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Should people be able to sell their organs to hospitals?

LadyJubilee8_18

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    I’m a Law and Order: SVU fan (nerd) and I saw a particularly burdensome episode yesterday that brought up the question of whether or not people should be allowed to sell organs. So many people die waiting for kidneys or other such organs every year when others, if given the option, could sell one of their kidneys and save lives. Of course, the ethics of this practice are questionable. Though poorer people would probably be selling the organs and richer people would probably benefit, I think a life saved is a life saved. And besides, the poorer person will have that much more money. Why not?
     

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      LadyJubilee8_18 said:
      I’m a Law and Order: SVU fan (nerd) and I saw a particularly burdensome episode yesterday that brought up the question of whether or not people should be allowed to sell organs. So many people die waiting for kidneys or other such organs every year when others, if given the option, could sell one of their kidneys and save lives. Of course, the ethics of this practice are questionable. Though poorer people would probably be selling the organs and richer people would probably benefit, I think a life saved is a life saved. And besides, the poorer person will have that much more money. Why not?

      This is a very bad idea.

      People would just start selling their organs, or those of their children or parents.
       
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      LadyJubilee8_18

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        akpete said:
        I second the "bad idea."

        1. Creates a capitalist environment for organ buying and selling. Oh boy.

        2. Sick poor people won't be able to afford a kidney, etc.

        But what if there were tight restrictions, maybe you do not have the right to sell your children's organs, only people over the age of 21 can sell, and you have no right to sell the organs of any other individual.

        Maybe if organs were available through donation and by sale, then poor people could just continue getting organs from the voluntary system.
         

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          LadyJubilee8_18 said:
          But what if there were tight restrictions, maybe you do not have the right to sell your children's organs, only people over the age of 21 can sell, and you have no right to sell the organs of any other individual.

          Maybe if organs were available through donation and by sale, then poor people could just continue getting organs from the voluntary system.

          Don't they already have a law that you can't drink alcohol unless you are 21, and you can't drive if you've had too much?

          You see how well that works....
           

          akpete

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            There would have to be some sort of restriction on price. We don't won't bidding wars going on...

            I agree that it would be nice to help as many people as possible. I just don't think that it would work.
             

            LadyJubilee8_18

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              OSUdoc08 said:
              Don't they already have a law that you can't drink alcohol unless you are 21, and you can't drive if you've had too much?

              You see how well that works....

              But you would have to sell your organs directly to hospitals. Hospital staff could screen every person trying to sell organs. It would be easier to control than traffic violations.
               

              akpete

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                LadyJubilee8_18 said:
                But you would have to sell your organs directly to hospitals. Hospital staff could screen every person trying to sell organs. It would be easier to control than traffic violations.


                Until there's a black market for organs. :thumbdown:
                 

                thebiz98

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                  akpete said:
                  I second the "bad idea."

                  1. Creates a capitalist environment for organ buying and selling. Oh boy.

                  2. Sick poor people won't be able to afford a kidney, etc.


                  COME ON GUYS. How about some logic? Some Analysis?

                  1) What does "Capatalist Environment" mean? You should be embarassed. Assigning a market price to organs (kidneys, skin, etc) is simply a DISTRIBUTIVE mechanism distinct from the HIGHLY INEFFICIENT system of the status quo. Right now, people don't give up their organs and EVERYBODY loses. While you are sneering about capatalists, people are dying! Surprise, surprise, people do things for money. What is wrong with selling organs?

                  It is not immoral.
                  A. What is moral in the first place...letting people die?
                  B. People who work in quarries, chicken processing plants, deep-sea construction, pro-football, some people will get scoped by soon-to-be GIs day in and day out...all of these people irreparably damage their bodies in exchange for money. Some people give their lives in the Police Force, the military... What is the functional difference? Just because it offends your sensibilities does not make it immoral.


                  Sick people no longer affording kidneys. Come on, buddy.
                  A. Sick people can hardly afford kidneys NOW. A lifetime of drugs and lost time at work.
                  B. The cost of the organ itself is a MERE fraction of the total cost of living with a donated organ (initial and subsequent hospital visits, drugs, diminished capacity for work...pain, unhappiness, emotional side-effects)
                  C. Now people can make money...people who didn't have money to start with, ie: poor people, can give up superfluous tissues for market-determined sums and support their families etc.

                  The status quo is a true blackmark on our society. People hooked up to dialysis machines? Doctors waiting for motorcycle accidents and affirmative consent forms? What twisted world would consent to this continuing?

