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Your Take: Legalize Organ Trafficking?

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Operation GameThere’s been a lot of buzz in the news lately on the issue of organ trafficking. While this CNN story wasn’t the first time I heard Nick Rosen’s story of selling a kidney for $20,000, it is certainly a sign that the discussion of selling organs is coming back into the spotlight.

The story of Rosen probably isn’t all that different from other people who have sold organs. They saw an ad, answered it, duped the hospital doing the transplant, and got paid. The difference was that he then bragged about it in a “documentary” about how easy it was to do (I say brag because the video supposedly has him lying on a bed covered in cash).

What do you think about organ trafficking? I’m against the idea. I believe someone should be able to sell an organ if they want to but I think that making organ trafficking legal opens up a whole host of legal, economic, and moral issues we can’t answer.

For example, if the market price of an organ is $20,000 then anyone who can’t possibly pay that amount would simply die. Any “rational” person, in the economic sense, who would freely donate a kidney to a stranger would now demand $20,000 because that’s the market price of a kidney. What if the person is mentally unstable? What if they aren’t considered emotionally fit enough to make the decision?

It just seems like once you put a price on something like that, you introduce a lot more headaches than you’re probably prepared to deal with.

What do you think?

(PHoto: myklroventine)

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60 Responses to “Your Take: Legalize Organ Trafficking?”

  1. Traciatim says:

    I think about it this way:

    How many anonymous organ donations are there today? I mean, ones not done by family members, friends, organs harvested from people who die and signed a card etc.?

    How many more would we receive if anonymous people could make 20K by donating a kidney?

    It seems to me like a win-win all around.

    • Jim says:

      I can see a system working if the recipient couldn’t pay to jump ahead of the list but then where would the $20K come from? (you don’t get over the moral aspects of pulling the plug early for a payday or other similar scenarios)

  2. Mardee says:

    The reason why money should never exchange hands (except for payment of medical expenses) is because there is so much potential for abuse, as you pointed out. This is the very same reason why we don’t allow people to accept payment for giving their children up for adoption. Any monetary payments for adoptions are heavily monitored by the court, because of the heavy potential for abuse by those people with enough money to pay for what they want. Any “loophole” or “exception” to that just opens the floodgates for misuse.

    • Jim says:

      Yes and that monitoring could, and likely would, become very expensive. Who would pay for that?

    • wizardprang says:

      “This is the very same reason why we don’t allow people to accept payment for giving their children up for adoption.”

      Not a good example: Adoption fees routinely run into the tens of thousands, so somebody is getting rich and money is changing hands; it is just that the birth parents don’t see any of it.

      • Mardee says:

        The fees are high because of the home studies required by the state. A typical home study in my state runs anywhere from $3000-4000. I just finished a private adoption, and the total costs to the adoptive parents were around $9000. About $4500 was for my time (I’m an attorney), and the rest for for court costs, the home study, and payment of the birth mother’s medical expenses.

        No one is getting rich off adoptions, not even the attorneys. I do adoptions because I love the feeling of helping someone.

  3. lostAnnfound says:

    What would happen if John Doe was able to raise the money through any means (friends, family, fundraisers, etc.) to “buy” the organ and then someone much better off financially offered double to the person donating because it was also a good match for him/her? Would we be looking at organs going to the highest bidder?

    What if someone was on life-support? Would some unscrupulous family member think of “pulling the plug” earlier because they could get $20,000 per kidney, $10,000 per eye, and $30,000 for the heart?

    Like Jim, I would be against this. I have been listed as an organ donor with the state I reside in (stamped on my license) for about 25 years. If something were to happen to me (car accident, etc.), I would rather be able to help out a person in need by giving freely rather than having anyone profit from it. It would be my way, I guess, of giving back.

    • Jim says:

      I’ve been an organ donor for as long as I’ve had a license and I agree with you, I’d rather help out someone who was in need than someone who simply had more money. Imagine not having the means and knowing you missed out on a life-saving organ because you couldn’t pay as much as the next person? That would a serious moral dilemma for our society because at that point money can buy you anything.

  4. Helen says:

    I’d like everyone here to imagine they, themselves need a transplant. Or your child. You would do anything to get one, wouldn’t you? Of course. But here’s the thing: If you allow the sale of organs, there is always going to be someone with more money than you. Right now the price is 20,000 dollars, what if I offered 100K? Could you raise that much? It’s open to bidding wars. How much money do you have? How much do you think you can raise? Bet I know someone who can raise more. Now you are out of luck. Then, sales take a slippery slope: does your donor LIKE you? Are you the right color or religion or profession for your donor to give you a kidney? Does your donor have a right to reject you if you used smoke, or drink or don’t use your turn signal when you drive? Right now, it’s a blind system and that’s okay with me. But I have first hand experience in this: I received a heart transplant from a family that continues to remain anonymous.

