Should Individuals be Allowed to Sell their Organs on the Open Market in the US - Research Paper Example

Should Individuals be allowed to Sell their Organs on the Open Market in the US? A Study of the Legal Kidney Market in Other Countries Abstract Kidney has been noted to be the body part that accounts for greatest portion of organ sales around the world. With the aging of the entire population, Rothman and Rothman (2003) observe that the number of patients with deadly kidney disease has increased. With patients failing to respond positively to dialysis, kidney transplantation provides the alternative solution. Giving a background on kidney disease, this paper focuses on kidney transplanting as one of the treatment approaches to kidney diseases, evaluating people’s reluctance to donating their organs after they die. Borrowing from various secondary sources, practices in various countries would be compared with regard to trade in human organs and appropriate conclusions drawn that argue against the legalization of trade in human organs in the United States. I. Introduction Kidneys are a pair of bean-shaped organs, almost the size of one’s fists located below the rib cage near the back’s middle. In these organs are millions of tiny structures referred to as nephrons which Danovitch (2010) indicates as responsible for filtering blood, removing soluble waste products and excess water as urine, thus regulating the concentration of chemicals such as potassium, sodium and phosphorous in the body. In addition, the kidney serves as a major site for the production of various hormones, mainly rennin and erythropoietin. It alters the concentration of body’s amino acids through the synthesis or metabolism and also controls glucose levels through gluconeogenesis. These nephrons would be the target for attack in case of a kidney disease. The damage as a result of chronic kidney disease inhibits the removal of waste and extra fluid from the body. With a prevalence of over 10% in most populations, chronic kidney disease has been a major problem in public health (Himmelfarb & Sayegh, 2010). Causes of Chronic Kidney Disease Due to the many functions that kidneys play in the body, there exist various kinds of kidney diseases including congenital and polycystic kidney diseases. In the same way, various reasons have been attributed to the onset of kidney disease. Danovitch (2010) considers longer lifespan as a risk factor for chronic kidney disease. The elderly experience age related functional and anatomical changes in their kidneys with subsequent lowering of the number of nephrons which lower the functioning of the kidneys exposing such persons to chronic kidney disease. According to Himmelfarb and Sayegh (2010), over 66% of those aged older than 20 would be more at risk due to the prevalence of obesity and overweight. Obesity on its own has been noted to cause chronic kidney disease through hypertension and diabetes mellitus, but Danovitch (2010) indicates that emerging evidence postulates that direct contribution of obesity to the disease could be through additional metabolic, inflammatory and compression mechanisms and mechanical compression as well. Himmelfarb and Sayegh (2010) indicate that obesity triples the risk of one developing chronic kidney disease. Since obesity propagates the development of reduced HDL cholesterol and hypertension, it would be appropriate to conclude that obesity and cardiovascular diseases synergistically contribute towards the development of kidney diseases. On lifestyle choices, it has been observed that tobacco and excess consumption of alcohol propagates kidney disease. Snuffing tobacco poses greater risk for the disease than tobacco consumption in any other form. Therefore, Himmelfarb and Sayegh (2010) advocate for healthy living as effective chronic kidney disease prevention approach. Healthy diet and regular body exercises play a critical role in ensuring that the body remains fit and free from the attack. Treatment of Kidney Disease Medication options exist for treating kidney diseases. However, at end-stage renal disease, ESRD, only two options would be viable: dialysis and kidney transplantation. In peritoneal dialysis, a membrane in the abdomen of the patient would be used in filtering waste products. The most common method of peritoneal analysis, referred to as continuous ambulatory peritoneal dialysis, CAPD would involve the individual being hooked up to dialysis fluid, charged four times a day, contained in a bag that would be carried around thus ensuring continuous dialysis (Himmelfarb & Sayegh, 2010). The other approach to peritoneal dialysis involves filling the abdomen with dialysis fluid into which wastes would filter severally, often during sleep before being drained from the body. Peritoneal dialysis could be undertaken without assistance from a healthcare professional. On the other hand, hemodialysis would require that the patient visits the dialysis center about thrice a week where a machine would be used to filter waste from the patient’s blood which would then be returned to the body once clean. This process undertaken by healthcare professionals would take between three and four