Panel debates whether paying organ donors would save lives

Panel debates whether paying organ donors would save lives

Jan 18
By Nanette Light

(AXcess News) WASHINGTON - The billboard reads "Cash for kidneys." A sign in the window says "Kidneys for sale."

If supporters of a paid organ donor market have their way, Americans could see signs like these and receive money for donating a kidney or part of their liver. That could increase the number of organs available for transplant.

"We should reward living people who donate organs, and then it will encourage others to do the same," said Dr. Sally Satel, resident scholar at the American Enterprise Institute and psychiatrist at the Oasis Clinic. Satel received a transplanted kidney from a friend in March 2006.

She spoke Wednesday at a panel discussion on the subject at the American Enterprise Institute

But roadblocks - the law and ethics - stand in the way.

Donating organs for money is illegal in the United States. But beyond law, opponents of a donor market said, adding money to something that is supposed to be a gift objectifies the human body.

Two speakers quoted Pope John Paul II has having said, "To use the body as an object is to violate the human dignity of the person," in his opposition to selling organs.

Alvin Roth, a professor of economics and business administration at Harvard University, presented his paper, "Repugnance as a Constraint on Markets."

The paper delves into transactions that produce disgust from the public, including prostitution, dwarf tossing, eating horsemeat, buying babies and selling organs. The paper also discusses how society's aversion to particular transactions affects the market.

"Often, it is the money plus something that is repugnant," Roth said. "Even though the something by itself might not be repugnant."

People think differently when trading something for money versus a comparable good, even if the money and value of the comparable good are equal, said Paul Bloom, psychology professor at Yale University. Bloom said introducing money makes the transaction more formal and sometimes unappealing.

"Some things are OK to give for free, like kidneys, but you are not supposed to give them for money," Bloom said. "The biggest taboo is putting a dollar value on life. This is difficult and repugnant."

Satel said that, when money is involved, many people don't think it can be accomplished in an ethical fashion.

The problem with ethics arises when a person in need of money chooses to donate an organ they wish to keep, said transplant surgeon Dr. Michael E. Shapiro, vice-chairman of the ethics committee for the United Network for Organ Sharing. UNOS coordinates organ donation and donation policies in the U.S.

"Anytime you get into payments, you can take advantage of people," Shapiro said in a telephone interview.

Shapiro said the majority of people who give a kidney do so to save a family member, and a small group of people donate to strangers. Beyond these groups, Shapiro said the only other reason someone might give a kidney is because they are desperate, but he said that's a bad idea.

"In order to live, you need money, and the only way they can think to do that is to sell an organ," Shapiro said.

Satel said to avoid taking advantage of the desperate and poor the government could offer tax incentives, health insurance or payments over a period of time.

"If you don't offer what's attractive to desperate people, which is to say cash now, you weed out that problem, plus you build a three- to six-month waiting period, so people are well-informed about what they are doing," Satel said.

Shapiro said financial incentives for organs may seem appealing to the public if they are disguised as health insurance for living donors but are not appropriate.

"Maybe we should just provide health care for all Americans and not make them fork over a kidney to do so," Shapiro said.

Satel said 67,600 people wait for a kidney. Last year, 16,470 people received kidneys, she said. Half of the donors were deceased, and half were living. Satel said 4,100 people died waiting.

Satel stated in an article, "Organs for Sale," that organ donations remain steady, despite public education.

But Shapiro rebuked this claim. He said from 2003 to 2006 organ donations rose by 30 percent.

"We are not quite where we were five years ago, even though people say donations are stagnant," Shapiro said.

Satel said emphasizing the greater good - saving a life - would raise support for compensation for organs and decrease people's aversion to the transaction.

"This is not a huge ethical concern most people have," Bloom said. "In some ways, I think this is easier than things that really do repel us, like eating horsemeat."

There is a resistance to money, said Michael Novak, an author and the George Frederick Jewett chair at the institute.

But he said there is more to be done through soliciting donations, adding there is no need to provide financial incentives to people until all other options have been exhausted. More publicity is necessary to point out the gap between the number of kidneys available and the number needed.

"We should trust the generosity of the American people before we turn to less attractive means," Novak said.

Source: Scripps Howard Foundation Wire