I received an email request to discuss the issue of setting up a market for buying and selling organs as reported in this article.
Two doctors suggested legalizing the buying and selling of organs. According to the article attached to the email, "about 400 people per year die in the UK because they are left waiting for a donor."
I received this email about a week ago, but did not have time to write on the subject right away. Then, today, I saw another related article in which a 16 year old girl died while waiting for a liver.
There is a significant difference between donating a kidney and donating a liver -- a person cannot donate a liver and live. However, establishing a market for livers still might help to reduce the shortage. A substantial cash donation to the estate of those who become organ donors will help to ensure that surviving relatives make sure that the deceaced's wish to have those organs donated are carried out efficiently.
The main argument in favor is that it would save lives -- and that is not a bad thing.
The BBC article suggests that the main argument against is that such a system would exploit the poor.
I do not see any merit to this argument. Apparently, if I get your kidney, and you get nothing, you have not been exploited. If you keep your kidney and get nothing, and I die, apparently that is okay as well. However, if I get your kidney, I live, and you get a substantial amount of money that you can use to improve the quality of your own life, then you have been exploited, and we can't have that.
Like I said, I don't get that.
Now, I do not have any difficulty imagining a science-fiction universe where the poor are used as spare body parts for the rich. I can imagine in my mind a community of individuals -- half blind, with one kidney, with patches of skin missing and scars from a dozen surgeries to remove various types of tissue, who make thier living selling body parts to the rich.
That would not be good.
Yet, there is nothing about setting up a market for organs that would require that we take this particular route. There are a lot of options between a total prohibition on organ sales, and setting up a completely unregulated market for body parts on e-bay.
A moderate position between these two extremes can establish limitations that prevent this type of horrendous scenario. For example, concerning the donation of a kidney, the physicians mention in the BBC article suggested a price of $40,000.
If this seems exploitive, one of the ways we can avoid this is to increase the payment -- make sure that the benefit to the contributor is substantial. We could, for example, make it a payment of $100,000; plus 4 years' free tuition, room, and board at a university or training in some skill. With a high price, there would likely be a surplus of candidates, allowing the government to select contributors according to who it thinks will make the most use of the benefits provided.
Another possible limit would be to allow only the government to purchase organs, and to then distribute them to those who need new organs, rather than to those who have money. In this way, we will not be setting up a system where the poor become organ farms for the rich to harvest and use as replacements.
Finally, we could add the requirement that the person supplying a kidney were to have his sole remaining kidney fail, that he would be entitled to a new one for free.
With these types of safeguards, it would be difficult to argue that the system would be exploitive. It would certainly be less exploitive than the black market that currently exists. Indeed, such a system could drive the black market out of business, since the system will ensure that there is no demand for black-market kidneys.
I can understand the squeamishness that some people may experience when thinking about this issue. Yet, it is quite possible that this squeamishness is like the squeamishness some people feel at the thought of homosexual (or interracial) sex. It is a learned response acquired through social conditioning that actually does more ham than good, and we would be better off being rid of it.
Of course, I could be wrong. I am not averse to allowing some societies to keep things like this illegal for a while, while others that are comfortable with these sorts of changes experimenting, to see if it benefits these people or if it brings about the horror stories that some fear.
A person with a good imagination can probably imagine other horrors that may be associated with paying for organs. Yet, once the individual has put his imagination to work coming up with a problem, I would like to suggest putting that same imagination to work coming up with a way of dealing with the problem other than letting people die.
Ultimately, it saves lives, and with sufficient safeguards, such a system could give both the contributor and the receiver significant better qualities of life than they would have otherwise had. It is not so obviously wrong that I am forced to object to any society giving it a try.