst of a medical emergency and disabled soldiers are placed higher up
on the list, according to the paper.
To be approved as a living donor, interested Iranians go to one of the
foundation’s offices to undergo medical testing (the donor pays for the tests). If
the foundation believes the kidneys are healthy enough for transplantation, they
approve the donor. Next, the foundation will contact the person nearest the top of
the list for that donor’s blood type, taking into consideration other factors such as
the donor’s physical build — a particularly small kidney might go to a child or
female patient even if they are listed below average-sized men because a closer
match between the size of a donated kidney and a recipient’s original kidneys
results in a better long-term outcome.
The Iranian government pays for the transplant surgery itself as well as one year
of health coverage for the donor after the surgery. The recipient (or their family)
pays the donor, using the foundation as an intermediary, Farshad Fatemi, a
micro-economist at Sharif University of Technology and author of the 2011 paper,
told Futurism. The base price is set at $4,600, but if the donor isn’t willing to sell
their kidney for that price, they and the recipient can privately negotiate a higher
amount shortly after a match is set up. In 2011, Fatemi estimated that organ
recipients will sometimes pay an extra $530 to $1,060 on average.
If the donor and recipient agree on terms, both undergo tissue testing to make
sure the recipient would be unlikely to reject the new kidney. If the results are
favorable, the patient and donor sign an agreement and are given a list of centers
and doctors that can perform the transplant. The center will hold the check from
the recipient during the surgery and hand it over to the donor afterward to ensure
payment is made.
A Viable Model?
While the Iranian system does speed up the process of organ donation for
patients — the average wait between reaching out to the foundation and receiving
a kidney is five months — Fatemi said the legal kidney market is not without its
shortcomings.
One issue is that doctors often fail to follow up with donors post-surgery. It’s
important to follow donors for several decades after donation to see how the
process affects them, Fatemi stressed, but said doing so would be difficult, as
donors often try to hide their identity to avoid the stigma associated with selling a
kidney. Educating the public on the benefits of donation, paid or not, could help
solve this problem, Fatemi said.
Fatemi also noted that, just like the illegal kidney market, the poorest, more
vulnerable members of society are still the ones donating in Iran’s legal market,
and they typically only do so because they feel they have no other option to
escape poverty. “I have been to the foundation. The people who are donating are
young and full of energy, but they are poor and selling a part of their body to
solve what may amount to very small problems in their everyday lives,” Fatemi
said.
Given the lack of follow-up, no one even knows for sure if these vulnerable
citizens benefit from the sale.
Though Iran’s market may be imperfect and only stops the illegal sale of one type
of organ, Fatemi believes it’s better than the alternative of having a black market.
The system protects disadvantaged donors by ensuring they are paid what they
are owed and taken care of medically, and it also gives recipients a second chance
at life that they may not get otherwise.
“With these transplants, people can live two, three decades longer than they
would without them,” said Fatemi. “During that time, they have good times with
their families. They are productive members of the economy. That’s the positive
side.”
For now, Iran still stands alone in allowing citizens to legally sell their kidneys,
and no other nation appears on the cusp of doing so. However, that’s not to say a
new legal kidney market couldn’t emerge. A 2015 study published in the
journal American Economic Review concluded that U.S. citizens were more open
to the idea of organ sales when presented with information on their potential
benefits, so at least one barrier to creating such a market — public disapproval —
could potentially be eliminated through education programs.
Still, Iran didn’t decide to legalize kidney sales until the situation was dire, so if
history is any indicator, the next nation to test a system will likely be one facing a
similar situation, perhaps somewhere like India where end-stage renal disease is
becoming more common and the black market is thriving. Meanwhile, nations
where the frequency of end-stage renal disease has stabilized over the last decade,
such as the U.S., may choose to continue with the status quo until new
technologies and treatments render the kidney market, both legal and illegal,
obsolete.
“Every time I go to the foundation, I wish for the day when we can clone a kidney
for a person,” said Fatemi. Until that happens, he said, Iran’s system is a good
one.
