Ethics of Paying for Organs and Tissues: Ethical Theory and Principles

Ethics of Paying for Organs and Tissues
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Abstract
The development of policy has always been a core factor in promoting the advancement of any sector. As far as the transplantation of organs and tissues is concerned, this is also the case. There have been concerted efforts to facilitate efficient organ or tissue donations and transplantations and many of these efforts have been successful. However, the frameworks within which transplantation occurs and is regulated, UAGA of 1968 and NOTA 1984 impose a ceiling on just how many people can benefit from organ and tissue transplantations. The development of waiting lists for potential organ recipients has played a significant role in stifling the number of people that can benefit from transplantation. In this sense, there is a need to transform the way organ and tissue transplantation is viewed and approached. One of the core ways in which this perspective can be changed along with helping millions of individuals is through the legalization of the sale and purchase of organs and tissues. Although current policy and legality frameworks do not support this approach, much can be gained from deliberating on the legalization of organ sale and purchasing. This paper looks to explore some of the ways in which organs and tissues can be sold and purchased on a free market basis. In doing so, millions stand to enjoy healthier and prolonged life from the use of purchased organs and tissues. Similarly, millions stand to benefit from the sale of organs, essentially creating a favorable situation for all.
Ethics of Paying for Organs and Tissues
Introduction
In a world that is continually facing more healthcare challenges in terms of terminal illnesses, organ transplants have become a major source of hope and encouragement for millions. Because of this, there is an increased desire by many potential organ recipients to expedite the process through which they receive an organ and tissue transplants. Unfortunately, the processes of organ donation and transplantation are quite clear and prohibit the sale and purchase of organs and tissues as needed. While the law predominantly prevents the sale of organs and tissues, it is worth noting that the ethical perspectives and conundrums associated with this practice work together to form the single the largest barrier in opposition to the sale and purchase of organs and tissues across the world (Jensen, 2011). As current regulations continue to prohibit this practice, millions of people across the world in need of organ and tissue transplants die while waiting for their turn to benefit from the generosity of others. This raises critical questions with regards to the ethical soundness of this practice, and this paper hopes to provide a holistic perspective on the issue.
Issues Surrounding Paying for Organs and Tissues
Across the world, the donation and transplantation of organs and tissues have been a significant issue that has continued to be debated with numerous viewpoints. This is mainly manifested in the form of ethical considerations over the practice of donating and transplanting organs and tissues (Davis & Crowe, 2009). Along the same line, the more controversial proposed practice of selling and purchasing organs and tissues as needed continues to fuel endless debates. One of the main issues in this regard is the ethicality of selling one’s organs and tissues. This practice seeks to commodify the human body, and by existence human life. In this way, many religious and ethical experts have argued fiercely against the practice of selling one’s organs and tissues as needed.
On the other hand, many realists have posited that the world is full of people that need organ and tissue transplantations in order to survive (Veatch & Ross, 2014). Similarly, the world equally experiences the death of millions of healthy individuals due to a variety of causes. In most of these individuals, some of the vital organs such as kidneys, the heart, and the liver are in great shape and capable of transplantation (Ashcroft, Dawson, Draper, & McMillan, 2007). By choosing to forego the transplantation of these healthy organs into the bodies of individuals that are in desperate need of said organs, this practice essentially lets the terminally ill die and deprives them of an opportunity to fight for life (Fisanick, 2009). As far as this category of people is concerned, such actions are not congruent with the healthcare principle of beneficence.
Taking into account the main two opposing perspectives above, the regulation of such a practice poses significant ethical, healthcare, and religious headaches that prove extremely difficult to address (Beauchamp, 2003). This is because allowing the sale and purchase of one’s organs and tissues essentially allows for the commodification of human life and his human body. Because of this, the laws of demand and supply will ultimately take control of this market and in the process sanction organ harvesting, trafficking, and cold-blooded murder as demand for organs and tissues increases (Bakdash & Scheper-Hughes, 2006). The seemingly impossible task of policing such laws and regulating those involved strengthens the case against the legalization of purchase and sale of organs and tissues. In essence, this debate is one that pervades the entire society and one that has a shirt, medium, and long-term consequences with great impact on society (Turner, 2009). For this reason, it becomes imperative that the question of the sale and purchasing of organs and tissue is answered conclusively (Biller-Andorno & Capron, 2011). In order to effectively achieve this, the various dimensions and ethical principles involved need to be comprehensively assessed.
