As if we don't have enough ethical issues to work through, here's another one heading at us full steam: Why not let people sell their organs? The discussion began, for me, from having served on the Ethics Committee here at Fort Sanders Medical Center. My sister and I have tossed it around as well. She is a physician who has retired from private practice to enter the relatively new specialty in medical ethics, serving as a resource and adviser to her colleagues when diffi cult situations arise and the decisions that must be made are between two rights -- or two wrongs.
Medical advances have created possibilities for which there are no precedents and no legal guidelines and involve predicaments no writers of ancient holy writ could've imagined.
Last week, an article by Jeff Jacoby in The Boston Globe brought the subject up for public debate. He mentions in his article the fact that Apple CEO Steve Jobs recently came to Tennessee to undergo a liver transplant -- begging the question as to whether or not such a high-profile person had somehow "gamed the organ donation system to jump to the head of the waiting list."
More than 100,000 Americans are at this moment on the waiting list for organ transplants. Federal law prohibits a donor from getting any compensation. It is considered a purely altruistic act.
Last year, more than 6,600 people died because they couldn't get a donor in time -- and, as Jacoby points out, were buried or cremated alongside bodies that had intact organs that were uselessly buried or cremated with them.
This is the question the article puts forth: Why is organ donation the one aspect of our health care system that must be entirely free of commercial motivation? He writes: "The surgeon who performed Jobs' transplant, the hospital, and the pharmacy that supplied his meds all were paid for the benefits they rendered. Why shouldn't the organ donor -- or the donor's family -- also benefit from the same free market?"
We allow people to sell their blood, don't we? Is there a difference? Must donating a liver or an eye -- by law -- be an altruistic act? The waiting list will continue to get longer and longer since a willingness to be altruistic in this case is not popular. Or would it make more sense to compensate financially, motivating people to help save the thousands of lives lost each year because of a lack of a donor?
There is something distasteful about selling organs, but I am not sure why. If someone I loved needed a liver or a bone marrow transplant, I would want it to happen quickly and any way possible. I wouldn't care whether it came from kindness or for cash. I would be charged for lifesaving care of any other sort -- why not this?
If, as a nation, we are not altruistic enough when it comes to donating organs, especially at death when they are of no further use, then perhaps our love of money might be a way of making it possible for others to live.
Jacoby suggests, and I tend to agree, that keeping organ donation a strictly altruistic activity is evidence of a misplaced idealism and anything but humane.
No matter how we feel about the money aspect, I see no reason a person would want to be buried with organs that might save a life. All it takes is putting that wish in writing -- and on our drivers' license -- and in our wills.
It may not be a happy topic to discuss with our parents or our children, but imagine the happiness it would bring to the family of the people whose life we could save.
Maybe there is a scriptural passage that we can turn to after all. One that is written into every religion across the globe: "Do unto others."
(Ina Hughs is a retired News Sentinel staff writer. She may be reached at firstname.lastname@example.org)