A Review of “An Ethical Market in Human Organs,” by Charles A. Erin and John Harris, and A Proposed Solution to the Current Organ Shortage

Masthead Logo The Fordham Undergraduate Research Journal Volume 1 | Issue 1 Article 7 December 2013 A Review of “An Ethical Market in Human Organs,” by Charles A. Erin and John Harris, and A Proposed Solution to the Current Organ Shortage Rachel Rattenni FCRH '14 Fordham University, Follow this and additional works at: https://fordham.bepress.com/furj Part of the Bioethics and Medical Ethics Commons, Biology Commons, Critical Care Commons, and the Tissues Commons Recommended Citation Rattenni, Rachel FCRH '14 (2013) "A Review of “An Ethical Market in Human Organs,” by Charles A. Erin and John Harris, and A Proposed Solution to the Current Organ Shortage," The Fordham Undergraduate Research Journal: Vol. 1 : Iss. 1 , Article 7. Available at: https://fordham.bepress.com/furj/vol1/iss1/7 This Article is brought to you for free and open access by DigitalResearch@Fordham. It has been accepted for inclusion in The Fordham Undergraduate Research Journal by an authorized editor of DigitalResearch@Fordham. For more information, please contact . A Review of “An Ethical Market in Human Organs,” by Charles A. Erin and John Harris, and A Proposed Solution to the Current Organ Shortage Cover Page Footnote Rachel Rattenni, FCRH 2014, is from East Hampton, New York. She is a biology major. After graduation, Rachel plans to further her education in science journalism. This article is available in The Fordham Undergraduate Research Journal: https://fordham.bepress.com/furj/vol1/iss1/7 FURJ | Volume 1 | Spring 2011 A Review of “An Ethical Market in Human Organs,” by Charles A. Erin and John Harris, and A Proposed Solution to the Current Organ Shortage R e v ie w s Rattenni: Review: An Ethical Market in Human Organs Rachel Rattenni, FCRH ’14 But was the sale ethical? While the National Organ Transplant Act bans the exchange of human organs for any “valuable consideration”, illegal organ sales such as the one depicted above occur frequently. There are currently over 100,000 people on the U.S. transplant waiting list, but only 20% can be covered yearly by deceased organ donors.2 Depending on where the United Network for Organ Sharing places one on its list, his or her chance of survival are most likely slim, since the majority of dialysis patients die within 5-10 years of starting treatment.3 An untimely death is not the only downfall of prolonged dialysis treatment. In addition, an average program includes four invasive three-hour sessions daily—racking up an expense of over $65,000 per year. In an effort to escape the high cost of dialysis treatments, several insurance companies have been found promoting illegal organ sales to their clients.4 Given the realities of the organ shortage, scholars from a variety of disciplines – including theologians, philosophers, economists, and sociologists – have debated both the merits and ethics of the way that organ donation is currently structured. In fact, in 2003, the Journal of Medical Ethics (JME) published a special issue on the supply of organs for transplantation. In this issue, several well-known scholars present arguments on a variety of topics related to organ donation, including Published by DigitalResearch@Fordham, 2011 presumed consent, compensated organ donation, and altruism. In this essay, I review one of the articles that appeared in this special issue of JME: “An Ethical Market in Human Organs” by Charles A. Erin and John Harris.5 I then review the published commentary of this article, which was written by Janet Radcliffe Richards. ENGLISH In 2005, an Israeli man named Nick Rosen answered an ad in his local Tel Aviv newspaper searching for someone interested in selling a kidney. Through funding from the broker who placed the ad, Rosen was flown to New York and set up with a dialysis patient from Brooklyn. After Rosen and the dialysis patient passed a simple procedure for the screening of illegal organ sales by saying the two were old friends, the successful transplant surgery was performed at the esteemed Mount Sinai Medical Center in New York. The Brooklyn resident walked away never again needing to go on dialysis, and Nick Rosen walked away happily with $15,000.1 In their article, Erin and Harris, both professors at the University of Manchester, begin by making the claim that human lives are at stake because there are not enough organs available for transplantation. They cite the attempts of such organizations as the British Medical Association, the American Medical Association, and the International Forum for Transplant Ethics to try to increase the supply of donor organs. Erin and Harris argue that one such remedy to the organ shortage might include a “market of living donors” that is “ethically supportable” with “safeguards against wrongful exploitation.” Thus the solution, according to the authors, would be a “single-purchaser system within a confined marketplace.” Effectively, in the system proposed by Erin and Harris, organs would be legally sold and made available to hospitals. They argue that an organization, such as the National Health Service for example, should purchase all organs and provide them to hospitals (much in the same way that organs from deceased organ donors are provided), without allowing for direct private sales. Erin and Harris also argue that organ sales and transplants should be restricted on a national basis, so that if an Indian citizen were to sell an organ in his or her country, then that organ could only be used by a need recipient in India. By restricting organ sales and purchases on a geopolitical basis, Erin and Harris hope to prevent the exploitation of citizens from poorer nations who may be more easily coerced into selling their organs. Aside from an increase in the amount of organs available for transplant, Erin and Harris note that regulating organ sales may present several other benefits. For example, patients who have received organs from live 202 1 FURJ | Volume 1 | Spring 2011 R e v ie w s The Fordham Undergraduate Research Journal, Vol. 1 [2011], Iss. 1, Art. 7 donors have double the life expectancy than those who have received organs from cadavers. They point out that insurance companies, as a result, would also spend less money on dialysis every year.6 There are also benefits to the donor: since medical care would be given to donors after surgery, they could be able to continue living their lives as they had been before their surgery. ENGLISH To answer the question of whether or not organ sales (as opposed to pure donations) are ethical, Erin and Harris highlight that, in the current system, the only person who is not compensated in some way for a transplant is the donor. They wonder why it is considered more ethical that a transplant surgeon, a hospital, and a patient who can now lead a healthy life all receive payment in some form, yet a donor is left with only a scar. Erin and Harris argue that making organ donation advantageous for the donor would (...truncated)