Organ selling.

[billydkid]

I find it ridiculous that a person should not be allowed to sell his or her organs (say, after death or a kidney or something) if they choose to or that a family should not be reimbersed for supplying an organ for transplant from a deceased loved one. Everyone else in the equation damn sure gets reimbursed, don't they? The doctor sure a hell is not going to perform a life saving transplant operation without being paid and the hospital certainly is not going to be donating its services, but somehow the one irreplaceble thing in the equation - the organ to be transplanted - is supposed to be donated out of the goodness of one's heart.

Now, I think donating organs is a fine and noble thing, but why shouldn't the people who supply the organs be given the right to benefit from the deal if they choose to? The doctors and the hospitals and the agencies who find organs certainly do. It represents to me the kind of thinking that seems to be so prevalent in society - that you and I should be noble and generous and altruistic if we are decent people, but that same sort of measure doesn't apply to those who run the show.

[WildCat]

This has been my sentiment exactly. There's a stunning hypocrisy on the part of the medical sector when they demand the organs of someone who may not even be able to afford a funeral for free while collecting hundreds of thousands of $$ for themselves.

Also, the shenanigans that go on w/ deciding who gets the organs that do become available is despicable. Maybe if they paid the survivors of the organ donors there wouldn't be a shortage in the first place, and thousasnds wouldn't die every year waiting for organs.

[American]

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[evildave]

The one little problem with that thinking is that you will harvest a lot of organs from live donors who are low income or impoverished, and few/none from people who are well off.

And the supportable price of organs will not make any an impact on personal poverty. Especially since the primary factor causing this is being a poor enough planner that the money will get squandered.

What you get then is poor people who also suffer from delicate health. An infection or accidental poisoning or other condition that they would have easily brushed off with two kidneys and ALL of their liver becomes a life-threatening illness with substantial hospital time.

And then who will pay for the treatment of these suddenly far more delicate people who have no money?

Now then, selling post-mortem organs... well, that seems OK... but then again, it's not really the lack of money that gets people NOT to harvest their loved ones. It's the religious and other superstitious "reasons". You can paste "donate" all over your drivers license, tatoo it on your chest with dotted lines saying "cut here", and fill out every form in the world indicating your willingness to donate your parts, and your next of kin or spouse can stop it all with one sob. "No, we want to bury him with his eyes intact, so he can see Jesus."

It's not like YOU can collect the cash from this situation, being dead and all.

[Leif Roar]

Originally posted by evildave
It's not like YOU can collect the cash from this situation, being dead and all.

Well, there are ways that could be implemented. "I'll pay you ten percent of the current market price for the right to sell your organs after you die."

[billydkid]

Originally posted by evildave




It's not like YOU can collect the cash from this situation, being dead and all.

Yes, but your family could. I, for one, would very much like my family to benefit from the sale of my organs should I meet an untimely death.

[evildave]

Assuming your organs are harvestable and your family doesn't wimp out and/or delay causing them to go bad.

And once your family has wimped out and decided NOT to allow your organs to be harvested, no measly amount of cash will get them to allow it.

What has happened in the past is that the hospital has collected organs due to perfectly valid organ donor information, and then been SUED for BIG $$$ by the family for "mutilating their precious child".

You can sell your blood, BTW. Of course, if it's not the premium stuff, nobody wants to pay much for it.

[Shinytop]

I think we will never see the selling of organs become legal for the simple reason that we are trying to maintain the image that great health care in this country is available for all. Letting the rich buy organs would pretty much take the poor out of the recieving end, now wouldn't it?

If we had any kind of universal health coverage where good health care is routinely available to all then I might support the purchase of the organs, not by the recipient, but by the health care system. Then the organs would still go to the neediest (we hope) and not the wealthiest.

[billydkid]

Originally posted by Shinytop
I think we will never see the selling of organs become legal for the simple reason that we are trying to maintain the image that great health care in this country is available for all. Letting the rich buy organs would pretty much take the poor out of the recieving end, now wouldn't it?

If we had any kind of universal health coverage where good health care is routinely available to all then I might support the purchase of the organs, not by the recipient, but by the health care system. Then the organs would still go to the neediest (we hope) and not the wealthiest.

