Organ Transplants Cause Inequalities within Societies - Essay Example

11 September Organ Transplants Cause Inequalities within Societies Introduction The very prospect of buying, selling or donating body parts appears to be repulsive and indignant. However, one may argue on the other hand that premature death that could have been averted by receiving an organ is also against the dignity of human life. The question now is not whether organ transplantation is against human dignity, but rather how it can affect human lives and societies. This is because organ transplantation is in such great demand that there is a thriving black market to meet the growing demand and counteract the low supplies obtained via organ donations. If the black market is analyzed, it is seen that most of the sellers are poor while most of the buyers of organs are comparatively wealthy (Satz 10). Most of the organ transfers in the black market are from the poor to the rich, from the third world countries to the first world countries, from non-whites to whites and from females to males (Satz 10). Why is it that these trends reflect the long perceived inequalities in society? There certainly is a link between organ transplantation and societal inequalities, be it on an economic or a health front. This paper thus argues that organ transplants can cause inequality within society. Organ transplantation will demarcate and enhance the pre-existing inequalities in society. 2. Background As per statistics laid out by the National Kidney Foundation, more than 89,000 patients in the US are currently awaiting organ transplant and about 4000 additional patients are added every month to the waiting list (unckidneycenter.org 1). Each day, 17 patients die waiting for a transplant (1). In 2004, 3,886 patients waiting for kidney transplant, 1,811 patients waiting for liver transplant, 457 patients waiting for heart transplant and 483 patients waiting for lung transplant died while waiting (1). Estimation of people who meet premature death simply waiting for organ transplants is difficult. Worldwide, it is estimated that 700000 patients are on dialysis and in need of kidneys (Erin and Harris 137). In Western Europe alone, 40,000 people wait for kidney transplantation while only 10,000 kidneys become available (137). It is thus obvious that there is a huge shortage of organs, so much so that governments worldwide are considering the prospects of a legalized organ market! However, it is feared that such a market will lead to exploitation of those (such as the poor) who are in desperate need of money, or those (such as women or weak sections of society) who are forced to sell or donate their organs for various reasons. Organ transplants, similar to reproductive technology and cloning, “both express and enhance social inequalities”, especially the inequalities existing between societies (Turner and Rojek 217). As Phillips justifiably points out, it is difficult to call everyone as equals when “the bodies of some are being employed to solve problems in the bodies of others” (154). 3. How Organ Transplants Can Lead To Societal Inequalities 3.1. Economic and social disparities Several studies have shown that inequalities associated with age, race, gender, socio-economic status, etc. exist in organ transplantation. In a study, Kjellstrand calculated the probability of receiving kidney transplant in the US in the year 1983 and found that the transplant rates were higher (31%) for men than for women (21%) (1305). He also showed that white patients had a higher transplant rate (30%) than non-white patients (20%). Moreover, patients who were aged below 35 years had a higher transplantation rate (85%) than those over 56 years of age. When gender, age, and race were analyzed together, Kjellstrand found that nonwhite patients between 21-45 years of age had only half the chance of receiving an organ transplant as compared to white patients in the same age group and gender (1305). Moreover, women in the 46-60 years age group had less than half the chance of receiving an organ transplant as compared to men of the same race and in the same age group. Thus, this research suggests that race, age and gender imbalances exist in the distribution or kidney transplantation. Kjellstrand believes that these disparities partially have a “morally neutral biological, medical, social, and cultural explanation”, suggesting that a fairer distribution of organ transplants is required (1305). On a similar note, Daw contends that the outcomes of organ transplantation processes have always disproportionately benefited white individuals when compared to other ethnic and racial minorities (7). According to his research compilations, the number of African Americans is higher in the transplant candidate populations and lower in the transplant recipient populations as seen in figure 1. Similar inequalities are seen for other ethnic minorities. This conclusion is based on data collected in 2007. Figure 1: Organ donation, organ reception according to race (Daw 37) Another major concern with organ transplantation is the existence of an organ black market. The buying and selling of organs is strictly against law and therefore, an illegal black market is thriving in the backdrop of the organ demand. Such a market, due to its illegal nature, is not regulated and therefore, organs are being bought at huge costs by those who are wealthy enough to buy and sold by those who are desperate enough to sell. In such a market, there is no competent authority to ensure the rights of buyers and sellers or to regulate the pricing. Organ brokers therefore exploit the poor and desperate, especially from third world countries, to supply organs to the wealthy. Moreover, in this milieu, the weaker sections of society are often affected, especially if they are females or if they belong to ethnic minorities. An example is that of Indian kidney sellers. A study that interviewed kidney sellers in India showed that a vast majority of them were married women (Satz 8). Because of the weak position of women in Indian society, the voluntary nature of such selling by married women is questionable. As Satz explains, one of the most common explanations offered by these women for selling their own kidney rather than their husbands was that their husbands were the only income source of their families or that their husbands were ill. It is thus argued that weaker sections of the society would become ‘spare parts’ for the rich (Satz 10). Therefore, it can be concluded that organ transplantation has led to the evolution of an organ black market that exploits the weaker sections of society. 