Encourage free market in body organs by Bruce Korol‏

Procuring transplantable organs from donors in a country that is always facing a shortage is a constant challenge and it's clear the problem requires another way of thinking.

The Journal informed us about the just-announced $200,000 provincial grant that will establish a reimbursement program to cover the expenses of living donors.

Iran has ended their waiting list for kidneys by paying living donors, while Singapore has approved a plan that provides significant financial payment to donors. Israel gives living donors priority if ever they personally need a transplant.

Jurgen de Wispelaere, a medical ethics researcher from the Universite de Montreal, recently suggested that tax credits be used to encourage organ donation. In his paper, de Wispelaere proposed the government create an incentive by providing a tax benefit to a second consenter for signing up to be a living advocate.

Forget about this and other slim government incentives to coax potential donors and let's open up what many would reflexively find repulsive: a free market in body organs.

Right now it is illegal to buy and sell organs in Canada. Each province has its own act. Alberta's Human Tissue and Organ Donation Act states: "No person shall offer, give or receive any reward or benefit for any tissue, organ or body for use in transplantation, medical education or scientific research." Violating it could result in jail time and/or a hefty fine.

Though donations have actually increased and provinces have tried to improve organ donation by raising awareness and reimbursing living donors for expenses, shortages persist.

Canadians who need a kidney, for example, face lengthy wait times for a transplant. As a result, many wealthy Canadians take their chances and travel abroad to purchase their organs.

Faced with a lengthy waiting list, it's an understandable reaction for an ailing individual, even if this entails further health risks and an uncertain outcome.

A shortage and a resulting black market naturally develop when the government prohibits an activity. Economists will tell you the purchase and sale of organs will increase organ donations and alleviate shortages.

In an open market, explains economist Gary Becker, the prices of organs for transplants would settle at levels that would eliminate the excess demand for each type of organ.

Donald Boudreaux, economics professor at George Mason University, says, "If organ sales were liberalized, the availability of organs would rise and their prices would fall. Transplant surgery would become more affordable and, thus, more lives -- not only of the rich but of all classes -- would be improved and saved."

Boudreaux also points out that prohibiting a donor from receiving compensation artificially increases "the marginal value of transplantable organs ... prohibiting organ donors from personally profiting keeps the quantity supplied of such organs lower than it would be in a free market."

Living donors could contract with those who need a transplant or an individual could sell the right to harvest their organs after they have died. The altruistically-minded can still donate their organs for free whether they're alive or dead.

Of course, the proposed practice of buying and selling organs is laden with bio-ethical concerns and has a tawdry stigma attached to it.

Critics argue that it might lead to the impoverished selling their organs to wealthy patients, that it offends human dignity or that it violates our shared humanness.

However, if there's a voluntary exchange between a recipient and donor, why should you or the government care?

If there's a recipient who wants to pay for an organ and a living donor who is willing to sell their organ why prevent it? Is it ethical to play God and forcefully condemn donors to poverty and potential recipients to death?

A person's autonomy should be respected. It doesn't matter whether the donation is motivated by charity, financial desperation or unmitigated greed and whether the selling of organs offend the moral sensibilities of the religious, medical or Canadian community, organ donation is a personal choice.

So, let people work out the ethical implications of selling their body parts and increase the supply by allowing a free market in organs.

Bruce Korol is a Calgary lawyer.

© Copyright (c) The Edmonton Journal

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