                  How do you motivate people to give organs? If you think good-will is sufficient, there is no reason to continue arguing, because we must come from different planets.

                  Yeah, I think there should be a regulated market for organs. And so should you.


                  Oh and by the way, there is a black market, ALIVE AND WELL. What are you going to do about that? How about make it CLEAN and SAFE?

                  Jeeze
                   

                  LadyJubilee8_18

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                    OSUdoc08 said:
                    Paying patients to harm themselves?

                    You don't have extra organs just to sell. You actually need them.

                    We are offering money to people so that they effectively shorten their lifespan.

                    That's a good preventive healthcare policy.

                    Yeah, good point...maybe you could sign up to be an organ seller in case you die and the money would go to your family...I don't know but that SVU episode made me think about it. I don't know how it would work, but maybe it could...
                     

                    akpete

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                      thebiz98 said:
                      COME ON GUYS. How about some logic? Some Analysis?

                      1) What does "Capatalist Environment" mean? You should be embarassed. Assigning a market price to organs (kidneys, skin, etc) is simply a DISTRIBUTIVE mechanism distinct from the HIGHLY INEFFICIENT system of the status quo. Right now, people don't give up their organs and EVERYBODY loses. While you are sneering about capatalists, people are dying! Surprise, surprise, people do things for money. What is wrong with selling organs?

                      It is not immoral.
                      A. What is moral in the first place...letting people die?
                      B. People who work in quarries, chicken processing plants, deep-sea construction, pro-football, some people will get scoped by soon-to-be GIs day in and day out...all of these people irreparably damage their bodies in exchange for money. Some people give their lives in the Police Force, the military... What is the functional difference? Just because it offends your sensibilities does not make it immoral.


                      Sick people no longer affording kidneys. Come on, buddy.
                      A. Sick people can hardly afford kidneys NOW. A lifetime of drugs and lost time at work.
                      B. The cost of the organ itself is a MERE fraction of the total cost of living with a donated organ (initial and subsequent hospital visits, drugs, diminished capacity for work...pain, unhappiness, emotional side-effects)
                      C. Now people can make money...people who didn't have money to start with, ie: poor people, can give up superfluous tissues for market-determined sums and support their families etc.

                      The status quo is a true blackmark on our society. People hooked up to dialysis machines? Doctors waiting for motorcycle accidents and affirmative consent forms? What twisted world would consent to this continuing?

                      How do you motivate people to give organs? If you think good-will is sufficient, there is no reason to continue arguing, because we must come from different planets.

                      Yeah, I think there should be a regulated market for organs. And so should you.


                      Oh and by the way, there is a black market, ALIVE AND WELL. What are you going to do about that? How about make it CLEAN and SAFE?

                      Jeeze


                      Wow. You need to calm down. I never said it was completely bad. As you'll see in one of my posts, "I agree that it would be nice to help as many people as possible." I just don't see how it could possibly be regulated. Show me how, since you obviously are better than me. :thumbdown:
                       
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                      thebiz98

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                        akpete said:
                        Wow. You need to calm down. I never said it was completely bad. As you'll see in one of my posts, "I agree that it would be nice to help as many people as possible." I just don't see how it could possibly be regulated. Show me how, since you obviously are better than me. :thumbdown:

                        It's really very easy. And it's no different from the regulation of airwaves or car sales. There cannot be a restriction on price; that doesn't eat the black market. All you have to do is have codified regulations about safety and procedure. The doctor/hospital acts as the intermediate, just like it does with any other surgery. There can be donor banks and donor lists just like with blood and marrow. It's not complicated.

                        The only reason I got excited was because of the mention of 'capatalist environment'. All I wanted to do was take a serious issue, like this, and bring it back to the rational.
                         

                        Shredder

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                          organs should be up for sale. that would eliminate the ridiculous wait lists that are currently in place. let the free market reign supreme as it should be in everything. poor people be damned. they will squander the organs if they receive them anyway. auctions are the most efficient method of determining market value, so auction off organs. down with lines, you should always be able to pay your way to the front.
                           

                          DrBowtie

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                            Well I don't think that a price tag could be set and regulated by a hospital or government. There will be vultures posting up in front of hospitals offering more and more cash for people to give them their organs for people willing to pay a higher price for immediate action.

