Should organs be on the market?

patients in need. In the UK, more than 400 die every year awaiting such an operation while in China, only 10 000 people get the transplant out of 1,5 million in need.
In medical circles, debate on the possibility of a market for organs remains unsettled since the year 2000 when it became topical in the UK.
Proponents for the market of human organs view it as a solution to the organ shortage while the pessimistic dismiss the idea on ethical and equity grounds.

Commonly transplanted organs are the kidney, liver, cornea, bone marrow and lungs.
They can be obtained from living or deceased donors.
Kidneys from living donors are more preferred and they give the recipient a better and longer lease of life.

In developing countries like Zimbabwe, patients have to go abroad for transplant due to lack of skills and technology.
Thus, dialysis is administered instead for patients with renal failure.
Iran is the only country in the world where trade for organs is legalised and currently has no waiting lists for kidney transplantation.
Charity organisations work with the government in controlling the trade and donors get at least US$1 000.

Other countries with history of legal trade are India, China and the Philippines but it has since been banned due to ethical concerns.
The ban effectively creates a price cap at zero dollars and this has led to a thriving black market often from the less developed world to western countries with undesirable equity implications.
The average amount received by donors is US$5 000 whilst recipients have to part with an average US$150 000, with middle men taking the difference.
Proponents of the market for organs argue that the market would provide incentives to donors unlike the present scenario.

In addition to that, they argue that making organ trade a criminal offence punishes people for trying to sell their organs which infringes on a right to decide what to do with one’s own body.
Furthermore, respondents in a research investigating the motivation to donate for spouses and friends cited personal factors as contributing to their decision for example improvement in quality of family life and the revival and extension of marriage.

The market proponents thus ask: if such personal gain motives were the incentives for donation, why can’t we consider that motivation can be manifested in monetary payments, as incentives for live kidney donation?
Worse still, the ban has led willing sellers into desperation and consequently, they expose themselves to exploitation and deceit in black markets. Sometimes they are swindled and get amounts that way below the promised.

In some instances, they are conned and get nothing whilst in the worst case, donors are murdered.
Instances have been reported of people who find out later that they had “donated” organs whilst they cannot even recall ever consenting to such an operation at any stage in their lives.
Citing these cases, proponents for the market for organs argue that legalising trade is better than black market trade.

Those in opposition prefer organs to be donated without a monetary attachment except surgery associated costs.
They argue for altruism and also that such markets exploit those who are short of money thus leading to a transfer of health from the poor to the rich.
In addition to that, it would mean that those in need of kidney transplants would have to bid the price alongside the rich with obvious results.
There is also a lot of opposition to legalisation of human organ trading from human rights groups particularly Organs Watch.

Another antagonist, Trevor Stammers, head of the public law department of St Mary’s University College London, argues that organ shortage is not due to lack of potential donors but rather indicates failure to turn potential into actual donors.
He gives example of Spain and Norway which have the best organ donation rates in the world and neither has introduced a fee for donation.

An idea has been proposed whereby the National Health System (NHS) purchases live organs and tissues just as it does other medical supplies or drugs and availing them as per clinical need or some other fair principle of distribution at no cost to the recipient.

Since there would be no direct purchasing, the rich cannot exploit the poor as is the case in illegal markets. In addition to that, the NHS would determine who gets the organ so all stand an equal chance of benefiting.

Furthermore, a fixed payment to donors of the right amount would be an incentive across different income levels and donors can raise enough money for different reasons for example, offset university loans.

The fixed payment should be equal to society’s valuation of the health gain enjoyed receiving individual.
In addition to that, the fixed payment would have to cover the losses of the donor. Such losses are expenses associated with the operation and more importantly, the loss of health-related quality of life.

Looking at this issue rationally, economists think about the most efficient policy to adopt under the present circumstances.
As such, it is more rational to partly support the idea of a market for organs but which is highly regulated since a free market would be massively inefficient and characterised by market failure.
The rich’s willingness and ability to pay for organs is obviously greater than that of the poor. Health is a merit good, that is, it can only be provided in order of merit rather than willingness to pay.

A decision made on the basis of capacity to benefit would be more plausible. We can even have a situation where the poor’s capacity to benefit is higher than that of the rich.
In addition to that, since the rich have a tendency of assigning relatively higher monetary values to their health, it is possible to have a situation where there is a net loss of health from the purchase of an organ.

This is whereby the rich end up benefiting less or not at all from the transplant relative to his attached transplant value.