Pros and Cons - Debbie Newman, Ben Woolgar 2014

Organs, legal sale of
Section H. Health, science and technology

One thing that is indisputable in all debates about organs is that there is a shortage of them in almost every country in the world; people die daily waiting for donor organs. However, as soon as we proceed to the vexed question of how to solve that problem, huge ethical and economic debates open up. Aside from compulsory organ donation, creating a trade in organs is widely seen as the most common possible method by which we could increase organ availability. There are few examples of this policy in practice; only Iran currently allows the sale of human organs, although India did until 1994 and the Philippines until 2008.The Proposition team can, though they are not required to, bite the bullet and make the ability to obtain an organ depend on the ability to pay, but more commonly, will seek to buy organs through a national health system.

Pros

[1] The overarching goal of any organ policy must be to increase the supply of organs. This policy achieves that by incentivising people to donate financially. It is possible either to pay people while they are still alive for certain organs (like a kidney or part of the liver) or to leave that money to their family after they are dead. Either way, that represents a real cash incentive to donate that is presently lacking.

[2] A belief in the principle of autonomy dictates that we allow payment for donations. We already allow people to donate their organs, but if that is a legitimate choice (so that there can be no objection from them about damaging their bodies, for instance), then adding money into the equation cannot possibly make that choice less legitimate. Indeed, all it does is make someone who decides to make that choice financially better off.

[3] Legalisation will wipe out the black market in organs. We know that there is a thriving black market, especially in India after it banned organ sales, because people will always be willing to go to extreme lengths to protect their lives. In a black market, exploitation and donation without informed consent are more likely, as are unsafe medical procedures that threaten to kill people as a result of donating.

Cons

[1] We should strive to obtain more organs, but this proposal will not achieve that goal. Many people at the moment donate out of a sense of altruism; as soon as organs become a product with a monetary value, that sense of altruism is lost. This policy means we would lose some organs. Moreover, if the state is paying for these organs, that will represent an enormous burden on the taxpayer that may hurt other areas of healthcare. If it is being left to the private sector, then though there may be more organs, the poor will be unable to obtain them, which is unacceptable.

[2] The difference between the choice made without money involved and one with it is huge; namely, the possibility for economic coercion. Under this policy, the poor may find themselves selling their organs, in spite of serious reservations about this as a health decision, just to get some money quickly. It is wrong that people might be forced into a choice that is so fundamental.

[3] Far from wiping out the black market, this policy will only encourage it. First, if organs can now be sold legally, that increases incentives to obtain them for free (by kidnap, or illegal purchase from countries like China that allegedly sell the organs of executed prisoners). Second, people will try to undercut the regulated market by reducing costs, meaning that all the problems remain.

Possible motions

This House would legalise the sale of organs.

This House believes in a free market in body parts.

Related topics

Protective legislation v. individual freedom

Surrogate mothers, payment of

Prostitution, legalisation of

Organ donation: priority for healthy lifestyle