    • Jim says:

      Helen, you and I are of one mind on this… there are so many unintended consequences and unforeseeable circumstances. If I needed a kidney, I’d probably pay as much money as I had and that’s going to be more than $20,000. I’m sure my family would spend as much as they needed to and that simply goes on forever and ever. $20k would seem like a pittance.

    • The Other Schmitty says:

      But someone will only pay $100k if he can’t find a cheaper organ elsewhere.

      I’ve never really thought about this before, so I may be way off here.
      Under current laws you can’t be compensated for your organs so for the typical person there’s no incentive to donate. If we allow compensation the supply of organs will skyrocket and the price should decrease. We could have a system of carefully regulated organ brokers. People who can afford an organ will have a much greater chance of getting the transplant they need; people who can’t afford an organ won’t be any worse off than they are now. We would just need to ensure that we can continue to receive organs from cadavers for free.

      • The Other Schmitty says:

        I should clarify that I was talking about non-vital organs. I don’t like the idea of a market for vital organs because you are effectively putting a price on someone’s life.

      • Beth says:

        Where are all these “free” organs going to come from? Are people going to donate their family members’ organs out of the goodness of their heart when there is money to be made?

        Picture this: a loved one dies in a car accident. While you’re still trying to come to terms with this loss, you’re approached by a potential buyer to sell a kidney. Then another buyer offers more money. Then a third buyer — and soon you’re in the middle of a biding war.

        Then someone else wants to buy the heart… and then the lungs… Before you know it, you’re a liquidation store for your loved one’s body parts.

        And how does this work if you’re the one donating organs? Will you trust your next of kin to respect your wishes rather than sell off bits and pieces of you? Could you determine the selling prices ahead of time in your will?

        These are people we’re talking about, not pieces of plastic or metal.

        • The Other Schmitty says:

          I don’t think anyone should be allowed to sell the organs of a dead person. Not even if the sale was arranged while the person was alive. I was referring to an individual selling his own non-vital organs and completing the transaction while still alive.
          I also don’t believe you should be allowed to make a direct transaction. Like I said, we would need a regulated brokerage, like the stock market, where an organization analyzes the demand and supply and sets a market value. I believe this would save lives.

          • Beth says:

            Interesting points. I’m not sure I’d feel comfortable selling my organs directly to a a family who needed them, but a broker to regulate —

            Oh. I’m going to stop that thought right there. A regulation system assumes too much — that policies will be effective and the people making them and enforcing them will be honest and fair. Sorry, but I don’t see that happening in the U.S. anytime soon.

            I can’t see a system like this ever coming into effect here (Canada) anyway. The idea of selling organs would go against our healthcare system.

  5. If someone wants to sell and someone is willing to pay, and they are willing to take the risks of doing so, then fine for them. But making it legal, would definitely cause more problems and raise more questions than I think we are capable of dealing with as a society.

  6. I’m not suggesting that this should be legalized, but I do wonder why it is legal to be paid for plasma and not for organs.

    For the longest time, I resisted being an organ donor because the thought of a piece of me inside someone else’s body (even after I died) freaked me out a bit.

    After Hurricane Katrina, I decided that this was a really bad reason to not be a donor. All of my organs are now available for recycling after I die.

  7. Manny says:

    I think that someone would just have to look at the data as far as what would happen to supply and demand. Yes, it would be unfair for all the kidneys to go to the richer part of society, but it also is kind of unfair for most of the world’s population to be walking around with an extra organ they don’t need, while some wait and die because they don’t have one that works.

  8. Nick says:

    I don’t really think it is that complicated, you don’t need to make this a free market to have beneficial effects. Either the government or a hospital (or you can even get insurance companies involved) offers a set amount for organ donations (the simplest case is kidney donation, since the risks of donating are low but the life saving advantage to the donee (sp?) is still present). It costs something like 100k to keep a person on dialysis right now, so if you pay basically any flat rate below that number the hospital/government/insurance company is saving money, the donator still gets significant cash amount and there are significantly more kidneys available to be received. You don’t need to do anything on the recipient side, so cutting in line because of money is no more a problem than it is now (I would argue that it is currently a problem).

    So right now you’ve got a situation where people are dying or having to stay on dialysis (which from what I know of people that have been on dialysis is not pleasant at all) because we have a shortage of organs.

