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Should we consider changing the law to allow the selling of human organs? You might think that this would cause some real scary problems, such as people who are poor being taken advantage of, selling their organs to strangers. Of course, this does bring up the question of why it is so terrible for a poor person to give away an extra kidney, while it is considered acceptable and even commendable for anyone's family member of whatever economic situation to do the same. Is it the fact that they are not related, or the fact that the person is compensated for his kidney that makes people squeamish about this?
In any case, let's start with how life-saving organs are obtained now, and the problems that presents. In the United States alone, about 7,000 people die each year for the lack of an organ transplant. Kidneys are the primary organs in demand, but the waiting list for all organs is over 100,000 now, and expected to grow. This means more will be dying.
Few medical professionals can deny that there would be thousands more organs available if there were financial incentives. Unfortunately, in 1984 Congress outlawed the the commercial trade of organs with the National Organ Transplant Act. They also established the "United Network For Organ Sharing," as the country's monopoly provider of organs. This organization maintains the national waiting lists, under an exclusive contract with the Department of Health and Human Services.
Fortunately, if you can find a friend or family member to donate an organ, you are all set. Otherwise you get put on one of the lists, and your place is determined by the criteria that are determined by this organization. You may or may not agree with those criteria, but you are allowed no alternatives, because selling human organs is illegal under the present laws.
Going outside of this system is strongly discouraged in any case. You are supposed to be passive, and wait your "turn," and possibly die waiting. Naturally those with money are looking overseas, and into the darker side of organ transplantation.
However, the primary issue here isn't about taking organs from living people. A friend or relative may donate a kidney a loved one, but the organs obtained by patiently waiting on the list are primarily from people who have died. There just aren't enough people willing to let their organs be used after their death. This is where a financial incentive could help.
If a person could agree to have his family receive $2,000 or $20,000 (let the market set the price) for an organ after he dies, there is no doubt that many thousands of people would live who are otherwise going to die. Why don't we allow this? The darker side of the business scares people, but that is here anyhow. In fact, it is encouraged by the lack of legal alternatives. It would be better to have as much of this business as possible out in the open where we can see what is happening.
Many medical ethicists think that involving money in the area of transplants is immoral. The opinion seems to be that a doctor or hospital making a lot of money from a transplant is okay, but to offer money to the person who donates the part (or to his surviving family) is wrong. It isn't that giving the organ is wrong - most of us are happy that this is possible to save lives. The idea is that somehow it is okay for everyone involved to be compensated except the person giving the organ.
My own view? Whether the donor is alive or arranged for organ donation after death after death, if he wants to charge another to help save his life, it is their business and their right. I have no right to say to the donor, " You can give your organ for free, but you cannot be paid for this serious procedure." I have no right to say to the recipient, "No, because this makes me uneasy, you'll have to die while waiting for a freebie." I don't gain the right to make these life-and-death decisions by joining with others and having my representatives pass such laws.
Other people just worry that a system which allows the selling of human organs will favor the rich. There are two things to note about this.
1. First, the larger part of the cost will probably always be the operation and hospital stay, so such a system won't necessarily raise the costs substantially.
2. Second, these operations are already expensive in any case, and are always more available to the rich or those with insurance, so compensating donors wouldn't change things much.
What we do know, is that the lists are growing. It is also easy to surmise that thousands of people would get to live if donations could be encouraged with money. Even live donation of a kidney can't really be so wrong for money if it can be done for love, can it? In either case a human being who is going to die gets to live. With appropriate safeguards, there is no reason a system allowing selling of human organs wouldn't work.
Statistics Source: Forbes magazine, August 13, 2007