Posted by Eugene Volokh:
Compensation for Organs and Organ Quality:
http://volokh.com/archives/archive_2006_11_12-2006_11_18.shtml#1163467040
Some readers raised this issue, which I had relegated to a footnote in
[1]my article, but which I thought I'd post in response:
Some have argued that allowing organ sales wouldn�t substantially
improve transplant patients� prospects, because it would decrease
the quality of organs available for transplant by attracting
providers -- such as intravenous drug users -- who are both
especially in need of money and especially likely to have certain
diseases. Yet this concern can be easily dealt with without a sales
ban. Diseases can generally be screened for, which wasn�t true
decades ago, when a similar concern drove blood banks to avoid paid
providers. And they would in any case have to be screened for,
since even charitable donors� organs may be diseased.
Blood banks, including German blood banks that routinely buy blood,
operate well with screening. Sperm banks and fertility clinics buy
and test sperm and ova; the same approach should work for organs,
too. And if compensation generates more organs, doctors can improve
average organ quality by being more selective about the organs they
use, and by setting aside organs that are not diseased but also not
optimal for transplanting.
Note also one item I didn't mention in the footnote: Recall that
people who are waiting for kindey transplants have a 6% death rate per
year, or over 20% over the duration of the current waiting list.
That's a lot of people dying for lack of organs. If compensation
yields more organs, and cuts even a year off the waiting list, and at
the same time (say) 0.1% of all extra organs are infected in ways that
can't be caught by screening (likely a substantial overestimate),
that's still a huge saving of life over the current system.
Tomorrow: A brief response to Leon Kass and other people who claim
that paying for organs is just plain wrong.
References
1. http://papers.ssrn.com/sol3/papers.cfm?abstract_id=941868#PaperDownload
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