                            Archaeologists when investigating sites and such aren't supposed to talk about there worth because it directly leads to and fuels a black market economy of the goods. I think the same thing applies here. Setting a price on life is not a good thing.

                            Also, how would the system work? The hospital pays the donor and then the patient pays the hospital for it? This would only add to the hospitals pocket. Do you propose it just as a clearinghouse for donors and patient to have the private deal done at for the "set" price? There is no way to regulate the cash exchange that could occur under the table.

                            In a capital market that would be set up by the sale, money is the talking factor. This would allow the rich to attain the organs and the poor would go by the wayside. Today's system isn't perfect but I think it is a hell of a lot more fair than anything else I can conjure up at the moment.
                             
                            i think it's fine to sell organs to hospitals. obviously, it should be regulated. maybe the govt, maybe a govt appointed agency. but there's a market for it, which means there's a possible efficient solution to it. as thebiz said, the status quo is inefficient. if you've studied economics, you'd understand this.

                            true, people will begin selling organs from people who are not themselves. but with any idea comes its own problems. it just depends on whether our society would rather risk people die waiting for organs or die for other reasons that come with this other system.
                             

                            akpete

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                              But how do we keep it from being the rich people competing with other rich people for the poor person's kidney, who goes for the more money and the shady doctor, and will sacrifice, even though it may be bad for their health. Would there be penalties involved (or what are, assuming there are some already in place)? I think it would be great if the hospital was the middle man, but then how do we control the hospital. Hey, they need new stuff too. Yes, these are all immoral examples, but it's all possible in our society.

                              Do other countries have any organ selling programs?
                               

                              LadyJubilee8_18

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                                yourmom25 said:
                                i think it's fine to sell organs to hospitals. obviously, it should be regulated. maybe the govt, maybe a govt appointed agency. but there's a market for it, which means there's a possible efficient solution to it. as thebiz said, the status quo is inefficient. if you've studied economics, you'd understand this.

                                true, people will begin selling organs from people who are not themselves. but with any idea comes its own problems. it just depends on whether our society would rather risk people die waiting for organs or die for other reasons that come with this other system.

                                If the hospital acts as an intermediate, then hospital doctors would have to excise the organs themselves. This way, no one can sell organs that do not belong to them.
                                 

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                                  thebiz98 said:
                                  It's really very easy. And it's no different from the regulation of airwaves or car sales. There cannot be a restriction on price; that doesn't eat the black market. All you have to do is have codified regulations about safety and procedure. The doctor/hospital acts as the intermediate, just like it does with any other surgery. There can be donor banks and donor lists just like with blood and marrow. It's not complicated.

                                  The only reason I got excited was because of the mention of 'capatalist environment'. All I wanted to do was take a serious issue, like this, and bring it back to the rational.

                                  No, it should be entirely voluntary.

                                  To those who think this is a "win"-win situation, ask yourself this:

                                  If you were poor, would you rather the government/outside organizations, did their best to help you secure employment and/or the skills and education needed for employment, or would you rather they offered to purchase your kidney, lobe of liver, etc.

                                  And to those who think that it is "all good" - read some articles about the organ market in Moldova. People are selling kidneys for pennies so they can buy saxophones and make a miserable living as jazz musicians, but then discover that their health has been damaged irreparably. Nice. Moldova will soon have as its primary export human organs.


                                  Sometimes people need to step back and think about how they themselves would like to be treated.
                                   

                                  DrBowtie

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                                    Everyone has talked about just selling their organs to the hospital. In order for this to work, you have to have patients on the other end willing to BUY them. If you try to fix the price, there will undoubtably be corruption. Also if you had the opportunity to buy a kidney if you need a kidney everyone would want to do it so it just creates a list of buyers analogous to the patient list waiting to get one anyway.
                                     
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                                    mercaptovizadeh

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                                      The one exception that I would support would be bone marrow. Blood is convenient since it is a very replenishable tissue, but unfortunately, it is too easy to give, and that could invite people not suitable as blood donors to sell their blood. Bone marrow involves a sufficient amount of pain that perhaps it would deter those interested only in money. So money would be a plus, but the motives would be philanthropic. I would support bone marrow, since it is replenishable, but not any tissues that will not grow back.
                                       

                                      akpete

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                                        mercaptovizadeh said:
                                        The one exception that I would support would be bone marrow. Blood is convenient since it is a very replenishable tissue, but unfortunately, it is too easy to give, and that could invite people not suitable as blood donors to sell their blood. Bone marrow involves a sufficient amount of pain that perhaps it would deter those interested only in money. So money would be a plus, but the motives would be philanthropic. I would support bone marrow, since it is replenishable, but not any tissues that will not grow back.


