Introduction
The medical field has made significant advances over the years which have resulted in the development of cures for hundreds of diseases leading to lower mortality rate and higher chances of recovery from ailments for people. This has undoubtedly improved the quality and/or prolonged the lives of many people. In the past few decades, inventions and breakthrough scientific discoveries in the biological field have resulted in the prevalence of access to sophisticated equipment and advanced diagnostic procedures that were once only in the reins of research institutes and few specialist hospitals. Arguably one of the most novel innovations has been organ transplantation which helps replace or remove ailing body organs. This technology has literally given a new lease of life to patients whose dysfunctional organs would have been an irrevocable death sentence to the patient in earlier years.
The fundamental reason for organ transplantation is to restore health or extend the life of the ailing patient. However, a scarcity in the number of organs available has resulted in many people not having access to the organs despite their dire conditions. Animal to human transplant and the legitimization of trade in organs present a means by which these scarcity can be dealt with. However, debate mostly on moral and ethical grounds has resulted in this two means not being employed. This paper argues that animal transplantation and commercialization of human transplantation organs should be legitimized since it provides the best means through which the shortage in organs can be alleviated. Several of the arguments raised both in favor of the sale of organs and their counterarguments shall be looked at so as to justifiably the calls for commercialization of transplant organs and use of animal organs.
Organ transplantation; The Dilemma
The Center for Bioethics defines an organ transplant as “a surgical operation where a failing or damaged organ in the human body is removed and replaced with a new one” (1). This kind of procedure can be undertaken on any body organ that has a specialized function. The various types of transplants may be broadly categorized as human to human and animal to human transplantations. The most prevalent form of transplantation at the present is human to human organ transplant which involves acquiring the required organ from a human being. Organs from human donors can be obtained from recently deceased people or from a living donor who are in most cases close relatives of the patient. Using of animal organs, a process known as xenotransplantation, involves the grafting of cells, tissues or organs from non-human animal species into humans. Daar notes that “xenotransplantation is seen by some mainly as an opportunity that could help overcome the shortage of organs from human donors” (54).
The acute shortage of available organs has led to a situation whereby majority of the people who need organ transplants failing or having to wait for long periods of times to get the organs. The United Network for Organ Sharing (UNOS) which maintains a real-time database of the status of people awaiting organs reveals that over 106,612 people are currently on the waiting list for organs in the USA. Bearing in mind that an average of20 people die each day while waiting for an organ, it is evident that the current sources for getting organs are inadequate (Center for Bioethics, 14)
While the success of organ transplantation is acclaimed not only through medical circles but also by the general citizenry, the extent to which these medical procedures can be undertaken have been greatly limited as a result of the relatively low number of available organs as compared to the increasing number of people in need for transplantations. While animal transplantations offer a means by which the shortage can be alleviated, ethical and human safety issues surround it. On the other hand, reliance on human donations has proven to be unreliable but calls for commercialization so as to increase the demand have been refuted on mostly ethical and moral grounds.
A Case for Commercialization
The lack of a legitimate market for organs has resulted in the increased suffering of patients and escalation of hospital bills. Mclaughlin, Prusher and Downie note that due to the shortage in organs caused by a lack of a market oriented means for acquiring the organs, many patients have to bear with painful medical procedures such as dialysis as they await organs for an indefinite number of years. Some patients end up dying as they wait and the medical expenses reach an excess of $50,000 per year. This is far more expensive than an organ would cost if there was a legitimate market. As such, a legally regulated market for organs would not only decrease the unnecessary suffering in patients thus improving the quality of their lives; but it would also result in less money being expended to cover the medical costs that people have to incur while they await transplanting.
Due to the desperation that springs as a result of organ shortages, many wealthy people opt for buying the organs from the black market where priority is given to the highest bidder. Meyer reports that some of these organs found in the black market are obtained through horrible means such as drugging unwilling victims and performing involuntary nephrectromy on them to obtain the desired organs (208). Reports of the illegal organ traders not paying the donors as promised are also rife thus highlighting the injustices that exist in a illegitimate and unregulated market. Creating a legitimate framework for commerce in organs would lead to a condition whereby the donors would be paid their dues and the regulated environment would ensure that cases of involuntary nephrectomy would be greatly reduced. The cost per organ would also be greatly reduced since its inflated cost is mostly as a result of the monopoly that illegal traders hold in the market.
Some of the grounds on which the ban on organ sales has been made has been on the arguments against profiteering from such business. Radcliffe-Richards, one of the adherent proponents for legitimizing organ sales explains that this is an irrelevant argument all the other parties involved in the transplantation process (physicians, hospitals and recipients) profit in some manner from the transplantation (1951). As such, it is only the altruistic donor who does not reap any tangible benefit from the transplant. It would therefore be justifiable for the organ donor to be monetarily compensated for their organs since some of the other parties involved, most notably the surgeons and hospital also make financial gains from this endeavor. It is therefore hypocritical to dictate that the donor makes no gain from his organ while not imposing the same on the other parties in the process.
In most of the democratic world, one of the most fundamental concepts is autonomy as far as personal matters are concerned. It would therefore stand to reason that one has a right to sell his/her organs since they are in essence the property of oneself. Making illegal the right to sale human organs therefore goes against autonomy since it denies a person the right to have dominion over their own body parts. The law should therefore allow for a person who is willing to sell their organs for monetary gains to do so since their body is their property and can be used for income generation.
