Michael Smith of Bloomberg.com recently wrote an article about the underground market for organs. Click here to read it. Smith tells the tale of those desperate enough to pay for organs and those desperate enough to sell them. According to the article, those in dire need of an organ are victims:
“With all the anxiety in getting a transplant, they exploit the patient,” says [Dr. Francis] Delmonico [of Harvard Medical School], who is president-elect of the Montreal-based Transplantation Society, which lobbies governments to crack down on trafficking.
But wait… according to Dr. Delmonico, those willing to sell the organs are also victims:
“The problem is that you have so many people who are desperate for a transplant and willing to pay for one and so many poor people who need the money and can be exploited,” he says.
So if both the buyer and seller are exploited, who precisely is taking advantage of them? The article mentions organ brokers and traffickers, but what characteristic makes them fundamentally different from those who manage legitimate transplant lists? Do they work pro bono? Do the surgeons? Do the hospital staff? If not, is that exploitation?
The article mentions that “legal transplants have a high probability of success.” There is no mention of the survival rate after illegal transplants, but I’d bet it’s higher than the survival rate of those who need but never receive a transplant. Let’s assume that the illegal transplants are more dangerous than the legal transplants. Why are they more dangerous?
The illicit organ trade is dangerous for the donor and patient because criminals take shortcuts, such as accepting organs from people who are sick and wouldn’t be approved by hospitals in the U.S., says Gabriel Danovitch, medical director of the kidney and pancreas transplant program at the University of California, Los Angeles.
Perhaps I construct a straw man here, but if the dangerous part of the “illicit organ trade” is the failure to screen donors for diseases, then why is the entire market illegal? Why not legalize the organ market and simply require medical testing before an organ can be bought or sold (the efficiency of the regulation is another debate for another day)? That would certainly lead to healthier results than we’re seeing in today’s underground organ markets, and it would probably lead to shorter waiting lists for kidneys.*
I suspect it’s because in some people’s minds, health is not the only issue. Some people find the very concept of selling organs to be immoral or distasteful. They believe it that organs should be donated out of love or altruism, and never for any other purpose. Here’s Danovitch on the illicit organ trade:
“It’s a filthy business in the same subcategory as the sex trade and child pornography,” Danovitch says. “That is why it has to be stopped.”
Get that? This guy just compared “peacefully buying (or selling) an organ to save (or improve) your own life” to child pornography. Health is not the main issue for him– I’m sure he wouldn’t endorse the “subcategory” even if it were medically safe– it’s the morality of the act. He places the act of organ donation on some high moral shelf that money would only bring crashing down. Not the money that pays for the surgical team, or the equipment they use, or the drugs they administer, or the hospital they operate in, or the staff and management of the hospital; that money’s kosher. But in Danovitch’s mind, the money going from patient to donor somehow turns the whole operation into the moral equivalent of prostitution and the sexual exploitation of minors.
Seriously, I think Danovitch and Delmonico mean well but are badly confused about morality. Aside from religious objections that some may have about sullying bodily purity, what is inherently immoral about paying for an organ donation? It is a peaceful transaction. It is inherently risky, but if buyer and/or seller don’t know the risks, don’t ban the whole practice. Just tell them the risks and then let them decide whether to go about their business.
If I ever need an kidney transplant, or if my wife or kid or a relative needs one, I will go about trying to secure that kidney through all peaceful means. That may well include trying to purchase a kidney. Hopefully, whoever tries to stop me will be a blood and tissue match because he will have unwittingly volunteered his organs, gratis.
* According to the article, Iran is the only country that allows you to pay a donor for an kidney. A study claimed that as recently as 2006, Iran had “no renal transplant waiting lists.” I never thought I’d say this, but I wish we would follow Iran’s lead on this one.