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The purpose of this essay is to further reinstate the claim that financial incentives should not be permitted in order to encourage organ donation. Research mainly consisted of searching through UOW databases, including summon. As financial incentives are only legalised in Iran proper statistical based evidence was difficult to come across, although what was found was evaluated and analysed. There are three main arguments of this essay: exploitation of the poor, loss of altruistic donors leading to the commodification of the human body and autonomy.
The research conducted indicated that providing financial incentives has many more disadvantages than advantages. Based on these findings, financial incentives for organ donation should not be implemented nor considered. The demand for organs for transplantation greatly exceeds the supply. As the number of individuals who are in need of a transplantation grows the less likely it becomes that they will receive the gift of an organ.
The procedure of a transplant has many risks and can be quite costly, which is why there are very few volunteer donors.
Currently, to combat the lack of donors, the introduction of financial incentives for organ donors is being considered. These financial incentives may very well increase donation, although they could have dire consequences. Financial incentives can include tax benefits, free health insurance, money in hand and any other types of material gain given to the donor. With all of this in mind, the introduction of financial incentives for organ donation should not be considered any further. Financial compensation for organ donation will bring about the exploitation of the financially vulnerable, the human body will be turned into a commodity and there will be a decline in altruistic donors.
Although it can be argued that we should have the right over our own bodies, individuals cannot grant proper consent for the operation with the enticement of financial incentives clouding their judgement. The introduction of financial incentives for organ donation will see individuals who are vulnerable, uneducated and in need of financial gain be exploited. Individuals who are compelled to donate an organ for a financial reward are likely to be desperate and poverty-stricken leading them to be exploited for the benefit of individuals with expendable money. Adair & Wigmore (2011, p. 191) recognise that in a society where compensation was provided, the demographic of organ donors would be living under the poverty line and in need of money. Harvey (1990, p. 117) uses Evans’ (1989) findings that organs are being sold to a recipient for an average of US $39,000, whereas the donor is only being rewarded around US $3,500. This indeed constitutes as exploitation of the financially vulnerable.
There have been many devastating consequences in countries where the sale of organs takes place. In Pakistan, many individuals have sold their kidneys to liberate themselves from slavery, but have found themselves back in debt when their compensation was insufficient (Adair & Wigmore 2011, p. 191). These individuals were abused and exploited by what seemed, through their eyes, to be a flawless system. Introducing financial incentives for organ donation may lead to poor and desperate individuals feeling compelled to undergo the operation and take the risks, contrary to their better judgement. This would lead to these individuals being exploited because of their financial situation. Furthermore, Mahdanian (2008, p. 120) found that in Iran where organ sales are legal, and men have authority over women, women are forced by their husbands to sell their kidneys to pay for their families essential needs.
A market where organ donation was compensated may rely on this exploitation alone to exist. There is no way to create a market in human organs where exploitation is non-existent; taking advantage of individuals who are in need of financial gain is ethically incorrect. Moreover, having the government offer financial incentives to increase organ donation would result in donors being exploited because of the financial motivations behind their decision. Introducing financial incentives for organ donation will result in the commodification of the human body and the loss of altruistic donors. Individuals who feel compelled to donate an organ for a price are costing themselves their humanity as they turn their bodies into a commodity, which can be auctioned, bought and sold. Truog (2005 p. 445) argues that the introduction of financial incentives for organ donors threatens the view that an organ is a gift of life. Mahdanian (2008, p. 120) further states that rewarding donors makes the donation feel more like a business transaction rather than a gift. This commercialization of organs is likely to leave donors feeling dissatisfied and malcontented once all of the compensated money is spent.
At present, the main source of non-cadaveric organs comes from volunteer and altruistic donors, if compensation was provided to these donors, the gift of an organ would significantly lose meaning, discouraging further donations. Furthermore, Demme (2010, pp. 46-47) discovered in a study that 96% of altruistic donors would donate again if possible and 84% would encourage others to donate, although in Pakistan 85% of donors who were compensated would definitely not sell a kidney again and 76% would discourage others from selling their organs. These statistics clearly provide evidence that the vast majority of individuals who were compensated for organ donation regret their decision and do not recommend doing so to others, consequently leading to a decline in organ supply. The notion that human organs can be bought and sold can negatively influence our human dignity and respect for the human body (Phadke & Anandh 2002, p. 310).
It is evident that the introduction of financial compensation for organ donors will result in negative outcomes; the consequences of donating an organ for a price will establish a chain of events leading towards organ commercialism and the eradication of altruistic donors. All individuals deserve the basic right to choose the fate of their organs. As individuals own their bodies, they have autonomy over their bodies in all aspects health; essentially individuals should have a right to donate a kidney. This argument is used by supporters of financial incentives for organ donation to justify the exploitation and commodification, which is definite to arise if compensation was legalised. However, it is evident that once an individual accepts money, their autonomy cannot be guaranteed. Adair & Wigmore (2011, p. 191) discuss that in the setting of paid donation, the risks of surgery are often not properly explained or understood leading to informed consent being uncertain.
As discussed earlier, the demographic of organ donors are usually poor and poverty stricken which makes them vulnerable to coercion, and since their consent for an organ donation is considered to be under coercion it can no longer be seen as valid consent (Major 2008, p. 68). Evidentially, once an individual accepts money their consent can no longer be authenticated. A market in organs would essentially be in the same category of paid human body transactions as slavery and prostitution (Phadke & Anandh 2002, p. 310). Providing financial incentives for organ donation makes it impossible to be able to validate consent and separate altruistic donors from those who are donating for the financial gain. This will result in many ethical issues and possible lawsuits in the medical department, if donors regret their decision or are harmed in the operation.
Although we should have the basic right to make decisions over our own bodies, it is evident that when there is the temptation of financial incentives for organ donation, especially for individuals who are in need of financial gain, our genuine autonomy cannot be guaranteed, leading to many ethical disputes. In conclusion, the negative effects of introducing financial incentives for organ donation greatly outweigh the positives. Providing financial incentives for organ donation is likely to lead to the exploitation of the poor for the good of the rich, the loss of altruistic donors and the commodification of the human body, also proven is the lack of ability to grant consent when material gain is present. Therefore, introducing financial incentives is extremely unethical and should not be implemented or even considered if individuals do not want to lose their humanity.
Adair, A & Wigmore, SJ 2011, ‘Paid organ donation: the case against’, Annals of The Royal College of Surgeons of England, vol. 93, no. 3, pp. 191-192. Demme, R 2010, ‘Ethical Concerns about an Organ Market’, Journal of the National Medical Association, vol. 102, no. 1, pp. 46-50. Harvey, J 1990, ‘Paying organ donors’, Journal of Medical Ethics, vol. 16, no. 3, pp. 117-119. Mahdanian, A 2008, ‘Iranian model of living, non-related kidney donation: a style to be condemned ethically’, Journal of Medical Ethics, vol. 34, no. 2, p. 120. Major, R 2008, ‘Paying kidney donors: time to follow Iran’, McGill Journal of Medicine, vol. 11, no. 1, pp. 67-69. Phadke, KD & Anandh, U 2002, ‘Ethics of Paid Organ Donation’, Pediatric Nephrology, vol. 17, no. 5, pp. 309-311. Truog, R 2005, ‘The Ethics of Organ Donation by Living Donors’, The New England Journal of Medicine, vol. 353, no. 5, pp. 444-446.
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