Organ Donation: Should it be Government Controlled?

Last year, almost 27,000 Americans received an organ transplant, which was a new national record according to the US department of health and Human Services. Donations from living persons were nearly 7,000, an increase of 2.3% from 2003. Despite the positive numbers, there are still nearly 88,000 people who are on the waiting list for an organ, and about 6,200 died last year before one became available (Hoppel 40). Organ and tissue donation is currently one of the most regulated areas of health care. The only means to receive an organ on the wait list is through donation (McAndrews 182). With the growing need for organ donors, there should be a suspension of the National Organ Transplant Act of 1984, which stops the buying and selling of organs. The focus of regulations should be on how to improve the potential for life not how to hinder opportunity.

In the Medical Law Review for Directed and Conditional Deceased Donor Organ Donations, James Douglas and Antonia Cronin reviewed the difference between the law and common misconception of organ donation. They describe living organ donations as ‘directed’ donations, those being a donation from an individual entitled to donate to another individual (Cronin 278-279). Often times these donations come from a family member, spouse or someone with a personal relationship with the recipient. There is such donations as non-directed, in which the donor donates an organ and their organs are allocated to suitable candidates. Another form of donation is through paired or pooled donations, when the organ is placed in a matching run and then allocated to a recipient. In a pool or paired donation the transplant recipient is unknown to the donor. Paired and non-direct donations were developed as a means of increasing the availability of donor organs. Making the choice to help save the life of someone in your family may be an easier choice than helping a complete stranger but many make the choice as they desire to help others.

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There are not only a physiological and physical affect to the donor; there is also a financial burden. A donor can incur medical bills, and recovery time from work. The American Journal of Transplantation reports that, on average, living donors in the United States incur $6000 or more in costs for travel expenses and lost wages (Delmonico 1189). With the lack of financial assistance and incentive the organ donor list is inadequate. At this time the National Organ Transplant Act is not only restricting the buying and selling of organs but any assistance one may need financially to cover the cost of the medical care. Assistance could come from many different areas such as tax exemptions, a healthcare voucher, or an education voucher for living donors, cash reimbursement, payment for funeral or burial, or simply the exchange of an organ for money (Clemmons 235). Kate Greasley was quoted in a journal, Insights to Changing a World, addressing these concerns by stating two arguments; philosophical and policy. Greasley’s philosophical argument stated that it “is the idea that there are some things which simply ought not to be for sale… it may be argued that such things have a special, intrinsic value…” This argument, based on the fact that things should not be for sale simply because they ought not to be, can also be applied to any good or service. A belief that a special intrinsic value is violated will not sell an organ or accept one that is sold (McAndrews 183). A legal ban should not be based on individual personal values because no two people have the same values. Autonomy is violated when the choice to be made is taken away and no chance is available to improve one’s living conditions. It is believed that marketable body parts would take advantage of the poor. The poor also have the option to refuse to take part in any such commercial endeavors (McAndrews 183). It should be up to an individual to make the choice to better their living conditions. People are known to go to extreme measures as they see they have fallen onto troubling times, this can go for the poor who seek financial stability as with recipients seeking organs.

The buying and selling of organs first became illegal with the passing of the National Organ Transplant Act in 1984. At the time, Congress was exceptionally concerned about the rise of an organ market and mindful of the potential inequities that could arise if destitute donors were coerced into selling their organs. The Senate Report accompanying the NOTA stated that “human body parts should not be viewed as commodities” (McAndrews 182). The act subjects violators to fines of up to $50,000 and a maximum of 5 years’ incarceration (Clemmons 233). There should be more focus from the government on better ways to remove barriers from organ donation. A counter argument in favor of legalization of the organ market is on the utilitarian approach. With the demand of organs increases people have a greater incentive to go to extreme measures and seek assistance from the black market rather than to continue their wait on the list. Within the black market the donor or recipient are often exploited or are victims (Clemmons 187). Even with the current legalization of the organ market there is still coercion between family members, etc. If the concern of the black market is so strong, legalizing the market will help combat the desire to seek organs through the black market.

The concerns that come with the buying and selling of organs are valid concerns. Breaking down the conflict we can see that yes there is a thought that organs are items that should not be bought, I respond with that idea that organs will not be sold as items you may see in stores, organ sales can still be controlled. But the National Organ Transplant Act prevents any and all assistance to donors. There is an opportunity to provide assistance with the cost that comes with becoming a donor. Some may make the choice based on financial gain, some may make the choice based on their own willingness to help others, but these choices should be allowed and not restricted. With such a lack of opportunity recipients sometimes may feel that they are forced to seek alternative means. This may bring them to seeking an organ from the black market, which in fact could be a 50/50 chance. Within the black market there are no rules, so to speak, there is not a definitive source for these organs. People could be killed to have their organs sold, people could be forced to give up their organs. By giving more opportunity through a more legalized approach and by being monitored it would put less of a need to seek out the black market.

When becoming an organ donor, someone is making the choice to give the gift of life to either someone you know or someone you will never meet. As a living donor, the donor is able to specify who receives your gift and after you have passed away the government regulates how your organs are dispersed. The choice to donate truly becomes an individual choice. Creating restrictions on organ donation is not the answer. Some may speculate that the poor may seek this as an opportunity for financial gain, and will make a choice based on the wrong outcome, but this may become a benefit to them as well as a recipient who are seeking additional time to their lives. There are many laws and regulations restricting many things, but restricting a choice that can be beneficial and not allowing chance is not what this country is known for. Regulations are needed to insure the safety of both the donor and recipient, and combat the black market. I’m sure if you ask someone on the donor list they may think there is no amount of money that is greater than their life. We should have a suspension of the National Organ Transplant act to allow the opportunity of life and not hinder it even more by adding such tight restrictions.


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