Nations tend to fight over land, minerals, ideologies…and now organs. Public outrage spread through the UK earlier this year when it was discovered that foreign citizens were receiving the organs of dead Britons through private transplants. In a new government-commissioned report, Britain is now looking to outlaw all private organ transplants by October. As the vast majority of Britons are on the public health program, this report will effectively be targeting transplants to foreigners. It also has wider ranging implications for British organ transplants in general.
British private organ transplants...why so worried?
First, the controversy: between 2007 and 2009 about 50 non-Britons received transplants from posthumous donors. While the organs were not paid for the surgeries were with doctors receiving a portion of the operation costs, generally around £ 20,000. The media, citizens on the street, parliament, basically everyone, cried foul and the National Health Service (NHS) and government scrambled to investigate and respond to the public outrage.
The potential of these private transplants scared Britain far more than their actual scale. There are about 8000 patients waiting for organ donations in the UK, of which about 3500 receive an organ and about 1000 die each year. Compared to 50 private patients over two years these numbers seem reasonably large. However, the very idea that a private market for organs may be opening up in Britain was enough to launch the government into uncharacteristically swift action. What is it that’s driving the frenzy?
While some have labeled the outrage as racist (many recipients were from Central Europe and the Middle East) and others have focused on the patriotic/xenophobic concerns, I think Britain’s fears stem from looking at the rest of the world. In China, the buying and selling of organs only became illegal in July of 2006. Even now, it is unclear whether or not doctors always obtain permission form patients to harvest “donated” organs after they die. Amnesty International has called for greater transparency in how the organs of executed criminals are handled in China. Similar problems exist in Pakistan, where about 95% of all kidney donors are women, and the donations of kidneys bring in millions of dollars in medical tourism each year. Organ tourism, as it is called, is also a huge business in India. Most recipients come from developed western nations or Japan.
If you find the organ black market as despicable as I do, perhaps it’s time we both took a harder look at the nature of the problem. After all, it is the developed nations of the world that are driving that market. We are the organ tourists. Britain’s efforts to regulate organ transplants, to keep the problem off their shores, is admirable in its efforts to promote the fair exchange of organs. In the end, however, it can only fall short. Like the war on drugs, perhaps the war on terror, attacking the supply will never solve the problem. You have to fix the demand.
And the simple fact is that under the current system, there will always be more hopeful recipients than donors. Trying to forcibly increase the supply of organ donors would be disastrous. Could we require every citizen to surrender their healthy organs upon death? Will body parts start to revert to the state? There are perhaps as many problems in those solutions as there are in the black market. I just don’t believe that the donor-recipient system can be balanced.
This is a tech blog so maybe I default to thinking that technology may always be the solution. In this case, however, it definitely is. Singularity hub has described how artificial organs may become readily available, including hearts. Imagine a world where we can grow all the kidneys, lungs, or livers we could ever use. The costs would be high in a monetary sense, but much lower ethically and politically. I’m not saying that such a solution is a possibility we should all hope for, I’m saying that it’s the only real solution and we should all work towards it. Developed nations should be throwing money and resources into increasing the supply of artificial body parts. The buying and selling of organs may seem like a far-fetched scifi problem, but then again so did Global Climate Change. It may seem like an isolated problem, but so does water shortage. For many, 1000 per year in Britain, the problem is already very real and very local.
Comments
The reason this is a prblem for most British people is that organ donation is the charitable act of a dieing person – it’s not that foreigners get them, it’s that they are sold. People like to belivve that their donation will be used freely to help someone using the NHS (a heath system that is free at the point of use) rather than going to the highest bidder.
The reason this is a prblem for most British people is that organ donation is the charitable act of a dieing person – it’s not that foreigners get them, it’s that they are sold. People like to belivve that their donation will be used freely to help someone using the NHS (a heath system that is free at the point of use) rather than going to the highest bidder.
@nmg, you’re certainly correct that one’s own body should be entirely in one’s own control.