                                        I agree with this. This would be similar to plasma donation (which I do). It becomes a little more simple when the tissue is replenishable.
                                         

                                        Ursus Martimus

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                                          Boy sometimes it is fun to read what people write with no clue what so ever.

                                          OSUdoc08 said:
                                          Paying patients to harm themselves?

                                          People do that all the time. Clinical trial companies pay thousands of dollars to test drugs on willing participants. I'm sure that does not always go without harm.

                                          OSUdoc08 said:
                                          You don't have extra organs just to sell. You actually need them.

                                          The incidence of unilateral renal agenesis is about 1:4000. Most people don't even know they have a missing kidney until it is found incidently. I'd say that is an example of not needing one.

                                          OSUdoc08 said:
                                          effectively shorten their lifespan.

                                          I would be very surprised if you found a decreased survial in kidney donors.

                                          I would be nice if people, especially those want to be doctors, speak with some creditability rather than what they make up. There is at least some middle ground in the whole issue. While for the most part selling of organs from living donors may not be the best, there shoud be some compensation to cadaver donors to the family, ie funeral expenses.
                                           

                                          cardsurgguy

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                                            why does everybody complain about this (a market for organs)

                                            who the hell do you (anybody that's against this) think you are deciding for a mentally competent adult what they then can and can't do with their own bodies if it doesn't negatively impact you at all??
                                            if a person is willing to see their organs, what gives any of you the right to force them not to be able to??

                                            people usually bring up this stupid point about the rich getting the organs since they have the money
                                            do I disagree that this would happen in a market system, no I don't, it would happen
                                            but dare I be so bold and say, so what??

                                            all of you are acting as if having an organ is somehow a "right" for people to have and that everybody who needs an organ should be able to have them with an equal probability
                                            it's not a "right" to get an organ
                                            there should be no expectation of receiving an organ if one needs a transplant, it's something that one is lucky to receive

                                            if two adults mutually agree to make private exchange (organ for money), it doesn't involve any of us

                                            how about this, for all of you who are against this, you can donate your organs after your death and specify that they go to whoever needs them the most and/or low income patients
                                            but don't force your idealistic utopian dreamworld BS viewpoints on anybody else
                                             

                                            akpete

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                                              cardsurgguy said:
                                              if two adults mutually agree to make private exchange (organ for money), it doesn't involve any of us


                                              This probably already goes on. And I'm okay with that. What I think could be the problem is when there are donation centers running like sperm banks.
                                               

                                              LadyJubilee8_18

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                                                mercaptovizadeh said:
                                                No, it should be entirely voluntary.

                                                To those who think this is a "win"-win situation, ask yourself this:

                                                If you were poor, would you rather the government/outside organizations, did their best to help you secure employment and/or the skills and education needed for employment, or would you rather they offered to purchase your kidney, lobe of liver, etc.

                                                And to those who think that it is "all good" - read some articles about the organ market in Moldova. People are selling kidneys for pennies so they can buy saxophones and make a miserable living as jazz musicians, but then discover that their health has been damaged irreparably. Nice. Moldova will soon have as its primary export human organs.


                                                Sometimes people need to step back and think about how they themselves would like to be treated.

                                                There are already programs that work to help poor people secure employment and/or skills and education needed for employment. No one is suggesting that the only thing the government should do to help the poor is to offer to purchase their organs. And let’s face it education takes a long time, most people need money now. If I was poor, I would want the government to offer me as many options as possible.

                                                Also, the US economy is much better than that of Moldova. When you choose to apply similar rules to very dissimilar nations, you run the risk of making inaccurate statements. Healthcare here is also held to a higher standard, so doctors would be better apt to determine the risks involved in organ donation and to skillfully perform the operation to keep damage done to the donor at a minimum.
                                                 

                                                LadyJubilee8_18

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                                                  getunconcsious said:
                                                  I think the current system works just fine, with UNOS overseeing the majority of transplants, while being supplemented by black market organs for those who can afford them. What would legal kidney-selling do besides increase the already existing despairity?

                                                  I just think that there are already people who are low on the UNOS list who could just buy a kidney. My grandpa needs one, but since he's old he will probably never get one. They take that into consideration
                                                   

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                                                    I'm putting my vote into the pro-organ buying camp. More people on the list will have access to organs this way.

