Sale of body organs has been from time immemorial regarded as morally objectionable and contrary to medical ethics. According to(Shimazono,2012) the shortage of available donors for various organs has led to illegal transactions for international organ trade. This includes transplant tourism whereby trading of organs across countries for recipients to have a transplant and this is facilitated by the internet to attract buyers. This type is common in China. In other cases, donors travel to the countries to donate their organs at a fee. In some countries, the poor are exploited to sell their organs for monetary purposes known as organ exporting countries while other countries receive organs from the said countries known as organ importing countries. Some of the targeted organs are the kidneys and the liver.
In the United States, it is illegal to sell organs for monetary compensation according to the National Organ Transplant Act of 1984. The penalty for breaking this law includes a fine of $50000 or five years in prison or both. Internationally countries have set various measures to curb organ sale. However, in Iran, it is legal to participate in organ sale. Some of the ethical issues surrounding organ sale are coercion to sell organs due to poverty, the risk of transmitting diseases during organ collection or unavoidable death occurrences. ( Al-Wakeel, Mitwalli, Tarif, Malik, Al-Mohaya, Alam& Kechrid,2012) states that some of the medical complications arising due to these practices include transmission of hepatitis C virus. Also, donors who have participated in the sale of their organs don’t attend follow up clinics due to financial constraints(Goyal, Mehta, Schneiderman& Sehgal,2013).
However, people should be granted the rights to sell their organs as the benefits outweigh the risks. A case scenario where a teenager who has been diagnosed with the end-stage renal disease who is in dire need for a transplant but all his family members are incompatible for various reasons. Legal organ sale will enable the teenager to have a compatible donor who is willing to sell their kidney. Organ sale would Save lives
According to(Procurement,2015) in the United States, 121,678 people await life-saving organ transplants and of these 100,791 await kidney transplants. Thirteen people die every day while awaiting a kidney transplant while 3000 patients are added to the waiting list every month. In 2014, 4761 patients died while awaiting kidney transplants while 3688 were too sick to undergo a kidney transplant. Few organ availabilities have led to premature death and escalated hospital costs. (Harris&Erin,2014) states that when one sells an organ they act selfishly while at the same time contributing to the public good. The sale of an organ to someone who is genuinely in need would save their life and prevent further complications. The kidney contributes to very important functions such as excretion of waste and balancing of the body pH. Therefore its necessity for kidney failure is urgent. A person who sells their organ who’d do so in the hope of saving someone’s life not committing a crime. Therefore people should be granted rights to sell their organs.
Critics to the sale of organs argue that the human body cannot be used as a good to transact because it reduces the dignity of human life. However, saving someone’s life cannot be equated to maintaining human dignity either can it be categorized in the same manner. This is because the person selling the organ may be in dire need to fend for their family while the recipient’s life is in danger if they do not have the kidney transplant. (Schmidt,2012) states that the clear alternative to transplantation is death. In organ transplant, the donor donates his organ due to the fear of losing his close relative while the recipient accepts the organ in fear of impending death if they don’t receive the organ. Therefore organ sale should also be legalized as it also aims at saving lives while revolving around the principle of beneficence.
Critics also state that allowing the sale of organs interferes with equity meaning that people who are willing to buy the organs either don’t have the money or the price is too high for them or those willing to sell their organs are exploited so their organs are bought at a very low price. This contributes to the poor becoming more poorer while the rich amass more wealth from this trade. However (Kishore,2011) states that the major aim behind organ sale is not necessarily the monetary value that is attached but saving the lives of the people who have an urgent need. However, this does not negate the fact that there is violence or sometimes murder associated with organ sale for vulnerable groups. People who are willing to sell their organs should be allowed because the benefits outweigh the risks.
(Savulescu,2013) states that if the government and health organizations have not outlawed risky behaviors such as smoking and drinking alcohol then they shouldn’t illegalize procedures that are of benefit such as organ sale. Therefore preventing organ sale is ironic while the risky behaviors are allowed. Autonomy refers to the ability to make choices and respect of the choices by all parties around. Money earned from the sale of the organs increases the quality of the life of the donor maybe by buying a new house or paying school fees for the children. It is ironic to illegalize organ sale while at the same time calling soldiers who die on the battlefield heroes. (Wilkinson&Garrard,2012) states that organ sale doesn’t necessarily mean coercion or lack of informed consent; on the contrary, organ sale should be made legal on the basis that one is willing to sell their organ based on informed consent and without coercion.
