There are a number of objections that people raise to allowing financial compensation to be given to organ donors. Below is a brief overview of the objections and responses to them. These issues are discussed in depth in articles on our ‘Articles’ page.
I. ‘Selling Organs is Illegal!’
In 1984, when Congress voted to outlaw giving “valuable consideration” to families of deceased donors and living donors, there was no nationwide procedure for procuring and distributing organs. The idea was to see whether sufficient numbers of people would voluntarily donate organs to meet the need of sick patients. Twenty five years later, it is painfully clear that relying solely on altruism is misguided. More than 7,000 American citizens die each year because an organ does not become available for them. Sometimes laws outlive their usefulness. Creative solutions, such as regulated donor compensation, must be implemented and tested as a way to increase the supply of transplantable organs. Just because it’s currently illegal to sell an organ is not an argument for it being inherently immoral.
II. ‘Medical Risk for Kidney Donation is High!’
There are two medical risks that accompany donating a kidney: risk of the surgery and risk of living with one kidney. As to the first, the surgery called a ‘Tummy Tuck’ is more dangerous than donating a kidney (see our Articles database and search for “Comparative Risk of Surgeries”).
As to the second, people live the same average life span living with only one kidney whether they were born with only one kidney or they donated a kidney. Since society encourages altruistic kidney donation, society knows the medical risk to the donor is minimal. And obviously there is no medical risk involved if we are speaking about offering incentives to families for the organs of someone who is already deceased.
III. ‘Selling Organs Commodifies the Human Body!’
Society allows for commodification of the human body when it can help other people, such as selling hair, blood, and sperm or eggs to help people with fertility treatments. In the 1800s, the concept of Life Insurance was rejected by society as commodification of the human body because it was seen as ‘immoral’ to evaluate life and limb in terms of money. Once it became clear that Life Insurance could significantly help orphans and widows and benefit society, it became legalized.
IV. ‘The Kidney Donor’s Motives are Impure!’
Motive is comprised of many factors; it is never singular in nature or pure. A paid fireman runs into a burning building because he wants to help others and because he is getting a salary. Physicians spend many years in medical school to ultimately help people and to make a good living. There is nothing immoral about getting money to incentivize admirable behavior. When a fireman/firewoman or a physician saves a life should they be looked down upon because they took a paycheck?
V. Paying for Organs will Crowd Out Altruistic Donors
Some think that offering financial compensation for organs will diminish altrustic donation. This conclusion is based on the assumptions that altruistic donors will be ‘turned off’ from donating given the commercialized flavor attached to donation and as a result of their belief that there is no need for altruistic donation since other people will step forward to sell their organs. There is not enough real-world data, however, to support this assumption that compensation will crowd out altruistic donation. And even if it were true, most likely the financial incentives offered will attract even more people to donate organs resulting in a net net increase in organ donors. In Iran, for example, when paying for kidneys became legal in 1988 the percentage of people donating organs remained stable at 12%.
VI. Slippery Slope: Payment for Organs Invites Kidnapping and Murder
The slippery slope argument is that if payment for organs became legal it would encourage kidnapping and killing of people for their organs. First, this argument – as all slippery slope arguments do – diverts attention from deciding whether or not payment for organs is immoral.
Second, just because there is concern for consequential abuse does not mean the abuse will happen. (In the U.S. during the early 70s, for example, anti-abortion advocates warned that legalizing abortion would open the door for infanticide – that never happened.) Thirdly, procedures could be put into place that would prevent it (only buying organs from living donors who are made aware of the risks, who have had a year cooling off period, etc).
Fourthly, there is currently children labor working in coal mines. No one advocates deceasing from using coal-powered electricity. What is advocated is stricter oversight and regulation to make sure there are no children working in mines.
Lastly, legalizing payment will remove the penal risk and the middleman thus reducing the price of an organ to the point where it would not be worthwhile for anyone to try to procure one illegally. In fact, it is only now that this is illegal to pay for organs and it happens anyway where prices are artificially inflated where there is such a concern.
NOTE: Please note that none of these objections apply to a donor who is already dead. At the very least, direct financial compensation should be given to families who agree to donate the organs of a deceased family member.