Ethical dilemma - selling organs

[La Sagna]

Should we allow people to sell their organs?

What If You Could Save 250 Lives By Feeling a Little Disgusted?

Picture having to eat a mealworm. Mealworms are the slimy, crawling larvae of the mealworm beetle. They are perfectly safe to eat. But you and I would probably not eat them here or there, we would not eat them anywhere. Not on a canape, and not with a fox. Not in a house, nor in a box.

Reflect for a moment on the feeling you get in your stomach at the thought of eating something so disgusting. That's uncomfortable.

Now suppose a large number of Canadians will suffer from that very same stomach-turning feeling for the next 24 hours. Let's say a million of us will suffer from that feeling. That's a lot of people feeling a great deal of repugnance. But imagine we could alleviate that stomach-turning feeling. All we have to do is let 256 people die. If we let 256 people die, a million of us will not have to feel repulsed or disgusted.

Would you trade the lives of 256 people in order to ensure one million people won't feel disgusted?

In Canada, that's what we do every year. Every year, we decide that we'd rather let about 250 people die than have to put up with feeling repulsed.

There are about 4,500 people waiting for organs in Canada. Most of those waiting -- nearly 80 per cent -- are waiting for a kidney transplant. In 2012, 256 people died on the waiting list. In the U.S., there are now 120,990 people on a waiting list for organs. 99,201 are waiting on kidneys. Last year, 3,381 people died waiting on a kidney transplant.

We have tried increasing altruistic donations. We have tried to get people to sign their organ donor card. But every year only about 2,000 transplants get performed, a number that has remained steady since 2006. In the U.S., about 16,500 people donate organs altruistically.

We could fix this. But it would mean allowing a market in organs. It would mean letting people sell one of their kidneys, like they do in Iran. Iran still has a waiting list. But no one waits for organs. Instead, there is a waiting list of people who want to sell an organ. We already know that a market in kidneys would work.

I know, I know: Gross! Repugnant! Repulsive! Disgusting! And so on.

But this really is the choice. 250 lives in exchange for your not feeling disgusted.

For every other concern, there is a simple fix.

Some of you might be worried about economic exploitation. Very well, we can restrict the market to all and only those people who make a certain amount of money per year. We can prohibit the poor from selling their organs.

If you're concerned about exploiting those who don't know enough, those who might regret their decision later, we can institute a waiting period of six to 12 months, coupled with a mandatory course. We can test how much people know about what they are getting into. If you pass the test, you get to sell a kidney, if not, then not.

That waiting period and test could also be designed in such a way that any worries about coercion or insufficiently informed consent gets taken care of as well.

If you're worried that only the rich will be able to afford organs, no problem: We distribute the organs according to the current standard, or based on need. We have a third party, like the government, or a charity, pay for the kidneys. So no one on the waiting list would have to pay for the kidneys at all. Whether or not you get a kidney would not depend on how thick your wallet is.

And if you're concerned about the meaning of money, or the symbolism of the whole thing, we can change how people get paid. Instead of a cheque, we could pay with a tax credit, or a tuition voucher. We could also insist that people can only use the tuition voucher, for example, on someone other than themselves. That would preserve the altruistic component -- you're not selling the kidney to benefit yourself financially, you would be exchanging a gift of life for a gift of education for someone else.

We can keep going like this for any worry you might raise, but I trust that you have enough imagination to figure out how to come up with a way to design the market to alleviate whatever concerns you can come up with.

All that's left is that uncomfortable feeling in the pit of your stomach. Would you really trade the lives of 256 people to avoid having to feel a bit uncomfortable?

If a market in kidneys disgusts you, so much the worse for your dinner plans. Get over it.

 

[Cornerstone]

Not until we have a situation where people don't need to in order to survive or get the most basic things.
When it is for pocket money, it will still be dumb but I can see people doing it.

 

[Lark]

I have thought about the possibility that people could write living wills for their organs should they die in an accident they could be sure that their dependents and survivors would be beneficiaries, this sounds a little grisly but not as grisly as the reality at present were corporations, pharmaceuticals and other private vested interests work hand in glove with public health providers to profit privately from the trade, "body shopping", and often doing so with genetic matter they have wangled from people for free.