The ability that one can make a choice to sell their organ to improve their life is one of the reasons people should be granted rights to participate in such sales. The assumption that organ sale is totally forceful and under coercion isn’t necessarily true considering there are volunteers. Banning organ sale encourages illegal harvesting and organ collection which is involved with high risks of contamination and unhygienic practices. If it is legalized there will be no need to into dangerous deals as there will be right policies and protocols put in place to ensure the procedures are conducted in an ethical manner.
With organ sale illegalized the practice happens under very secretive circumstances due to the legal repercussions of being involved. (Cohen,2012) states that in Flynn V holder case the sale of bone marrow stem cells for transplantation will be permitted. This brings in a lot of confusion since all it is a part of the body system yet some organs such as the kidneys have been prohibited for sale. The ban against organ sale means the sale occurs undercover which might place the risk on the lives of the seller and buyer. Illegal organ trade has been associated with violence and murder and especially due to payment wrangles. However, if the government grants the people the rights some of these issues may decrease because one can easily file a lawsuit in court.
According to (Hippen,2013) the United States should learn several lessons from Iran which has legalized organ sale. This includes a massive decrease in the number of people on the waiting list since the legalization while at the same time there is no shortage of available organs. In Iran, if one is unable to pay for their kidney transplant the government or charity organizations pay it on their behalf. However, the rules include that the transplant physicians should not be involved in any kind of the transaction between the buyer and the seller. The United States has been at high demand compared to supply for organ transplants which lead to premature death and poor quality of life. Lessons from Iran legalization of organ sales include legal guidelines are set to determine how the trade is conducted while ensuring that those unable to pay are covered by insurance companies or charities. There is also the aspect of legalizing organ trade decreases the harm involved while the business is done undercover.
Conclusion
The balance between moral law and human rights in the organ sale is quite controversial especially as only one country in the world has legalized it. However, there should be a consideration to saving human life compared to morality. This, however, doesn’t mean that other factors affecting organ trade should be underestimated such as exploitation, violence, and murder. They should be considered while putting into place various guidelines. According to(Crowe,2014) there should be a balance between the moral law governing the people and consideration of human rights. This means that the government involves the medical workers, bioethics and legal teams while formulating laws affecting the health sector.
Organ sale should be legalized on the basis that human lives would be saved because there would be easy availability of the organs, for example, a buyer whose kidney is compatible to that of the seller who has the end-stage renal disease. The costs involved in hospitalization and rejection of transplants would be decreased. Organ sale should be legalized since the citizens have the autonomy to sell their organs in the bid to save someone’s life as they improve their own. Finally, the risks involved with illegal organ sale would be decreased and have standard guidelines on how to deal with them. The benefits of organ sale generally outweigh the risks.
References
Al-Wakeel, J., Mitwalli, A. H., Tarif, N., Malik, G. H., Al-Mohaya, S., Alam, A., … & Kechrid, M. (2012). Living unrelated renal transplant: outcome and issues. Saudi Journal of Kidney Diseases and Transplantation, 11(4), p. 553.
Cohen, I. G. (2012). Selling bone marrow—Flynn v. Holder. New England Journal of Medicine, 366(4), pp. 296-297.
Crowe, M. B. (2014). The changing profile of the natural law. BRILL.
Goyal, M., Mehta, R. L., Schneiderman, L. J., & Sehgal, A. R. (2013). Economic and health consequences of selling a kidney in India. Jama, 288(13), pp. 1589-1593.
Harris, J., & Erin, C. (2014). An ethically defensible market in organs: A single buyer like the NHS is an answer. BMJ: British Medical Journal, 325(7356), p. 114.
Hippen, B. E. (2013). Organ sales and moral travails: lessons from the living kidney vendor program in Iran.
Kishore, R. R. (2011, December). Organ Donation: Consanguinity vs Universality–an Analysis of Indian Law. In Transplantation proceedings (Vol. 28, No. 6, pp. 3603-3606).
Procurement, O. (2015). Organ procurement and transplantation network. HRSA, DHHS, 9.
Savulescu, J. (2013). Is the sale of body parts wrong?. Journal of medical ethics, 29(3), pp. 138-139.
Schmidt, V. H. (2012). Selection of Recipients for Donor Organs in Transplant Medicine1. The Journal of medicine and philosophy, 23(1), pp. 50-74.
Shimazono, Y. (2012). The state of the international organ trade: a provisional picture based on integration of available information. Bulletin of the World Health Organization, 85, pp. 955-962.
Wilkinson, S., & Garrard, E. (2012). Bodily integrity and the sale of human organs. Journal of medical ethics, 22(6), pp. 334-339.
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