Organ Donation Compensation: A Simple Solution or Inevitable Inequity?

Organ Donation Compensation: A Simple Solution or Inevitable Inequity?

Organ Donation Compensation: A Simple Solution or Inevitable Inequity?

No doubt allowing people to sell their organs would increase the supply for those awaiting transplants. But would the societal benefits of such a move be offset by a further widening of the gap between the rich and poor?

     
Organ Donation Compensation:  A Simple Solution or Inevitable Inequity?
image by: pgrandicelli BEE FREE

A compelling case was made recently in the Wall Street Journal for changing U.S. law to allow people to sell their organs. The authors have done their research, employing a variety of statistics to demonstrate just how dire the situation is for those in need. 

For example, they tell us that in 2012, with 95,000 Americans awaiting a kidney transplant—up from 54,000 in 2002—only 16,500 transplant operations were performed, while 4,500 people on wait lists died. They tell us the average wait time for a kidney is 4.5 years, whereas as it was 2.9 years a decade ago. They tell us that a person aged 45–49 averages eight more years of life on dialysis, but 23 more years if she receives a transplant. They point out that in Iran, which is one of the few countries to allow for the open purchase and sale of organs, wait times for kidney transplants have been largely eliminated

Being that the article was written by a pair of economics professors—including Nobel laureate Gary S. Becker—it's not a surprise that their argument includes the economic angle. Dialysis averages $80,000 per year which means the lucky kidney recipient can expect to pay $350,000 before receiving a kidney, a cost far higher than the $150,000 for the transplant itself. They even suggest a cost for kidneys:  approximately $15,000. This money would go to the donator if she is alive, or to the donator's heirs if the donator chose to sell her organs "forward" (in which case, of course, more than just her kidneys could be harvested).

The Wall Street Journal article comes three months after the Clinical Journal of the American Society of Nephrology published a study finding that paying living donors $10,000 for a kidney would increase transplants by 5%–20% and would be more cost effective than the current system.

But as that study found, and as Becker and co-author Julio J. Elias admit, the idea of paying organ donors is strongly opposed by most doctors, including transplant surgeons, not to mention academics, political leaders, and many others (though not necessarily the general public). Becker and Elias say the rationale for the opposition is three-fold:  1) "paying for organs would be ineffective," 2) "payment would be immoral because it involves the sale of body parts," 3) "the main donors would be the desperate poor, who could come to regret their decision."

For the sake of argument, let's say Becker and Elias satisfactorily address these concerns—that the system they propose addresses Objection #1, that #2 is a wholly subjective question, and that the potential problem posited by #3 could be obviated by "safeguards [that] could be created against impulsive behavior or exploitation," such as a waiting period of three months or longer "to reduce the likelihood of rash donations."

Still, there is a potential problem the authors completely fail to address: that allowing the purchase of organs would further widen the gap between the rich and the poor by giving the rich (even more) access to organs than the poor are afforded.

In the authors' own words, they advocate for the establishment of "an open market" for organs.  And as we know from the United States' great experiment in the open market, scarcity drives the costs of goods and services, whose cost will settle at whatever level the market will bear. Thus, without the strictest of constraints—constraints that probably cannot be fully implemented in an open market—some organs would inevitably end up in the body of the highest bidder.

Although the authors claim the sale of organs would make them more available to the poor—for example, if Medicaid helped pay the related costs—because the market would be dominated the wealthy, it's not clear that the increased number of available organs would proportionally benefit the poor, while clearly such an increase would disproportionately benefit the rich.

Moreover, as the authors admit, "the poor would be more likely to sell their kidneys and other organs." And however much such a sale might be a financial windfall—although the authors' proposed price of $15,000 is too small an amount to remove most people from a state of poverty in the long term—it is inarguable that one is better off not having one's body cut open whenever it can be avoided. Thus an unintended consequence of an open market for organs is that the poor, already less healthy than the wealthy for a variety of reasons, would be made that much less healthy by an increased percentage subjecting themselves to unnecessary surgery.

