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Market for Organ Trading
As of January 18th, 2007, there were 94,664 Americans on the Organ Procurement and Transplant Network (OPTN) waiting list. Patients waiting for kidney transplants account for roughly two-thirds of the list. Given the severe shortage of kidneys, more than 3,500 people now die each year while waiting for a kidney transplant. By most projections, the number of patients waiting for kidney transplants is likely to increase significantly in the next few decades. This presents a classical economic problem of the demand for organs far outstripping the supply. If altruism is a sufficiently powerful motive, the supply of organs would satisfy the demand and there is no need to change the existing system. However, many patients continue to die today from the acute shortage of kidneys and other organs. If the government legitimizes the purchase and sale of organs, a market for organs trading would increase the supply of organs. Individuals motivated by financial gain would come forward to donate their organs. This would alleviate the suffering of patients waiting for organ transplants and save thousands of lives. It is understandable that opponents of organ trading worry that organs would be commodified, therefore violating the sanctity of the human body, and that the poor could be exploited of their own body parts. In this paper, I first present both sides of the argument to the reader before responding to the arguments that are against organ trading.
By a “market for organ trading”, I mean a regulated market operating under certain principles and constraints.[1] The strongest argument for organ trading is that it would increase the supply of organs for those in need. It is a reality that few people are willing to give up their organs upon death, and it is even more difficult to persuade a living person to donate an organ. In a sense, people are rational in demanding monetary compensation for there is a price to be paid in discomfort, fear and lost wages in the process of donating an organ. A prototype of an organ market already exists in
An open market in organ trading would eliminate existing black markets. Currently, patients in need for organ transplants would travel to poorer countries such as
Proponents of organ trading believe that an organ market is a mean to achieve the ultimate moral end of saving human lives. An existing market for human blood, eggs and sperms have led to increased happiness and improved quality of life for all those involved in the transactions. The same is likely to be true for the organ market. Some proponents of organ trading would further argue that organ trading is a moral mean in itself. Sellers of organs are not coerced to give up their organs. Sellers of organs should have the freedom and the choice to exchange their organs for financial gain. They should be trusted to act in their best self interests, without the paternalistic tutelage of society and government telling what is best for them.
The strongest argument against organ trading is that it invites people to see the body and thus the self as a mere commodity. Organ trading would violate the dignity of human life. The market treats the organ as any other product and allegedly removes the human quality from it. Opponents of organ trading believe this would debase those who trade in organs as the organ is treated as a mere commodity with an explicit and impersonal price tag.
But how exactly is the commodification of organs any different from our commodification of labor service? We sell our labor service and hence a part of ourselves to the highest employer in the marketplace. Moreover, it is important to keep in mind that organ trading is a voluntary transaction rather than a coercive one. If a potential seller of the organ believes that is degrading or “morally incorrect” to sell his organ, he has the choice not to partake in the transaction. The squeamish sensibilities of the moral majority should not the dictate the organ seller’s freedom of action.
Besides the moral problem of commodifying organs, opponents believe that organ trading would lead to other ethical compromises such as the exploitation of the poor. Given that the act of organ removal is usually irreversible, opponents believe that the poor may not have the information and the knowledge to make an informed decision. The poor are therefore likely to be exploited by unscrupulous surgeons, being pressured to make a decision without understanding the risks involved. Another related fear is that the poor may make their decisions on impulse and subsequent regret their decisions. As such, society and the government have the moral obligation to protect them.
Why should the moral majority be arrogant enough to believe that it knows what is best for the poor? Under the regulated market model, the necessary information would be conveyed to potential donors to let them make informed decisions. A waiting period could be enforced between the time the seller makes his decision and the time of the transplant operation. Poverty does not equate ignorance. If society takes the unfortunate stand that the ignorant should be protected from themselves, then there no reason to stop intervention at organ trading. It could be extended to financial decisions; lifestyle decisions etc and a multitude of other decisions in life. This is the surest road to serfdom.
Some opponents of organ trading believe an open market for organs would lead to human rights abuses. People may be kidnapped for their body parts or that totalitarian governments would harvest the organs of their people. These organs obtained through questionable means may be smuggled into the legal organ market in
Although it is possible that some authoritarian governments could harvest the organs of their people and sell them to the
In conclusion, an open market for organ trading is likely to significantly increase the supply of organs and save thousands of human lives who die waiting for an organ transplant. It would further eliminate the black market for organ trading and establish optimum safety standards under a regulatory authority. However, the objection of the moral majority is likely to stifle any developments in the organ market in the foreseeable future. The society as a whole needs to thoroughly explore the concrete benefits and moral consequences of organ trading and come to a consensus on the increasingly pressing problem of organ shortage.
References
- A. Bagheri, Kennedy Institute of Ethics Journal, 16, 269-282 (2006)
Compensated kidney donation: an ethical review of the Iranian model.
[1] As Dr. Benjamin Hippen argued during the June 2006 Council meeting, a properly regulated market in organs would be distinguishable from a free market by its four side constraints. First, the market must be safe for the vendor and the recipient. Safety, here, would be determined by current medical knowledge and practice. Second, the processes of donation and transplantation must be transparent, meaning that the risks of the surgeries and the potential outcomes must be clear to the vendor and the recipient. Third, there must be institutional integrity. Each institution involved in organ transplantation (hospitals, transplant centers, and even transplant physicians) must establish policies that explain the institution's moral commitments regarding organ vending, namely whether or not the institution will support it. And fourth, the organ market must operate under the rule of law. The law would provide the boundaries of the market (i.e., what can and cannot be done while buying and selling) and would provide a means to settle contractual disputes, which naturally arise in any market setting)
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