3.2. Health disparities Another serious issue with organ transplants is that it will result in health inequalities. Organ transplants require medical procedures such as surgeries, which entail risks. Donating or selling an organ is thus a risky proposition whose consequence can only be known in the future. Some studies have shown that nephrectomy results in marked deterioration in health in some individuals (Satz 8). By donating or selling a kidney, a donor becomes vulnerable to health risks that may result if the remaining kidney is damaged due to overwork or age. In case of other organs that are obtained from cadavers, the recipients may suffer if a disease or disorder is overlooked or if a damaged organ is transplanted. Because of the kidney black market, the poor and underprivileged who sell their kidneys do not enjoy health insurance or medical claims in case of future health problems arising out of the organ selling. Most studies on kidney transplants have shown that there are very few adverse effects in the case of donors. However, many of these have been conducted in wealthy countries and their results may not necessarily correspond correctly to conditions in poorer countries where people do not have proper access to proper nutrition or clean water (Satz 8). A study by an Organ Donation Taskforce in the UK has shown that health inequalities are also associated with racial disparities with regards to organ transplantation (nhsbt.nhs.uk 29). It showed that although organ transplantation demand is increasing for all groups, the increase in demand is greatest for black and minority ethnic groups, while the number of transplants and donors has remained static. Furthermore, there are fewer donors among the black and minority ethnic groups compared to other groups. According to the report, with an increase in the number of organ transplants, there is a “risk of a widening gap between the white population and BME groups if health inequalities” are not focused upon in recommendations (30). Organ transplants directly increase health inequalities by introducing an environment of the ‘haves’ and the ‘have nots’. By ‘haves’, it is implied here that some have the power to attain the desired organ either through wealth or altruistic means, while the ‘have nots’ may be deprived of organs as they either cannot afford to buy one in a black market or acquire one through altruistic donations. 4. Alternate Views Those in favor of organ transplants argue that organ transplants are the need of the hour. Organ transplants are equally adept at inducing societal inequalities as much as any other human activity such as food consumption or accumulation of wealth. Moreover, legalized and ethically regulated organ markets can also successfully alleviate the ethical issues raised by organ black markets (Savulescu 138). For instance, a successful model of a legalized organ market is that of Iran, where a “compensated and regulated living-unrelated donor renal transplant program” was adopted (Ghods and Savaj 1136). This model increased the number of renal transplantations to such an extent that the kidney transplant waiting list was eliminated completely. The model also addressed major ethical issues concerned with marketization of kidneys. As discussed, many counter-argue against the statement that organ transplants cause social inequalities, and that the risk is as much as that for simple daily activities such as food consumption, where social inequalities exist, as the poor are always deprived from good nutrition, which is enjoyed mostly by the wealthy. Therefore, one cannot eliminate food consumption, and similarly organ transplantation. However, it should be understood here that the question is not whether organ transplantation should be eliminated or not but rather what social inequalities will it enhance and how these can be controlled. 5. Conclusion In light of the arguments presented, it is concluded that organ transplants can cause inequality within society. Organ transplants have resulted in a kidney black market, where the poor and underprivileged are exploited into selling organs to the wealthy, who can afford to buy organs for large sums of money. Moreover, organ donations seem to be more in favor of the better socio-economic groups. Racial, age and gender disparities also exist. Organ transplantation also results in health inequalities where some have a better health advantage over others in terms of wealth and race. If organ transplants are to be encouraged and continued, these inequalities will have to be uprooted. Works Cited Daw, Jonathan. “The Causes of Racial Inequalities in Kidney Transplantation.” Princeton.edu, 15 September 2010. Web. < http://paa2011.princeton.edu/papers/111113>. Erin, Charles and John Harris. “An ethical market in human organs.” Journal of Medical Ethics 29 (2003): 137–138. Ghods, Ahad and Shekoufeh Savaj. “Iranian Model of Paid and Regulated Living-Unrelated: Kidney Donation.” Clinical Journal of Nephrology 1 (2006): 1136–1145. Kjellstrand, Carl. “Age, Sex, and Race Inequality in Renal Transplantation.” Archives of Internal Medicine 148 (1988): 1305-1309. nhsbt.nhs.uk. “Organs for transplants.” www.nhsbt.nhs.uk. Web. < http://www.nhsbt.nhs.uk/to2020/resources/Taskforceevidencereview.pdf>. Phillips, Anne. Our Bodies, Whose Property. Oxfordshire: Princeton University Press, 2013. Web. Satz, Debra. “Why Some Things Should Not Be for Sale: The Moral Limits of Markets.” Ethical Issues in the Supply and Demand of Human Kidneys. (2010): 1-22. Savulescu, J. “Is the sale of body parts wrong.” Journal of Medical Ethics 29 (2003): 138–139. Turner, Bryan and Chris Rojek. Society and Culture: Scarcity and Solidarity. California: Sage, 2001. Web. unckidneycenter.org. “25 Facts About Organ Donation and Transplantation.” National Kidney Foundation. Web. < http://www.unckidneycenter.org/25facts.pdf>. Read More