Thursday, April 17, 2008

For Sale: 34-Year-Old Kidney (slightly used)

Should you be allowed to sell your own organs for transplant? Philosophy Now reports that Philosophy Prof. Mark J. Cherry of St Edward’s University, Austin, Texas has called for the trade to be legalized. He believes this would destroy an existing black market and improve the conditions surrounding transactions. He made the proposal in Prohibitions, a book published by the Institute of Economic Affairs

In a radio debate he was opposed by an organ-recipient who felt that all donations should be altruistic. His proposal was welcomed cautiously by Prof. Nadi Hakim, the surgeon who performed the world’s first hand transplant. Having seen the changes possible in patients who receive transplanted organs, he said that such items were beyond price, but that any method to stimulate the supply of donors should be examined.


Anonymous said...

Yes, we should! The government shouldn't restrict what we can and cannot do with out own bodies (abortion, suicide). Besides, a black market already exists. Much like the drug trade, legalization will eliminate the dark, dirty, underbelly of the trade.

Steve Gimbel said...

The worry with this libertarian line is that what is voluntary to one in economically security becomes less or not so in economically vulnerable contexts. There's a reason that most of the American troops killed in the war are from economically worse off situations. Many -- certainly not all -- of those who choose to serve do so because options like college that are very much open to more affluent young adults are not there for them. The worry is that this becomes the same sort of situation where economic disparity makes this a less than completely voluntary act -- that is, all other things being equal this person would not have sold his kidney, but he needed the money.

With the difference in access to health care, this would generally mean we are harvesting organs from the poor to plug them into the well-off whose health insurance covers the costs.

Maybe it's a good idea, but there are certainly questions that need to be answered from the other side.

jfinnell said...

Initially, my thoughts on this issue aligned with anonymous. "Hey, it's your body. No one can tell you what you can and can not do with it."

Practically, however, we know exactly where the majority of the organs would come from: the economically disadvantaged.

At the same time, this practice already exists around the country: blood banks and bone marrow centers. A good deal of the people donating their blood or marrow are in need of money. What is different about an organ?

As was pointed out, the black market for organs already exists! However, in order to avoid abuse (coercion, for example) a significant amount of government regulation would have to accompany any legalization of organ donations. With so much red tape it is hard to say that the black market would cease to exist.

Would the increase in available organs to save lives offset the decline in the quality of life for the economically disadvantaged? Good question.

Anonymous said...

We can always mandate that organ donation postmortem be the rule, and not the exception. This would give an influx as well, but those people who have strong religious objections could still be allowed to opt out. Those of us who don't pay much attention to such, would automatically be on the list.

Why don't we do this instead, and see how the availability pans out, before leaping to such extreme, and questionable methods?

Anonymous said...

I have to agree that mandating that organ donation postmortem be the rule, and not the exception, is a simple, direct way of ameliorating the shortage of organ donations.

Another incentive plan would offer registered organ donors reduced health insurance premiums. Such a program would reward those who agree to be a benefit to the healthcare system as a whole with a healthcare related benefit for themselves.

Hanno said...

Last anon was me.

jfinnell said...

If we move towards the "presumed consent" model that Hanno has offered up, organ donations are still faced with the difference in access to health care. Whether we want to admit it or not, economics plays a role in this decision.

Those living under the poverty line or without health care will be asked to sacrifice their organs for those who were lucky enough to afford the factors (health care, etc.) that contribute to their longevity. Not surprisingly, your income has a direct correlation to your health.

As Steven pointed out, "this would generally mean we are harvesting organs from the poor to plug them into the well-off." We would still be doing this with presumed consent.

Additionally, incentive plans that offer registered organ donors a reduction in health insurance premiums only works if everyone has insurance.

Perhaps part of the solution exists in prevention, instead of reaction. Providing access to health care and equal access to healthy food will contribute greatly to preventing organs from failing in the first place.

Of course, this wouldn't cover all organ failure (genetic defects, car accidents), but I think the majority of organ failure could be prevented (disclaimer: this would need to be substantiated with medical data).

9 Finger Willy said...

On behalf of the poor,

Let me get this straight. People ought not be allowed to sell their organs to the highest bidder while they are alive, since this would most likely lead to the exploitation of the poor.
So, to protect the poor from exploitation we shall cut them off from one –if not their only—means for getting ahead. On behalf of the poor, I say go help someone else… I may wish to be exploited, better that than poverty.