In March 2008, the government passed a new law banning the sale of organs. After the practice was cracked down, the number of transplants increased from 1,046 in 2007 to 511 in 2010. [75] Since then, the government has taken a much more active stance against transplant tourism. Some critics argue that the Iranian system exerts some coercion, as more than 70% of donors are poor. [10] There is no short- or long-term monitoring of organ donor health. [11] In fact, there is evidence that Iranian donors achieve very negative results, both in terms of health and emotional well-being. [12] The kidney is the most in-demand organ in transplant tourism, with prices for the organ ranging from as low as $1,300[12] to $150,000. [54] Reports estimate that 75% of all illicit organ trafficking involves kidneys. [55] The liver trade is also present in transplant tourism, with prices ranging from $4,000[56] to $157,000. [2] Although livers are regenerative, so liver donation is not fatal, they are much rarer due to an excruciating postoperative recovery period that deters donors.
Other commonly sold high-priced body parts include corneas ($24,400) and unfertilized eggs ($12,400), while cheaper physical goods include blood ($25 to $337), skin ($10 per square inch) and bones/ligaments ($5,465). [2] Although there is a high demand and, therefore, a very high price for vital organs such as heart and lungs, transplant tourism and organ trafficking in these regions is very rare due to the sophisticated nature of transplant surgery and the state-of-the-art facilities required for such transplants. [2] However, other critics argue that such a free market system for organ trafficking would encourage organ theft through the murder and neglect of people who are ill for financial reasons. Proponents of the free organ market object to these claims that murder is already committed for profit; sanctions are in place against such acts in order to minimize their occurrence; And with proper regulation and prosecution, such incidents in legal organ trafficking could also be minimized. [121] Many advocates advocate legalizing the sale of organs for reasons of autonomy. Individuals are generally free to buy or sell their goods and labour power. Proponents of organ markets say people should also be free to buy or sell organs. [101] From this perspective, the prohibition on the sale of organs constitutes a paternalistic or moralistic interference with the liberty of the individual.
Proponents recognize that there is some risk of harm associated with selling a kidney as opposed to selling a tangible asset such as a car. However, they find that people are able to engage in dangerous occupations (such as lumberjacks, soldiers, or surrogacy) that carry a significant likelihood of bodily harm. [102] If individuals are allowed to take this risk for money, they should also be able to take the risks of selling a kidney. Proponents of organ sales claim that this reasoning confuses the kidney with the whole person; [116] As long as the transaction is carried out in a manner that minimizes risk to the donor and equitably compensates the donor, that person will not be reduced to a means to an end. For those of us who have obtained a driver`s license, it is possible to mark ourselves as an organ donor after death. For kidneys, however, living donors are also a possible option. After all, everyone has two and most people can function well with one. Nevertheless, there are only a few living donors. In the United States, donations are the only legal way for people to obtain organs, and often these donations are less than the actual demand. For example, one source claims that the number of kidney transplants that can be administered in a year in the United States is about 20,000, far less than the 100,000 per year that would be needed to meet demand. In addition, the same source explains that under current laws, some people have to wait nearly 10 years to get a kidney transplant, and often people on the waiting list die before they can get a transplant. There are many arguments as to why organs should only be acquired through donation.
However, there is also compelling evidence of why buying and selling organs in a law firm is the best way to save as many people as possible. Proponents also argue that organ sales should be legal because the procedure is relatively safe for donors. [96] The short-term risk of donor is low – patients have a mortality rate of 0.03%,[97] similar to some elective cosmetic procedures such as liposuction. [98] In addition, the long-term risks are also relatively low. A 2018 systematic review found that kidney donors did not die before non-donors. [99] Donors were at slightly increased risk of chronic kidney disease and preeclampsia (a condition sometimes seen during pregnancy). The review found no difference in rates of diabetes, heart disease, high blood pressure or mental illness. Several studies of American and Japanese donors have found that they report a better quality of life than the average non-donor. [97] Proponents of organ procurement argue that, given the relative safety of kidney donation, individuals should be allowed to undergo this surgery for a fee. Essentially, the pros and cons of advocating for a legal organ market are difficult to assess.
Monetary rewards for organs cause problems where the poor are disadvantaged. Yet paying donors is an easy way to dramatically increase organ reserves, potentially saving thousands of lives each year. In both cases, there will be ethical dilemmas. However, it is clear that if the U.S. wants to abolish the current waiting list, something has to change. If it is heavily regulated, it is not impossible to have a system that eliminates the waiting list for kidneys and protects donors from exploitation. Iran is a prime example; On this basis, the United States, as well as other countries currently struggling to meet the demand for organs, could use the Iranian model to meet demand and reduce the exploitation risks often associated with the organ market. He seems hopeful that in the coming years, as research continues on this topic, a more viable solution to the demand for organs in the United States will be implemented. One of the arguments against legalizing the buying and selling of organs is that it would likely lead to a society where only the rich would have access to vital organ transplants and the poor would be the main donors of those organs. Currently, the U.S.
system fights this inequality by not paying or charging people for organs and granting people organ transplants only by putting them on a waiting list that comes first, grinds first. This means that no matter if someone is rich or poor, an individual has the same chance of receiving an organ transplant as the next person. When there is an organ market, there is a dynamic of exploitation between rich and poor, where the poor sell their organs and are often not fairly remunerated. This is an important reason why the World Health Organization has begged states to end «transplant tourism.» Transplant tourism has attracted the attention of the international community as a deeply exploitative practice, due in large part to its process. This is because it often happens that the poor sell their organs at low prices to an intermediary, who then sells the same organs to wealthy buyers for large sums of money. For example, one source points out that in Pakistan, people are abandoning their loins to be freed from slavery. However, the same article states that when people sell their organs, their health often deteriorates, which can plunge them further into a life of poverty. Thus, while more organ transplants could be performed in a more capitalist system, it would likely only benefit the upper classes, creating a deeply exploitative and unequal system. Some market opponents take a paternalistic stance that prohibits the sale of organs on the grounds that the government has a duty to prevent harm to its citizens.
Contrary to the argument discussed above, «coercion by poverty», these criticisms do not necessarily call into question the validity of donor consent. Rather, they say that the dangers posed by organ donation are too great to allow a person to undertake them voluntarily for money. As mentioned earlier, organ sales reviews cite research suggesting that kidney sellers suffer serious consequences from surgery that yield far worse results than altruistic kidney donors. Even assuming that kidney sellers will achieve similar results to donors in a regulated market, one cannot ignore the fact that a nephrectomy is an invasive procedure that, by definition, inflicts injury on the patient. [113] These critics argue that the government has a duty to prevent this damage, even if the potential seller is willing to take it upon itself.