For patients with serious accidental injuries or end-stage diseases of an organ, the only way for them to survive is to perform organ transplantation. However, the demand for organ transplant is far more than supplies. Look at the graph of organ transplant in past decade, the waiting list for organ transplant keeps growing and it grows way faster than the grow of number of donated organs, which is represented by the “donor” line and “transplants” line in the graph shown above. Facing this situation, more and more people are calling for an organ market—a platform where patients and donors meet each other and the donation of organ is paid with money. In my last blog I introduce you the issue of legalization of organ market, and in this blog I will further explore some pro and cons arguments from different aspects.
Ethnic: discourage altruism?
Firstly, there are always a lot of ongoing debates on ethnic of organ market. The main concern is loss altruism. Some people are afraid that financial payback will discourage organ donation motivated by altruism. In his paper Abouna (1991) has shown that there is “considerable evidence to indicate that marketing in human organs will eventually deprecate and destroy the present willingness of members of the public to donate their organs out of altruism.” (167). Satz (2010) agrees with him and states that financial payment will reduce people’s moral obligation to do the same action. He worries that if there are more organ sellers entering the organ market, the spirit of altruism would disappear, which may result that fewer and fewer people sign up to be even a deceased donor. If everyone is getting paid, then why bother do it for free? That will look stupid and unnecessary. David Rothman support this idea from a different angle, and he points out if a market is established; the supply will be diminished because of access to available “goods” in the market.
However, giving the circumstance that altruistic living donations are not many, even organ sale discourage altruism, it attracts more organ sellers, which provide more solid organs for organ transplant. Furthermore, Erin and Harris (2003) believe that the current ethical problem of organ donation is that “everyone is paid but the donor”. “The surgeons and medical team are paid, the transplant coordinator does not go unremunerated, and the recipient receives an important benefit in kind. Only the unfortunate and heroic donor is supposed to put up with the insult of no reward, to add to the injury of the operation.” Donors have not been greatly appreciated and well treated. In a one-year follow-up of live kidney donors, the data indicates that some donors do not have adequate follow-up or insurance coverage for donors, which is also the reason why the number of living donors does not grow much these years.
Messy “post-operation period”
Some people are worried about the follow-up care of donors after transplantation. Who is going to cover medical bills of follow-up for the donor? Apparently the insurance company won’t because the trades are neither accident nor involves involuntary actions, and the recipient will certain take care of medical bill for a post-operation period, however, the problem is how long the this period is. Anyone losing an organ will have significantly increased risk of various types of disease. Every part of our body exists for a reason; it is a result of revolution of millions of years. Although modern medicines can take care of some of the problems caused by removal of an organ, the indirect harm and potential diseases cannot be estimated and predicted. Moreover, when that happens, it is hard to determine whether it is caused by organ donation or patient’s own health condition. If we are considering this risk, the whole organ market system would have more troubles than it appears to.
Profit: how much can we get?
In term of profit, healthcare industries will take a portion not only because they provide the platform but also as a compensation of loss of profits from organ transplantation and materials for medical research. When hospitals and clinics receive donated materials from deceased, they reserve the right of determining how to utilize it; of course the priority will be find matching patients, but they surely can use that material to manufacture medicines or performing any medical research if they are aware that the donation will not be transplanted.
If the government ever legalized organ market, strong regulation and monitoring by government is urged because only government can provide credibility and a guarantee for organ trade.The reason that guarantee of government is desired is because unlike an ordinary market, the real buyers and sellers get connected through the system, and the whole market only serves as a platform for communication. Therefore there has to be some sort of credibility to stabilize the platform. Besides, the length of post-operation period can be carefully determined by healthcare industries based on their past follow-up research data. For organ sellers, they need to sign a consent which declares he/she is aware of the risk of the procedure and responsible for all illness and diseases once pass that post-operation period for the rest of their life.In addition, before the consent, every donor will receive a complete lecture on harm and risk as well as possible changes of their medical insurance plan after organ removal. The procedure of organ removal is irreversible, and therefore to avoid any unnecessary lawsuit, hospitals need to make sure that no donors will regret their actions.
So far I introduced you the topic of legalization of organ market and explored possible solutions for arguments against this proposal. Look at data and facts from organdonor.gov, I don’t think the future of US organ donations system is optimistic. A new system regulating organ donations and transplant is expected for management of organ transplantation.
Abouna, G., 1991, “The Negative Impact of Paid Organ Donation.” Organ Replacement Therapy: ethics, justice, commerce, Berlin: Springer-Verlag, 1991. Web. 8 July 2013.
Erin, C.A. and Harris, J. “An Ethical Market in Human Organs.” Journal of Medical Ethics 29:137-138 (2003): Web. 8 July 2013.
Knox, Richard. “Should We Legalize the Market for Human Organs?” 21 May 2008. Web. 8 July 2013.
R.D. Bloom, et al. “Medical Follow-Up Of Living Kidney Donors By 1 Year After Nephrectomy.” Transplantation Proceedings 41.9 (2009): 3545-3550. Academic Search Complete. Web. 8 July 2013.
“The Sale of Human Organ.” Stanford Encyclopedia of Philosophy. 17 October 2011. Web. 8 July 2013.
U.S. Government Information on Organ and Tissue Donation and Transplantation. Web. . 8 July 2013.