Should Organ Donors be Compensated?
ShouldOrgan Donors be Compensated?
Thepurchase of body organs for transplant from people who are willing tosell them has become a reminiscent and an extremely controversialissue. It is an issue that has slowly developed from being doneoccultly in some poor or developing countries to being debated openlyby the American Transplantation Society and the American Society ofNephrology. The sale of organs for transplant is prohibited in theUnited States. Globally, medical associations and religiousauthorities have strongly condemned the act of selling human organs.They consider such transactions as ethically and morally unacceptableas well as inhumane (Arnold et al, 1361). However, despite thesecondemnations, many people on the waiting list of organ transplant,and continue to die and suffer because of the serious shortage oforgan donors. Presently, more than one hundred and twenty thousandspeople are awaiting transplants of organs such as livers, kidneys,lungs, hearts, and other organs depending on the diseases they aresuffering from. The campaigns to encourage people to volunteer asorgan donors has not yielded the expected results few people arewilling to donate their organs without charging money. This hascreated a high demand for transplant organs, making people to seekthe available alternatives such as buying the organs from the blackmarket. The increasing number of deaths every year due to lack oftransplant organs has made some of the transplant surgeons to startadvocating for a legalized and regulated market for organs fortransplant. This has received a lot of reactions with some peoplesupporting it while others argue that it is ethically wrong(Kalogjera, 19).
Thereare three main arguments usually given in support of compensatinghuman donors for their organs. The first argument is based on thefact that competent and independent adult human beings have the rightto do as they wish with their bodies, particularly if what they aredoing is not considerably dangerous to another person. Therefore,people should be allowed to sell their body organs if they want sincethey own them. The second argument is that organ sale saves life byreducing the serious shortage of organs for transplant. Saving oflife here is seen in two ways. One person, the recipient is savedfrom dying from a terminal disease while the other person, the donoris saved from dying of hunger. The shortage for these organs fortransplanting is so huge that more drastic measures need to be takenso as to get the additional transplant organs which are required.Therefore, if paying for these transplant organs will add moretransplant organs, then the sale of organs for transplant isjustified (Kalogjera, 19).
Anotherargument which supports the sale of organs for transplant is thatthere seems to be no major difference between other generallyaccepted dangerous practices, especially sale of one’s “riskylabor” and sale of transplant organs. There are so many practicesthat pose the same risk or even greater risk than that associatedwith donation of organs. Some common kinds of “risky labor” suchas fire fighting, coal mining, military defense in a war, and deepsea diving are regularly more unsafe than the sale of transplantorgans. However, these risky jobs are considered heroic, and insteadof showing disapproval for being dangerous to human life, it isperceived as right and just to compensate the people who carry outthese kinds of dangerous practices. The difference in the way thatsale of organs and provision of risky labor is perceived should notbe justified on the basis of the good results produced by “riskylabor”. This is because the result of a sale of organ fortransplant is saving another person’s life and this is just as goodas or even much better than the results of the “risky labor.” Hence, it is not consistent to let people get compensated for sellingtheir “risky labor” while denying them the chance to becompensated for their own organs (Truog, 444).
Theopponents of sale of transplant organs give the following reasons foropposing the idea of having a legalized market for organs. They fearthat the sale of transplant organs will promote stealing of bodyorgans. It will also promote the killing of brain dead and comatosepatients by doctors in a rush to harvest their body organs fortransplanting and make profit. Another reason for objecting the saleof transplant organs is because it will lead to supply of transplantorgans which are of poor quality, that is, most people who will bewilling to sell their body organs for transplant are most probablythose whose organs are of poor quality. Exploitation of the poorpeople in the society is also another reason for objecting aregulated market for transplant organs. Most people likely to selltheir organs are those who are not rich in an effort to make money.The opponents of organ market fear that the poor will be paid verylittle money for their organ. Furthermore, if they get complicationsin the course of having their organs removed or after the donation,all the money they receive would be used for medical check ups andbuying drugs. Also, they claim that the sale of organs for transplantwill not be fair to all people. Only the rich people in the societywill afford to buy organs for transplant, leaving the poor who cannotafford to buy hopeless (Stempsey, 195).
Theopponents also fear that if an organ market is allowed, the bodyorgans will start to be seen as commodities which one would sell andmake profit. This could result to a general coarsening and cheapeningof the relationship between human beings. In addition, thecompensation system would force out the system of volunteerdonations, thus weakening the altruistic or the charitable bond whichnormally brings people together. Some religious groups also prohibitthe sale of body organs. They claim that it is inhumane and disregardit as body mutilation. Various opponents actually feel thatxenografting and other techniques which do not involve sale of humanorgans are more ethical. Xenografting is the process of gettingorgans or tissues from a creature of a different species and graftingor transplanting it into another creature of a different family orspecies. A regular example is where pig heart valves are transplantedin human body. Another reason for opposing compensation of organdonors is that it will make it difficult or problematic for people tomake valid decisions. People will be encouraged by monetaryincentives to do things which otherwise they would not have done, andthose which are most likely to be dangerous to them or those whichare against their principles (Kuczewski, 53).