    Basically we are saying that it’s ok to literally let people die because abuse might make the system more unfair than it currently is. I don’t really understand that kind of logic, I guess.

  9. usul356 says:

    I recommend you watch Repo: The Genetic Opera. It’s a much different movie than I would usually watch, but it does have an interesting story. One of the main story lines is that when an organization figures out how to make organs, getting replacement organs becomes like plastic surgery. The main line of the story comes in when the government approves repossession of organs from people that aren’t making payments. This will give you a totally different look on organ trafficking.

  10. Safeway Sage says:

    I have worked in the organ and tissue transplant community for many year and now work in blood banking. All of the moral judgments aside, of which I have many, paying people to donate organs, tissue, or blood is a systemically bad idea. Don’t even get me started on plasma…

    The tissue and organs that are donated are screened VERY thoroughly via medical/social questionnaires, review of medical charts, and possibly coroner records. If there was a financial incentive to donating organs or tissue, the pool would become much more suspect because of people lying during their own or the next of kin interview.

    Yes, there are serological tests that can be done to determine if the person is infected with something, but this large influx of people trying to beat the system be it organ or tissue wise will cause great inefficiencies and make the system worse than it even is!

    I see this is getting too long, therefore I cut this rant short.

    S_S

  11. Chuck says:

    It could reduce the need for life insurance (in a completely non-emotional analysis).

  12. Anno ny says:

    My wife is a carrier for a kidney disease that my sons will get. They will both get the disease by their mid to late 20s. Medication will suppress it for some time, but they will likely need transplants before they are 30.

    I am not in favor of having an organ free market, but I am in favor of organ banking. If it happens that I am not a compatible doner for either of my sons, I would happily donate a kidney now for the promise that one of them would get one at a later date.

    In the mean time, I think that making being an organ be the default condition when you sign up for a drivers license would eliminate the need for selling/buying organs. People are lazy, even it it’s just avoiding an opt-out checkbox on their license application

  13. Nick says:

    The issue of organ screening is a significant one, though I’m not sure how the system can actually be worse than it currently is. Yes, it will worse in the sense that it will be harder to screen for things, but it certainly won’t be worse in the sense that there will be fewer healthy organs available, which really seems like it should be the metric that matters.

  14. dilbert69 says:

    Anyone who wants my organs after everyone is sure I’m dead is more than welcome to them, as I won’t be needing them anymore. That being said, I do think that people own their bodies and should be able to sell them or parts of them for money if they wish.

  15. CK says:

    http://www.nytimes.com/2006/05/15/opinion/15satel.html

    So I can sell my sperm, plasma, and ladies can sell their eggs. But I can’t sell a kidney? Not sure how it’s really any different. Many die just because we’re squeamish about this being “moral”. I find it quite moral to save more lives by offering an incentive.

    • wizardprang says:

      Sperm, plasma and eggs are self-replenishing. The comparison would be valid if your kidneys grew back.

      I question the consistency behind being able to give something away but not being allowed to sell it… however, if you are dying and can’t afford the new liver, there will be too much temptation to bash a compatible donor over the head in an alley…

      • Andrew says:

        Eggs are not self-replenishing. A female human is born with all she will ever have. She probably can still spare some, but she definitely won’t make more.

        • Wizard Prang says:

          When I said “self-replenishing” I did not mean “infinite”. You know what I mean, even if my phrasing was not totally correct. My point still stands.

          • dilbert69 says:

            I don’t think it’s just a semantic difference. I agree with you that most women can spare a great number of eggs. If I were given $1 billion at birth but forbidden from ever earning more money, my fortune would not be self-replenishing, but it would still be plentiful. If I had no money at birth but had (or developed) the ability to work and earn, my fortune would be self-replenishing but would likely not be plentiful. It’s not accurate to conflate self-replenishing with plentiful. The two are totally different concepts.

            That having been said, if your point was that eggs, sperm, and plasma are things you can give away and still have plenty left for yourself, regardless of the mechanics of it, then I agree wholeheartedly.

      • CK says:

        You can give a piece of your liver and it will grow back so how is that different from my examples?

        Also, “Bash a compatible donor over the head”? How would you know who was compatible? And what would you do if by chance you bashed someone who was an exact match? Pull the organ out yourself? And put it in how?

        • Wizard Prang says:

          I am not an expert on livers, but aren’t they rather exceptional in that regard?

          The second point was admittedly metaphorical; my point is: If your life was resting on the outcome, I could say “where there’s a will, there’s a way”, but perhaps “necessity is the mother of invention” would be more accurate.

