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How Can Commercialization of Organ Transplants Affect the Amount of People Saved Due to Transplantation?
Medicine has had tremendous progress in its ability to save human lives. Transplantation of organs is one of such innovations that gave hope to millions of people. However, transplantation could be more effective, as currently, the rate of demand for organs is much higher than that of supply. Various initiatives have been talked through to resolve the issue, leading to the idea of commercialization of organ transplants as the ultimate solution. Currently, human organs can only be donated and purchased for free by those in need. However, the idea of commercialization lies upon the assumption that humans will be more likely to provide organs if they were paid for it. Therefore, more organs will be available and more lives would be saved. However, commercialization of organs for transplantation is a complex step that would lead to a variety of consequences, both saving more lives and reinforcing the inequality trends.
Commercialization of organ transplantation: current legal and ethical state of affairs
Commercialization of organ transplantation is arguably among the most complex and indefinite issues than human civilization currently faces, combining debates from ethical, legal, economic, and medical fields. Currently, in most countries, including the US, commercialization of body parts is prohibited, meaning that individuals have no legal right to buy or sell their own organs both when the individuals are alive or dead. In most contemporary countries, organs for transplantation are available only through non-commercial operations, like donating one’s organs after death. There are multiple state-level and international agreements that define the legal status of the human tissue, including the Human Tissue Act of 2004, which directly prohibits any form of organ trade (Hardcastle, Rohan John 126). Such legal position of human tissue is explained through a variety of arguments. First, the definition of a human body as a subject of property is considered as objectivation of people and contradicts the modern judicial interpretation of a person (Simmerling, Mary et al. 130). In other words, if our bodies are just about the same type of property as any other objects, then a human individual, being a combination of its organs, may also be considered as a property. Such statements contradict the modern liberal and humanistic ideological perspective of human development, leaving without any attention the ideas of individual value (not in a material, but rather in a spiritual way) and freedom. These claims are backed up by most of the contemporary religions that, however, do not protest against the voluntary donation of the organs for transplantation (Bruzzone, Patricio 1064). While there are some religious leaders and activists who claim the sacredness of the human body should not be violated during life or after the death, Pope Benedict XVI, for example, openly supported the idea of free donation of the organs and said that he willed to do that after the death (Bruzzone, Patricio 1066). Still, most of the religions are extremely opposed to the idea of commercialization of human organs, claiming that selling or buying our bodies for profit is an immoral and sinful act.
At the same time, other perspective claims that each individual has the right over his or her body and is able to do with it whatever thinks is better, as far as it doesn’t hurt other people. From this point of view, our body parts should have the same status of property that any other objects that we own. Moreover, if we can have a right to own objects that are not part of our organism – thus, objects that are external in relation to us – we should definitely have the right to own and use our bodies the way we want to. Especially such argumentation is powerful when taken into account the number of human lives that could be saved as a result of commercial transplantation because of the growth of selling initiatives. Arguments from both sides are strong and convincing, leading to moral dilemmas and ongoing public debate in the variety of fields. While currently, most countries prohibit any forms of commercial distribution of human tissue, the discussion is far from getting closed, only growing in its significance and practical implications. To understand the efficiency and dangers of commercialization of organ transplants, it seems important to review both positive and negative potential consequences of commercialization.
Positive potential consequences of commercialization of organ transplants
Humanity is still experiencing a significant lack of organ donors. Despite the rise of the number of donors for the last few decades, in the US, “almost 17,000 persons were waiting for a kidney transplant in 1990. But this number grew rapidly so that about 65,000 persons were on this waiting list by the beginning of 2006” (Gary S. Becker and Julio Jorge Elias 4). The advances in surgical technology and financial affordability of the population to use organ transplantation have led to increases in both demands for the organs and the supply. However, the increase has not been balanced, as the demand has been growing far more intensively than the supply, leading to even more people who are waiting for a suitable organ for transplantation. This imbalance is only growing, leading to the need for reforming the system of organ transplantation. While the process of changing the value system of the population, causing more people to donate their organs for transplantation needs seems an incredibly slow and complex set of work on multiple institutional levels, commercialization of this process might be the most significant and fast solution. First, human organs would arguably have a high price, as for the consumers they would mean the ability to survive. Such feature would mean that for many people the motivation to sell their organs while being alive, as well as to agree for transplantation of their organs when their dead (with their family receiving the money) would rise significantly. Simmerling and colleagues suggest that commercialization of organs for transplantation would lead to as much as 100% satisfaction of the demand (Simmerling, Mary et al. 130). In other words, for every individual in need for an organ, there would be an organ ready for transplantation. Such a high level of expectations, of course, does not include the issue of the financial ability of the recipients of transplantation to afford the operations. Still, it seems that thousands of lives only in the US could be saved, especially if the healthcare system would include the commercialized transplantation service and provide insurance for them.
