Organ donation has been widely practiced in the healthcare industry recently in an attempt to help diseased people or even save them. The transplantation procedure is “a surgical operation where a damaged or nonfunctional organ in the human body is removed and replaced with a new one” (Choudhury, 2021, p. 7). The lives of many patients in critical conditions may depend on donation, which is why the healthy organs of other people can be transplanted to achieve a positive medical outcome. Primarily, the events providing a person with an opportunity to donate their organ or organs usually involve that person’s death: people who are about to meet their end can preliminarily make a decision to donate some of their organs to those who require them. Despite the potential advantages of transplantation, it is also associated with several ethical issues, especially those related to the organ-trading market, which involves buying and selling organs for money. Selling organs is unethical according to the ethical principles of respect for autonomy, non-maleficence, and justice, but the recipient can choose to reward their donor monetarily.
Unethical Aspects of Selling Organs
First of all, it is essential to note that buying and selling organs within a black market is not only illegal but also completely unethical and dangerous. The organ market is restricted in most countries, including the United States: Congress approved the National Organ Transplant Act in 1984, prohibiting the sale or purchase of human organs (Choudhury, 2021). Therefore, people cannot (legally) and should not (ethically) sell or buy organs.
The demand for organs increases nowadays, leading to the introduction of different policies, laws, and ethical principles related to organ donation. One of them is the respect for autonomy principle, stating that respect for involved people should not be the cost for organ donation (Choudhury, 2021). Each human has their own dignity, and it does not favor organ donations involving money since they lead to the person’s degradation. The desire to help other people with one’s body parts should be founded on a sense of altruism, and the corresponding procedures are supposed to be based on generosity (Choudhury, 2021). The process of making a decision to give one’s organs to another person in need of them involves pure intentions and determination to help people and save lives. Therefore, even a single thought of doing so for money may make people lose their self-respect. Many researchers even report that donors may “experience social stigma for having sold a part of their body and suffer emotional and physical damages” (as cited in Choudhury, 2021, p. 8). Thus, selling organs for money can have dangerous consequences for donors.
Financial gains from organ donations can also influence donors and give them the wrong motivation to make a particular decision. When someone chooses to give their organs to another person, their intentions are based purely on the desire to help that person and improve their health condition. Therefore, such a donor is interested in ensuring that their own organs are healthy enough to be provided to a particular recipient without potential dangers to their health. The donor, in this case, will be willing to undergo every required medical test to analyze their condition and make a decision on whether their organs can be transplanted to a specific patient. However, if people donate their organs in order to receive a sum of money, they may be less concerned about the recipient’s safety. For instance, they can lie to the doctor about their current condition or previous history to ensure that their organs will be accepted, thereby violating the principle of non-maleficence and endangering both the recipient and themselves (Choudhury, 2021). People who donate organs for free can be trusted more by clinicians and patients.
The principle of non-maleficence involves avoiding harm not only to the recipient but also to the donor, and donating organs for the wrong reasons may be dangerous for them, as well. People may be willing to give their organs due to different circumstances: for example, they cannot provide their families with enough food, or one of their children needs an expensive operation to cure a severe medical condition. In this case, people may ignore their own health and disregard the negative consequences donating a particular organ may have on them. For instance, the removal of both kidneys can bring crucial damage to the donor’s body, and the ethical principle of beneficence does not justify such a donation: many surgeons argue whether it is ethically correct to remove one person’s body parts to promote the others’ well-being (Choudhury, 2021). Nevertheless, people in dire need of money may not care about their own bodies, donating organs and endangering their lives and health.
Another important ethical principle associated with selling organs is the principle of justice, which, in the case under discussion, primarily concerns the gaps and differences between poor and wealthy populations. According to Choudhury (2021), the marketing aspect of organ donation appears as an immoral and disrespectful practice due to various socio-economic challenges faced by poor and uneducated people. Such people may experience a certain amount of pressure for the reasons mentioned previously, and they would also have lesser chances of obtaining vital organs if their health were in a critical condition. Wealthy people, on the contrary, “will always enjoy undue advantage of procuring organs because of their financial positions” (as cited in Choudhury, 2021, p. 9). As it is known, justice has always been a significant aspect of modern ethics, meaning that the corresponding principle should be considered appropriately. The opportunity to sell organs will make it easier for rich people and more difficult for the poor to obtain them, creating injustice in the healthcare industry, which would be unacceptable.