But why wouldn't insurance cover organs just as it cover the other medical costs? (to whatever extent your insurance does do those things?) Likewise, if the poor are not denied medical care because they can't afford it (and I don't know that this is the case) why would they be denied access to organs? Someone pays for their medical care, why not also for their transplant organs?

[evildave]

Well, they do cover it.

If you really want to buy an organ, go to another country where it's legal. If you're rich (and amoral) enough, you can buy the organ from some kid who thinks it will do his/her family good, have whatever doctors you like do the surgery, and be back home in a week, never paying any mind to what happens to your harvested <s>victim</s>, er 'volunteer' a month from now when they start pissing blood.

[WildCat]

My post referred only to organs harvested after death.

Originally posted by Evil Dave
Assuming your organs are harvestable and your family doesn't wimp out and/or delay causing them to go bad.

And once your family has wimped out and decided NOT to allow your organs to be harvested, no measly amount of cash will get them to allow it.

What has happened in the past is that the hospital has collected organs due to perfectly valid organ donor information, and then been SUED for BIG $$$ by the family for "mutilating their precious child".

You can sell your blood, BTW. Of course, if it's not the premium stuff, nobody wants to pay much for it.

All of this happens now, it has nothing to do w/ selling organs.

Paying for organs would save thousands of lives every year! Are you really willing to let people die over some vague ethical principles? So what if it's the poor who sell them? Doctors don't seem to have any moral problems w/ letting people die because they don't have the money to pay, but suddenly it's unethical to buy organs from dead people? I don't get it.

And if you think doctors don't care about your ability to pay, I suggest you call a few in your phone book and try to schedule an appointment, be sure to answer "no" when asked if you have insurance (it will be the first question they ask). I have done this myself, because I don't have health insurance, and usually have to do w/o any treatment despite having excellent credit and the ability to pay. It's all about the $$ as far as most doctors are concerned.

[evildave]

As I point out, it would do little to nothing.

I'm an organ donor, and I don't care about monetary reward.

Money won't wave a magic wand and make all of the social problems "go away".

Whether or not you were paid, or your family could be paid, all it takes is a delay or a crybaby relative to prevent successful harvesting. You agree that this is the problem now. Hospitals are afraid of getting sued for harvesting. If there is a monetary BONUS for harvesting (after all, the hospital will take its cut), it only makes the harvesting seem more sinister.

If you really want to save thousands of lives, why not shoot for millions and ensure that stem cell and cloning research and organ fabrication that could produce 100% compatible parts are available?

After all, if they can grow a new kidney or liver or lung or heart in a jar for you from a sample of your tissue, there isn't much need for vaguely compatible organ donors. If we can cause a damaged brain to regenerate, perhaps some of the very people we're harvesting from now can be saved.

And why am I talking "science fiction"?

Well, it's less unlikely than all of the ethical, legal and social issues with paying people for organ donorship just up and disappearing.

If you need a kidney, may I recommend a trip to China where they keep the capital prisoners alive until someone needs a matching organ. Maybe you can get a package deal.

[WildCat]

Originally posted by evildave
Whether or not you were paid, or your family could be paid, all it takes is a delay or a crybaby relative to prevent successful harvesting. You agree that this is the problem now. Hospitals are afraid of getting sued for harvesting. If there is a monetary BONUS for harvesting (after all, the hospital will take its cut), it only makes the harvesting seem more sinister.
I don't know what your point is here - are you arguing against organ donations? If the family accepts $$ it would make it hard for them to win a lawsuit, claiming they didn't approve. And the hospital already takes a cut today.
If you really want to save thousands of lives, why not shoot for millions and ensure that stem cell and cloning research and organ fabrication that could produce 100% compatible parts are available?
Obviously that's ideal, but still many years off. What about the here and now?
If you need a kidney, may I recommend a trip to China where they keep the capital prisoners alive until someone needs a matching organ. Maybe you can get a package deal.
This Chinese black market brought to you courtesy of the shortage here. Allow people to sell their organs and this shortage wouldn't exist.

[evildave]

Wrong. We'd only end up wth our own thriving black market.

Are you planning on selling your organs any time soon, or is this just "something for other people"? You'd have to be pretty dumb to sell some of your guts for any price, and pretty sleasy to charge someone extra for it.