hours. Nonetheless, prolonged dialysis could be harmful to the patient and also the functioning of the kidney. Successful kidney transplant would prolong the patient’s normal life with minimal expense. Kidney transplantation refers to a procedure where a healthy kidney would be placed from another person to the patient. Danovitch (2010) observed that about 33% of kidney transplants have been successful with several recipients surviving for over 20 years. II. Sources of Healthy Kidneys The sources of the kidney could be a living donor who has no kidney diseases. Kelly, Maghan and Serio (2005) observe that 40% of the donated kidneys in the US and Europe would be from live sources. It could also be from a deceased donor, a cadaver who died recently but with no chronic kidney disease. Danovitch (2010) observes that 50% of kidney transplantation sources in the US would be from cadavers. Such donors could be strangers such as a friend or spouse or relatives such as child, parent or sibling. After getting the kidney, it would be placed in cool saline water known to provide 48-hour preservation as healthcare providers perform the necessary tests to match the blood and tissues of the donor to those of the recipient prior to the operation. III. Reluctance of People to Donate Organs after Death Even with these possible sources of kidneys, Rothman and Rothman (2003) observe the acute shortage that still prevails in the US and globally. In spite of the awareness on organ donation, people continue to be skeptical about donating their organs after death due to various reasons. First, the belief of a person having to be buried whole has been widely documented with some religions such as Muslims calling for the need to have the body whole after death as it should be returned to the maker whole (Cho, Zhang & Tansuhaj, 2009). Religion has been widely documented as a factor that influences donation decisions. The research study by the Department of Health, DH (2010) for example attributes the low organ donation rate in Black-Caribbean as guided by religious belief against disfiguring the body, this being wrong before God. Various religions including Christianity consider the body as holy and should not be mutilated. Black-Africans hold a similar position appreciating God as a healer. From the recipient’s perspective, their religious faith makes them fear taking up the character traits of the donor. Muslims worry about the delays that would result from the organ donation process after death of the donor and the organs being given to non-Muslims which could have dire consequences. Buddhists fear that the process could interfere with the death and subsequently the rebirth process. Finally, there has been widespread mistrust on hospitals meant to undertake organ transplantation processes. The belief is that with the organs being their major focus, such hospitals would give minimal care to the donors and their bodies. Other prospects hold the opinion that such hospitals could prematurely terminate medical care to them as they wish death on them so as to have their organs. Just as in the US, in the UK, DH (2010) documents that Africans perceive hospitals as not valuing them, hence not given chances in life due to racism. Others hold the opinion that while they would freely donate their organs, hospitals would only sell it to the rich and thus disadvantage the needy poor. With the Uniform Anatomical Gift Act 1973, the US upholds volunteerism in donating organs hence the need to sensitize the public against the myths and beliefs that discourage organ donation so as to save human lives. IV. Why International Organ Trafficking is flourishing The trade in the body parts of humans including hearts, livers, kidneys and lungs continue to be widespread globally with Kelly et al. (2005) citing kidneys as the most sought after organ. The large number of recipients waiting for the organs propagates this trade. These organs could be obtained through coercion from inmates or people slaughtered to benefit the affluent recipients capable of paying for the illegitimate transplants. Lack of knowledge among patients on the ethical implications of purchasing organs makes it right among the patients to buy the organs. The recipients of these organs would in most cases be wealthy individuals who do not have financial problems but health problems. With the poor willing to give their organs for financial gains and the patients willing to part with money to have the organs, the trade thrives. According to Cho et al. (2009), globalization has also seen these recipients of organs adopt foreign cultures which propagate trade in human organs, notably the culture legalizing trade in human organs from India, China, Japan and South Korea. Trading in organs could be highly profitable. Considering the facilitators in the community, such economic considerations could push them to selling their organs or illegally getting organs from others so as to meet their financial needs. Kelly et al. (2005) give the example of Thailand, particularly in Philippines where the countryside peasants and those living in cities’ slums would be ready to sell their kidneys for financial gains. Such poor communities would have