Finally, one can also argue that staying healthy is something of special merit. It not only benefits you personally, but your family and society in general as well. You have, therefore, an obligation to keep your body intact by avoiding health risk activities, including selling your body parts for money. Some religions, in fact, teach us that your whole body should be preserved for the life after death. As stated by the teaching of Islam: "To God we Belong, To Him is our Return." Accordingly, you belong to God and your body parts are not like the pieces of property you own and thus can be sold at your discretion. [Christianity? Except for maybe some fundamentalist sects, most Christians believe that organ donation is a charitable act of love that fits under "Love thy neighbor" and that the body at death is different from the whole, glorified, resurrected body in life after death. Buying and selling organs, however, are seen as illicit, abominable acts. Pope Benedict XVI said "the body can never be considered as a mere object" so the "logic of the market" cannot be applied to organ donation. See the article: Pope Warns of Dangers of Selling Human Organs at http:// www.catholic.org/international/international_story.php?id=30460 I think most Christian religions would believe the same.]
Is there the probability that economic crimes will increase if there is a legal market for human organs? Will some profiteering entrepreneurs try to steal or incise organs from other people so as to sell them to the highest bidder? Is it probable that some villains will victimize vulnerable people by luring them into the trap of selling their kidneys? Considering these and similar questions, the market system may be prone to serious abuses unless there is vigorous government oversight and appropriate binding regulations. These and similar thorny issues need to be thought of and properly addressed before contemplating a free market.
Proponents of Legalization
Proponents of legalization argue that without a market, the selling of human organs may go underground, in which case, grave exploitations of our most vulnerable people will result. This happens even in Iran where organ sales are legal. Often, needy patients end up paying a hefty price to the matching donors following intense negotiation between the two parties. Then again, there is no guarantee that such a system does not create undesirable consequences that may hurt those who are supposed to benefit from it. In other words, there are costs and benefits, and the market system is rationally defensible if the expected benefits outweigh the costs; but there is no concrete evidence to support that they do. Some would even argue, oddly so, that a legal market may help our ailing economy which is in need of additional spending. This argument is as illogical as buying a cow just for a glass of milk.
Rational discussion of legalization may increase public awareness of the seriousness of the issue and the need for government to get more involved by providing funding for medical research aimed at developing human organs in laboratories. This would be the least painful approach to dealing with this paradoxical issue. The question is do we have the technology to develop human organs in labs? (See http://www.ted.com/talks/anthony_atala_printing_a_human_kidney.html )
Concluding Remarks
After weighing the evidence for and against the legalized market, I am inclined to believe that the legal market is not an acceptable solution that can effectively assuage organ shortage. It creates too many problems and too many unanswered questions. Shortage is not caused by low or lack of price. People do not wish to donate a kidney in expectation of pecuniary gains. Unlike the peasants in the rural areas of a less developed country who are the major source of kidneys that are for sale, I believe the poor in the U.S. are not so depredate they would sell their body parts for money, even if it were legal. And, if a few of them do so, it is not going to change the prospect of alleviating the shortage. Plus, they would be well-informed about the possible health risks and the harm they may suffer because of the possible side effects. They cannot, therefore, be lured into selling a kidney against their wishes. So I think an attempt to boost supply through monetary incentives is futile at best. Likewise, people do not seek a kidney because it is cheaper or more expensive; they seek it because they are suffering from an unfortunate medical condition and they hope that there is a matching donor somewhere out there that can save their life. In other words, shortage is not a price problem and should not be dealt with by finding a monetary solution.
A legal market may also create unthinkable situations in which the most vulnerable people may be taken advantage of by the greedy middlemen for the sake of personal gain. Moreover, there is a compelling physiological reason why we are naturally endowed with two kidneys. We need both to survive well, and as a backup if one is damaged by accident or disease. Kidneys are not the only organs that come in pairs, and offering money for kidneys may open the door to trading these other organs! In addition, most of the available kidneys under our current system come from deceased people who altruistically wished to donate their organs to save lives and not for monetary gain. Actually, why would a deceased person be concerned with money anyway? If they wanted to help their surviving family or loved ones financially, they could buy a good life insurance policy.
Although society should strive to alleviate human suffering, we should not, however, achieve that objective by undermining our respect for human dignity and endangering other people's lives. It should be done in a fair, safe, and equitable manner and not by violating people's rights for financial gain. The main concern should be to preserve human life and not turn the human body into a tradable commodity.
We should be able to hammer out a solution to organ shortage that is acceptable, and create a system that, while effectively dealing with the shortage and the resulting loss of human lives, is not prone to misuse and exploitation. Any system should be properly regulated by government to protect each and every party involved. Without rigorous government oversight, the possibility of misuse and mistreatment of vulnerable and uneducated people exists. According to many observers, public education concerning the importance of organ transplantation is very helpful. This can be accomplished through raising public awareness via public service announcements and advertisements focused on the importance of donation and the laws and regulations that govern organ transactions. We already have a plethora of public service announcements related to smoking, wearing seat belts, domestic violence, and numerous other health concerns. Organ donation is a very significant way that people can show compassion and caring for one another. A legalized market may save some patients from experiencing the anxiety of the waiting list system and its heartbreaking limitations, but not all. Although the experience of Iran may offer some hope, we should be cautious; what may work in Iran, may not work in the U.S.
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