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Introduction
Organ donation encompasses an individuals deliberate choice allowing their body part(s) to be removed and transplanted to another person. It is a legal process whose legitimacy is obtained through such means as the donors consent given when alive or dead or by the assent of their next of kin. Currently, there is a global shortage of organs, which has exposed the failure of the system, which relies on altruism and necessitated alternative means of promoting organ donation. In recognizing the ever-growing disparity between the demand and supply of body parts, some experts and other policymakers have proposed the review and the subsequent amendment of the existing legal frameworks to legalize transplant commercialization. Although this strategy could incentivize organ donation and help reduce the gap between supply and demand, it would exploit the vulnerable, promote unscrupulous body part trafficking, and trigger economic and health ruin for the donors.
Potential Exploitation of the Vulnerable Groups
The push to legalize the commercialization of organ donation is primarily driven by the heavy demand, which has perennially outstripped supply by extensive margins. According to Lauerer, Kaiser, and Nagel (2016), the waiting list of body parts recipients has been growing exponentially against a corresponding decline in the number of people willing to give their usable organs. The vulnerability of the people seeking organ transplants in an attempt to avoid premature death, mainly from the developed countries, is matched against the economic susceptibility of potential donors, often from developing countries. Unscrupulous individuals see the potential gain and exploit the weakness and predisposition of the desperate recipient and seller. From this perspective, legalizing the sale of body parts would inherently legitimize the market despite the notable motive and outcome of human exploitation. In this regard, enacting legislation permitting the sale of body organs in the open market should not be allowed.
Additionally, legalizing the sale and purchase of transplantable parts would create a market and economic situation which favors the affluent while exploiting the socioeconomically disadvantaged donors. Indeed, one of the drivers reinforcing the proposal of paid organ donations is the availability of wealthy buyers and impoverished sellers. This implies that the latters sole reason and motivation for donating is not anchored on altruism but on obtaining some financial benefit from the transaction. According to Held, McCormick, Chertow, Peters, and Roberts (2018), the dominant demographic feature characterizing most of the people willing to sell their organs is their high illiteracy levels, living in abject poverty, and easily misled. Consequently, most of the paid donors cannot make informed decisions and comprehensively consider the resultant health complications, such as potential dangers and harm threshold, due to their socioeconomic disadvantage (Williams, 2018). In this regard, legalizing the sale of body parts would entrench the imbalance of power between the poor and rich, without providing any protection or support to the former, such as postoperative care. Therefore, the sale of organs should not be legalized due to the potential commodification and objectification of poor donors.
Body Part Trafficking and Incentivizing Hastened Deaths
As the legally available body parts for transplant satisfy a negligible percentage of the global need, new illegal opportunities emerge for organ brokers, and other unscrupulous characters seek to exploit the situation. According to Negri (2016), an estimated 10 percent of the organs transplanted globally have been completed and conducted using components obtained unlawfully from the black market. For instance, transnational organized criminal outfits have targeted vulnerable populations, such as people fleeing conflict zones, but the immigrants under anesthetic, and harvest their organs for sale in lucrative markets. Similarly, other illegal organ traders use coercion and blackmail to compel their victims to donate body parts for sale in the ready market. Despite the promised financial benefits, the victims of trafficked organs rarely receive the full amount of money, if they receive any at all. In this regard, free markets for the sale of organs would inherently escalate the poaching of humans due to the incentive granted by the legalization. Therefore, legalizing the commercialization of body organs would inherently increase the risk of trafficking and expose more people to illegal harvesting for the subsequent supply to the ready market.
Additionally, legalizing the sale of body organs would promote unethical practices due to the huge shortages of transplantable parts. As the public donations for these critical components continue to diminish, medical practitioners may be put under pressure to declare severely ill patients dead or implored to hasten their demise so that organs are harvested from the cadavers. Schweikart (2020) contends that the legal foundation for the dead donor rule requires that donors should be dead before any processes of organ retrieval can be initiated. While this obligation establishes an ethically medical framework for protecting the vulnerable from being killed for their organs, legalizing the sale of such body parts can incentivize the sacrificing of seriously ill patients. Ely (2019) notes that numerous incidents have occurred where healthcare professionals accelerated the deaths of car crash victims and other terminally ill people so that they could harvest their body parts. In other instances, a hospitalized patient may die due to the donation procedure after the removal of critical organs. Therefore, legalizing the sale of body parts in the open market would incentivize such malpractices and inflict more damage than harm.
Violation of Human Dignity
Legalizing the sale of body parts inherently perpetuates the notion that some people have less worth than others and that everything can be procured by the wealthy. The prevailing organ shortages have necessitated the consideration of alternative means through which individuals on the ever-growing waiting lists can quickly receive the transplants. According to Gillespie (2019), the introduction of money and profit motives in the organ donation processes would inherently reinforce socioeconomic stratification and allow the affluent to assign prices on organs. This market-based solution and commodification of body parts towards addressing the shortages reflect the notion of paying people for their organs and offends the preservation of human dignity. Indeed, those procuring the organs would feel that the donors are commodities that can be procured from the market, thereby degrading and equipping them with other commodities.