Dimensions
Ethics
As far as bioethics is concerned, the sale and purchase of organs and tissues raise serious questions. The first and arguably the most important question revolves around determining the set of conditions that an individual has to meet before they are allowed to engage in the sale of their organs (Nucci, 2018). This is an important question because it helps determine some of the core factors that will contribute to an individual engaging in self-deprecation and commodification that could lead to death (Beauchamp, 2003). Similarly, many opponents of this principle posit that it is virtually impossible to establish regulations and protocols regarding the sale of organs. For instance, what rationale is used to determine that an individual is allowed to sell say a kidney and not a pancreas or any other organ? At the same time, how will such laws establish the minimum or a maximum number of organs that an individual is allowed to sell, at what price, and to whom? In essence, the core issue involved in the ethics of this practice is a value (Cherry, 2015). How is it possible to determine the value of one human being or their organs relative to another? This becomes impossible and makes it extremely difficult to navigate the ethical issues surrounding the sale and purchase of organs (Davis & Crowe, 2009).
Society
Another core factor that significantly influences this process is society and its perceptions, norms, and cultures. Across the world, different societies have different cultures and practices that influence their worldview as well as how they live and approach life and death (Fisanick, 2009). While the sale and purchase of organs and tissues would save millions of lives across the world, it would also result in a breakdown of social order and human bonds. Such a law can easily result in the eventual treatment of human beings as livestock that can be harvested at will (Greenberg, 2013). Such an approach equally transforms how society will perceive family. How will it be possible to ensure that the social bonds that keep families and the society together are maintained in an environment that values human life mainly due to its monetary value in terms of organs? In this sense, sanctioning the sale and purchase of organs and tissues stands to dismantle social bonds and result in a breakdown of society as it is known.
Economy
Economically, legalizing the sale and purchase of organs stands to have monumental financial ramifications (Beauchamp, 2003). Legalizing this practice would essentially subject it to taxation. In doing so, however, human beings will start to be treated like commodities, futures, and options on the course. While this would inject billions into the economy, it would equally ruin millions of lives seeing as it is virtually impossible to regulate such a tumultuous and subjective market (Turner, 2009). As far as the economy is concerned, the sale and purchase of organs stand to have significantly more benefits compared to drawbacks.
Religion
In terms of religion, the sale and purchase of organs are likely to have significant implications. The values and practices of different religions will significantly influence how the sale and purchase of organs are approached and whether it is accepted. In Christianity, the body is considered a temple of the Holy Spirit and Christians are urged to keep their bodies pure as a means of protecting the dwelling place of the Holy Spirit. As such, the mutilation of the body in the form of organ selling goes against every principle of Christianity. By defiling and mutilating the body for selfish gain, such a practice would be in perennial conflict with Christianity. This raises serious questions on the applicability of this practice, its feasibility, and its support from all vital factors of society including religion.
Education
In the case of education, the allowed sale and purchase of organs and tissues is likely to stimulate research and development initiatives. Over time, this is bound to ensure the significant growth of the industry in terms of developing best practices for organ harvesting and transplantation (Cherry, 2015). At the same time, the insights developed in this regard are also likely to be implemented in the harvesting and transplantation of other body parts, which will serve as an epitome of the commodification of the human body and human life by extension (Farrell, Price, & Quigley, 2011). In this way, life is likely to lose value and meaning, which is detrimental to the social order that has helped stabilize human societies for thousands of years.
