Organs of the people, by the people, for the people

Weekly Debates

The Society convened for the second time this semester to debate the question, Resolved: The selling of one’s organs should be legal. The resolution foreshadows a night of arguments for individual liberty and saving patients’ lives weighed against the potential costs to society from legalization.

On the affirmation, Ms. Anna Mastryukova (SFS ’16) of New York commenced her speech by stating that philosophical and legal precedents have established people’s ownership of their own lives as property. John Locke’s principle of each individual’s right to life, liberty, and property served as the inspiration for the founding of America as a republic. Furthermore, the Supreme Court ruled in Oregon v. Smith (1953) that the government will protect people’s actions as long as the consequences are only borne by the individual. Therefore, it is the negation’s duty to prove that there are direct negative externalities resulting from a mentally competent person’s decision to sell their organs.

Ms. Dimitra Rallis (COL ’15) of New York argued that legalization would disproportionately hurt low-income groups. Not only would poorer people be more pressured to sell their organs for the money, but they would also be less likely to be the beneficiaries of organ transplants because they are less able to afford them. Moreover, the number of altruistic organ donors would decrease dramatically if organ sales are legalized, which means the entire process would be monetized to favor the wealthy. Ms. Rallis framed legalization as a misplaced policy that would widen the gap in healthcare quality between rich and poor while dehumanizing the lower classes as walking stockpiles of organs. “We wouldn’t see organ sellers as beings with whom we could share humanity,” Ms. Rallis said.

In response, Ms. Heather Regen (SFS ’14) of California emphasized the drastic shortage of organs in the U.S. Roughly 5,000 people die each year on the 83,000-person waiting list for kidneys. While the number of kidneys demanded continues to increase, the number donated has stagnated, so organs previously deemed medically unfit for transplant are now being used out of desperation. She disputed the negation’s claims about the dangerous implications tied to legalization. We already place a monetary value on human lives, so legalization would not significantly exacerbate any risk of dehumanization. People will still receive organs based on a waiting list and there will be formal rules and medical professionals governing the entire process to prevent corruption that would favor the wealthy. The U.S. government could still cover transplants for low-income groups because the cost of a kidney is far cheaper than dialysis.

Speaking for the negation, Mr. Greg Miller (SFS ’14) of Ohio cautioned against placing a monetary value on human life. Affirming the resolution would make organs into a commodity, further entrenching discrimination against sick people as liabilities. “Markets may be efficient, but they are not fair or equitable,” Mr. Miller argued. “Commodities go where they fetch the best price, not where the need is greatest.” Because legalization still would not create enough supply of kidneys to satisfy global demand, it would actually exacerbate the “Red Market” for illicit kidney sales. People could be exploited and extorted for their kidneys. “The affirmation will trade one moral evil for another: the life of a person on the kidney waiting list for the life of a victim of organ trafficking,” he stated.

Mr. Snow (COL ’13) kicked off the negation floor speeches by explaining the simple policy action that allowed his home state of Washington to be a net exporter of organs: making organ donation an opt-out rather than an opt-in process. Legalization is unnecessary because a simple alteration with the DMV registration system can produce its healthcare benefits while avoiding the risks of commodification. Ms. Dailey (COL ’14) argued for the affirmation by saying that the moral quandaries presented by the negation are for an individual to sort out. Ms. Miller (COL ’14) retorted that destitution in society drives people to extreme ends for money, when they are in no state to consider moral factors. Legalization of organ sales would lower the threshold for the most debased in society. Building an economic defense for legalization, Mr. Mellen (SFS ’15) noted that the government seems to have imposed a price ceiling of $0.00 for the price of an organ, allowing demand to far exceed supply. Legalization would solve organ shortages and replace the black market for organs with an open market.

Ms. Blakeway-Phillips (SFS ’16) shot down the crux of the negation’s commodification argument by pointing out that we already place a price tag on our body parts through insurance: “Beyoncé’s voice is worth a million dollars, and her smile is priced even higher at five million. If she’s owed that much for a damaged body part, why can’t she sell it?” In response, Mr. Zajac (COL ’15) said that the debate isn’t about a philosophical question of rights to one’s body, but rather about the consequences of legalization. “Legalization means organs will start flowing towards people with money, and people will be denied organs just because they lack money,” he cautioned. Ms. Wood (SFS ’14) acknowledged that illicit organ sales are a problem, but disputed that legalization would significantly exacerbate it. With medical oversight and background checks, people won’t be able to just show up at a hospital with a stolen kidney in a Ziploc bag. However, Mr. Lim (SFS ’13) did not harbor as much faith in the efficacy of government to stamp out abuses. And when people get desperate, there’s lots of room for abuse. Resident Libertarian Mr. Spagnuolo (SFS ’14) emphasized that he had even less faith in the government, but argued that such fears are outweighed by the social benefits of legalization. Selling organs would give people more opportunities to get out of poverty; he criticized the negation’s laments as liberal elitism.

In his closing keynote, Mr. Miller drew upon his research as a State Department intern to underscore that organ transfers on the black market happen every single day. There are corrupt hospital workers who will steal organs from dead bodies and who will transplant any organ you bring in for a small “tip.” He emphasized that the legality of kidney sales does not affect its demand and legalization cannot produce enough supply to solve the problem entirely. Instead, the best way to increase the supply of organs in the long-run is through educational campaigns that alter people’s behaviors surrounding organ donation. Ms. Regen underscored the urgency and severity of our national organ shortage. Educational campaigns are a nice idea, but take too long to have an effect. Paraphrasing Jon Stewart, she criticized the affirmation for letting a possible dystopic future prevent us from addressing an actual dystopic reality. Wealthy people already have an advantage because they can pay any price for an organ on the black market now. It’s poor people that are dependent on the waiting list that would be significantly reduced through legalization.

Ms. Rallis reiterated the risks to legalization; the vast majority of participants in Iran’s organ selling program are under the poverty line, and 58% of organ sellers reported negative health effects. Furthermore, monetary compensation for organs would decrease the number of donations, further placing organs out of reach for most people. She advocated switching to an opt-out organ donation system to solve the medical problem while avoiding the negative implications of class division and dehumanization. Finally, Ms. Mastryukova argued that the moral benefit of saving lives outweighed any possible increase in dehumanization, which already occurs in the status quo. Furthermore, the government currently pays $95,000 per year per patient for dialyses through Medicare and Medicaid, so economically, buying kidneys from donors is a superior alternative. Ultimately, she urged a vote for the affirmation because the negation failed to prove that an individual will experience any direct negative effects from another person choosing to sell their kidney.

The Society voted 41-4-26 to affirm.

Congratulations to Ms. Mastryukova and Ms. Rallis for being newest members inducted into the Society, and the first inductees of 2013!

ELD,

Chloe J. Krawczyk

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