The Black Market of Foreign Kidney Transplants
The black market of foreign kidney transplants is an ethical issue that is enduring a lot of heat in our society today. In places such as Moldova, China, Egypt, Pakistan, India, Israel/ Palestine, and Kosovo, there are people who have reached a point in their life where they have reached the bottom of the poverty level and out of the need to survive, apply to sell their organs to North American buyers. Many people victimize the buyers, but it should be recognized that they too are dying, and they too are at a point in their life where they are forced to make a life and death decision.
Many Westerners of today’s society hold the view that the buying and selling of kidneys is, “a kind of global social tragedy” as recorded in an article on CBC the Passionate Eye. But can one who has not experienced what another is going through rightly condemn the moral decision of those involved?
On the one hand, there is the sad reality that there are multitudes of people in Eastern countries that are living with abject poverty and malnutrition. These people are in circumstances that the average Western Canadian cannot relate to, and so cannot rightly condemn for their desperate actions.
On the other hand, there is the Canadian of varying age, stuck on dialysis with no family to donate a desperately needed organ. They are faced with the knowledge that the waiting list for a kidney will take years, and that it is quite possible that in that extended time, their health will deteriorate enough that they will no longer be eligible for the transplant. And so if, in that state of mind, they do pay a man or woman from a foreign land for their freely given organ (at the same time lifting that family out of the poverty that they had so desperately wanted out of) can their actions really be condemned?
It is not as if the foreign family signed up for the donor list without heavy consideration. They knew the risk the operation could have on them, and the fact that they signed up anyways shows how much they have to gain from taking part in the trade. And so in this situation, both sides are happy – on both, life is gained.
Much of the problem with this black market stems from an idea that these trades create a two-sided world. On one side, there are those who are rich and buy organs off of desperate foreign individuals, and on the other side there are those who are being taken advantage of because of their desperation. That is the exact reason why this matter is so controversial. Human morals vs. Human desperation.
Many ethicists debate whether or not the black market of foreign kidney transplants is an abhorrent way of devaluing life, or if it could possibly be a way to sustain the lives of many around the world. Stephanie R. Murphy, an internet columnist for LewRockwell.com outlines some of the objections raised by ethicists against a human organ market. To begin with, one of the objections is as follows: “An organ market would encourage organ thieves. It also encourages the killing of comatose and brain dead patients to harvest their organs and make a profit.” Contained in that statement is a logical fallacy; it’s like saying, ‘taking money out of a bank account only encourages people to rob banks’. The statement is also making a biased implication that the organ market is immoral, and uses that bias to insist that if a person makes one immoral action, they will be compelled to make more.
Another concern brought up by ethicists is that selling organs is dangerous, even for those organs which can be removed without killing the donor (for example: the kidney), and so by completing the transplant, the life of the patient is placed at less of a value than that of the recipient. Stephanie R. Murphy responds by asking, ‘Isn’t it more dangerous to have black market organ transactions?’ The point is a fair one. As long as the buying and selling of organs is stigmatized by society as it is, the transactions will still continue to go on in secret, but will be in less stable and potentially hazardous environments. By removing the stigmatism against the organ market, the operations can then be supervised by surgeons in safer environments and the health of the patients can be assured.
When it comes down to it, donating a kidney for money – or any human organ for that matter – is a free choice. As for the objection; ‘foreign kidney transplants devalue the lives of foreigners’, can it not be turned around to ask, ‘why should foreigners not get the right to make their own choices? Is it not devaluing their lives to say otherwise? To restrict them from the ability to make that choice?’
As with all decisions, it does come with a price. In 2002, an article was published in the Journal of the American Medical Association that examined the effects of offering payment for kidneys in India. The results showed that 96% of people sold their kidneys to pay off debt, that 76% still had debt six years later, that 86% of people reported deterioration in their health status after donation, and that 79% would not recommend to others that they sell their kidneys.
Granted, this survey was only taken in India, not any of the other donating countries, and couldn’t possibly have included all of the donators. But the results are still sobering and provide an alternate viewpoint on this complicated issue.
It must also be taken into account that these statistics do not reveal how those surveyed used the money that they earned, how many people were included in the survey, whether or not there were other factors that could have affected their health besides the transplant, or the degree in which their health deteriorated.
Also, unlike the results shown above, TED Case Studies states that India displays a dramatic success rate of kidney operations. The study also says that “Supply and demand created a marriage of un-equals, wedding wealthy but desperate people dependent on dialysis machines to those in India grounded down by the hopelessness of poverty.” Differing from the study shown in the previous paragraph, this case illustrates a symbiotic relationship, benefiting both sides.
Consequentialism is the ethical belief that an action is right if it promotes the best consequences, and that the best consequences are those in which happiness is maximized. As for the black market of foreign kidney transplants, if the results shown in the Journal of the American Medical Association are viewed as an irregularity, I believe that the organ market in a way does create the greatest amount of good: both people are saved. A dying North American is given a life, and a foreign individual is given the chance at one. Yes, perhaps the idea of selling body parts seems inhuman and immoral – perhaps it is – but if both parties are consenting, and both are aware of what they are agreeing to, and if the outcome is better for everyone, can their decision really be condemned?
On the other hand, according to the Virtue Theory of Ethics, (for example, Aristotle’s Moral Theory) an action is right if it is what a virtuous agent would do in the circumstances. I cannot manage to coincide the term ‘virtuous’ with the black market of foreign kidney transplants. A word to better describe it is ‘necessity’ and ‘survival’. But virtuous? I don’t think it can be described as that. In that case, there are many ethicists that would be opposed to the idea of this black market, above all: Aristotle himself.
But I also believe that there comes a time in life when virtue is not always an easy option, where need becomes the only thing left that drives us. That the most ancient and influential part of us burns with an innate need to survive. And if the survival of the greatest number of people can be achieved through foreign kidney transplants – whether it be through saving the life of a desperate North American, or the life of a desperate starving foreign family through less than desirable means, does the ends justify the means?
It is a question that is not easy to answer, not until we ourselves are placed in that position – perhaps not even then. But until that moment all we can do is agree to not judge too quickly, learn as much as we can, and reflect on the information we have gained.
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