Organ Sale -- Opposition Argument

Organ Sale -- Opposition Argument

Proponents of the legal sale of organs for transplant argue that adults of sound mind have an autonomous right to make the decision to sell their organs if they choose to. According to that view, there is no justification for interfering with their right to make decisions irrespective of the fact that those decisions may present serious risks and potential long-term negative consequences (Beauchamp & Childress, 2009). From a patient's rights and patient autonomy perspective, they suggest that if patients may legally choose to donate organs without compensation to specific recipients, (typically, but not always, family members), there is no rational justification for prohibiting them from choosing to do the same for strangers in return for monetary compensation (Beauchamp & Childress, 2009). For people of limited financial means, the income from selling an organ without long-term life-threatening consequences could make a meaningful difference in their lives and at no greater sacrifice than that allowed under different circumstances.

That argument does have some merit. Donating a kidney or part of a liver does not necessarily pose a long-term threat to the life of the donor. Certainly, it is not a risk-free procedure, but it is not substantially different from some of the other types of risks to which adults may legally subject themselves. Arguably, skydiving and mountain climbing (especially free climbing) are more dangerous than donating an organ and both of those sports are permitted to be pursued professionally for monetary compensation. Other forms of completely unregulated behavior, such as overeating irresponsibly or choosing to neglect the responsible self-care of manageable long-term illnesses such as diabetes present many of the same types of long-term health risks as those associated with organ donation, regardless of whether or not it is compensated.

From a utilitarian perspective, the benefits of organ donation are unquestionable. Whether or not compensation to the donor is involved, every donor organ is a potential life saver for a recipient. Moreover, there is no other possible use of donor organs: they cannot be diluted and diverted from their intended recipients into a black market the way prescription drugs (for one example) can be misused and exploited purely for profit. Furthermore, there is a perpetual critical shortage of suitable donor organs available to the thousands of patients on recipient organ lists (Levine, 2008). Every year, thousands of potential organ recipients die before a matching donor organ becomes available for them (Levine, 2008). Therefore, every single organ recipient who receives a donor organ from a donor paid for voluntary participation corresponds to one more spot on the organ recipient eligibility list. Generally, the organs available from donors who choose to donate their organs for paid compensation would not be the same sources as the organs traditionally available to waiting potential recipients because those organs are almost exclusively obtained from the cadavers of individuals who chose to sign organ donor cards prior to their deaths (Tong, 2007).

Many of the arguments advanced by those in support of organ sales are actually valid: the choice is substantially indistinguishable from other choices permitted for different reasons; and any addition on donor organs to the very tight "market" of available donor organs would likely mean that one additional organ would become available to other potential recipients. However, the principal argument against the permissibility of selling donor organs is not the denial of those admitted benefits. Rather, it is a function of the inevitable consequences of wealth disparity and the traditional economic principles of supply and demand. Moreover, the fact that organ sales are permissible in other countries provides an opportunity to observe the actual consequences of that permissibility.

Precisely because donor organs for transplant are in such critically short supply, they would command a high price that only the wealthy could afford to pay. Since selling an organ is a considerably desperate means of earning income, only the relatively poor would choose to do so. This sets up a social and economic dynamic that exposes the poor to exploitation by the wealthy. This is precisely the situation that has already occurred in countries where organ sales are legal: in many cases, the organs of the desperately poor are purchased by the wealthy for the equivalent of only a few months' pay or even less (Levine, 2008). Beyond the natural economic dynamics of the market for donor organs, the poorest members of society would be especially vulnerable to exploitation by virtue of their comparatively lower literacy rates, education, understanding of the comprehensive risk-benefit analysis, and because they have less access to quality legal advice and representation (Tong, 2007).