                                                    I say we auction off 10% of the organs a year to the highest bidders, then take this money and pay for the rest of the organs. Believe me, a wealthy individual would easily pay $5 million to get to the top of the list for a kidney. We could then take this $5 million and buy 500 kidneys that would normally not be in the market without compensation and everyone is better off. Yes, the rich can buy their way in, but in the process, they end up paying for another 500 kidneys on top of it. Everyone wins this way.

                                                    It's not like people would be selling their kidneys when they're strapped for cash. We would be able to recover some of the organs that parents don't want to sign over when Johnny plows his Camaro into the ditch and dies and they hee-and-haw back and forth until the organs become worthless. The $10,000 would probably change their mind since the kid (unfortunately) is already gone.
                                                     
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                                                      (Here's another fun scenario, not exactly the same as this Law & Order idea... )

                                                      Why don't we genetically engineer a new form of life that we can call "homunculi", or in other words "lesser humans." The genetic modification could target the development of the neural crest and prevent induction/differentiation of higher brain tissue. We let the organism develop out, embryo to fetus etc, and it is born viable with only lower brain stem function and no conscious perception or the ability to form rational thought. All qualities that we would deem characteristic of human life - those qualities of personhood - are totally missing. The current medical prognosis for this status is actually death - look it up, death is defined as the permanent loss of higher brain activity (e.g. consciousness.)

                                                      So let's grow the homunculi, let them mature out, and effectively we could harvest their organs, without the ethical baggage of taking organs from human donors.

                                                      Is this any worse? Thoughts?
                                                       

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                                                        BTW Full Metal Alchemist rocks....

                                                        i would have to say some for of compensation could increase the number of donors but IMO a capitalistic system should not be used. Just keep the system the way it is but give incentives for being a donor, ie help with funeral expenses and such. Also this money should be paid for by the government not the patients.
                                                         

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                                                          crazy_cavalier said:
                                                          (Here's another fun scenario, not exactly the same as this Law & Order idea... )

                                                          Why don't we genetically engineer a new form of life that we can call "homunculi", or in other words "lesser humans." The genetic modification could target the development of the neural crest and prevent induction/differentiation of higher brain tissue. We let the organism develop out, embryo to fetus etc, and it is born viable with only lower brain stem function and no conscious perception or the ability to form rational thought. All qualities that we would deem characteristic of human life - those qualities of personhood - are totally missing. The current medical prognosis for this status is actually death - look it up, death is defined as the permanent loss of higher brain activity (e.g. consciousness.)

                                                          So let's grow the homunculi, let them mature out, and effectively we could harvest their organs, without the ethical baggage of taking organs from human donors.

                                                          Is this any worse? Thoughts?
                                                          What about animals then. Say you could harvest pig organs.. (heart valves? ahem). If you're in favor in this, surely you would be in favor of humonculi harvesting, as it isn't even concious. We create life all the time so that we may destroy it for our own benefit (ie, a cow farm). Besides vegetarians, I think most rational people would love this idea.

                                                          but, it's a pipe dream. so let's make the organ market legal instead.

                                                          has anyone seen dirty pretty things?
                                                           

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                                                            MedRower said:
                                                            What about animals then. Say you could harvest pig organs.. (heart valves? ahem). If you're in favor in this, surely you would be in favor of humonculi harvesting, as it isn't even concious. We create life all the time so that we may destroy it for our own benefit (ie, a cow farm). Besides vegetarians, I think most rational people would love this idea.

                                                            but, it's a pipe dream. so let's make the organ market legal instead.

                                                            has anyone seen dirty pretty things?

                                                            Haven't seen that movie, yet.

                                                            There's something inherently unethical about growing a lifeform to promote your own interests... I suggested the homunculus idea just as devil's advocate, personally I think even raising cattle to slaughter them for food is sorta bad. Yet there is good in it as well, it does provide valuable food and all, and I'm certainly NOT going to become a vegetarian because I'm that sensitive of the animal cruelty...

                                                            Ahh, I just don't know... what I do know is that cross-species transplants pose problems for host integration (i.e. the donor tissue is likely to be rejected) so let's try to stick with human to human transplantation. I mean, I can't really imagine putting a pig liver into a human body.
                                                             

                                                            jeffsleepy

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                                                              OSUdoc08 said:
                                                              Good idea.

                                                              Let's encourage suicide too.

                                                              And drug abuse....

