This week’s “Daily Journal” guest columnist is Donna Martinez, associate editor of Carolina Journal.
Could you cut off your own leg to save your life? This man did. Another brave soul amputated his arm when faced with no other choice. If death was the alternative, I’m convinced I could pick up a knife and do what was needed to stay alive.
What if it wasn’t your life, but your pocketbook, that was at issue? If you were offered money for — literally — a piece of yourself you could technically live without, would you succumb to the desire for cash?
It’s done routinely in Iran, where a market for kidneys is alive and well, as discussed in two academic papers summarized recently in The Wilson Quarterly. Willing donors, mostly poor, meet willing buyers, some poor and some not. Transplant candidates can be matched with donors through a charitable foundation. Both parties agree to a flat fee.
Thankfully, paying donors for organs and tissues is illegal in the United States, whether the donor is alive or deceased, per the 1984 National Organ Transplant Act. Programs like the one in Iran, and those operating in other countries, are macabre. They turn my stomach, despite my advocacy for market economics.
Many free marketers disagree with me — some work at the Locke Foundation. They have reasoned arguments and sad stories they say support letting a market for organs develop in this country. Using their rationale, Iran’s program shows the power and beauty of the marketplace to meet needs, having eliminated the waiting list for kidneys in Iran. Indeed, reports say more than 20,000 transplants have taken place since the Iranian kidneys-for-sale program began in 1997.
They’re right on that point. A free-wheeling market will always produce benefits for both parties in the transaction, as those seeking a product or service find those who have it for sale. Yes, I’m an ardent believer in markets.
But despite its efficiency, buying and selling organs is part of a small category of activities that go well beyond the bounds of morality and ethics. My free marketer friends fail to give sufficient weight to the fact that human beings aren’t commodities. No one should be bought and sold like a sliced-up loaf of bread.
It mocks human dignity and the sacred nature of life. Our society already engages in enough of that.
That’s why we’ve placed societal and legal boundaries on a limited group of activities such as human cloning, euthanasia, and embryonic stem cell research. Buying and selling body parts should stay in this box.
Regardless, intellectual honesty requires me to acknowledge a stark fact: The voluntary system of organ donation in the U.S. doesn’t meet the demand. As of June, 2,876 people were waiting for an organ or tissue transplant in North Carolina; 75 percent of them need kidneys. Nearly 72,000 kidneys are needed across the country, and kidney disease is growing.
Rather than trafficking in organs, we should have a serious consideration of “presumed consent,” which is now in place in several European countries. Under presumed consent doctrine, every person is presumed to be an organ donor at death unless they’ve expressly opted out.
I once opposed this policy, but have come to believe it is a moral alternative that preserves an individual’s freedom to decide yes or no, and doesn’t move us into a cash-for-life marketplace.
For those who can’t fathom their organs inside another living person, there’s a way to contribute voluntarily to science and justice right here in North Carolina. Western Carolina University recently opened its Forensic Osteology Research Station (FOREST). Only the second in the U.S., FOREST will study the decomposition of human remains.
The goal is to help law enforcement by adding scientific underpinnings to areas such as the circumstances, surroundings, and time of death. As John Wiggins with the North Carolina Justice Academy told the Charlotte Observer last month, “I have no doubt that it will benefit law enforcement in helping us to clear murders.” WCU needs donated bodies.
My policy suggestions won’t eliminate the U.S. organ deficit, but they’re a start. We must allow each of us to retain the right to decide what we do — or don’t do — in the private and consequential area of life and death. In this age in which money can buy just about everything, we should also protect moral and ethical boundaries in limited circumstances. That means having enough respect for life not to add kidneys to the “for sale” list.