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Donating Organs for Money: Ethical or Not?

Currently, there are around 114,000 people on the waiting list for an organ transplant in the United States alone, and everyday, 20 people die due to the lack of available organs for transplant. This is the sad reality for a system that relies on people’s generosity for a potentially life-saving treatment for someone in need. Yet, what if we could legally sell our organs, such as our kidney, lung, liver, or intestines? Would this help more people in need of a life-saving transplant?

This chart shows the issue of organ shortages. Image Source

What is the risk of living organ donations?

In organ transplants, the recipient must be compatible with the donor’s blood type, body size, as well as other factors, which is why family members can often times be organ donors for a patient. However, one in four living donations are from donors that are not biologically related to the patient, so donating your organs could save someone without compatible family members.

Yet, organ donations are not completely risk-free for the donor. While most organ donors can live normal, healthy lives, some surgical complications associated with donating an organ includes pain, infection, blood loss, blood clots, injury, pneumonia, and occasionally death.

According to American Transplant Foundation, “Some possible long-term risks of donating a kidney may include high blood pressure (hypertension); large amount of protein in the urine; hernia; organ impairment or failure that leads to the need for dialysis or transplantation,” and liver transplants have an even greater risk than kidney transplants.

Data shows that out of 3,086 living organ donors, at least four of these donors end up needing a liver transplant due to their organ donation. However, in general, organ donors usually do not develop serious complications because of the organ transplant.

This chart shows the risk of developing health problems due to an organ donation. Image Source

However, there is currently a black market for organs

The risk of organ donations is an important because it surrounds one of the main concerns about whether or not we should legalize selling your organs. Many people believe that selling organs exploits impoverished individuals, because of the financial incentive.

People who need the money may be less likely to understand the consequences of selling their organs, and people shouldn’t compromise their health for money. However, the risk of organ transplants is relatively low compared to other methods of getting money, including selling on the black market.

The Global Financial Integrity states that the organ black market makes an estimated $600 million to $1.2 billion annually.

Global Financial Integrity

Selling organs on the black market is much more dangerous as the donor may not receive adequate healthcare from qualified individuals, so by legalizing paid organ donations for hospitals, this will help organ donors receive proper surgery and healthcare from medical professionals instead of turning to the black market. Still, the benefits compared to the risks of paid organ donations are heavily skewed towards more privileged people, and this system of inequality is far from perfect. An article in the British Medical Journal described it as, “harm[ing] a poor person and sav[ing] a rich one”.

What about organ harvesting?

In addition, another concern many people have over selling organs is the issue of organ harvesting, which means kidnapping and killing people for their organs. However, similar to medical procedures, the organ donor would have to consciously consent to donating their organs, and the procedure can only be done at an authorized hospital by medical professionals. The entire process should be regulated by the government and recorded with written informed consent from the donor, so there will be no incidents of people walking in to sell a suspiciously butchered kidney.

Strict laws could be passed to regulate the sale of organs, so only certain authorized hospitals have the right to perform these operations and only the organ donor has the right to consent to a paid organ donation, no one else can consent on behalf of the donor, including legal guardians.

Another concern with selling organs involves religion. Some religious groups believe that your body isn’t yours, it’s given to you by God. While I won’t comment on religion since people have different beliefs, selling your organ could help you save someone who desparately needs an organ. Even though financial compensation may be a reason why someone donates an organ, legalizing paid organ donations could help increase the number of live-saving organ transplants, and ultimately, your donation will help others live healthier, happier lives.

Other countries have legalized paid organ donations, but with varying degrees of success

Other countries have experienced varying degrees of success with legalizing paid organ donations. For example, in Iran, the government pays the donor around $4,600 for a kidney and free healthcare for a year. This has greatly improved the issue of kidney shortages, as paid kidney donations have “essentially eliminated” the waitlist for kidneys.

However, this system doesn’t come without it’s flaws. Iran’s system is highly controversial, and some say that unfair exploitation is inevitable. To illustrate, 70% of the people who want to sell their kidney in Iran are categorized as poor. The injustice in this system is obvious, as poorer people risk their health because of financial insecurities, while the rich people receive the benefits. In a free market like in the United States, this injustice will only become greater as only rich people will be able to afford to buy organs while underprivileged people risk their lives to support their families, and often times, they can’t afford their own healthcare.

However, Nasser Simforoosh, chairman of the urology and kidney transplantation department at the Shahid Labbafinejad Medical Center believes that “Instead of doing something illegal to cover their debts, like stealing or smuggling, they are saving a life first. This is not exploitation. The end result is good for the recipient and the donor.” While having a paid organ donation system is highly controversial and subject to exploitation, it has also helped save thousands of lives.

“Instead of doing something illegal to cover their debts, like stealing or smuggling, they are saving a life first. This is not exploitation. The end result is good for the recipient and the donor.”

Nasser Simforoosh, chairman of the urology and kidney transplanation department at the Shahid Labbafinejad Medical Center

While paid organ donations is far from the ideal solution, the waiting list for organs is growing everyday

With new emerging technology in stem cell research, the need for organ donations may diminish. However, this is far from reality as our demand for organs is still high as ever, and one solution could be to legalize selling organs. Despite studies showing that allowing paid organ donations would increase the supply of organs, this system is far from perfect and could potentially exploit impoverished individuals. Yet, people are still dying everyday from the lack of organ donations, and paid organ donations could be the solution to saving lives before we are able to develop better solutions.

Bibliography

Facts and Myths about Transplant. 21 Mar. 2019, www.americantransplantfoundation.org/about-transplant/facts-and-myths/.

“What Can Be Donated.” Organ Donor, 27 Apr. 2020, www.organdonor.gov/about/what.html.

“Everything You Need to Know about Organ Transplants.” Medical News Today, MediLexicon International, www.medicalnewstoday.com/articles/325631.

“Benefits and Risks of Becoming a Living Organ Donor.” American Transplant Foundation, 22 Aug. 2018, www.americantransplantfoundation.org/about-transplant/living-donation/about-living-donation/.

“Risks and Benefits of Living Kidney Donation.” Risks and Benefits of Living Kidney Donation | Weill Cornell Medicine, weillcornell.org/services/kidney-and-pancreas-transplantation/living-donor-kidney-center/about-the-program/risks-and-benefits-of-living-donation.

Nguyen, Katie. “Black Market Trade in Organs Targeted in Anti-Trafficking Treaty.” Reuters, Thomson Reuters, 26 Mar. 2015, www.reuters.com/article/us-europe-trafficking-organs/black-market-trade-in-organs-targeted-in-anti-trafficking-treaty-idUSKBN0MM2FR20150326.

Hall, Abigail. “Let People Sell Their Organs.” Forbes, Forbes Magazine, 23 Dec. 2015, www.forbes.com/sites/realspin/2015/12/14/sell-organs/.

Bengali, Shashank, and Ramin Mostaghim. “’Kidney for Sale’: Iran Has a Legal Market for the Organs, but the System Doesn’t Always Work.” Los Angeles Times, Los Angeles Times, 15 Oct. 2017, www.latimes.com/world/middleeast/la-fg-iran-kidney-20171015-story.html.

Press, Associated. “In Iran, Unique System Allows Payments for Kidney Donors.” STAT, 17 Feb. 2017, www.statnews.com/2016/08/25/organ-donation-kidneys-iran/.

Barnieh, Lianne et al. “The cost-effectiveness of using payment to increase living donor kidneys for transplantation.” Clinical journal of the American Society of Nephrology : CJASN vol. 8,12 (2013): 2165-73. doi:10.2215/CJN.03350313

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