An organ transplant refers to a surgical operation that involves the removal and replacement of a destroyed body organ. Body organs perform distinct functions and if any of them is damaged, the body cannot function properly. A graft involves replacement of damaged tissues with good ones. The tissues can be drawn from some parts of the body or from another individual. Unlike organ transplant, grafting does not involve complete organ replacement, and this can be used to distinguish them. “The term “organ transplant” typically refers to transplants of the solid organs: heart, lungs, kidneys, liver, pancreas and intestines” (Caplan, 1999).
A patient in need of an organ transplant can acquire it through two sources. First, recently deceased individuals often act as a potential source of transplant organs. Such organs are known as cadaveric. An individual has to consent that he will act as a cadaveric donor when he dies. Living individuals act as the second source of organs. There has been a lot of debate concerning organ donation. In this case, some individuals contend that people should sell their organs, while others do not support it. In my view, selling of organs should not be allowed because of the following reasons.
Commercialization of organs will contradict the ethical issues that govern organ transplantation. Organ transplantation is characterized by ethical dilemmas, which stem from the inadequate supply of organs. Therefore, many individuals seeking this service are unable to access it due to scarcity of organs. Distributive justice theory can be applied in opposing the selling of organs. Distributive justice theory has some guidelines, which are usually applied in organ allocation. One of them is equal access criteria. It states that there should be fair allocation of organs among patients regardless of their status in society. “To encourage equality in organ transplantation, the equal access theory encourages a distribution process for transplantable organs that is free of biases based on race, sex and income level” (Veatch, 2002). Consequently, selling of organs will benefit the affluent individuals and discriminate against poor patients.
Individuals who oppose this theory contend that individual’s worthiness should be applied in organ distribution. According to them, people whose organs have been damaged due to poor habits like smoking should not be given any preference during allocation of organs. This is because they are responsible for their illnesses. Moreover, such individuals also cause unnecessary demand for organs. These two arguments make sense, but the concept of individual’s worthiness is often misinterpreted because it is often linked to a person’s socioeconomic status. Besides this, the concept of individual’s worthiness is discriminatory since it classifies patients based on the causes of his or her illness.
Maximum benefit is the second provision of the distributive justice concept. In this context, maximum benefit is aimed at increasing the effectiveness of organ transplants. This implies that the ability of a patient to survive after undergoing a transplant should be taken into account before he or she can be given an organ. The life years gained is an idea used to determine the effectiveness of a given transplant. Therefore, selling of organs will lead to a situation whereby people who may not benefit much from organ transplants will buy them simply because they have resources.
Some ethicists have opposed maximum benefit concept on the basis that it is not possible to predict the effectiveness of a transplant in terms of life years gained. Secondly, defining and measuring success in this context has also been questioned. For instance, “is success the number of years a patient lives after a transplant” (Beaulieu, 1996)? Or should it be looked at in terms of how long the transplanted organ will work? The maximum benefit concept is also opposed for being subjective. Its critics contend that it enhances discrimination. In my view, proper medical examination of a transplant candidate can offer better predictions of his or her ability to survive. Hence, maximum benefit should be applied because it will make organ transplants more efficient. This is because it will minimize wastage of the scarce organs.
The supply of organs can be increased considerably through many strategies. For instance, many organs can be obtained from one cadaveric donor. Consequently, cadaveric donors can be increased through various approaches in order to improve the supply of organs. Since transplant organs can be increased through various mechanisms, therefore, there is no justification for selling organs.
Living organ donation is fairly advantageous because most donors and recipients usually have similar genes. This makes such transplants more successful. However, the consequences of this type of transplant outweigh its benefits, because of the following reasons. First, the living donor has high chances of experiencing long-term health complications, which might be difficult and expensive to solve. Secondly, living donors can also develop psychological problems.
Nonfinancial incentives have gained much popularity, and they are increasingly used to obtain many organs from living individuals. For example, “the new law allows living donors in Wisconsin to receive an income tax deduction to recoup donation expenses like travel costs and lost wages” (Childress, 2001). However, many experts have argued against the application of financial incentives in acquiring organs. Experts also believe that it is very unethical and immoral for people to exchange their organs for money. This is because this strategy will appeal to individuals who are poor and vulnerable. Hence, they will be compelled to remove their organs for the purpose of getting money. This will also favor rich people because they will use their resources and influence to get organs. In the USA selling organs does not have any legal provision. Indeed, “the National Organ Transplant Act of 1984 banned such a practice” (Cohen, 2002).
Although there are a few arguments that support trading in human organs, some people believe that it is the economic disparities that make people to resort to such practices and not their informed minds. Therefore, they blame the selling of organs on the government due to its failure to eliminate socioeconomic inequalities. Proponents of selling organs also believe that it is really not unethical to sell organs because it boosts the supply of organs. However, the major challenge in this context is that proper measures have not been adopted to make this process safe. “This critique extends not only to the medical system but also to legal and religious safeguarding organizations as well” (Siminoff, 2001).
Apart from the above highlighted sources of organs, other alternatives have been introduced by scientists in order to increase organ supply. For example, artificial organs and organs derived from animals are viable alternative sources. Besides this stem cells can also be used. Nonetheless, the source of these cells has been questioned by ethicists.
The above discussion indicates that organ transplant has been primarily affected by the shortage of the organs, and the overwhelming demand for them. With regard to this challenge, better methods and strategies should be applied in order to increase the supply of organs. Ethical standards should also be considered when formulating legislations and other procedures that govern organ transplants. In conclusion, living organ donors should, therefore, not be allowed to engage in selling their organs because of the risks associated with it. “It is important to note that receiving an organ donated from a living or deceased donor is a life changing event, hence, it should be treated with a lot of dignity” (Veatch, 2002).