The desperate plight of those awaiting donated organs is self-evident. And there can be no question that the status quo is insufficient to address the demand.  But plunging ahead into an open market for organ donation may not be the "obvious and sensible solution" Becker and Elias claim, particularly in regards to live donations by the poor. It's a dangerous and perhaps unethical game to play with alleviating the suffering of some by increasing the suffering of others and the inequity between the two groups. 

While compensation for some organ donations may be a viable way to improve the status quo, a truly open market for organs might turn out to be little more than one more way for life-and-death decisions to be dictated by the almighty dollar.


About the Author:

Except for a four-month sojourn in Comoros (a small island nation near the northwest of Madagascar), Greggory Moore has lived his entire life in Southern California.  Currently he resides in Long Beach, CA, where he engages in a variety of activities, including playing in the band MOVE, performing as a member of RIOTstage, and, of course, writing. 

His work has appeared in the Los Angeles Times, OC Weekly, Daily Kos, the Long Beach Post, Random Lengths News, The District Weekly, GreaterLongBeach.com, and a variety of academic and literary journals.  HIs first novel, The Use of Regret, was published in 2011, and he is currently at work on his follow-up.  For more information:  greggorymoore.com

operating room photo by: Ruhrfisch

Related Videos

The Latest from Moore Lowdown

Want to Reduce World Hunger? Eat Less Meat (Especially Beef)e

Want to Reduce World Hunger? Eat Less Meat (Especially Beef)

America is one of the world leaders in per capita meat consumption—which means we’re also one of the most inefficient users of land and other resources when it comes to feeding people.

Can One Simple Change Double Organ Donation?e

Can One Simple Change Double Organ Donation?

Die in the USA, and your organs go to waste unless you’ve opted in to the organ donation problem. But it doesn’t have to be this way—and in many countries, it isn’t.

Dedicated Bus Lanes: The Easiest Way to Improve Public Transite

Dedicated Bus Lanes: The Easiest Way to Improve Public Transit

The buses are there. The roadways are there. All that’s needed to make bus travel better⎯and therefore more viable⎯is the will to give them their own lane once in a while.

Want to Reduce World Hunger? Eat Less Meat (Especially Beef)e

Want to Reduce World Hunger? Eat Less Meat (Especially Beef)

America is one of the world leaders in per capita meat consumption—which means we’re also one of the most inefficient users of land and other resources when it comes to feeding people.

Can One Simple Change Double Organ Donation?e

Can One Simple Change Double Organ Donation?

Die in the USA, and your organs go to waste unless you’ve opted in to the organ donation problem. But it doesn’t have to be this way—and in many countries, it isn’t.

Dedicated Bus Lanes: The Easiest Way to Improve Public Transite

Dedicated Bus Lanes: The Easiest Way to Improve Public Transit

The buses are there. The roadways are there. All that’s needed to make bus travel better⎯and therefore more viable⎯is the will to give them their own lane once in a while.

Amazon and the Steep Price of Conveniencee

Amazon and the Steep Price of Convenience

There's no mystery as to why we shop Amazon. But perhaps all that convenience isn't worth the overall cost.

Want to Reduce World Hunger? Eat Less Meat (Especially Beef)e

Want to Reduce World Hunger? Eat Less Meat (Especially Beef)

America is one of the world leaders in per capita meat consumption—which means we’re also one of the most inefficient users of land and other resources when it comes to feeding people.

Can One Simple Change Double Organ Donation?e

Can One Simple Change Double Organ Donation?

Die in the USA, and your organs go to waste unless you’ve opted in to the organ donation problem. But it doesn’t have to be this way—and in many countries, it isn’t.

Dedicated Bus Lanes: The Easiest Way to Improve Public Transite

Dedicated Bus Lanes: The Easiest Way to Improve Public Transit

The buses are there. The roadways are there. All that’s needed to make bus travel better⎯and therefore more viable⎯is the will to give them their own lane once in a while.

Amazon and the Steep Price of Conveniencee

Amazon and the Steep Price of Convenience

There's no mystery as to why we shop Amazon. But perhaps all that convenience isn't worth the overall cost.

Stay Connected

©2018 | HealthWorldNet, Inc. | 108357

Last Updated : Saturday, December 1, 2018