Do you really want to hold your organs for ransom? You could always arrange something behind the scenes for cash. Then go under the knife and have a lovely little crescent scar on your back, and live (on average) many fewer years of your own life.

I am an organ donor. I don't see any reason that offering money for it would make a difference. What sort of seedy people would want money for it?

Besides, only relatively few cases will yield usable organs. You die outside a hospital, and you're generally not fit for anything. Die of cancer or an infection, or poisoning, same deal. You live a lifestyle that makes your parts suspect, no deal.

Shall we pay people money "in case" their organs could be harvested? Or make an organ lottery? How about we take a hundred-thousand dollar surgery and add the expense of paying for the harvested guts, too at some sort of "market value"? Then the insurance companies will certainly not underwrite this sort of surgery with that kind of wild variable in it. Especially if you have a rare enough blood type. This will only help to make organ transplants virtually impossible for most people.

Of course, we could get a LOT more appropriate donors by dropping the seatbelt and helmet laws. Young, healthy people with fatal head/neck trauma are the best candidates, after all. We can even pretend that the change in policy wasn't the cause of their deaths. After all, it was the momentary inattentiveness of someone on the road that *really* caused the death.

[Cain]

EvilDave is a misnomer :)

Anyway, Nicholas Kristof, Op-ed columnist for the _NYT_ had a provocative column on the sale of organs. My initial objections to monetary compensation for organ donations were identical to Evildave's, but given that 6000 people die a year waiting for an organ, that policy is certainly open to experimental change. Nobody, I should add, suggests living persons ought to be able to buy, sell, and trade organs on a "free," unregulated market (sorry Shanek).

Here's the article with the anecdotal, human interest story edited out:



...

The shortage of organs is so desperate that each day 17 people die while waiting for them. The woman who usually sat in the dialysis chair next to Mrs. Johnson died while waiting. And the reason for these deaths is not just failed kidneys or hearts, but failed policies — specifically, the ban passed by Congress in 1984 on any payment for organs.

Organ donation policy may seem a fringe concern at a time when we're about to go to war. But the present policy costs up to 6,000 American lives a year, far more than will die in Iraq. A furious debate erupted in the medical community this year on this issue, and by the time the policy is overturned — as it will be — it'll have killed more Americans than the entire Vietnam War.

The problem is that altruism is now the only motivation allowed to induce next-of-kin to give up a loved one's heart, lung, kidney, pancreas or intestine for donation to others. And altruism isn't working.

...

Of course, it sounds macabre to pay for body parts. David Kaserman, an economist who is himself a kidney recipient, recalls that when he submitted a paper to a medical journal in 1990 urging payment for organs, a reviewer declared: "Whoever wrote this paper is morally bankrupt."

But tens of thousands of deaths later, the medical community is coming around. This year the American Medical Association endorsed pilot testing with some form of incentive for supplying organs. The United Network for Organ Sharing, which coordinates the transplant system, gingerly made a similar proposal, as did a panel of the American Society of Transplant Surgeons.

Professor Kaserman has just published a book urging a market for organs, and a new collection of essays, Entrepreneurial Economics, has two chapters inveighing against the ban on payments for organs.

"Welcome to the era of organs for dollars," Transplant News declared.

"There's been a significant shift in the medical community generally and transplant community specifically, especially over the last 18 months or so," said Mark Fox, director of transplant ethics and policy at the University of Rochester.

Still, there's widespread resistance, and Dr. Fox himself opposes payments as ethically objectionable and of dubious effectiveness. The American College of Surgeons and the National Kidney Foundation both recently blasted the idea of payments.

Nobody is talking about payments to live donors, only to the estates of the dead. One proposal is to offer $2,000 or so of the funeral costs of anyone who has contributed organs.

"We don't wish to intrude on altruism," said Francis Delmonico, a professor of surgery at Harvard Medical School. "But perhaps there are some individuals who might be receptive to an appreciation from society — not a payment, but a reimbursement of funeral expense, for consent to donation of that family member's organs and tissues."

One of the biggest problems with the existing system is that the shortage means that many live people end up donating spare kidneys to needy relatives. At least two live donors died in the last three years because of the surgery, and a third was left in "a vegetative state."