Ethical Theory and Principles
As aforementioned, it is vital to assess the ethicality of the practice of selling and purchasing organs and tissues. This is mainly because such a practice is bound to have numerous ethical perspectives that can critically contribute towards the success or failure of such a bold step within the society (Cohen, 2013). The first and most critical ethical theory that should be addressed in this regard is the theory of utilitarianism. This theory advocates that the action whose outcome has the most positive results for all involved is the right action. As far as selling and purchasing tissues and organs is concerned, this becomes difficult to ascertain. While selling organs and tissues will likely degrade human life and subject millions of people to healthcare risks and challenges, it equally stands to save millions of lives among the patients that are in dire need of organ and tissue transplants and that are capable of paying for them (Jensen, 2011).
In this way, this approach stands to benefit only the wealthy as they will have an opportunity to access and buy the healthiest organs possible from the market (Rothman, 2002). This results in the discrimination of the poor seeing as they are incapable of affording such organs. Consequently, this practice does not ascribe to the principle of utilitarianism since its outcomes are not the best for all that are involved (Veatch & Ross, 2014). However, it is equally vital to remember that although this practice does not embody the values of utilitarian ethics, it does make an effort to save more people that are currently being saved (Rothman, 2002). By allowing the sale and purchasing of organs and tissues, millions of people that would have died before they received a donor organ are given the opportunity to live (Scher & Kozlowska, 2018).
It is also important to acknowledge the principle of autonomy in this issue. Once declared adults, human beings take responsibility for themselves and their decisions. At this time, people are free to engage in whatever they desire to provide; it is allowed within the legal confines of the law. This goes a long way towards providing freedom and liberty to individuals in choosing the path they want their life to take. In this sense, they exercise autonomy over their life (Beauchamp, 2003). By this measure and using this example, individuals equally have a right to determine what happens to their organs and their bodies because they are the ones responsible for them. This allows individuals to decide what to do with their bodies, and organs, as desired. Taking this into account, it becomes vital that the sale and purchase of organs and tissues are allowed. Not only will this provide millions with the ability to regain their health and contribute towards society, but it also stands to provide dignity to dying individuals who can sell their organs to improve the financial situation of the families they leave behind.
Although such action has unintended consequences, it is vital to remember that such a practice will be guided by the principle of non-maleficence (Ambagtsheer, Zaitch & Weimar, 2013). Although there will be instances of organ harvesting and trafficking, proper legislation will ensure that the ethical and the healthcare principle of non-maleficence is observed. By ensuring that only the qualified will be allowed to conduct harvesting and transplantation procedures, healthcare facilities can help contribute towards the realization of non-maleficence (Berman, Lipschutz, Bloom & Lipschutz, 2008). This is critical to the successful implementation of such an initiative.
Taking into account the ethical theories and principles outlined above, ensuring that potential sellers can sign consent forms that allow for the harvesting of their organs and tissues either upon death or as desired will greatly help the healthcare sector. In order to deter the abuse of this privilege, it can equally be established that all monies from the sale of organs will go to the family members of the seller in question (Jensen, 2011). This is a critical aspect of ensuring the successful development of this legislation. By this measure, it becomes possible to develop legislation that is aimed at providing individuals with an opportunity to sell their organs and tissues. At the same time, it gives those capable of purchasing organs an opportunity to live without having to wait on donations (Cohen, 2013). By ensuring that the family members of the donor predominantly realize the financial benefits of these sales, it then becomes possible to help the ill provide their loved ones with a better chance at life as they approach death (Wilkinson, 2011). Even in such instances that are crafted to work in the best interests of all those involved, it is inevitable that there will be individuals that will abuse the system and disregard the ethical principles designed to ensure successful regulation of the sale and purchase of organs.
Relevant Policy and Associated Barriers
At present, it is important to understand the policies that exist on organ donation and transplantation in the USA. The Uniform Anatomical Gift Act (UAGA, first enacted in 1968) presently governs the processes of organ donation across the USA. UAGA currently allows individuals to authorize the gifting of their organs before death or a surrogate of the deceased to authorize a gift after one dies. In this way, getting donors to agree becomes a central aspect of organ donation (Wilkinson, 2011). From UAGA and the National Organ Transpla...