Should Organ Trading be Legalized ?

Recently, I have come across numerous article on Organ Trading both online and offline. I believe most, if not all of us have some vague recollection of the case of the former Singaporean retail magnate of CK Tang, Tang Wee Sung. He allegedly attempted to buy a kidney for $300,000 from an Indonesian immigrant. As a result, he was fined $17,000 and sentenced to one day’s jail. The would-be donor, Mr. Sulaiman Damanik, was jailed for three weeks. The middleman who arranged the transaction, Mr. Wang Chin Sing, received the heftiest sentence of fourteen months jail. To read up on a more detailed account of the incident, click here.

This shows how people, out of desperation, are forced to resort to the black market of organ trading to buy kidneys, lungs and other vital organs for themselves. In Tang's case, he has been on dialysis for over a year and suffers from various heart problems. Doctors have estimated that he would not live beyond 5 years.

Now, for the main topic: Should Organ Trading be Legalized ?

Personally, I am for organ trading, not just for Singapore, but for the entire world. Why? In the United States of America alone, there were are more than 50,000 on the waiting list for kidney transplants in 2000. Only a mere 15,000 of them received kidney transplants. This implies a mean waiting period of nearly four years before a person on the waiting list could receive a kidney transplant! In the same year, almost 3,000 died while waiting for a kidney transplant, and half that number died while waiting for a liver transplant. These numbers will only continue to increase as the population grows.

What does this show? It shows that clearly, altruism or altruistic donations are not enough. We need something else, something more dependable. Organ Trading.If altruism were sufficiently powerful, the supply of organs would be able to satisfy demand, and there would be no need to change the present system.However, this is not the case in any country. While the per capita(person) number of organs donated has grown over time, demand has grown even faster. Inevitably, the length of the queue for organ transplants has grown significantly over time in most countries, despite attempts to encourage greater giving of organs, such as campaigns.

The situation in Singapore is equally dire. Studies have shown that Singapore is fifth highest in the world in terms of incidence of kidney failure. According to a news report, at least 3,500 people in Singapore have kidney failure; 600 are on the transplant list. Moreover, the demand for organs transplantation continues to increase rapidly. Between 1998 and 2003, the number of people waiting for a kidney increased by almost 20% to 673 patients. Singapore has tried time and again to improve the allocation of available organs among the needy, such as giving greater priority to those who needs them the most. These steps have helped, but they have not stopped the queues from growing, nor prevented thousands from dying while waiting for transplants.

On the other hand, countries like Iran, who have legalized organ trading, have almost no queue for organ transplants! They have proved, beyond all reasonable doubt, that organ trading is the sole solution to this plight that has the world in an iron-cast grip.

However, there are critics and a lot of people who are against it. They feel that it is immoral and unethical to sell what we were born with. I say: Get off your high horse! You don't know how heartbreaking and antagonizing it is to witness one's loved ones suffering a slow and painful death. In all likelihood, you have never been affected personally by the shortage of organs. If this issue becomes personal, I can guarantee you that those who were against it would adapt immediately and become an avid supporter of organ trading; such is the hypocritical nature of humans. They ignore a problem until it threatens to inflict personal harm. Let me ask you; is committing an immoral act worth saving one person's life? Or is it more important to preserve these natural gifts, at the expense of others' of lives? I sincerely believe that under no circumstances, saving someone's life should take a back seat to ethics or principles. The value of a life cannot be compared with that of moral values.

People are also against organ trading as they fear that it will lead to an economic allocation of resources where only those who can pay will receive an organ transplant, to the point where an organ is treated as a commodity.

This is not true. That is what happens in the black market. However, with proper and well-defined framework, the white market will be different.

One idea is to set up a kidney registry for registering and screening donors and recipients to find suitable matches and ensure that there is no coercion, duress or exploitation involved. Furthermore, it would make sure that organs are allocated on the medical condition of each donee, not on the financial value or assets of the donees. Also, the donar's organs will only be accepted if it is a suitable match for one of the donees. A charity or administrative body like the government could easily take care of this and related matters such as donor's and donees' consent, protection of identities of donors and donees, requirements, insurance and other pre and post-transplant issues. As this is handled by a legal administrative body, we would not have any problems that were in the black market.

Another set of critics admit that allowing organs to be bought and sold would be positive. However, they object as they feel that the lion's share of the organ supply would come from the poor. They think that with this implementation, the poor would be induced to sell their organs to the middle classes and the rich. Though there is no reason for complain should the organs of poor persons be sold with their permission after they died, and the proceeds went as bequests to their parents or children, voices might be raised if mainly poor people sold one of their kidneys for live kidney transplants.

Think about it. On the other hand, would poor donors be better off if this option were taken away from them? Maybe a limit on the number of organs that could be supplied by those with incomes below a certain level could be put in place, but would that improve their welfare?

Moreover, it is far from certain that a dominant fraction of the organs would come from the poor in a free market. Most of the organs used for live transplants are still donated by relatives or friends. Scenes wheret volunteers would almost entirely consist of low income families are inaccurate as many poor people would have organs that would not be acceptable in a market system because of organ damage due to drug usage,various diseases and over consumption of alcohol.

Some critics are worried that as a side-effect of legalizing organ trading the total number of organs available for transplants might decrease as it would sufficiently lower the number of organs donated altruistically as there would be plenty of other organs available on the free market.That scenario is extremely unlikely since only a minority of potentially usable organs are available for transplants currently. Compensating people financially for donating their organs would enormously widen the scope of the potential organ market.

If we do not legalize organ trading, we are indirectly helping the black market of illegal transplants to flourish, with poor clinical results for many patients and exploitation of the poor. In the black market, the quality of the surgeons and hospitals is generally very low, drastically reducing the quality of the organs sold and the compatibility with the recipient's organ. If we choose not to legalize organ trading , the desperate , like Mr. Tang Wee Sung, will have no other choice but to continue to turn to the black market. We have to realize that by criminalizing organ trading, we do not eliminate it but instead breed a black market with the middleman taking the largest portion of the amount which the grateful patient is willing to pay the donor.

In conclusion, organ trading is the most effective method in enabling those in need of organ transplants to receive one much more quickly than under the present Singapore system. I find the cons of allowing the sale of organs insignificant, when weighed against the thousands of lives that would be saved by the jump in supply of organs.