Monthly Archives: January 2009

Wake Up UNOS! It’s Not Working!

Is it ethical to compensate people for their organs?  That is the question that has perplexed ethicists since long before human organ transplantation became a reality.  Even 18th century philosopher Emmanuel Kant had thoughts on the subject because the poor were being exploited for their teeth, teeth that were transplanted into the empty gums of the very rich. 

Is a global market for organ sales the answer?   Can a for-profit system exist, save lives, and still not exploit the poor? A series of experts — medical doctors, international health experts, and ethicists — looked at the issue on Feb. 8, 2008 in the second of four Harvard conferences on current controversies in global health.     

The present altruistic system of obtaining and allocating organs in the United States simply doesn’t work.  When you have a situation in which there are one hundred thousand people waiting for organs and several thousand dying because of no organ availability then something must change. There are many options but medical ethicists and UNOS (United Network for Organ Sharing), which controls the entire American system, are so hung up on the ethics of transplantation that change has become impossible albeit extremely necessary.  While the ethicists argue people are dying.

I write this blog not as an advocate for selling human organs but as an advocate for the dying.  What is wrong with considering some sort of compensation?   I believe we can avoid a situation in which the desperately poor are lured into selling their organs and become vulnerable to exploitation in the growing industry known as “transplant tourism.”

Some time ago I wrote a blog headlined, “Would you sell a kidney for $47.000.  The blog outlined a plan by an Australian physician that would set up such a system.  It was not an offer to buy a kidney.  Yet, I have received at least a dozen emails from people who want to sell their kidneys.  Some have good reasons others just say they need the money.

I don’t believe in setting up a worldwide market for human organs.  I believe as do many ethicists that the poor, underprivileged and uneducated would become victims.  I do, however, believe that we can compensate people in some manner, perhaps paying for related medical expenses (especially in the case of kidney donors who may have uncovered complications).  There may also be some merit in compensating donors for funeral expenses. 

According to Luc Noël, who tracks transplantation issues for WHO (World Health Organization of the United Nations) in Geneva, in the United States alone, one additional donated kidney a month to each of 58 donation service areas would create equilibrium — an equal number of waiting patients and available organs — by 2013.

The point it that we must do something.  To let UNOS continue to stonewall this horrible situation is unforgivable.   At least try a new plan in a test site for a year or two.  Perhaps a combination of presumed consent and some sort of compensation would be workable but let us at least test a concept instead of continually discarding all options without trial. 

Every year thousands die waiting for organs yet there is no public outrage.  Why not?  Why aren’t we all angry about the fact that people are dying unnecessarily? It is time that the number of available organs increased.  The altruistic approach isn’t working UNOS!  It is killing people and your intransigence is responsible. 

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