Copyright 1983 NPG,Ltd. SELLING HUMAN ORGANS ISSUE: Should we allow human organs, such as kidneys, to be bought and sold like ordinary commodities? (1) No, we should prohibit anyone from buying or selling organs. (2) Yes, the introduction of market-based pricing would help alleviate much human suffering and actually reduce the overall economic burden. BACKGROUND: The issue of how to procure human organs covers everything from hearts to bone pieces. But most of the controversy so far centers on the most "popular" organ transplanted, the kidney. Each year more than 10,000 people need new kidneys. But only about 5,000 of these people receive new kidneys, mostly because of the shortage of available organs. In theory, there are enough organs. Each year there are 20,000 deaths that create potentially usable organs. When interviewed in ordinary circumstances, nearly 80% of people say that they are willing to donate the organs of a loved one, should they die in a fashion which makes them a potential donor. Yet, for reasons subject to extensive and intense debate, that generalized willingness to donate does not translate into an adequate supply of organs. To fill the gap, patients are kept alive by use of expensive dialysis machines. Each year the public spends $2 billion through Medicare to support dialysis, which comes to about $30,000 per patient per year. In the near future the demand for transplant operation likely will skyrocket. The FDA recently approved a new drug -- cyclosporin -- which doubles the previous success rate. The demand for transplantable organs thus will soar. To meet that anticipated demand several firms have proposed establishing a system for locating people willing to donate their organs for payment. The firms would then pass on that cost plus their own overhead to the patient. One firm estimates that the cost of an organ such as a kidney, procured through this system would be about $15,000. POINT: These proposals for setting up "organs for sale" networks cannot be tolerated; they must be immediately outlawed. We cannot allow people to sell their own organs because that is not only repugnant to decency, it will create gruesome blackmarket operations. Moreover, the proposals would exploit poor foreigners by encouraging them to sell body parts to rich Americans. We do not allow people to sell themselves into slavery; we cannot allow them to sell their vital body parts. This goes beyond morality. Living donors of virtually any organ increase their risk of death or disease. Moreover, it does not take much imagination to conjure up horrible images of hard-hearted relatives of a dead person selling the body for cash. With the vast number of potential but unused donors, we should redouble our efforts to stimulate voluntary donors, not set up "bodyshops." COUNTERPOINT: We should not only permit but encourage private firms to locate organs for donation. Provided that he does not kill himself, a person's body is his own to do with it as he wants. As a matter of fundamental principle, government must not be allowed to tell a person how to use his or her body. The proposed private donor systems are not fundamentally different from firms that pay for blood donations. Few would argue that these profit-making operations do not help to supply vital blood products. And yet when originally started, the donation-for-pay stimulated intense debate. Now we can see that the original controversy proved vastly overblown. A careful examination of the economics will show that the cost to the patient and the public to purchase organs is far less a burden than that which they bear today. According to current estimates, the cost of a purchased kidney would be less than the cost of six months on dialysis machine and subject many patients to far less agony. And, costs aside, many people today die for lack of donors; these lives would be saved if we would take steps to increase the supply of available organs. QUESTIONS: o If organ sales are allowed, how would you put a price on the value of a human organ? o If organ sales are allowed should there be mechanism, perhaps through insurance or government assistance, that allows all people to obtain organs regardless of their financial means? o Would this issue be less controversial if the organ seller were terminally ill? o Would it be immoral for a person to sell his organs for implant in strangers? o Is it better to keep a person on an artificial organ than to give them a transplant from an organ bought from a donor? REFERENCES: FDA Approves Drug to Aid Organ Transplants, John Wilke, The Washington Post, September 3, 1983, p.A1 Va. Doctor Plans Company to Arrange Sale of Human Kidneys, Margaret Engel, The Washington Post, September 19, 1983, p.A9 Doctors Decry Plan to Buy, Sell Kidneys, Judie Glave, Associated Press, The Washington Post, September 24, 1983 (Note: Please leave your thoughts -- message or uploaded comments -- on this issue on Tom Mack's RBBS, The Second Ring --- (703) 759-5049. Please address them to Terry Steichen of New Perspectives Group, Ltd.)