It is sometimes said that desperate circumstances require desperate measures. But desperation can also lead to the exploitation of the vulnerable. Such would be the case if we created a market in live-donation human kidneys.
The need to increase the number of kidneys for transplant is, of course, very real. More than 100,000 patients are on waiting lists to receive “the gift of life” in the United States. Moreover, currently, the supply from dead and altruistic living donors is insufficient to meet the need, which is why some advocates want to pay people to sell one of their two kidneys.
“Hundreds of millions of healthy people walk the streets quietly carrying two kidneys,” he wrote. “They need only one. The head-scratcher is how to get kidneys from the people who have one to spare into the people who need one. Getting them from genetically modified pigs, as was recently found possible, won’t be a widespread solution for a very long time. There’s a simpler and long overdue answer: Pay people for their kidneys.”
I understand the appeal, but we should not go down that road. Why? First, there is the issue of safety. Strictly speaking, it is true that people can live well with one kidney. But Mr. Walsh’s claim that we don’t need two is also misleading. One kidney is simply not as good as two.
Then, there are the usual risks attendant with any serious surgery, such as bleeding, infection, and complications from anesthesia.
It is one thing for a donor to risk these complications to save a loved one’s life or out of the pure goodness of their hearts. But it is quite another to seduce people to become sellers—suppliers who would mostly be poor or desperate—and persuade them to risk their health or life for money, tax credits, or a mortgage down payment—some of the suggested enticements being proposed to persuade people to give up a kidney.
Beyond safety and exploitation concerns, a market in human kidneys would harm the culture by converting our bodies into a potential commodity, thereby adding to the growing trend toward human instrumentalization. Indeed, Mr. Walsh justified his advocacy on the basis that we already allow certain body parts and functions to be commercialized:
“Though markets exist for human tissue, bone, amniotic stem cells and blood plasma and for the use of a woman’s womb and her eggs, organs cannot legally be bought and sold.”
Where would it end? What would come next—selling pieces of liver? Perhaps even lethal organ removal from people who want euthanasia? Or what about paying women who want to abort to gestate to a later stage of pregnancy so the baby’s organs can be harvested?
No, Wesley! That goes too far!
Imagine the commercial possibilities!
Making matters worse, people might be induced to legalize kidney selling as much by the profit motive as by the altruistic desire to save lives. Organ procurement is very remunerative for organ distribution organizations, transplant surgeons, hospitals, and others within the organ transplant industry. Those who procure or transplant organs often do quite well by doing good. When organs are donated, this fact of organ transplant medicine is of lesser concern. But when monetary incentives are offered, the risk to vulnerable patients increases.
Organ donation is to be applauded. Indeed, more can be done to make living donation easier—such as paying for more out-of-pocket expenses incurred by donors than currently permitted. People should not be forced to pay to save a life.
But the well-being of the healthy matters too. Turning a precious “gift” into a flesh product and donors into “vendors” would risk terrible inequity in which only the financially desperate would sell for the benefit of those with greater means. Such a plan would also further our society’s ongoing descent into a crass utilitarianism that looks upon the weak and vulnerable as resources ripe for harvest. In summary, the laudable end sought by establishing a market in human kidneys does not justify the exploitive means.