  16. cody says:

    At the risk of running against the grain, why are we assuming that the price of a kidneys or other non-necessary organ will rise? Won’t naturally the amount of potential candidates rise as the practice of donation becomes monetarily incentivized, thus increasing market volume and dropping price? Also, what about the possibility of artificial organ development? Wouldn’t legalizing organ trafficking have a positive side effect of creating demand for the creation of these products? This is a complicated issue, and I’m just curious why we are focusing on the negative unforeseen side effects.

  17. dilbert69 says:

    Also, the word “trafficking” has negative connotations. If we want a chance at a rational debate, it’s better to use a neutral term such as “a free market in organs.”

    • wizardprang says:

      You’re right: A free market in organs is a good thing, trafficking in organs is not. The problem is guaranteeing the former while suppressing the latter…

  18. Patrick says:

    This is a very sensitive issue that is also extremely complex. There are so many positives and negatives to each side of the issue. It should be a humanitarian issue, but many people would rather have the money.

  19. zapeta says:

    I’ve been registered as a donor for many years so I fully expect someone to get whatever organs are suitable when I die. I think legalizing organ trafficking is a bad idea for many of the reasons mentioned above. That being said, I might be willing to part with a kidney for the right price.

  20. Safeway_sage says:

    Hmm… next thing you know there will be commodity markets and futures trading for the various body parts!

    All I know is that the selling of organs and tissues will NEVER be allowed by the FDA. They are in the business of protecting recipients, not lining the pockets of the donors.

    S_S

  21. liz says:

    Great idea, I was getting worried about rich people. I wouldn’t want them to have to wait in any lines with the dirty, undeserving lower classes.

    • Safeway_sage says:

      Liz, good one! :D You are absolutely right, I retract my previous statements. I wouldn’t want those undeserving, flithy poor people to get organs either. They would probably waste them on drink or something like that…

      Oh, wait or maybe its the other way around? :)

  22. Greg says:

    2 years ago I donated a classic Avanti to the make a wish foundation.

    Even if a market for organs was legal would not some people still donate?

    Whle there are many sticky issues with this topic I cannot help but think an offer of money would bring more people to the table.

  23. Michele says:

    Right now as I write this, my cousin, who had a kidney transplant 29 years ago, does dialysis 3 times a week and waits for a new kidney. No one in the family is a match, or their health is such that they can’t donate. He is fairly certain he will die before they find a kidney for him.

    We live in a very selfish country and there are very few organs for the people who need them. Even tho there are a lot of people who are willing to donate organs, there are still many who will not. Sure you hear the odd story of someone donating to a stranger and saving their life, but considering all those who die waiting, its not enough.

    I don’t think selling organs is the answer, but I can’t blame the desperate from trying anything to live either.

    Another thing to consider, we don’t sell our blood to the Red Cross, but they sell it to hospitals for a profit that amounts to 53% of their yearly profits. So, if the red cross can sell your blood, shouldn’t you be able to also?

  24. Dj Hams says:

    It would also be beneficial if this $20,000 was tax deductible. This would further increase the number of donors. We need more donors! Nothing in life is free, and that is the beauty of capitalism.

    • Chuck says:

      How about get rid of the payment, and just have a tax credit? Then it doesn’t matter if the recipient has the money or not. The government gives me $3,000/year to help me pay my mortgage, it seems like a tax credit for donating a kidney wouldn’t be so bad.

  25. Scott says:

    Allowing payments for organs is the answer. Your qualms have the direct result of condemning 11 Americans a day to death who cannot get a transplant.

    You are using laws to force your preferences on individuals interested in private mutual exchanges. By forcing the current price of kidneys to be zero, you have the predictable outcome of a shortage which requires rationing through lists and altruistic personal relationships.

    Removing the ban would create a market clearing price that would likely be a fraction of the $20k black market price today. Thousands of lives would be saved and tens of thousands would get to avoid waiting on dialysis which significantly improves the outcomes of transplants.

    A market clearing price means no waitlists and we’d know exactly how much to raise in government or charitable subsidies so that the poor wouldn’t need to be denied. Certainly any private insurance plan that covers dialysis or transplants today would likely cover the kidney cost for the insured.

    It would be pretty easy to establish regulations to prevent sales being forced on the mentally incompetent. You wouldn’t need to worry about drug addicts and the unhealthy selling their kidneys for cash because no one would want them or pay much when you can buy a less risky one.

    You don’t need two kidneys to live a full and healthy life. Many people would undergo the procedure to gain funds that could enrich their lives, a trade-off that they and not you are best prepared to judge.


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