There are people who have survived AIDS or cancers and who have done so because of their genetic inheritance but who are often from undeveloped or underdeveloped parts of the world or communities within the west and easily lured into programmes at a too cheap a compensation to them or their potential beneficiaries and often for free, the donar systems in the UK are things I support, I dont mind that systems intended to, at least at first, to benefit people rather than generate profits can seek to exploit altruism, I carry donar cards for both the UK and ROI. Although I know that some of the marketisation of the NHS in the UK, for instance, has been about hopes to exploit the population as and, more importantly the information held on the population, as sort of huge but cheap or free market research laboratory.

 

[Eventhorizon]

Hmmm... selling organs is a bit like porn dont you think? Bad choices and all. You should be allowed to sell your organs at the age of 30.

 

[Skarekrow]

@Lark has it right...if you are an organ donor you are being profited from unbeknownst to most people. We have the occasional “organ procurement” at work, they used to call it an “organ harvest”...I think they both sound pretty bad personally.
I don’t want to deter anyone from being an organ donor, I have personally seen lives saved by someone donating an organ...it is a very worthwhile thing to do...I am one myself.
In surgery, the vital organs are taken first...they have a a very short life span...some for just a few hours, so time is a necessity for most. But then the second and third round of “procurements” take place...bones, skin, eyes, tendons, etc. as these have a longer “life”. These are also the big money makers for the companies that process the tissue and eyes...they make a killing (pardon the pun).
Whenever we use “cadaver graft” in surgery, be it bones, skin, etc...two things - it is vital that we have these tissues available during the surgery...especially surgeries where there has been loss of bone, tendon (those don’t just grow back btw), and especially skin....I trained at the Grossman Burn center down in LA and later was the lead burn tech for the hospital I worked for in southern CA....we used A LOT of cadaver skin....there is an absolute need! The second thing though is the price...thankfully, I don’t really have to deal with contracts and prices, but I am still aware of how much they charge the hospital, who then marks it up for your insurance.

What I disagree with are profit margins...they are too big in most cases...they sell your eyes for thousands of dollars.
I don’t think we should have a market for organs per say....but I also think that perhaps the family should get some help with something like funeral expenses at the very least.

 

[Cornerstone]

Hmmm... selling organs is a bit like porn dont you think? Bad choices and all. You should be allowed to sell your organs at the age of 30.

Who's going to want some grey, scuffed up kidney that old? It'd be in the bargain bin, dripping onto the floor.
No, if I'm going to pay for a kidney to eat...I want it to be fresh and barely toxic at all.

 

[Cornerstone]

@Lark has it right...if you are an organ donor you are being profited from unbeknownst to most people. We have the occasional “organ procurement” at work, they used to call it an “organ harvest”...I think they both sound pretty bad personally.
I don’t want to deter anyone from being an organ donor, I have personally seen lives saved by someone donating an organ...it is a very worthwhile thing to do...I am one myself.
In surgery, the vital organs are taken first...they have a a very short life span...some for just a few hours, so time is a necessity for most. But then the second and third round of “procurements” take place...bones, skin, eyes, tendons, etc. as these have a longer “life”. These are also the big money makers for the companies that process the tissue and eyes...they make a killing (pardon the pun).
Whenever we use “cadaver graft” in surgery, be it bones, skin, etc...two things - it is vital that we have these tissues available during the surgery...especially surgeries where there has been loss of bone, tendon (those don’t just grow back btw), and especially skin....I trained at the Grossman Burn center down in LA and later was the lead burn tech for the hospital I worked for in southern CA....we used A LOT of cadaver skin....there is an absolute need! The second thing though is the price...thankfully, I don’t really have to deal with contracts and prices, but I am still aware of how much they charge the hospital, who then marks it up for your insurance.

What I disagree with are profit margins...they are too big in most cases...they sell your eyes for thousands of dollars.
I don’t think we should have a market for organs per say....but I also think that perhaps the family should get some help with something like funeral expenses at the very least.

In the UK, we tick which organs to donate. I don't think I opted for retinas, the rest were vital organs.
I hope I didn't tick retinas, anyway. I may have to look into that (pardon the pun).

 

[Eventhorizon]

Who's going to want some grey, scuffed up kidney that old? It'd be in the bargain bin, dripping onto the floor.
No, if I'm going to pay for a kidney to eat...I want it to be fresh and barely toxic at all.

Obviously. Thats why I say 30 because otherwise kids at the age of 18 start selling the organs to party, go to school etc. Hell I would have, you just dont think at that age, not well anyway.