Monetary Rewards for Organ Donation
However, there is an ethical way of receiving money for donating organs which involves the recipient’s will to thank the donor and reward them somehow. Suppose a dying person gives their consent to transplant their particular organ upon their death to another person who needs it critically due to their medical condition. The recipient’s health significantly improves after the transplantation procedure, and they survive and return home from the hospital, feeling grateful to their savior, who has now passed away. In order to express their gratitude, the recipient decides to send the donor’s family members a certain sum of money or any other material rewards. Such a situation does not violate primary ethical principles discussed earlier since it does not actually involve “selling” organs. Sending money to the donor’s family is the recipient’s own decision, and it was not the donor’s initial intention to take payments for their organs. They did it purely out of their will to help someone, meaning that this case does not involve any form of commercial trade, and it can be ethically justified.
Nevertheless, the situation changes if the donor is not a dying person – for instance, they only donate one of their kidneys and continue living, but the recipient decides to send them some money as a token of their gratitude. The act of selling organs is also absent in this case, but it would be unethical from the donor’s side to accept the money. According to the ethical principle of respect for autonomy mentioned before, paid organ donations lead to degradation (Choudhury, 2021). In other words, even if the recipient tries to reward their donor after the operation, they should not accept any money as it would be unethical.
The Opposing Argument: Rights and Freedoms
An opposing view states that an individual is supposed to have full right over their body in terms of donation, provided that the corresponding decision is not forceful. Some people suggest that “it is the freedom of the donor to sell organs and it is also the freedom of the recipient to buy the organs” (Choudhury, 2021, p. 8). The supporters of that viewpoint believe people should make their own decisions regarding their organs, and it is their right to request money for the donation of their body parts.
However, that position contains severe mistakes that modern ethics cannot tolerate. The ethical perspective suggests that “we as a part of the human society, place ourselves in a substandard position, if we allow vulnerable persons to sell their body organs on the grounds of commodification” (as cited in Choudhury, 2021, p. 8). People, being the owners of their bodies, supposedly indeed have control over their organs, but they also have the right to their moral dignity’s preservation. Everyone should remember that turning their own organs into trading goods can have negative consequences, such as losing self-respect. Furthermore, the legal perspective suggests that people actually do not have the right to sell their organs, as per the laws mentioned in the previous sections. The National Organ Transplant Act of 1984 prohibits selling organs, and this regulation was created based on ethical concerns (Choudhury, 2021). Overall, the fact that people own their bodies does not make organ selling ethical.
Solution to the Problem
The solution to the ethical problem of selling organs would involve promoting various practices to prevent organ trading. People working in hospitals and transplantation facilities should constantly inform donors and recipients about transplantation ethics, reminding them that using money in the procedure is unethical. Moreover, additional policies and regulations within the law could decrease the activeness of the illegal organ market. People should understand that selling organs is wrong from both legal and ethical perspectives.
Ethical principles of respect for autonomy, non-maleficence, and justice suggest that selling organs is unethical, but the recipient may somehow reward their donor in particular cases. People’s choice to give their own organs to ease someone’s condition or even save their life is an act of goodwill involving the sincere desire to help others. Giving consent for body parts’ transplantation involves generosity, and people’s organs should not become trading goods. There would be many negative consequences, including population degradation, inequities between poor and wealthy people, and dangers related to the health of both donors and recipients. The recipient, however, can choose to thank their donors by sending their families some monetary rewards after the transplantation procedure, which would not be unethical since it does not involve any act of commercial trade. Nevertheless, the decision to donate organs should be based purely on a person’s will to help someone, not on the desire or need for money.
Choudhury, A. R. (2021). Organ donation: Moral ethics and human values. Adhyatma: A Journal of Management, Spirituality, and Human Values, 5, 7-14. Web.