                                                              alcohol abuse....

                                                              yes let's.......

                                                              who cares about the well being of others?


                                                              By the way.....I'm a donor.....but I'm not charging for it......


                                                              Hey, just curious. What's up with you deleting your own posts all the time? What's the point?
                                                               

                                                              2009doc

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                                                                this isn't a new idea, there is already a black market for organs. its a really big problem ethically, this is why it is illegal, and we use an organ list- unbiased of economics, race, etc. the new york times had an article on this a year ago, i've included the link to the abstract...sorry i didn't pay the $3 to get the original article...however i would HIGHLY recommend reading the article, it is very long and does a good job of presenting both sides of the issues.

                                                                http://query.nytimes.com/gst/abstra...A0C708EDDAC0894DC404482&incamp=archive:search

                                                                of course this article does not address selling organs directly to a hospital...but still offering money for organs will disproportionately effect the health of the poor- not a good idea.
                                                                 

                                                                tcar18

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                                                                  I would like to say no, I don't think organs should be sold because you should be able to get one regardless of income. Also, if people were getting paid for organs why would anyone donate them? People would be selling the parts of their dead family members to pay for the funeral.

                                                                  However, If it was my wife, my son, my daughter: I would do anything to save them, including pay any price for an organ. And, I think most people would do the same thing.
                                                                   

                                                                  uptoolate

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                                                                    This is from today's MDConsult Curbside- apparently we're not the onyl one's watching SVU. Here is (at least most) of the text. Its in the Student Union section if you want to log on:


                                                                    The transplant floor can be overwhelming for anyone new to the hospital such as a medical student. There is a never-ending supply of deathly ill people waiting for the organ that may save their lives. These patients are often among the sickest in the hospital. Taking the time to talk to



                                                                    one of them made me realize what they go through every day. Every day is the same... They wake up in the morning and ask, "Will today be the day I finally get the organ I need?" It is a constant waiting, with no definite end in sight. They remain hopeful and try not to think about the grim reality that there are many more of them than there are organs available for transplant. This fact will doom many to never receive the organ needed. This fact means that many will not survive their hospital stay. It is important for me, as a medical student, to understand not only the disease processes but the social issues surrounding my patients care. I cannot focus only on the pathology and ignore the issues surrounding the cure.

                                                                    Since the advent of transplant technology, a debate regarding the procurement of organs has raged. Once success rates for transplant procedures increased and patients began living full lives years after the procedure, the waiting lists for organs mushroomed. However, the supply for organs has not increased with the demand. Currently there are thousands of people on organ transplant waiting lists who will die before they ever receive an organ. Whether to offer some sort of incentive or financial payment for organs is a hot topic. Recently, an episode aired on ABC's 20/20 where John Stossel interviewed an individual who wanted to sell one of their kidneys; it was argued that if someone wants to sell his or her kidney, society should not stand in the way. Even the AMA has become involved in the debate.[1] On one hand, we have the prospect of increasing the organ supply and saving lives. On the other, all of the ethical problems that arise from paying for human organs. This debate stirs images of grave robbers in the 19th century. Who has the legal rights to body components after death? Is the body of a person a piece of property that one can even own? It is important that, as physicians, we understand the arguments and the historical implications of this issue.

                                                                    I would like to address the ethical issues surrounding incentives for increasing the organ supply. I am assuming that increasing the organ supply is a good and moral thing to do and that the organs will be allocated in a fair manner. There are two different methods of procurement, each warranting separate discussion. Live organ donation, causing the most recent controversy, involves a living person donating a kidney. Cadaveric donation involves procuring organs from a deceased body. I believe that while the ethical questions surrounding the two issues are similar, they are different enough to be discussed separately.

                                                                    Many find it to be morally wrong to pay someone to donate a live organ. I feel that it could be assumed that it is morally wrong to pay for or to allow donation of a necessary, unpaired organ such as the heart; this would result in the death of the donor. There is, however, great controversy over the donation of a single kidney.