Moreover, it seems that even now many individuals from the Western countries use “medical tourism,” when they visit countries like Pakistan, India, and Iran (where buying an organ for transplantation is legal) to get the transplantation (Sajjad, Imran et al. 752). These operations are incredibly risky and have higher failure rates because of problems with the quality of the operations and the organs that are being bought. Thus, it seems that there is a need for the international community to legalize the trade of organs while taking it under careful control, reassuring that every procedure is dealt with according to the law and medical requirements. The need for more human organs for transplantation is bigger than ever before and is still growing and commercialization is the only significant and quick way of saving thousands of people whose lives are at the stake. At the same time, such measure is the instrument for many people to support themselves and their families financially, proposing their organs both when they are alive and when they are dead. If such a policy would receive careful and thorough plan for regulation on the international level, numerous individuals would benefit.
Problematic potential consequences of commercialization of organ transplants
Despite the optimism expressed above, there are multiple issues connected to other consequences of commercialization of organ transplantation. Of course, the potential of saving so many lives is quite astonishing, yet there is a need to consider the harm that humanity will face as a result of such structural change. First, regarding those who sell the organs, it seems clear that the least secure and privileged groups would be more likely to sell their body parts than the privileged social classes. For poor classes, their body would be among the most profitable resources, while rich people would be among the buyers of this kind of service. Moreover, the more financial capabilities the person would have, the more chances he or she would have to receive the organs of the best quality and in shorter terms. As Simmerling and colleagues put it, “allowing people with financial means to move to the front of the waiting list is unfair to everyone else on the list who lack the means to jump to the top” (Simmerling, Mary et al. 133). Still, in a commercialized set, this outcome is inevitable. Thus, in a situation of extreme need, people would still be divided by their economic capacities, which means that even in organ transplantation process the economic inequality would spread. The argument that poorer social categories would receive the ability to gain economic power has been refuted in Goyal’s study of economic, emotional, and social consequences of selling organs in India, where these operations are not banned (Goyal, Madhav). As Goyal concluded, “selling a kidney does not lead to a long-term economic benefit and may be associated with a decline in health” (Goyal, Madhav 1589). In the Indian case, kidney sellers used this money to pay debts and take care of their families, but they were not able to make any structural changes to their low socioeconomic status. Thus, it seems that the commercialization of organ transplantation is a step that would increase global inequality, spreading it into the essential sphere of human life – to the distribution of human body parts.
Moreover, such a trend would only exist at the level of a single society. If the entire world commercialized organs for transplantation, populations from poor countries would highly likely to export their organs to the wealthy populations, causing growth in health inequality. The existing “medical tourism” would become a regular phenomenon. However, what is even more frustrating and dangerous, is that while theoretically commercialization would lead to 100% satisfaction of the demand, most of the people who need organs for transplantation might not afford this procedure. The reorganization of the entire concept of the international legal system and insurance concerning human organs is an incredibly complex process that would lead to controversial results. Not only the demand would highly unlikely to be satisfied because of the high price of organs, but there might also be a serious problem of too intensive supply. People would sell their organs, which will be ready for transplantation, yet there will be no customers ready to pay the price. Many organs would be not used, with the majority of people stuck in the economic inability to purchase this service. Thus, the idea of commercialization of organs for transplantation seems far from resolving the issue of high demand for organs.
Commercialization of human organs for transplantation is still illegal in most of the contemporary countries, with individuals being able only to donate their body parts. While the introducing of human tissue market is a controversial affair in both ethical and economic measures, it is estimated that the demand for human organs has been rising for the last decades, meaning there have to be new transplantation approaches. Commercialization of human organs is one of the potential resolutions, hypothetically satisfying 100% of the demand. However, commercialization would mean that inequality in the world would only rise, while any individuals would simply be not able to afford the organs for transplantation. Although commercialization will surely save more lives, its negative consequences are arguably more damaging and unfair than the positive ones.
Hardcastle, Rohan John. Law And The Human Body. Oxford, Hart, 2007.
Simmerling, Mary et al. “The Commercialization of Human Organs for Transplantation: The Current Status Of The Ethical Debate.” Current Opinion In Organ Transplantation, vol 11, no. 2, 2006, pp. 130-135. Ovid Technologies (Wolters Kluwer Health), doi:10.1097/01.mot.0000218924.04526.a4.
Bruzzone, Patricio. “Religious Aspects of Organ Transplantation.” Transplantation Proceedings, vol 40, no. 4, 2008, pp. 1064-1067. Elsevier BV, doi:10.1016/j.transproceed.2008.03.049.
Becker, Gary S., and Julia Jorge Elias. “Introducing Incentives in The Market For Live And Cadaveric Organ Donations.” Journal Of Economic Perspectives, vol 21, no. 3, 2007.
Sajjad, Imran et al. “Commercialization of Kidney Transplants: A Systematic Review Of Outcomes In Recipients And Donors.” American Journal Of Nephrology, vol 28, no. 5, 2008, pp. 744-754. S. Karger AG, doi:10.1159/000128606.
Goyal, Madhav. “Economic and Health Consequences Of Selling A Kidney In India.” JAMA, vol 288, no. 13, 2002, p. 1589. American Medical Association (AMA), doi:10.1001/jama.288.13.1589.