My uncle spent almost 10 years on the organ transplant list waiting for a new heart. After undergoing a cardiac AV node ablation and pacemaker implantation, the severity of his condition improved, as did his overall quality of life. He was moved down significantly on the transplant list. Despite this, my uncle would go on to lead a successful life, without a transplant heart, as a private practice lawyer. He was compassionate, generous and was always willing to fight the good fight for others.
In 2017, these inherent qualities coupled with his strong legal ability and high ethical standards were recognized by his clients and peers, as he was awarded an “AV Preeminent” rating. Unfortunately, 8 months ago, my uncle passed away unexpectedly in an automobile collision that was shortly preceded by a subarachnoid hemorrhage. Even despite his untimely death, or his own health set-backs, he wanted to make sure his last act would be a final extension of his compassion and generosity towards others; he became a LifeGift organ donor.
Since its inception, organ donation has remained a consistently difficult problem. According to the United Network for Organ Sharing (UNOS), in the United States “22 people die each day from lack of available organs”. (https://unos.org/data/)
The legalization of organs sales provides a potential way to close the ever-growing gap between organ supply and demand, while providing preservation of patient autonomy. However, the ends do not justify the means? Organ sales should remain illegal due to unavoidable economic and ethical concerns such as: market regulation, transplant tourism, exploitation of the economically disadvantaged, and its blanket threat to human dignity.
People have the right to do what they want with their body.
Beneficence is supported due to the fact that thousands of Americans die every year waiting for a viable organ. Legalization of organ sales would be in the organ recipients’ best interest, as it would likely improve their condition and overall quality of life.
There are moral obligations on autonomy that limit its reaches. Autonomy should not be exercised to the point of putting others as harm. Moreover, an individuals’ autonomy should be challenged and questioned when the decision isn’t in their best interest. Autonomy should provide a way to protect people from themselves.
While beneficence may be supported in organ recipients, it is questionable in the donor themselves.
Physicians should, first, “do no harm”. They often encourage organ donation from patient’s family members/friends if at all possible. However, whether the donor is a family member, or a stranger seeking compensation, the harm and possible risks remain the same. There is no ‘worsening of harm’ when comparing the two types of donors, so nonmaleficence would not be obscured; the dangers presented when organs are donated for free vs. for compensation, are equal.
Nonmaleficence is rejected in discussion of organ sales, as the physician is causing unnecessary harm. While the outcome may ultimately benefit the recipient, the living donor’s life would be placed under unnecessary risk through the removal of one of their healthy, viable organs. Additionally, instead of having the recipient as the sole patient in this situation, legalization of organ sales would yield two patients, both the recipient and the living donor.