                                                                    As a basis for discussion, I want to make the distinction between donating a kidney and donating blood, semen, or hair. While these are all parts of the body, they are fundamentally different. A kidney is a discrete, non-renewable organ. Blood, semen, and hair are all renewable and not discrete. Whether payment for those tissues is acceptable is not the purpose of this paper. The argument that paying for blood and paying for a kidney are equal types of exchanges is a flawed conclusion.[3][7]

                                                                    Live Organ Donation

                                                                    Kantian Dignity

                                                                    There is a dignity inherent in the human body and in every individual. "Kantian dignity" dictates that we not use the body as a means to an end.[2][3][4] There are motivations other than money that could move potential donors to violate this "Kantian dignity," including guilt or low self-esteem.[5] However, the living body is not a commodity to be bought and sold.[6]

                                                                    Altruism

                                                                    Some argue that because we allow altruistic donation of a kidney to a recipient, we should allow a father to sell his kidney to cover the cost of lifesaving medication for his daughter... after all, if she needed a kidney we would let him give it to her.[8][9] While this may be an ethically acceptable scenario, it is impossible to ensure such arrangements in the real world. Too many possibilities for abuse exist and the situation would be difficult if not impossible to police. Allowing this scenario raises questions about the definition of altruism; how altruistic does one have to be? Can you sell your kidney to buy a neighbor needed depression medication, a measure that is not lifesaving but is certainly needed? Or could the money be used to buy a car to get to work or a television? When is the donor motivation not altruistic enough? Those who propose allowing kidney sales only if the money goes to altruistic purposes have good intentions, but are ignoring the inevitable results of the real, flawed world.

                                                                    Exploitation

                                                                    Those against live kidney donation often argue that it is exploitative of the poor, and the choice to donate is not freely made but coerced. The counter is that society lets the poor engage in other work that the rich avoid... poor immigrants pick strawberries and the military is comprised of a disproportionate number of poor people. Why should society decide... and how capible is society to decide what is good for the poor? Is a means of financial support or an opportunity to better their situation being denied? This line of thinking is flawed on many levels.

                                                                    First, there are actions that we, as a society, do not allow people to engage in for purely moralistic reasons.[2] If we find it morally repugnant for a person to be reduced to a level that the only financial course of action left is to sell part of their body, society has the right to legislate on solid moral ground. Second, the sale of a kidney does nothing to help the circumstances of the seller.[10] This has been demonstrated in an article in JAMA entitled "Economic and health consequences of selling a kidney in India;" organ sellers were in worse physical condition after the sale and all but one were in the same or worse financial situation post-donation.[11]

                                                                    Cadaveric Donation

                                                                    Cadaveric donation of organs is a different issue. Here the organs are no longer part of a live human being and the deceased has no more use of the organs. Under the current system, when someone dies, the organ procurement agency attempts to ascertain whether the deceased indicated whether or not he/she wished to be a donor. If it was their wish, the procurement organization speaks to the family to gain consent to remove the organ(s). If it was not the donor's wish, no action is taken. If no indication for donor preference exists, the agency approaches the family to get the family's permission. The family is approached because it is assumed that the family will have the interests of the deceased in mind and will represent the intent of the donor as honestly as possible.[12] (While this is obviously not the case in every situation, we must assume that if the deceased has left no direction of his own then the family can and will represent his or her wishes.)

                                                                    Most incentive plans fail at this juncture. Incentive plans involve paying the family of the deceased by either deferring funeral expenses or tax benefits, or by outright payment. An incentive, by definition, is a method by which a person is moved to do something they would not normally do. However, the family should not need an incentive to make a decision the deceased would have made themselves. By offering incentives, it seems easy for the family's interests to trump those of the deceased. Instead, the objective should be increasing the number of people who agree to become donors prior to death. The incentive should only be for the donor to register as a living being.

                                                                    A Possible Solution

                                                                    (see next page)
                                                                     

                                                                    uptoolate

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                                                                      Solidarity Model

                                                                      There are two possible scenarios to obtain the goal of incentivizing organ donation that I believe are ethically acceptable. One is referred to as the solidarity model.[13] As a society, it is agreed that those who want to donate their organs upon death receive a slight advantage in the allocation process if they were ever to need an organ. There are probable methods of abuse in this method. Someone could sign up to be a donor once they are put on a waiting list and then, after receiving the organ, decide not to donate. However, I think that such a model has promise, will cost very little, and has the potential to greatly increase the organ supply.

                                                                      Zero-Premium Life Insurance

                                                                      The second method is a zero-premium life insurance policy.[14] Under this model, people would sign up to be donors understanding that, when they die and if their organs were able to be procured, the family receives $5,000. (I have used an arbitrary number.) The individual receives nothing directly from the agreement. There is no buying or selling of the potential organs on the secondary market. It is just a way for the individual to give something to his family. This would be funded by people voluntarily agreeing to pay an extra dollar at the Division of Motor Vehicles while getting their license or registering their car, similar to the practice of giving to the presidential election fund on a tax return.



