We already accept the ethic of private healthcare. It is not unreasonable that the seriously ill be entitled to spend their own money on saving their own lives. It is preferable that some individuals receive organs, and survive, than none at all. There is a spurious equality in everybody dying.The wealthy will not be the sole beneficiaries of a policy of organ purchase. For each successful kidney transplant operation, valuable hours on a dialysis machine will be left vacant. The expense of palliative care for an individual requiring a transplant operation will be eliminated.
The donor of an organ, or his family, will stand to benefit considerably from the sale. Even the most impoverished individual will not choose to donate their heart or lung and thus die. Neither would a surgeon be prepared to conduct such an operation. Yet, both a kidney and a piece of liver can be removed without significant detriment. It is patronising to consider that the individual cannot make a reasoned decision to donate or sell these organs. The family of a relative recently deceased ought also to be able to choose to save the life of another and simultaneously receive some remuneration.
Legalisation of the sale of organs will eliminate the corruption that has led to reported executions and ‘thefts’ of organs. A successful transplant operation is dependent upon knowledge of certain characteristics of the donor. Therefore the origin of the organ must be known. The black market cannot be regulated, but its purpose would be defeated once the sale of organs became lawful.
The specific virtues of a scheme of sale of organs is that each transaction remains one of personal consent, and an incentive is provided to donate organs. ‘Presumed consent’ is a euphemism for robbery. The donor card scheme, by which individuals carry a card indicating their intention to donate organs is scarcely a difficult or unknown means of showing true consent. In the wake of the public outrage in early 2001 following the practice at Alder Hay Hospital of removing organs from deceased children without the consent of the parents, it is evident that a system of presumed consent would be unacceptable. The victims of the system would be a family already grieving for the loss of the relative.Any improvements to the efficiency of the donor and transplant arrangement cannot compensate for the simple absence of organs. The sale of organs would increase the number available at home and allow surgeons to search for the parts overseas.
A legitimate market in human organs would not be inconsistent with either public or private healthcare services. The transplant surgeon, the nursing staff and even the pharmaceutical companies producing the anti-reaction drugs receive payment for each operation performed. Why should the donor of the organs, arguably the most important actor in any transplant, not also receive remuneration ? The United States already tolerates markets for blood, semen, human eggs, and surrogate wombs. Is there a moral difference between a heart or a lung and an ovum ? It is remarkable that a lifesaving treatment should apparently have no financial value.
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