Imagine that you face family pressure to hand over a kidney to a childless cousin, while you yourself have four children who need you . . . [sic]

Moreover, paying for organs would be cost-effective, because dialysis costs much more than the transplant operation itself.

"We're losing 6,000 lives a year, more than twice the number killed in the 9/11 attacks," notes Professor Kaserman. "And if we were paying for the organs, federal expenditures would go down. So we're actually spending money to kill people."

The "reimbursment"/payment distinction is rather facetious, similar to Bush's tax cut that "gives you back your own money." A person in the top 1% screams in moral outrage, "I'm not being greedy -- it's MY money. I'm just getting MY money back."

The main problem is religion. Organ donation (after death) unleashes the true power of altruism. Imagine we lived in a futuristic society that required everyone to take a special altruism pill. This pill over-rides the instincts and free-will of the person who takes it under very strict conditions: If you can save at least two people from dying at the expense of your own life, the pill triggers a chemical reaction in the brain that could possibly send you to death. Everybody benefits in the long-term because you're more likely to be one of the two victims than the sacrifical hero, sentry, etc (we know evolution has similar built -in mechanisms based on genetic releated-ness).

Organ donations after death is not only altruistic, but benefits everyone in ways ten times greater than any Brave New Worldish pill. Your need for the organs is exactly zero, but the chances you may need a kidney or heart is significantly greater than zero.

Elementary stuff we probably know already.

Again, religion is obviously the biggest obstacle. My dad wasn't especially pious at one time, but he(now he's crazy) floored me when he opposed organ donation. Why is that, Pop? "How am I going to live in the next world?" he rhetorically replied. Oh, and who donates bodies to all the fetuses that get aborted each year? Suppose someone has two bad kidneys in this world, will they die young in the "next life"? He didn't take too kindly to those simple questions and I cut the conversation short for fear he may suspect me of atheism.

I think we'd profit immeasurably more from a national discussion of the topic than 2000 dollar reimbursments. Of course, obstinate religious Americans are also three times more likely to believe in Mary's virgin birth than evolution... still, I feel common sense and decency could prevail (especially since these goals can be presented exclusively and powerfully in terms of narrow self-interest).

[Tmy]

This thread has got me thinking of blood donation.

When you donate blood is the person who later receives the blood charged for it?? Is there profit being made from your blood donation?

[Jessica Blue]

It's a sad old world....are our livers now an economic commodity?

Human organs: the next futures market?

"The Transplantation Society, which describes itself as the principal international forum for the advancement of both basic and clinical transplantation science throughout the world, argues on its web site that organs and tissues should be freely given without commercial consideration or financial profit. This, unfortunately, is a cry in the wind, ignoring the realities of the capitalist market and the worldwide growth of poverty and social inequality.

Ms. Scheper-Hughes reports that the American Medical Association is considering options that include a futures market for cadaver organs that would operate through contracts. The pervasiveness of this grisly commodification of body parts leads Scheper-Hughes to pessimistically conclude that the very idea of organ scarcity has to be questioned. It’s an artificially created need, invented by transplant technicians and dangled before the eyes of an ever-expanding sick, aging, and dying population. And it’s a scarcity that can never under any circumstances be satisfied, for underlying the need is the quintessentially human denial and refusal of death."

http://www.wsws.org/articles/2002/apr2002/body-a26.shtml

[Prospero]

My view on this is simple:it's your body, do with it what you please. If you make a very poor decision, well, you probably won't have to live with the consequences. As for the pipe dream about universal health care and equal opportunity for all and neediest getting organs first, I don't see how it's even possible to maintain the illusion that such is even possible.

I did read EvilDave's view that this will take place primarily among the poorer classes and will result in more problems for them in the long run. I'm mixed as to how to respond. On one hand, I'm sure there will be more informed consent forms to sign than is easily imaginable, so their desire to proceed is entirely their responsibility, but at the same time, in a section of society that suffers so terribly from poverty, this would appear as a get-rich-quick scheme and no amount of informed consent would dissuade them. I guess it would have to be left to the individual doctors' consciences as to whether to allow cases such as that. There would obviously be some inscrupulous individuals which couldn't care less, but this is a capitalist society and that is their prerogative.