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Should The Black Market For Human Organs Be Legalized?

Mikki McKay
CJ 1010
Antonette Gray
Salt Lake Community College
February 20, 2018
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INTRODUCTION
Opinion is a strong and dominant factor in today’s society. Analyzing a driving

force behind a principle or movement is important to understanding the issue itself and

to forming an opinion for oneself as to a position on the issue. Ultimately, opinions are

powerful drivers of issues, but most opinions are whimsical feelings that we can’t

describe nor discover their origins. For example, someone may state that they are

“against the death penalty.” Why? A normal answer may be, “Well, I don’t think that

people should die for any crime.” But why do they feel that way? They would probably

respond with something like, “I just do.” This example brings to light the importance of

research. Analyzing an issue with an open mind will allow for critical thinking and

adopting a stance on an issue but brings with it a higher level of accuracy and

conviction – important when dealing with issues prevalent in society.

This paper will seek to investigate the legalization of the black market for human

organs and will come to a conclusion based on research and opinion – but an educated

one. Initially it appears a simple conclusion, why would society ever legalize something

such as selling personal body parts? But to another, it may seem as simple as supply

and demand. More people need kidneys than are receiving them and regulating the

market would help to stabilize that need. In either scenario, there is no right or wrong

and like in most public policy decisions, it becomes a question of weighing available

data and research to make a well-founded decision. In doing so, it is imperative that the

research be well-founded, scholar-based, or peer-reviewed, or the conclusion will

simply be opinion-based opinion.

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ISSUE

The idea of transplanting an organ from one human to another seems an

impossibility but it is an everyday reality. However, there are issues that accompany the

miracle. There are not enough organs to be received. According to National Public

Radio, in 2008 there were approximately 75,000 Americans that were in need of a

kidney. However, in 2009, only 18,000 were donated. This resulted in 1 in 4 Americans

receiving the heavily anticipated miracle [ CITATION Ric08 \l 1033 ]. NPR also reports that

the problem is not forgiving. An individual cannot merely sit and wait forever while

receiving dialysis which leads to nearly 4000 individuals will pass away in a given year

such as 2009 and another 1200 would have become too sick to be eligible for a

transplant and thus removed from the waiting list [ CITATION Ric08 \l 1033 ]. Also, notable in

the argument is that in 2002, the median time to wait for a kidney was 1144 days.

Therefore, an individual had to not pass away, not get too sick, and hold fast for over

three years before receiving a lifesaving kidney [ CITATION Mar16 \l 1033 ]. The above data

factually demonstrate the argument of supply and demand. If the market was regulated,

there would likely be more supply and many more people would receive kidneys and

other necessary organs. There are many arguments which will be covered further but it

is interesting to note the differences between belief-based opinions and fact-based,

neither makes the issue right or wrong, just different. Some believe the sale of organs

defeats the “giving” nature of donation. They believe that donation is a selfless act and

that noble gift should be preserved [ CITATION Mar16 \l 1033 ]. Many economists and

doctors state that an open market would alleviate the immense gap between supply and

demand [ CITATION Boy12 \l 1033 ]. This would likely save many lives. Others believe that
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legalization would cut down on the coercion that exists in which family members or

society pressure individuals to sell their organs. Others believe that selling the organs is

taking advantage of the poor and that legalizing the process would exacerbate that

problem, while others believe that the poor would be supported with organ regulation.

This exploitation of the poor is proclaimed by some even further by proclaiming that

poor are further manipulated because of low education. Even further, it has been shown

that people engaged in “medical tourism” programs further stimulate black market

transplants because individuals can have access to healthcare not available in their

native country while at the same time taking valuable money back [ CITATION Rog11 \l 1033

]. This benefit would be enhanced as well as diminished under legalization. Fewer

people would be likely to leave their country because there would be a bigger supply.

Rules, laws, and administrative avenues would protect those poor willing to trade a

kidney for money.

