Organ Donation: A Contentious Debate
Organ donation has been a contentious debate since it encompasses the harvesting of body parts from one person and the transplant to another individual, an undertaking which touches on human morality and ethics. The perception of organ donation as a controversial subject has seen the society fail to face head-on the crisis that is the American organ transplant system. The national waiting list for organ recipients has been growing with each new dawn at a time when transplant survival rates have risen steadily, with more than 90% of kidney transplant recipients alive five years after the transplant took place (Chatterjee, 1324).
The Growing Demand for Organ Transplants
For instance, there are more than 26,000 individual waiting for kidney transplant, 2,900 for heart transplant and an additional 35,000 waiting to receive other vital organs (Goldberg, 2120). The conventional waiting list before a transplant takes place according to the recent report published by United Network for Organ Sharing (UNOS) is five years (Chatterjee, 1324). This paper seeks to propose a lasting solution to the country's organ donation and transplant through adoption of a legislation that legalizes incentivizes donation of body parts.
The Ineffectiveness of the Current Organ Donation System
Problem related to donation of body organs and its impact
The current organ donation system that exists in United States does not satisfactorily supply all the vital body parts that are needed by its citizens. The ineffectiveness of the system is attributable to the fact that the current legislation governing body organ transplant, the National Organ Transplant Act of 1984 which was signed into law by President Reagan prohibits compensation for organ donations, limiting the donors to those driven by altruism (Goldberg, 2120). The legislation has made the process of procuring and distributing organs to patients inefficient since it has been incapable of matching the growing demand of recipients with new organ donors.
The physicians and health care practitioners in the country have also compounded the problem by expanding the criteria for transplantation beyond the conventional restrictions that had been placed such as age, and systemic disease (Chatterjee, 1324). The expansion has seen the number of potential recipients grow significantly, making it challenging to keep up with the ever rising demand for organs since the recipients range from children to the elderly in the society.
The society has been reluctant in embracing organ donation as a life saving endeavor because the transplant system is structured in such a manner that the donors have to go through numerous checks before they can be shortlisted for donation. In addition, the system limits donation to a small percentage of people within the society who are altruistic and well informed of the impact their body parts have on others (Veatch, 110). The government and the UNOS have been ineffective in developing an effective sensitization campaign that can educate the members of general public on the importance of donating their body organs and the various transplant options that exist (Gill, 137). The failure to inform and educate the people coupled with a limited number of people who can legally donate their body parts to others, has seen the national donation system descend into a crisis.
The Hard Moral and Ethical Stance
Body donations have also been incapable of keeping up with the growing demand for transplants because of the hard moral and ethical stance that is held by politicians and conservatives (Gill, 137). The failure to make changes on the legislations to allow for incentivized donors to come onboard is attributable to the perception that it will create social stratification within the society which will in turn lead to the exploitation of the poor (Eyting, Hosemann, " Johannesson, 57).
The notion that the people will not be capable of making informed decision and will be driven by the desire to make money, in donating their organs has seen motions to amend the legislation and allow for amendments to the current organ donation act. The ethical and moral hard stance although meant to make sure that the society does not lose its core values, has seen thousands of people die each year because they are incapable of getting much needed transplants. For instance, the recent statistics from UNOS elucidate that only eight people in the country receive organ transplants, while more than 150 people are added to the recipient waiting list (Eyting et al., 57). The figures indicate that the system has a deficit of more than 70 organ donations, a shortage that cannot be addressed using the conventional approach of altruistic donations.
A Proposed Solution: Legalizing Incentivized Donations
The lack of enough volunteers to meet growing number of recipients is a challenge that requires the federal government through the congress to rethink its approach to organ transplant and consider making changes to the existing system (Eyting et al., 56). The development of a new system that is radical and which does not limit volunteers to those willing to donate their organs for the sake of saving lives without getting anything in return, will help make sure that other members of the general public who are willing to donate but need to get compensated for their organs are brought onboard. The change in legislation will go a long way in helping reduce the waiting list and making sure that more lives are saved since people will be able to receive the vital transplants they need before their condition deteriorates.