Human dignity encompasses the recognition that individuals have a unique value intrinsic to their humanity. Although various contingent aspects of the opposition towards human market organs can be adjusted or modified, the notion of human dignity cannot be promoted in such a scenario, regardless of any improvements. Alpinar-Sencan, Baumann, and Biller-Andorno (2017) argue that where people are circumstantially susceptible to selling their organs for whatever reason, their human dignity, self-worth, and value are adversely impacted. This view is corroborated by Andorno (2017), who argues that since the trafficking and the subsequent sale of whole people violate their dignity, the vending and trading of their organs engender the infringement of human worth. Moreover, the people purchasing these critical organs regard them as objects, while the donor views the part as an item that can be sold for the benefit of the recipient. From this perspective, the sale of body parts is an affront to intrinsic human dignity, and its legalization should not be allowed.
Health and Further Economic Ruin for the Paid Donors
Donating an organ is associated with a significant predisposition to short and long-term health risks, including body part malfunction and psychological problems. These increase exorbitantly when the donor does not get the requisite pre and postoperative preparations and procedures. Nakazawa et al. (2019) posit that the retrieval of body parts is a major surgical undertaking, which may engender severe compromise on the donors health, including wound complications, bleeding, infections, and unnecessary incisions. As noted, most people selling their organs do so to obtain an economic benefit and are misled into believing that the process is completely harmless. In this regard, they are oblivious of the inherent decline in their general health, including heightened anxiety, resentment, and depression, and lack the essential post-donation support. Arguably, this deterioration of overall wellbeing is deepened and intensified by the realization that the donors contribution was merely a commercial transaction and their organ was procured like a commodity in the open market. In this regard, the sale of body parts has a greater health toll on the donors and should not be legalized.
Further, the selling of organs does not often result in any significant economic benefit to the donors. Generally, these sales are largely conducted in the black market by unscrupulous individuals who exploit and culminate in shortchanging the body part owners. This problem is compounded by health deterioration, which inhibits the donors ability to work or engage in other physically demanding productive activities. According to Krekula, Forinder, and Tibell (2018), most people do not know that organ donations require prolonged care in intensive care units with a large financial burden on the donor. Legalizing organ markets would place more people the harm to organ traffickers who would be willing to circumvent the legal framework while providing a minimal advantage to the sellers. This implies that the perceived economic breakthrough after selling ones organ does not materialize. From this perspective, the selling of body parts engenders financial ruin to the seller due to the unseen economic burden from prolonged hospital stays and the inability to resume demanding productive activities. In this regard, organ donation should remain an act of altruism anchored on peoples informed willingness and genuine desire to help others.
Conclusion
Conclusively, it is impossible to create a legal and ethical market for body organs, and the enactment of any legislation legalizing such transactions would engender more harm than good. The perennial organ shortage and the ever-shrinking public donations are the major drivers promoting the legalization of the sale of body parts. This scenario has fostered the exploitation of the vulnerabilities of the donors and their recipients by unscrupulous individuals due to the profit motives in the nature of the transaction. Additionally, the sale of transplantable body organs would be influenced by the presence of socioeconomically disadvantaged people who are willing to do anything to escape the impoverishment and wealthy individuals desperate for their health. Legalizing the commercialization of such transactions would incentivize the poaching and the subsequent harvesting and trafficking of human organs as more people would be seeking to legally bridge the gap between the demand and supply. Moreover, such sales violate the concept of human dignity by the commodification and assigning of monetary value to things that cannot be adequately quantified in monetary terms. Therefore, the sale of body organs in the open market should not be legalized.
References
Alpinar-^encan, Z., Baumann, H., & Biller-Andorno, N. (2017). Does organ selling violate human dignity? Monash Bioethics Review, 34(3-4), 189205. Web.
Andorno, R. (2017). Buying and selling organs: Issue of commodification, exploitation, and human dignity. Journal of Trafficking and Human Exploitation, 1(2), 119127. Web.
Ely E. W. (2019). Death by organ donation: euthanizing patients for their organs gains frightening traction. Intensive Care Medicine, 45(9), 13091311. Web.
Held, P., McCormick, F., Chertow, G., Peters, T., & Roberts, J. (2018). Would government compensation of living kidney donors exploit the poor? An empirical analysis. PLOS ONE, 13(11), e0205655. Web.
Krekula, L. G., Forinder, U., & Tibell, A. (2018). What do people agree to when stating willingness to donate? On the medical interventions enabling organ donation after death. PLOS ONE, 13(8), e0202544. Web.
Lauerer, M., Kaiser, K., & Nagel, E. (2016). Organ transplantation in the face of donor shortage ethical implications with a focus on liver allocation. Visceral Medicine, 32(4), 278285. Web.
Nakazawa, E., Yamamoto, K., Akabayashi, A., Shaw, M., Demme, R., & Akabayashi, A. (2019). Will you give my kidney back? Organ restitution in living-related kidney transplantation: Ethical analysis. Journal of Medical Ethics, 46(2), 144150. Web.
Negri, S. (2016). Transplant Ethics and the International Crime of Organ Trafficking. International Criminal Law Review, 16(2), 287-303. Web.
Schweikart, S. J. (2020). Reexamining the flawed legal basis of the dead donor rule as a foundation for organ donations policy. AMA Journal of Ethics, 22(12), E1019E1024. Web.
Williams, N. (2018). On harm thresholds and living organ donation: Must the living donor benefit, on balance, from his donation? Medicine, Health Care, and Philosophy, 21(1), 1122. Web.
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