organ trade flourish due to lack of civic and professional organizations to oppose this. In Manila, the kidneys would be sold out in the open with majority of those who sell their kidney failing to improve economically as they become weak and fail to do manual tasks thus losing their jobs. Doctors also play a critical role in propagating human organ trade. In other communities, poor socio-economic backgrounds would cause people to sell their organs in order to pay debts, meet their family needs or pay for some crucial surgeries. Such persons consent to the removal of their organs for financial returns only to be shortchanged and not paid or partly paid thereafter. Recognizing this demand, brokers and doctors commercialize human organs so as to gain profits. Cho et al. (2009) give the example of India where the rich and their doctors have made it a norm to buy kidneys from the Indian villagers that are debt-ridden. Another critical factor in the increase of illegal organ trade in Eastern Europe has been the nascence of centralized and democratic institutions and governments that do not protect the public against exploitation through such crimes. Unregulated environments also provide ground for thriving of organ trade. Thailand maintains no central organ registry with its private hospitals not being effectively supervised by the relevant state medical authority. Consequently, Kelly et al. (2005) observe that medical administrators and physicians have the freedom of setting up illegal organ trades. In contrast, Singapore has effectively regulated organ distribution including capital punishment for those that go against organ distribution legislation. Nonetheless, because its Asian citizens object to removal of organs from the deceased, the huge number of those waiting for kidneys creates demand that propagates the illegal trade. Majority of these citizens would travel to China to have organs from executed inmates. V. Conclusion: Effect of Legal Market for Organ Trade on Vulnerable Citizens From this paper, legalizing organ trade market in the US would be detrimental to citizens considered as most vulnerable. With the interest being on the donor organs, such persons would be victims of inhumane acts as brokers and surgeons strive to get the required organs. It has been indicated that in China, inmates would be maimed and have their organs sold to buyers. People would be forcefully converted to donors if only to have the perpetrators achieve their objectives. The poor willing to sell their organs, such as those from slums in the US, could be shortchanged and fail to get the agreed compensation. After all, the National Organ Transplant Act 1984 protects such persons as it advocates against selling human organs. For those that would successfully sell their organs, there would be detrimental effect on their bodies causing them to be weak so as not to actively undertake their job responsibilities. As such, such people fail to secure employment and become poor. Similarly, the recipients play a detrimental role on the lives of the most vulnerable. This being the demand side of the chain, their continued buying of human organs continues to put the vulnerable at risk of exploitation by brokers and surgeons. As the demand decreases due to the number of those getting organs illegally increases, the government measures to rectify the situation decreases in effectiveness. The affected lot would be majorly the poor who do not have adequate resources to buy human organs. In the long run, most of these poor persons would succumb to such diseases. This demand jeopardizes the chances of living of some of these vulnerable persons such as the inmates as perpetrators seek to have organs from them. Finally, legalizing trade in human organs opens the American healthcare to organs from other countries which comes with its challenges of foreign diseases and health conditions. The poor who would not afford the cost of adequate screening of such organs consequently end up suffering from strange health conditions, which further jeopardize their ability to access medical care. The porous borders would open the US to other illegal trades as noted by Cho et al. (2009) including drug trafficking and smuggling of arms. As such, respect for human body should be upheld and trade in organs be treated as illegal. References Cho, H., Zhang, M. & Tansuhaj, P. (2009). An empirical study on international human organ trafficking: effects of globalization. Innovative Marketing, 5(3), 66 – 74. Danovitch, G. M. (2010). Handbook of kidney transplantation (5th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. Department of Health (2010). Organ donor campaign: Faith & organ donation. Retrieved 20 February 2013 from http://www.organdonation.nhs.uk Himmelfarb, J. & Sayegh, M. H. (2010). Chronic kidney disease, dialysis and transplantation: A companion to Brenner & Rector’s The Kidney. Philadelphia, PA: Saunders Elsevier. Kelly, R. J., Maghan, J. & Serio, J. D. (2005). Illicit trafficking: A reference handbook. California: ABC-CLIO. Rothman, D. J. & Rothman, S. M. (2003, October 23). The organ market. The New York Review of Books. Retrieved 20 February 2013 from www.nybooks.com Read More