 

[Skarekrow]

In the UK, we tick which organs to donate. I don't think I opted for retinas, the rest were vital organs.
I hope I didn't tick retinas, anyway. I may have to look into that (pardon the pun).

I believe we have the ability to distinguish between organs, eyes, and tissue.
I selected all three...because I will be dead and I will not care in the slightest....lol.
The eye banks (very fitting term btw) make the most....even more than they get for a heart or liver. Though, the big surgeries like a heart transplant make big money for the hospitals and the Surgeon performing the surgery...if we are talking just plain pricing, then your eyes are like gold.
There is absolutely NO reason that the family couldn’t get some of that profit....I don’t want to take myself off the list as a donor just because they will make what I consider inflated profits from my death, because I feel that the potential benefits I could give to someone else who needs my organs or tissue outweighs my distaste for their greed.

 

[Cornerstone]

What if your bits and bobs are also given to a stinky-rich person who is profiteering from the organ trade? That would be a bummer, I think.
I wonder, if we are still 'alive' after death, would it best to just be cremated and then there will be no reason to look back.

 

[Skarekrow]

What if your bits and bobs are also given to a stinky-rich person who is profiteering from the organ trade? That would be a bummer, I think.
I wonder, if we are still 'alive' after death, would it best to just be cremated and then there will be no reason to look back.

Then I’ll just haunt the shit out of him....lolololol.

 

[ThomasJ79]

I'm a bit conflicted on the matter of organ donation. It seems like a genuinely kind thing to do for other human beings in need. If I, or a loved one, needed an organ to survive, I would be in favor of it. But, its seems very few people question the fact that it is still a business and with that come many ethical dilemmas because of the nature of the business. It really bothers me that people make so much money during the whole process. I understand that people still have to make a living and that it should cost money to have done, but I don't know. I think the medical industry isn't at all as ideal as we may all wish it to be. I have found many doctors to be terribly greedy, rude, full of pride, even though they do much good in our society. It seems to be part of the nature of the job they decided to do for a living. It is obvious to me that once you're dead you have no value to the medical industry. The one receiving the organ pays out(or the insurance company) for the organ, the medical staff receive a large profit, and your body is picked apart like a car in a junk yard. The family of the one donating doesn't receive any money or anything at all for what they did for the greater good of society. Obviously, the deceased won't benefit at all, but that is kind of my point; that you cannot be valued because you're dead. The ones that donate do help save a life, and that alone is worth doing it, but you're also helping make other people rich in the process. It is the latter that concerns me.

 

[muir]

Under our current system some people would feel under economic pressure to do it therefore there will be exploitation so i think its a bad idea

We should look instead at improving the general health of people and i think the best way to do that is to ensure people are happy and the best way to do that is to create a fairer more equal society (with less exploitation)

 

[j654dgj7]

Hmmm... selling organs is a bit like porn dont you think? Bad choices and all. You should be allowed to sell your organs at the age of 30.

Agreed. I get sort of bummed out even at the thought that some people have to / want to do that. That doesn't mean that it's not necessary or going to happen, however, and therefore I think it might be a good idea to regulate it.

Under our current system some people would feel under economic pressure to do it therefore there will be exploitation so i think its a bad idea

We should look instead at improving the general health of people and i think the best way to do that is to ensure people are happy and the best way to do that is to create a fairer more equal society (with less exploitation)

This is a great idea as a long term solution for those who sell their organs because they need to.

 

[muir]

There's already a thriving black market in it

http://www.jewishjournal.com/israel/item/israeli_organ_trafficking_ring_arrested_20100408

[h=2]Israeli organ trafficking ring arrested[/h]
Israeli police arrested six men from northern Israel accused of being involved in an organ trafficking ring.
The suspects, including a military brigadier general and two attorneys, were arrested Wednesday, according to reports. The ring allegedly identified potential organ donors through advertisements promising up to $100,000 in exchange for their kidneys. Some were reportedly paid $10,000 and others nothing at all. The transplants took place in Ecuador, Azerbaijan and the Philippines, under substandard medical supervision. Some of the donors are still suffering from medical complications.
Israel outlawed providing organ donors with financial rewards in 2008; all organ transplants are supposed to be carried out through the National Transplant and Organ Donation Center. Israel has been cited as one of the world’s trouble spots when it comes to the illegal organ trade.