ayFor years and still today, the buying and selling or organs for transplantation has been thought of with disgust and has been strictly prohibited. The case for allowing organ sales, primarily kidney sales, is being given because the reasons for the prohibition of these sales do not apply anymore. The argument distinguished within the article Organ Transplantation: Gifts verses Markets, is that either new arguments must be made to defend the need for such a prohibition or that the trade of organs must be strictly regulated. The selling of ones’ organs should not violate the right of freedom, and should be categorized and protected by the privacy of individuals on the basic principle of their autonomy
Exploitation of the poor
The main argument against the selling of organs, such as kidneys, has been the obvious exploitation of the poor. This argument, having been valid for years, indicates that the reasons the poor would agree to the selling of their organs is for help their economic situation. That they are desperate for any kind of income that their desperation would outweigh their perception for risks involved, and that they are not well educated in those risks, therefore not making them quality, genuine candidates, and would leave them at risk for getting taken advantage of. One argument that follows this is unless we can eliminate poverty in general, this cannot be the argument that is given to have such strict exclusion against the selling of organs.
Ignorance
The idea that “ignorance is bliss” has been another reason that has been stated regarding the trade of organs. That knowledge of risk is not well known due to the education level of possible sellers. This argument is another one that we are able to find a solution for. It is accurate that the importance of informed consent throughout the medical community is essential for any treatment or procedure, therefore, the insistence of counseling for individuals who have decided to sell their organs would be a crucial part of the journey.
Having a regulatory agency that was involved to help with this education would eliminate the concern for ignorance. This would not completely eliminate the risks of corruption, but it will give a knowledge base of what to expect and what to look for when it comes to protecting themselves from exploitation.
Rich verses the Poor
In society, it is well known that there are certain advantages that rich have more opportunity for privilege then the poor. One of the greatest objections to the selling of organs, is that the advantage that a rich person would have over one without the expanded means of money. Although the selling of organs seems to be the most outrageous medical procedure the rich would be able to take advantage of, there is an argument that the rich have the resources for private medicine that are not accessible to the poor.
The argument against this is to have the exchange of money go through one central locations. This location would be an independent agency that would regulate fixed fees for organs. You would not be able to just use your resources to encourage a doctors or sellers and whether or not you decide to donate or sell your organ, this agency would be the central vice to organize payment between parties.
Women and Children
One important and vital objection to the selling of organs is the risks that is placed on women and children in poverty stricken countries. The idea that due to lack of resources and protection for these women and children, they would be treated like possessions instead of individuals and their organs taken from them without any kind of consent or hope for adequate medical treatment.
This argument, although valid, can be challenged by indicating that there are other practices, far more harmful that are not prohibited involving women and children. With regulation globally, there would be more protection against these circumstances, however, as we know, there are many who do not see regulation as final, only an obstacle to get to what they want.
Kidneys verses other vital organs
Kidney sales are the most common due to the general population having two, and the ability to live their lives normally with only one. Giving up one kidney to save a life or receive financial compensation can seems like a practical alternative for some. The objection that is being argued is that if we were to legalized the sale of kidneys, then other vital organs would be next on the list, such as hearts.
In Europe, there is a regulatory agency that allows women to sell unused or unwanted eggs to couples who are in need of those eggs to start a family of their own. They regulate compensation to $1500. In the United States, there are brokers who seek out college students who may be willing to part with eggs for compensation. There is not a regulated amount currently in the United states, but most organizations taking these eggs would rather a vendor have altruistic reasons for donating rather than monetary reasons. With the European market putting a regulated fee on this trade, there is some form of protection as well as compensation for the individual who desires a value that is placed on their contribution.
Presumed Consent
An important aspect of organ donation that has been approved in countries like, Spain, Austria, and Belgium, is “presumed consent”. This is a way that offers the country more organ donations than if the person has opted to become an organ donor. In this scenario, the case would be for patients who are brain dead or have died. In most parts of the world, a family would have to “opt in” for donation or their loved ones organs, basically giving consent to be harvested. In countries where the doctrine of “presumed consent” has taken place, families do not have to give consent for the harvesting of those organs. Once the person is considered “lost” the processes of keeping the organs viable are started immediately.