THE WALL STREET JOURNAL. | LIFE & STYLE
THE SATURDAY ESSAY | JANUARY 8, 2010
The Meat Market In a race to prevent thousands of needless deaths
a year, countries from Singapore to Israel are launching innovative new programs
to boost organ donation. Alex Tabarrok on paying donors for kidneys, favoritism
on waiting lists and the shifting line between life and death.
By ALEX TABARROK
Harvesting human organs for sale! The idea suggests the lurid world of horror movies and 19thcentury grave robbers. Yet right now, Singapore is preparing to pay donors as much as 50,000
Singapore dollars (almost US$36,000) for their organs. Iran has eliminated waiting lists for
kidneys entirely by paying its citizens to donate. Israel is implementing a “no give, no take”
system that puts people who opt out of the donor system at the bottom of the transplant waiting
list should they ever need an organ.
Millions of people suffer from kidney disease, but in 2007 there were just 64,606 kidneytransplant operations in the entire world. In the U.S. alone, 83,000 people wait on the official
kidney-transplant list. But just 16,500 people received a kidney transplant in 2008, while almost
5,000 died waiting for one.
To combat yet another shortfall,
some American doctors are routinely
removing pieces of tissue from
deceased patients for transplant
without their, or their families’, prior
consent. And the practice is perfectly
legal. In a number of U.S. states,
medical examiners conducting
autopsies may and do harvest
corneas with little or no family
notification. (By the time of autopsy,
it is too late to harvest organs such as
kidneys.) Few people know about
routine removal statutes and perhaps
because of this, these laws have effectively increased cornea transplants.
Routine removal is perhaps the most extreme response to the devastating shortage of organs
world-wide. That shortage is leading some countries to try unusual new methods to increase
donation. Innovation has occurred in the U.S. as well, but progress has been slow and not
without cost or controversy.
Photo illustration by Mick Coulas, photos: Alamy (heart), Photo Researchers (lung, kidney)
* 3,363; Americans who died waiting for a kidney transplant, January to October 2009
Organs can be taken from deceased donors only after they have been declared dead, but where is
the line between life and death? Philosophers have been debating the dividing line between
baldness and nonbaldness for over 2,000 years, so there is little hope that the dividing line
between life and death will ever be agreed upon. Indeed, the great paradox of deceased donation
is that we must draw the line between life and death precisely where we cannot be sure of the
answer, because the line must lie where the donor is dead but the donor’s organs are not.
In 1968 the Journal of the American Medical Association published its criteria for brain death.
But reduced crime and better automobile safety have led to fewer potential brain-dead donors
than in the past. Now, greater attention is being given to donation after cardiac death: no heart
beat for two to five minutes (protocols differ) after the heart stops beating spontaneously. Both
standards are controversial—the surgeon who performed the first heart transplant from a braindead donor in 1968 was threatened with prosecution, as have been some surgeons using donation
after cardiac death. Despite the controversy, donation after cardiac death more than tripled
between 2002 and 2006, when it accounted for about 8% of all deceased donors nationwide. In
some regions, that figure is up to 20%.
The shortage of organs has increased the use of so-called expanded-criteria organs, or organs that
used to be considered unsuitable for transplant. Kidneys donated from people over the age of 60
or from people who had various medical problems are more likely to fail than organs from
younger, healthier donors, but they are now being used under the pressure. At the University of
Maryland’s School of Medicine five patients recently received transplants of kidneys that had
either cancerous or benign tumors removed from them. Why would anyone risk cancer? Head
surgeon Dr. Michael Phelan explained, “the ongoing shortage of organs from deceased donors,
and the high risk of dying while waiting for a transplant, prompted five donors and recipients to
push ahead with surgery.” Expanded-criteria organs are a useful response to the shortage, but
their use also means that the shortage is even worse than it appears because as the waiting list
lengthens, the quality of transplants is falling.
Routine removal has been used for corneas but is unlikely to ever become standard for kidneys,
livers or lungs. Nevertheless more countries are moving toward presumed consent. Under that
standard, everyone is considered to be a potential organ donor unless they have affirmatively
opted out, say, by signing a non-organ-donor card. Presumed consent is common in Europe and
appears to raise donation rates modestly, especially when combined, as it is in Spain, with
readily available transplant coordinators, trained organ-procurement specialists, round-the-clock
laboratory facilities and other investments in transplant infrastructure.
