A Market for Organs

There's a fascinating article in the Chronicle of Higher Education today about increasing calls for a market in donor organs to be established:

Last year more than 6,000 Living Americans gave parts of their bodies to people in need. Most donated a kidney, which released the recipient from hours of dialysis, renewed his or her health, and probably extended the person's life.

And it was truly a gift. Federal law prohibits donors from receiving money for an organ, a policy that also holds in many other parts of the world.

Yet everyone involved in the transaction benefits except the donor. Surgeons and other medical-staff members are paid for their work, the hospital brings in cash, and the insurance company saves the cost of dialysis. Both private insurance and public assistance will pay for a donor's surgery and immediate medical care, but not for any health problems that may arise later. What's more, donors seldom get reimbursed for travel to the transplant center and for the wages they lose when they take off work, even though such payments are allowed by law.

In sum, only the donors pay for their altruistic act. It is a lot to ask.

Despite the thousands who donate, demand for kidneys and other transplantable organs far outstrips the supply. Right now, more than 70,000 people in the United States are hoping for a new kidney. Each year thousands die while waiting.

An increasingly vocal group of economists and other social scientists has called for a market solution: Increase the supply of donated organs by offering new incentives — including cash.

More recently a few transplant surgeons have taken up the cry. Once unmentionable, the idea of paying donors is now openly debated at medical meetings and in the pages of medical journals. Scholars from other disciplines have chimed in as well: More than 10 books devoted to the subject have been published in the past two years.

In this report, The Chronicle looks at the global market for body parts and the ways some scholars and physicians have proposed to meet the growing demand fairly.

"My argument is for a regulated market," says Arthur J. Matas, a surgeon who directs the University of Minnesota's renal-transplant program. He and others envision a system in which a national organization would pay a set price and provide long-term follow-up care.

Dr. Matas thinks that with proper oversight, which may be possible only in developed countries like the United States, such a system would both increase the supply of organs and preserve the dignity of the seller.

Many other scholars and physicians, however, insist that our laws and ethical traditions are correct to forbid the commodification of the human body. Some of these market skeptics draw on Immanuel Kant's argument that the sale of organs is intrinsically a violation of human dignity. "It is impossible to be a person and a thing, the proprietor and the property," Kant wrote in his Lectures on Ethics. "Accordingly, a man is not at his own disposal. He is not entitled to sell a limb, not even one of his own teeth."

Other skeptics argue from a more practical standpoint: A just market in human organs is imaginable in theory, they say, but in our actual world of steep inequalities, organ sales would inevitably lead to coercion and exploitation. According to many reports, that has already happened.

The problem of growing demand and lagging supply is worldwide, and generally it is the rich who are demanding and the poor who are supplying.

Wherever oversight is scarce, a thriving black market in organs has emerged. Some global estimates suggest as many as 10 percent of transplanted organs may be sold. That dismal reality has fueled calls for regulating the market rather than driving it underground.

"Let's reduce the harm that comes from it," says Abdallah S. Daar, a surgeon and bioethicist at the University of Toronto, who has observed organ markets in places like Iran, which has set up a system for paying donors. "Our sitting back and moralizing is not helping at all."

The full article is behind their subscriber wall so I can't link directly to it, complete with pictures of guys from Pakistan showing off their scars from kidneys donated to "transplant tourists."

Now there's the premise for a jihadi zombie movie that I would pay to see...