The argument in this case is that through this process these countries are able to maintain a higher transplant rate than most others, which gives those on the waiting list a higher chance of hope. This process however, maintains that the persons’ family who have not only lost their loved one, but was not involved in the decision making of donating those organs, receive nothing in return for essentially saving multiple lives. They are asked to be altruistic when no one involved is.
Hypocrisy
Throughout the arguments of why or why not to allow those giving up their organs to be compensated, we have seemed to overlook the hypocrisy within this whole system. Nobody would argue that the medical staff, surgeons, hospital, transplant coordinator, and even the recipient of the organ benefit from the procedure. For the recipient, a second chance at life, and for the hospital and staff the benefit of a paycheck, but no one argues for the person or family giving up that organ. That person, although heroic, whether living or not, receives nothing in return for their contribution to giving life back to an individual who may have died without it.
There is no other situation where the person who is giving up the most, gets the least in return. Even those who offer surrogacy for couples who cannot give birth to their own child, receive compensation. If there is a parent who is willing to give up one organ to pay for the cost of a medical procedure for their child, how can we not find a way to make compensation a possibility for those individuals who need it.
Statistics
Currently the statistics are as follows in the United States regarding organ transplants, donors, and those who are on waiting lists for organs. According the UNOS, there are 116, 705 people who are in desperate need of lifesaving organs. 75, 749 of those individuals have an active status on the waiting list. Those remaining are listed as inactive due to health circumstances or insurance issues.
From January 2017 to September 2017 there have been 25, 034 transplants performed and 12, 211 donors. One of them most shocking statics are the number of transplants from January 1988 to September 2017. Within those 29 years, only a total of 712,766 organs have been transplanted, most of which are kidneys.
According to UNOS, 20 people die each day waiting for a donor organ, which means that over the last 29 years there have been 211,700 deaths related to the need of donor organs. Although the statics seem to be in favor of those who have received, the amount of those lost during the wait for a transplant is dehumanizing.
Ethical Solution
If there was a way to make the market ethical for the buying and selling of organs, it would involve confining the market to a union or state that can be self-governing. The organization would set parameters that involved only citizen or residents of that union or state would be allowed to sell their organs. One huge benefit from this possible outcome is that families of those who donate would be eligible to receive organs if needed. With the selling of those organs, all medical needs would be met, and testing would be strictly mandated to avoid any and all possible unfortunate outcomes.
There would be a fair market trade value put on the organ donated that would be based on priority. The prohibited area of this is that there would be no sales that are directly between individuals, and no exploitation of individuals who are nonresidents or citizen. A strict policy would be held in place that did not allow any oversees organs to be used in countries that were considered low income. This eliminates exploitation of those in areas where their circumstances may make them desperate for money and may not receive the best care or education on their sacrifice. This also helps to give those are the UNOS waiting this a chance to move up on that list.
The benefits of healthy individuals making the contribution of their organs is more ideal for transplantation the alternative cadaver option. These paid donors would need to go through a process of seeing a psychiatrist to be determined as competent and knowing of all risks involved. Making sure that the paid donor is completely educated on the journey they are about to undergo is essential to making sure that they have true informed consent.
The argument within this process is for the benefit of all individuals involved. The recipient would receive what they would need to live their life, and the paid donor would be compensated and granted long-term medical care relating to their transplant process. This ensures that any complications involved would be taken care of by medical professionals who understands the process of transplantation, and who may have even been initially involved in that patients treatment and post care.
Conclusion
There are many arguments that can be presented in either direction for and against the selling of ones’ organs. It is important to look at the arguments that stand to protect individuals from being exploited and corroced into selling their organs and the best way to do that is through education.
Having an organization that is designed to aid in the process or selling ones’ organs can minimized or even eliminate the risks of corruption. Giving individuals the opportunity to survive and sacrifice themselves, being paid or not, is an important part of freedom. We need programs that allow for one to be involved this way but that they are also being protected in the process. These are decisions that are hard and can have consequences but there is a way to taken the utilitarian view and use it to make this a benefit that would support those involved.
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