                                                                      ...no one is being coerced, the interests of the deceased are being followed...



                                                                      The ethical problem most evident in this model is that we are paying for the organs. If the organs cannot be procured, then the family gets no money. While I agree this is a less than perfect system, I believe it is still an ethically acceptable solution. It is differentiated from paying for a kidney because the organs are from a living, breathing, thinking person. No one is being coerced, the interests of the deceased are being followed, and it is in the family's interests not to object to the deceased's wishes.

                                                                      Some who are against these kinds of programs wonder why donors should we paid for doing the right thing.[15] I would agree that it is a less than perfect system. It is, however, a less than perfect world in which we live. We should be mindful that the goal is to save the lives of people who are waiting for organs.
                                                                       

                                                                      LadyJubilee8_18

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                                                                        crazy_cavalier said:
                                                                        (Here's another fun scenario, not exactly the same as this Law & Order idea... )

                                                                        Why don't we genetically engineer a new form of life that we can call "homunculi", or in other words "lesser humans." The genetic modification could target the development of the neural crest and prevent induction/differentiation of higher brain tissue. We let the organism develop out, embryo to fetus etc, and it is born viable with only lower brain stem function and no conscious perception or the ability to form rational thought. All qualities that we would deem characteristic of human life - those qualities of personhood - are totally missing. The current medical prognosis for this status is actually death - look it up, death is defined as the permanent loss of higher brain activity (e.g. consciousness.)

                                                                        So let's grow the homunculi, let them mature out, and effectively we could harvest their organs, without the ethical baggage of taking organs from human donors.

                                                                        Is this any worse? Thoughts?

                                                                        This is a bad idea not only for ethical reasons, but because the organs would be tarnished since they came from a cloned human being. In order to clone humans with this sort of defect, you would have to select for cells that mutate readily. This is the only way a scientist could induce enough mutations to get the correct product....cells that mutate readily are also prone to cancer and that’s an even bigger health issue. Also, cloned individuals (well animals) age about twice as fast as normal individuals. I'm not sure why, but this is also a serious consideration.

                                                                        Then we have practical issues to worry about. Given politics and the ethical gray area, no one would ever make this idea legal; it would take forever to just clone one human being since the process is not refined; and it would be a very expensive way to produce organs, you can't exactly mass-produce humans.
                                                                        Just a bad idea in general and way more ethics and practical issues than just giving people the right to sell their tissue.
                                                                         

                                                                        abraxas

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                                                                          sorry if this is alittle bit off topic...

                                                                          For a while I have wanted get my bone marrow typed (sorry don't know the exact wording but when u get included on the possible donor list) and i have had some trouble finding out how to do this. If anyone knows how to go about getting put on the donor list i would appriacte them telling me how to do it.
                                                                           

                                                                          ilovehedgehogs

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                                                                            cardsurgguy said:
                                                                            why does everybody complain about this (a market for organs)

                                                                            who the hell do you (anybody that's against this) think you are deciding for a mentally competent adult what they then can and can't do with their own bodies if it doesn't negatively impact you at all??
                                                                            if a person is willing to see their organs, what gives any of you the right to force them not to be able to??

                                                                            people usually bring up this stupid point about the rich getting the organs since they have the money
                                                                            do I disagree that this would happen in a market system, no I don't, it would happen
                                                                            but dare I be so bold and say, so what??

                                                                            all of you are acting as if having an organ is somehow a "right" for people to have and that everybody who needs an organ should be able to have them with an equal probability
                                                                            it's not a "right" to get an organ
                                                                            there should be no expectation of receiving an organ if one needs a transplant, it's something that one is lucky to receive

                                                                            if two adults mutually agree to make private exchange (organ for money), it doesn't involve any of us

                                                                            how about this, for all of you who are against this, you can donate your organs after your death and specify that they go to whoever needs them the most and/or low income patients
                                                                            but don't force your idealistic utopian dreamworld BS viewpoints on anybody else

                                                                            compelling argument, as a libertarian I agree that people should be allowed such freedoms of pesonal choice, however, as a compassionate person I do not believe it is ethical to promote degradation of the lives of the poor even further in a society where they exist precariously anyways. Imagine selling a piece of your body to pay the bills...regardless of the benign health consequences and all practicalities aside, there is something disgusting about that.
                                                                             
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