The British Medical Association has called for a presumed consent system in the U.K., and
Wales plans to move to such a system this year. India is also beginning a presumed consent
program that will start this year with corneas and later expand to other organs. Presumed consent
has less support in the U.S. but experiments at the state level would make for a useful test.
Rabbis selling organs in New Jersey? Organ sales from poor Indian, Thai and Philippine donors?
Transplant tourism? It’s all part of the growing black market in transplants. Already, the black
market may account for 5% to 10% of transplants world-wide. If organ sales are voluntary, it’s
hard to fault either the buyer or the seller. But as long as the market remains underground the
donors may not receive adequate postoperative care, and that puts a black mark on all proposals
to legalize financial compensation.
Only one country, Iran, has eliminated the shortage of transplant organs—and only Iran has a
working and legal payment system for organ donation. In this system, organs are not bought and
sold at the bazaar. Patients who cannot be assigned a kidney from a deceased donor and who
cannot find a related living donor may apply to the nonprofit, volunteer-run Dialysis and
Transplant Patients Association (Datpa). Datpa identifies potential donors from a pool of
applicants. Those donors are medically evaluated by transplant physicians, who have no
connection to Datpa, in just the same way as are uncompensated donors. The government pays
donors $1,200 and provides one year of limited health-insurance coverage. In addition, working
through Datpa, kidney recipients pay donors between $2,300 and $4,500. Charitable
organizations provide remuneration to donors for recipients who cannot afford to pay, thus
demonstrating that Iran has something to teach the world about charity as well as about markets.
The Iranian system and the black market demonstrate one important fact: The organ shortage can
be solved by paying living donors. The Iranian system began in 1988 and eliminated the shortage
of kidneys by 1999. Writing in the Journal of Economic Perspectives in 2007, Nobel Laureate
economist Gary Becker and Julio Elias estimated that a payment of $15,000 for living donors
would alleviate the shortage of kidneys in the U.S. Payment could be made by the federal
government to avoid any hint of inequality in kidney allocation. Moreover, this proposal would
save the government money since even with a significant payment, transplant is cheaper than the
dialysis that is now paid for by Medicare’s End Stage Renal Disease program.
In March 2009 Singapore legalized a government plan for paying organ donors. Although it’s not
clear yet when this will be implemented, the amounts being discussed for payment, around
$50,000, suggest the possibility of a significant donor incentive. So far, the U.S. has lagged other
countries in addressing the shortage, but last year, Sen. Arlen Specter circulated a draft bill that
would allow U.S. government entities to test compensation programs for organ donation. These
programs would only offer noncash compensation such as funeral expenses for deceased donors
and health and life insurance or tax credits for living donors.
Bloomberg News
Source: Organ Procurement and
Transplantation Network
World-wide we will soon harvest more
kidneys from living donors than from
deceased donors. In one sense, this is a
great success—the body can function
perfectly well with one kidney so with
proper care, kidney donation is a low-risk
procedure. In another sense, it’s an ugly
failure. Why must we harvest kidneys
from the living, when kidneys that could save lives are routinely being buried and burned? A
payment of funeral expenses for the gift of life or a discount on driver’s license fees for those
who sign their organ donor card could increase the supply of organs from deceased donors,
saving lives and also alleviating some of the necessity for living donors.
Two countries, Singapore and Israel, have pioneered nonmonetary incentives systems for
potential organ donors. In Singapore anyone may opt out of its presumed consent system.
However, those who opt out are assigned a lower priority on the transplant waiting list should
they one day need an organ, a system I have called “no give, no take.”
Many people find the idea of paying for organs repugnant but they do accept the ethical
foundation of no give, no take—that those who are willing to give should be the first to receive.
In addition to satisfying ethical constraints, no give, no take increases the incentive to sign one’s
organ donor card thereby reducing the shortage. In the U.S., Lifesharers.org, a nonprofit network
of potential organ donors (for which I am an adviser), is working to implement a similar system.
In Israel a more flexible version of no give, no take will be phased into place beginning this year.
In the …
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