Arguments against Commercialization
Despite the various arguments presented in favor of commercialization, there exist some real threats to legalizing human organ sales. A particular fear is that this trade would invariably lead to the poor especially of the third world countries being preyed upon by the rick from developed countries. This is a well founded fear considering the fact that majority of the buyers in black markets are rich people from developed nations. Mclaughlin, Prusher and Downie document how poverty combined with the allure of easy money make a poor man from Brazil sell one of his kidneys to a rich Israeli (1). This is a classic case of how the desperation of the poor can be exploited should this trade be legalized. Despite arguments that the selling of body parts leads to the donors faring better as a result of the money earned, research demonstrates that the sale of organs does not alleviate poverty as proponents for the same insinuate. A study by Goyal et at (as cited by Rothman) shows that in India “87% of those for sold a kidney reported deterioration in their health status… and of those who sold a kidney to pay off debts., 74% still had debts 6 years later. In such scenarios, paternalism (which in this case involves the government coming in to protect the poor people from themselves) may not only be necessary but actually preferred.
A case for Animal-human Transplantation
Some of the basis by which animal organs have been objected against has been the problem with organ rejection and infections which make transplantation a risky procedure. However, Nairne asserts that new generations of immunosuppressive drugs as well as improved medical procedures have made it possible for transplants to be accepted by the body with increased safety for the patient (1). This means that the traditional restriction of organ donations to be primarily from close relatives for compatibility issues has been removed by these new drugs. With the waiting list growing by the day and the current reliance on human donations not meeting the needs, turning to animal organs presents a viable solution which would lead to increased availability hence shortened waiting time for patients.
In addition to this, more research is underway which aims at producing animals (clones) whose blood groups and organs are genetically engineered to survive or be accepted by the human body. Upon the success of such an innovative venture, the issue of compatibility will be resolved as well as that of the organ supply shortage that is evident globally from the long waiting lists in different areas. On the same note, cloned or genetically engineered animals have been known to breed faster (2 to 3 years) and will therefore produce harvestable organs at a much faster rate than humans thereby catering for the organ deficit. Noticeably, being mammals, the difference between the human and most animal organs is slight and if the aim of such transplantations is to preserve and save lives then it is a cause worth taking.
Arguments against Animal-Human transplantation
One of the major concerns raised with regard to animal-human transplant is the risk of transmission of infectious agents into the recipient and the subsequent transmission of the infections to the wider population. These were the grounds on which a Europe-wide ban on xenotransplantation was imposed in Europe in 1999 as well as in Australia in 2004. While the World Health Organization does propose that the use of some reliable strategies for prevention, detection and containment may alleviate this risk therefore making the technology possible, health experts concede that the risk of viral infections remains high (WHO 2). The threat of the diseases spreading to the general population with catastrophic results has resulted in top scientists being wary of animal-human transplantations.
Animal rights groups assert that animal cruelty is prevalent in xenotransplantation. In order to perfect these procedures, the animals undergo a series of excruciating experiments in terms of surgery and drugs which at times lead to the death or at least physical impairment of these animals. According to an article in “Uncaged” (2004), evidence discovered from an international drug corporation Novartis indicates that the cruel and inhumane dissection of millions of primates over the years had yielded no results towards finding a solution for the violent rejection of these organs by humans. As such, they argue that more focus should be directed at the stem cell research and other upcoming alternatives to solving the human organ crisis.
Discussion
While there exist valid reasons for blocking the introduction of trade in organs, we must not fail to consider that without a legitimate market for organs, the black market continues to flourish mostly at the expense of the donors who do not receive nearly adequate compensation for their organs. The current shortages have led to human rights crises in countries like China where organs from executed criminals are harvested and sold off. This is despite widespread condemnation for the practice by human rights groups.
Furthermore, as has been demonstrated in this paper, the reliance on altruism has resulted in untold suffering and death of patients as they wait for organs to become available. This goes against the very principle on which medicine is founded, that is to alleviate human suffering by improving the health of the body and prolonging lives. It is therefore the moral obligation of medical professions and the society at large to seek out any feasible ways though which the unnecessary suffering and death of the patients can be alleviated. Animal organs and legitimization of organ commerce present the best means by which these can be achieved.
Conclusion
This paper set out to argue that animal – human transplantations and legalizing of commerce in organs are the two ways through which the shortage in organs can be tackled. However the advantages and disadvantages of these methods have been discussed and possible recommendations made. The animal to human transplantation has pulled in a lot of ethical controversies over the decades and as discovered, the risks prevail over the potential benefits that can be accrued from this method. On the other hand, the advantages to be gained by commercializing organs for transportation far outweigh the perceivable risks and as such, moves should be made to legalize this activity so as to lead to more lives being saved. However, care should be taken to ensure that this trade is not exploited by unscrupulous person for their own benefits at the cost of the organ donors and recipients who should be the beneficiaries of these new measures.
Works Cited
Center for Bioethics. “Ethics of Organ Transplantation.” 2004. Web.
Daar A, S. “Animal-to-human organ transplants–a solution or a new problem?” Bulletin of the World Health Organization. 77(1):54-61, 1999.
Mclaughlin Abraham, Prusher Ilene and Downie Andrew. “What is a Kidney Worth?” 2004. Web.
Nairne Patrick et al. “Animal-to-Human Transplants the ethics of xenotransplantation.” Nuffield Council on Bioethics, 1996.
Uncaged: protecting animals. “Korean pig organ transplant plans spark international alarm.” 2004. Web.