International Solutions and the Role of Financial Incentives
The scarcity of organs donation is a global challenge and it is not confined to United States. Internationally however, there are various approaches that nations have adopted to make sure that they are in a position to meet the growing demand of new transplants and these include presumed consent, express consent and the incentivized system (Goldberg, 2017). Presumed consent system has been adopted by numerous countries such as France, Austria, Spain, Italy, and Singapore among others and it is based on the understanding that all citizens will donate their organs upon death unless they dissent the option while still living (Goldberg, 2017). Under the express consent system, individuals are expected to make a proclamation while alive that they would wish to donate their organs upon death. According to Eyting et al., (56), the adoption of the systems although having gone a long way in rising the organ donation numbers, there is still a deficit that the countries face since people fail to declare whether they will donate their body parts or not and the living family members contest in court any efforts for presumed consent.
The two systems although capable of increasing the number of organs available for transplant, there are numerous legal challenges that exist in United States which would make it challenging to effectively adopt the approaches. For instance, the First Amendment which outlines individual rights and liberties as well as the religious liberties would be used by conservatives and religious bodies to bar their adoption since they proscribe cadaveric donations (Chatterjee, 1323). The incentivized system which has only been adopted in Iran has proven to be more effective since it has been able to address the deficit in transplants across the nation. The adoption of the system which offers incentives for both the living and cadaveric organ donation will go a long way in making sure that the long waiting period is eliminated since it will increase the number of potential volunteers across the country (Chatterjee, 1323). The adoption of the system requires a change in the legal framework to make sure that healthy donors are able to donate their organs without fear of charges been filed against them.
Addressing Concerns and Increasing Donation Rates
The restriction on incentivizing organ donation is based on the understanding that the sale of human body parts is immoral and unethical since it devalues the sanctity of life. The individuals and institutions who are opposed to the offering of financial incentive perceive the practice as trafficking in human flesh. The perception although true to some extent, it is worth noting that the human body is already commodified since there are other forms of human trafficking taking place in the country such as the sale of female eggs through ova banks which are more appalling (Goldberg, 2017). The financial incentives for people to participate in organ donation drives would help persuade more members of the general public to engage in the exercise, making sure that more organs are harvested to help fill the deficit that exists and shutdown the growing black market for organs (Goldberg, 2017). The long waiting recipient waiting list coupled with shortages of available organs have seen more people resort to using orthodox methods such as the black market to get the transplants that they need, which is not only a healthy risk but also increases the crime rate within the society.
The inclusion of financial incentives would help make sure that more people volunteer to donate various organs in healthcare facilities across the country (Veatch, 103). The concerns on whether the incentives would go a long way in compromising the people are misinformed since the compensation that will be given is not intended to reimburse the donor for the market value of their organs plus a profit but is only meant to motivate them to participate in donation or join a donation agency. The altruistic ideals that have through the years guided the act of donation will not be eroded by the inclusion of a monetary reward or even non-financial incentive to the donors (Veatch, 103). The amount that the volunteers will receive will not be commensurate with the value and they will be driven to donate by the good that they will be doing and not the benefits that they reap.
Conclusion
The current organ donation system is dependent on the availability of altruistic volunteers. The system, although admirable and above reproach on the basis of morals and ethics, has failed to produce enough volunteers to meet the high number of organs needed. The demand for organ transplant exceeds the amount of supply that is available, with close to 18 people dying each day as they wait to receive their transplant. The situation is bound to continue if the society and the legislature, which is tasked with formulating and amending laws, do not think of an out-of-the-box solution such as financial incentive for organs, which will make sure that more donors join the national organ registry. The financial incentive system offers a plausible solution that can help eliminate the shortage that the nation is facing and ensure that people do not die because they have waited for long to get an organ they need.
Work cited
Chatterjee, Paula, et al. "The effect of state policies on organ donation and transplantation in the United States." JAMA internal medicine 175.8 (2015): 1323-1329.
Eyting, Markus, Arne Hosemann, and Magnus Johannesson. "Can monetary incentives increase organ donations?." Economics Letters 142 (2016): 56-58.
Gill, John S., et al. "Financial incentives to increase Canadian organ donation: quick fix or fallacy?." American Journal of Kidney Diseases 63.1 (2014): 133-140.
Goldberg, D. S., et al. "Increasing the number of organ transplants in the United States by optimizing donor authorization rates." American Journal of Transplantation 15.8 (2015): 2117-2125.
Veatch, Robert M. "Why liberals should accept financial incentives for organ procurement." Organ and Tissue Transplantation. Routledge, 2017. 103-120.
