The current forum discussion on PRI/BBC The World is Tackling the Global Organ Shortage. This week's guest is Dr. Mustafa Al-Mousawi, past president of the Middle East Society for Organ Transplantation. Listen to the podcast and ask Dr. Al-Mousawi questions in the forum. He'll be checking in and responding throughout the week:
Worldwide, there is a dire shortage of organs for transplantation.
In the United States alone, more than 100,000 people are waiting for new hearts, lungs and kidneys. Many of these patients will die waiting.
Frustrated, some patients turn to a global black market in organs.
To tackle the organ shortage, countries are experimenting with various strategies.
Israel just enacted a new law to boost the number of donors. The law favors donors over non-donors when it comes to receiving an organ. And some Americans are pushing a controversial solution - legalizing the buying and selling of organs.
Iran is already doing that. The Iranian government gives every kidney donor $1200 and one year of free health care. This system has increased the availability of organs, but at what price?
We spoke about the Iranian law with transplant surgeon Dr. Mustafa Al-Mousawi, past president of the Middle East Society for Organ Transplantation.
He argues that the Iranian system may have reduced the organ shortage, but it is unfair to the donors, who are often poor and underprivileged.
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I don't think you need to be an economist, or an ethicist, to see why this is a bad idea.
Look, the whole point of any market is that you have people engaging in voluntary transactions. That means there is, insofar as you can help it, no coercion -- otherwise it isn't a market. And there are things you can buy and sell that we do not allow because there is a power imbalance between the parties involved.
This is similar. If you are desperate enough to need to sell your kidney, then there is a problem. And this isn't like selling your car or your shoes. You can do without either of those. You can't do without a kidney, not if something goes wrong. That is why we only remove kidneys from people when they aren't working or the person giving the kidney is dead already.
This isn't a voluntary transaction. It's coercion. No. you don't have to sell your kidney, right? But if you need the money, then by definition you do. It's like when you tell someone "you don't have to give me your money, but I will shoot you in the gut if you don't." Or, "hey, you don't have to go into prostitution but if you don't you will starve."
You might live after getting shot. Care to take that bet?
So, poor people get to give up an organ, compromising their chances of survival while rich folks get to have the kidneys. That sounds great /snark. Why not do it in reverse? Let's have a lottery where the more income you report on your taxes, the higher number you have for giving up a kidney. So richer people get in line first to give up an organ. No exceptions. Any takers? Anyone? Bueller?
Hey, post that on the forum where people will see it and can respond. Here is not as good a place.
Wooow, nobody thought about it..legal or not, you can read everywhere about some new methods and "stimulus" to organ donors people, and how giving their own organs to someone else could bring financial benefit ....
So many complicated ethical issues in organ transplantation. The new law in Israel makes sense on a certain level...but, wait! if you are sick (sick enough to, for example, need an organ), you *can't* donate organs and if you are healthy (enough to be a donor), then you don't really *need* an organ donation. If there is a case in which a person is (for example) in a car crash and her most immediate need, *the* thing that will save her life and restore the quality of her life is an emergent heart transplant. Maybe on a soap opera. But in real life? Not so much.
Registered organ donors in the United States can get preferred access to donated organs by joining an organ donor network named LifeSharers.
If you agree to offer your organs first to other LifeSharers members, you'll get preferred access to the organs of every other member of the network. As the LifeSharers network expands, your chances of getting an organ if you ever need one keep going up -- if you are a member. LifeSharers already has over 13,000 members.
Giving organs first to organ donors creates an incentive for non-donors to become donors. This increases the supply of organs and saves more lives. Saving the maximum number of lives should be the primary goal of our organ donation/transplantation system.
Giving organs first to organ donors also makes the system fairer. People who aren't willing to donate their own organs should go to the back of the transplant waiting list as long as there is an organ shortage.
If you want to donate your organs to other organ donors, you can join LifeSharers at www.lifesharers.org or by calling 1-888-ORGAN88. Membership is free. There is no age limit. No one is excluded due to any pre-existing medical condition.
Actually, black people in the USA are overrepresented* among those with kidney disorders who would benefit from more kidneys being made available through a donor compensation program. (*presumably this has to do with kidney-disorder medicines being tested mostly on eurasians, who are genetically homogenous compared to afro-americans)
-Essentially, you would be paying white middle-class people to provide kidneys for a lot of black patients, provided the compensation is big enough so that not just poor people find the option attractive.
There is already a "black" or "gray" market for organs in third-world countries. By giving monetary compensation to organ donors in the industrialised world -and keeping the whole thing *strictly regulated*- we can keep the trade under control. Just saying "no" means approving of the status quo, with overloaded official efforts to provide transplant organs, and a black market in the third world servicing "transplant tourism".