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The ethics of organ donation

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The National Organ Transplant Act of 1984 banned the sale of human organs and non-replinishable tissues in the United States. Prior to that, "donors" sold organs such as kidneys for transplant, and these donors typically were among the poorest members of society.1

The ban on the sale of organs means the most vulnerable members of society are not exploited for their body parts. The cost of this policy is that donated organs are scarce; simple economics suggest that many more would be available if the donors could receive compensation. In fact, during the early 1980s, when organ sales were legal, the average wait time for a donor kidney was less than a year, but today it is more than five years.2 (Most discussions on the sale of organs center on kidneys because these can be given by living donors, unlike most organs.)

Dr. Arthur Matas, former president of the American Society of Transplant Surgeons, has proposed legalizing the sale of kidneys under a system regulated to protect (he says) donors.2 South Carolina State Senator Ralph Anderson endorses a different kind of compensation; he sponsored a bill that would have allowed prisoners to receive reduced sentences in return for donating organs.3 (I was not able to find out by "press time" whether this bill passed.)

While living kidney donors have historically been poor, transplant recipients are more likely to be rich and/or well-insured. While organ transplant lists don't take ability to pay into consideration, the poor and uninsured often don't make it onto the lists at all.4

Increasing organ donation and saving the lives of those with organ failure is a worthy goal. And the economics are obvious. But economics are not ethics.

What Dr. Matas and Sen. Anderson don't acknowledge is that nobody has a right to a transplanted organ. It's a privilege to receive body parts from another individual. And providing a material incentive to "donate" is known to result in the exploitation of those in desperate circumstances -- the poor and, in the case of Sen. Anderson's proposal, the imprisoned. How many free, financially secure people would be willing to undergo dangerous surgery to sell irreplaceable body parts? The fact that these vulnerable members are not eligible to receive organs for financial reasons underlines the inequity of these ideas.

It's important for us as a society to protect our most vulnerable members. And that means we cannot consider mutilating them when they are desperate. You could call it Frankensteinian blackmail.

Watch this space for follow-up articles on organ sales worldwide.

Notes

1. "Policy Debate: Should there be a market for human organs?" South-Western College. (http://www.swlearning.com/economics/policy_debates/human_organs.html)

2. "Doctor Proposes Sale of Kidneys." John McKenzie, November 19, 2007. ABC News. (http://www.abcnews.go.com/WNT/Health/story?id=2977619&page=1)

3. "Give a Kidney to Shorten Your Prison Sentence?" Gigi Stone, March 9, 2007. ABC News. (http://www.abcnews.go.com/US/LegalCenter/story?id=2940289&page=1)

4. "Need an Organ? It Helps To Be Rich." Joy Victory, January 20, 2006. ABC News. (http://www.abcnews.go.com/Health/story?id=1514702)


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2 comments:
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Milehimama said...
February 9, 2008 at 1:33 PM  

SC Senate Bill 481 passed and was signed by the governor:
http://www.scstatehouse.net/sess117_2007-2008/bills/481.htm

It's sister bill, S 480 is the one that declared that a a prisoner would get 180 days off their sentence for a meritorious humanitarian act. It seems that blood donation isn't humanitarian enough, and possibly marrow donation might not be enough (not sure on that) but kidneys will get you time off for "good behavior".

I don't think any prisoner could honestly be free from coercion on this topic, by the very nature of their being imprisoned. Without being free from coercion, how can they truly and freely consent?

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Milehimama said...
February 9, 2008 at 1:34 PM  

Let me try that link again - forgot to put in the HTML:
SC S 481

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