@Kevin, I concede that regulating someone’s rights to sell themselves is paternalistic. However, my point is that there are many ways to turn a voluntary act into a coerced one. IMHO, poverty is such a method. Certainly, the kidney trade in Pakistan is indicative that the voluntary/coercive borders are blurred. But perhaps you are right that an open market would change that. I can’t be certain.
Which is why I advocate an artificial organ transplant system. Not only would such a system avoid donor-matching issues, it would help us, hopefully, circumvent the ethical debate of organ trading.
A final point: certain fields such as emergency services (fire/EMS/police)operate outside the free market. Organ transplants, I propose, would work best in a similar station. No one wants to deal with free trade when they are on fire, bleeding, or held at gunpoint; likewise when they are in need of a lung. However, I am willing to concede on this point as well, provided the free trade organs were artificially created.
@nmg, you’re certainly correct that one’s own body should be entirely in one’s own control.
@Kevin, I concede that regulating someone’s rights to sell themselves is paternalistic. However, my point is that there are many ways to turn a voluntary act into a coerced one. IMHO, poverty is such a method. Certainly, the kidney trade in Pakistan is indicative that the voluntary/coercive borders are blurred. But perhaps you are right that an open market would change that. I can’t be certain.
Which is why I advocate an artificial organ transplant system. Not only would such a system avoid donor-matching issues, it would help us, hopefully, circumvent the ethical debate of organ trading.
A final point: certain fields such as emergency services (fire/EMS/police)operate outside the free market. Organ transplants, I propose, would work best in a similar station. No one wants to deal with free trade when they are on fire, bleeding, or held at gunpoint; likewise when they are in need of a lung. However, I am willing to concede on this point as well, provided the free trade organs were artificially created.
@Aaron: There are few instances of the former because organ selling is done on the black market.
If organ selling was legal, the process would be much safer and more people would volunteer.
And you don’t help desperate people by taking away options. If a person is desperate enough to sell a kidney, then their evaluation is that selling the kidney is good for them. Otherwise, you are asserting that you just “know better”, which is paternalistic and wrong.
@Aaron: There are few instances of the former because organ selling is done on the black market.
If organ selling was legal, the process would be much safer and more people would volunteer.
And you don’t help desperate people by taking away options. If a person is desperate enough to sell a kidney, then their evaluation is that selling the kidney is good for them. Otherwise, you are asserting that you just “know better”, which is paternalistic and wrong.
Why not let people decide to do what they want with their own body, including selling parts or committing organs upon death in exchange for a fee today? The problem with the “black market” or organs is that the laws relegate free exchange between consenting adults into a black market.
Why not let people decide to do what they want with their own body, including selling parts or committing organs upon death in exchange for a fee today? The problem with the “black market” or organs is that the laws relegate free exchange between consenting adults into a black market.
I think that “voluntary basis” is sort of the crux of the problem. Can dead people volunteer, or be volunteered by family/friends/government? Perhaps even more complex: Is someone who voluntarily donates a kidney for some extra spending money the same as someone who voluntarily donates a kidney because it’s the only way they can get money for food/water/shelter? There are very few instances of the former and many, many instances of the latter.
I think that “voluntary basis” is sort of the crux of the problem. Can dead people volunteer, or be volunteered by family/friends/government? Perhaps even more complex: Is someone who voluntarily donates a kidney for some extra spending money the same as someone who voluntarily donates a kidney because it’s the only way they can get money for food/water/shelter? There are very few instances of the former and many, many instances of the latter.
Let’s engineer them so cheaply that “donated/bought” doesn’t come into play.
Let’s engineer them so cheaply that “donated/bought” doesn’t come into play.
I don’t have a problem with organ selling, as long as it’s done on a voluntary basis.I’d sell a kidney if the price was right.
I don’t have a problem with organ selling, as long as it’s done on a voluntary basis.I’d sell a kidney if the price was right.