The latest information that is being done regarding organ transplantation demonstrates that public perception and issues of supply-and-demand greatly influences the number of organs that will be donated to the medical field, regardless of the methods used. Whether it is legal or not has become a major ethical and moral issue for the public to now decide, with desperate needs for organs throughout the world forcing the concept of organ market trade–to save lives on one hand and destroy lives on the other—with the buying and selling of organs becoming a successful business venture for everyone involved, excluding the needy and poverty who are forced to sell their organs to make ends meet. Money seems to be a major impact, depending on the country and business involved, influencing the availability of the organs due to the high need for them that is developing throughout the world to the highest buyer.
Increasing demands for desperately needed organs and body parts have brought the organ market to the front where ethics are becoming a fast changing issue due to a need that is becoming difficult to meet. According to Paul Garwood (2007), “different approaches are being taken to meet the demand for organs and halt transplant tourist, which is growing due to an increase in kidney disease and renal failure” (Garwood, 2007). Organ transplantation requires regulations in order to protect both the donor and the patients, whereas presently the organ black market does not supply this (Taylor, 2006) with dubious methods and organs being supplied, and also under force. Due to this lack of regulations, a commentary paper by Jeffrey Zaltzman has found that in some countries, those who have the most money gets the organs (Zaltzman, 2006).
On September 7, 2006 the Bioethics Organization of the United States discussed their report on “Organ Transplantation and Policy Reform,” which was based on health, freedom, and dignity. It was stated that the need for kidney transplants was increasing much more rapidly than what was being supplied by cadavers or live donors, with suffering on dialysis and premature deaths resulting from the lack of organs that are presently available, as both Zaltzman and Garwood demonstrated in their papers yet focused on different areas—these differences involved the methods used to retrieve the organs, and what methods were used to decide who and what were to receive the organs, and also why.
The Bioethics Committee also stated that the kidney organ markets are pro-life, which has the ability to allow the supply of this need for the first time in the world–however was needed to get the job done. Zaltzman’s paper showed that distance had very little to do with deciding who was to get the organ, yet The ethic and moral argument, they felt, was changing due to the fact the understanding of liberty is also changing. Any ethical laws prior to this may be thrown out of court, as “The Supreme Court said in the case Lawrence v. Texas that what our necessary and property limits to liberty in one generation are, in fact, offenses against liberty to the next.” (Bioethics Org., 2006).
Kidney transplantations are different from other surgeries as, “unlike most other medical procedures available, patients die while waiting for organ transplantation” (Zaltzman, 2006). Also in Zaltzman’s commentary it was found that “kidney transplant outcomes are inferior once waiting times exceeds 2 years, and especially so after 7 years”. This pressure for organ retrieval in Garwood’s paper is demonstrated through his study on high-pressure sales in underdeveloped countries where $1,500 dollars for a kidney is an outrageous sum of money for these people. He states, “Experts like Dr. Francis Delmonico said the world is gripped by a crisis when it comes to organ failure-particularly kidney—and that this has resulted in limited supplies of organs and exploitation of the poor through organ trafficking” (Garwood, 2007).
It is impossible to discuss the selling and buying of body organs without the issue of exploitation coming up. In Paul Garwood’s 2007 article, “Dilemma over live-donor transplantation” he refers to a woman, Haleem Bibi , who is the mother of seven children living in rural Pakistan, who sold one of her kidneys for approximately $1,500 to make ends meet. Unfortunately, months later she has become very ill due to the fact she has no money for after surgery care. Garwood writes that case after case shows “the neediest are often exploited by a thriving market for organs” (Garwood, 2007). The ethics of selling body parts to pay bills or to purchase food and clothing has become a major factor in underdeveloped countries, whose organ donations bring insignificant amounts of money into their lives, and eventually death to the individual who cannot care for himself or herself after the surgery for the organ removal. Yet people have the right to do what they want with their body, and most people feel donating an organ is acceptable in today’s culture. This is demonstrated in an article written by J. Savulescu in 2002,
People have a right to make a decision to sell a body part. If we should be allowed to sell our labor, why not sell the means to that labor? If we should be allowed to risk damaging our body for pleasure (by smoking or skiing), why not for money which we will use to realize other goods in life. To ban a market in organs is, paradoxically, to constrain what people can do with their own lives” (Savulescu, 2002).
Garwood’s statistics find that “about 10% of the 63,000 kidney transplantations carried out annually worldwide involved payment of non-related donors of different nationalities, according to the World Health Organization” (Garwood, 2007). Due to the Bioethics Committee ruling and to the high need of organs, ethical reasoning has changed which allows individuals to do what they want with their bodies to fulfill that need regardless of whether we feel it is right or wrong. But Zaltzman states this high demand arrives from lack of organization and properly conducted agencies to fill the supply-and-demand of organs in some countries,
Unlike the United States and member countries of Eurotransplant, Canada does not have a single national transplant with coordinated organ sharing and allocation. Although this would be a bold initiative, it is unclear whether such as organization would actually have an impact on the actual number of transplants being performed (Zaltzman, 2006).
Conclusion
In conclusion, the fact that we have entered epidemic proportion for needed kidneys, other organs, and body parts–with very little being supplied to ill individuals due to organ shortages—demonstrates that a reliable organ market is much needed for today’s medical field. Ethically, this may have been an issue prior to this generation, but presently it is not, due to a high need for organs that was not present during this time. This demand has opened a market that not only allows us to sell our own body parts for a fee but also encourages it. This is becoming a very popular yet dangerous way of survival for those in poverty areas, in addition to other avenues continuing to open to fill this need—cloning, organ donation by prisoners, etc.
The black market will continue to supply this demand at high prices, if a more legalized and controlled organ market does not develop that will fill this medical need, but without the control and safety that is needed for both the donor and the patient. None of us can fully understand what desperation is until we are faced with the choice of having to buy a kidney from someone in Iraq or Pakistan or die, due to the fact of its unavailability in our own country—this kidney may be for ourself, our mother or father, our wife or husband, or our children. Truly, only then will we fully understand and make an individual decision regarding this decision.
