Emerging technology often forces us to face difficult ethical decisions—and sometimes it exposes bad ethical positions. That’s what’s happening in the realm of human organ transplantation.
For the past 40 years since transplantation really became successful, the guiding ethical principle behind organ donation in the U.S. has been altruism. It is against the law for organ donors to benefit financially from their donation. If someone wants to donate one or more organs, either while still alive or after death, the donor must do it out of the goodness of his heart.
Of course, that prohibition against financial gain isn’t applied to the medical community. Organ transplant surgeons make a lot of (well-deserved) money. The hospital and other providers make a lot of money. The organ recipient receives enormous benefit.
Only the donor is punished by the high-minded altruists.
That stand may have been allowable in the early days of organ transplantation because little harm was being done. Transplantation was new, complications were many and only a few places could handle the procedures.
Today, however, we have many highly skilled transplant physicians. And there are thousands of patients waiting for an organ—an organ they can’t get because there is a shortage of suitable donors.
The United Network for Organ Sharing says that there are more than 92,000 people waiting for an organ. There were 9,400 transplants between January and April of this year, but only 4,800 donations.
In standard economics, when demand exceeds supply, it means the price is too low. So economists would say let the price rise until supply and demand reach equilibrium. But we can’t do that here because the altruists would rather let thousands of people die rather than let donors receive any financial benefit.
Fortunately, that is slowly changing. More and more economists and physicians are speaking out against the status quo.
A number of alternative forms of remuneration have been proposed. For example, the organ recipient’s health insurance might pay for the burial expenses of the donor, either immediately or in the future.
And groups are forming to help drive that change. LifeSharers, led by Dave Undis, has managed to pull together a number of the brightest thinkers in the country trying to push the agenda. Indeed, LifeSharers has its own alternative plan on the table.
And increasingly the media are willing to do “fair and balanced” articles on the topic of donor compensation.
Exploding medical technology has exposed the altruists’ destructive principles. If we ever hope to reduce the shortage of human organs that causes so much needless suffering and death, we will have to find some way to pay for them.