Currently,more voices trying to convince the opponents of the sale oftransplant organs to change their stand on this issue and supportcompensation of organ donors are evident. The way to convince theopponents to support regulated sale of organs is by proving wrongtheir arguments on this issue. This is beginning to yield some resultbecause even some of the people who initially were opposed to organmarket are starting to form strong arguments in support ofcompensating organ donors. The opponents claim that the legalizedorgan market will only favor the rich because they are the only oneswho will be able to buy the organs. However, this is not true becauseif a legalized market for transplant organs is established, the priceof the transplant organs would fall making it possible for all peopleto afford (Stempsey, 195). Better still the state will control theprices of the transplant organs by using the regulatory mechanisms,just like it does with other goods and services. After all,socioeconomic inequalities have prevailed in the today’s society,and the rich are already buying the organs from the black market. Sothe only way to make the present system fair is to legalize the saleof transplant organs. In addition, it would even be more unfair todeny the people who are able to afford to buy transplant organs usingtheir own earned money, through honest means, for the reason thatother people are unable to pay for them. We are living in a basicallyheterogeneous society where equity of all the people has to bedefined in a pragmatic and realistic terms (Stempsey, 195).
Theclaim that organ market will promote organ thieves is also not truebecause for an organ transaction to take place there requires someimmunological factors. For instance, the match between the recipientand donor, and their blood type has to be tested first. Therefore, itwould be impossible for organ thieves to get a random match for aparticular recipient. Furthermore, if the opponents say thatlegalized sale of organs will be dangerous to the donor, what aboutorgan transactions done in the black market? Isn’t that even moredangerous? Organ removals performed in the black market are done insecret and this means that they are performed in dangerous and poorconditions. Sale of organs through black market is also risky becauseif one does not get paid there will be no legal remedy available forthem. Also, if the donor experiences some complications from theorgan removal he or she may not be able to pay for the cure of thosecomplications, and this could cause death. Therefore, it is importantto have a legalized and regulated market rather than have blackmarket organ transactions (Stempsey, 195).
Also,xenografting cannot be said to more ethical compared to compensationof organ donors as the opponents claim. A regulated transplant organmarket promotes voluntary exchange of organs between the recipientand the donor, that is, the donors gives their consent to sell theirorgans for transplant (Truog, 444). Animals are not able to giveconsent, and even if they would do, they would not allow their organsto be removed for xenografting since they don’t benefit in any wayby having their organs removed. More still, xenografting posesdangers to the recipients because their bodies can reject the animalorgans, and also the viruses which are found naturally in some animalspecies. The concern that the rich countries with money power mightdrain transplant organs from countries that are poor thus making themmore vulnerable can also be solved through regulation. This can behandled easily by prohibiting exports of transplant organs for human(Truog, 444).
Inconclusion, after researching and evaluating the arguments of boththe proponents and opponents of the issue of compensating organdonors, it seems that the proponents make the strong argument.Iagree with the arguments of the proponents that the market fortransplant organs should be legalized and regulated to solve thecurrent shortage of organs and their high demand, as well as reducethe risk involved in organ transactions carried out in the blackmarket. If the market for sale of transplant organ is legalized andregulated, people who were fated to die an early death due terminaldiseases will have hope of surviving. In addition, it will be unfairto allow people waiting for organ transplant to continue dying orsuffering in pain, not because they lack people to donate organs tothem but because there are no legal system to allow them to buy thetransplant organs from the donors freely. It is also important toremember to respect the patient’s right to be relieved fromsuffering and pain which is intrinsic. I also believe that it isethical and in consistent with dignity of human to allow compensationof organ donors, that is, it is the best way to thank a personwilling to donate an organ to another person. Legalization ofCompensation of organ donors will also help in alleviating the heavycosts associated with prohibition of organ sale such as higher burdenof diseases due to expensive treatments, untimely deaths, and moralbias.
ArnoldR, Bartlett S, Bernat J, et.al. “Financial incentives for cadaverorgan donation: An ethical reappraisal”. Transplantation,2002 73(8):1361-1367.
Kalogjera,Liliana M. "New Means of Increasing The Transplant OrganSupply." HumanRights2007 34.4: 19.
KuczewskiM. G. “The gift of life and starfish on the beach: The ethics oforgan procurement”. AmericanJournal of Bioethics,2002 2(3):53-56.
Stempsey,William E. "Organ Markets and Human Dignity: On Selling YourBody and Soul". ChristianBioethics: Non-Ecumenical Studies In Medical Morality2000 6 (2): 195–204.
Truog,Robert D. "The Ethics of Organ Donation by Living Donors".NewEngland Journal of Medicine2005 353: 444–446.