The heart of the problem

Recently, NPR (yes-I listen) had an interesting segment on organ donation, and whether it was now time to start paying people for their spare parts.  Aside from the logistics of the operation, matching organ to person like a set of Garanimals clothing items, there are some overriding ethical considerations.

Ethics?  I know.  In a world where women can rent someone else’s womb and gender can be changed with the snip of a scissors, ethics might seem to be a quaint and outdated notion, especially when it smacks into free-market capitalism and the libertarian ideal of “if it’s in or on my body, I get to do what I want with it.”

Blog Image 761144 - Flowers
Did Time have to pay a royalty for that heart?

But it’s important to look at what kind of world we will enter if we start putting price tags on kidneys.

We start with the unfortunate reality that there are far too many people in need of a transplant, and far too few organs available.  While most people support voluntary organ donation and register as organ donors when they get their driver’s licenses, the demand exceeds the supply to such an extent that there are people who’ve spent half of their lives on waiting lists.

But if, as the NPR segment suggested, we permit people to be compensated for their organs, we change the playing field for both the sick and the healthy in ways that may completely obliterate the guiding principle enshrined in the Hippocratic Oath: Do No Harm.

If we start allowing people to sell their organs, or receive insurance or tax credits for donating them, we set up a system whereby the rich will be able to buy good health at the expense of those with shallow pockets.  If we look at humans as wholesale organ suppliers, we then create the possibility of a middle man who can market your goods to a needy and desperate public, a cross between Victor Frankenstein and Henry Ford.

But, you say, there is already gross inequity in the way that organs are distributed.  Just look at what happened when Mickey Mantle needed a liver because the one God had given him was marinated in alcohol and other controlling substances.  He jumped to the front of that desperate line, and received a healthy liver, only to die a few months later.  Then there was Dick Cheney, who at the age of 71 received a new heart.  Rich and famous men do have an advantage, it seems.

But these egregious exceptions are just that, exceptions. Most people are in the same boat when it comes to tragedy.

The good news is that federal law bans compensation for organ donation, and that’s something that even the most libertarian among us should applaud. 

There is something repellent in the idea that we can make money off of someone else’s grief, even if that grieving person would be willing to pay.  It reminds me of that cheesy 70’s movie Coma where an entrepreneurial doctor placed people into medical comas so he could then harvest their organs.  Of course in that case, the donation was compulsory and unanticipated.  But the idea that humans are nothing more than the sum total of their organs is strikingly similar.

Life, including all of the necessary apparatus, is priceless. 

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