Demonstrating the idea that this market is geared toward the poor is drastically

illustrated in data accumulated by Mr. Mendoza as he studied this phenomenon in the

Philippines. First and foremost, he points out that the problem is only going to worsen

because there is increasing incidence of diabetes and hypertension as well as an

“epidemic rise of patients who have been diagnosed with end-stage renal disease

(ESRD), where both kidneys permanently fail to work. Therefore, many more people will

require kidneys in the near future. The Philippines was named by the World Health

Organization as one of the top five countries for black market organ trading and was

projected to rise to top three by 2007 and therefore is likely close to number one in its

current state.
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Currently, in the Philippines, almost all donors are male (98.4 to 1.6 female) [ CITATION

Rog11 \l 1033 ] which is interesting because it could be concluded that poor males are

sacrificing their personal organs for the betterment of their families. Strengthening this

point is research showing that 57.9 percent of donors fall within the low-income classes

and 30.6 fall into the extremely poor category but ultimately almost all are below the

poverty line [ CITATION Rog11 \l 1033 ]. The most telling point is that the difference between

those donors that are married and those that are single is about the same but that those

with dependents is significantly higher. People are donating to be able to take care of

their families. This also supports the point that is extremely prevalent in available

research. Many donors feel a latent or outward pressure from family and/or friends to

sell their organ in order to provide for their family, pay off debts, or other financial

issues.

How much will it set you back? In the U.S. a kidney will cost the buyer about

$262,000. This amount varies around the world depending on the country in which

research is being conducted. It is also difficult information to lock down due to the illegal

nature, much like asking how much does a kilo of cocaine cost in each country.

However, the data dictates, understandably, that in most places, there is an outlandish

brokerage fee [ CITATION Org18 \l 1033 ]. This leads to other conclusions regarding

legalization. It is likely that if it were legalized and regulated in the U.S., it would remain

an expensive endeavor, (it isn’t like a legal kidney transplant is cheap). This leads to

concluding that individuals may still be willing to leave the U.S. and their home countries
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and go where the transplant could be done for possibly hundreds of thousands of

dollars cheaper.

CONCLUSION

Iran is one of the only countries to establish a system of organ donation that is

legal and regulated. There are considerations to be made such as the fact that the

government system was regulated, and the donors received payment and health

insurance. However, it is important to note that the number of transplants doubled within

the first year and four fifths were from unrelated sources [ CITATION Rup08 \l 1033 ]. Do we

conclude that the answer is legalization? Common sense dictates that regulation would

benefit the good of society. Most people would initially believe that criminal activity

should be halted in favor of a solid legal system. However, research shows that there

are deeper levels. Scholarly research is strong in this area and provides valuable

information and it is further verified and peer reviewed. The information available on this

subject is vast because of its opinionated nature. The research, however, appears

divided into small, nitpicky opinions and large overarching principles. Also, assumptions

run rampant within the research, for example, if organ transplants were regulated in the

U.S., a large assumption is that people wouldn’t simply continue to receive transplants

in other countries where the transplant is cheaper and non-regulated. There are other

assumptions as well. Many scholars stated that coercion would cease after regulation.

This could be true, but it could also move the other way and more people would be

pressured into solving their financial difficulties through this method because through

regulation, it would be easier and legal. This topic is difficult to come to a concrete
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conclusion and likely, there isn’t a black and white correct answer. However,

considering the research, the overarching arguments and principles are:

1. The main demographic engaging in this practice are male

2. They are (in most cases) trying to solve a financial crisis

3. In many cases they are pressured or guided by an outside source

4. Black market organ donation highly discriminates against the poor

Considering the aforementioned points, regulation would likely create a standard

pricing system for organs which would assist in higher compensation for donors. This

will increase pressure to donate and it also may lead to people going to other countries

where they can continue to get a cheaper rate. In the positive, regulation would likely

increase the number of organs donated per year and reduce the massive demand on

the system. Regulation will make donating very easy, more people will accept this as a

financial safety net and be coerced into donating. The poor will likely still be targeted for

the same reasons and will still donate for the same reasons. For this reason, a strong

conclusion could be made for non-regulation.

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References

Boyes, W., & Melvin, M. (2012). Microeconomics. Boston: Cengage Learning.

Cherry, M. J. (2016). Kidney for Sale by Owner. Washington D.C.: Georgetown
University Press.
Knox, R. (2008, May 21). Should We Legalize the Market for Human Organs? Retrieved
from NPR: https://www.npr.org/2008/05/21/90632108/should-we-legalize-the-
market-for-human-organs
Major, R. W. (2008, January 11). Paying kidney donors: time to follow Iran? McGill
Journal of Medicine, pp. 67-69.
Mendoza, R. L. (2011, March 1). Price deflation and the underground organ economy in
the Phillippines. Journal of Public Health, pp. 101-107.
Organ Trafficking Prices and Kidney Transplant Sales. (2018, January 23). Retrieved
from Havocscope: https://www.havocscope.com/black-market-prices/organs-
kidneys/
Taylor, J. (2006, December). Black markets, transplant kidneys and interpersonal
coercion. Journal of Medical Ethics, 32(12), pp. 698-701.