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Kristen Hicks
Molly Foland
English 111
October 12, 2015

Supply and Demand: The Need of a Compensation System for Organ Donation
As the case has been since the inception of organ donation, the number of available
organs and willing donors greatly exceeds the number of patients on the transplant waiting list.
The very idea of regulation of a black market and compensating donors may sound gruesome to
most people, but it should not. According to the United Network for Organ Sharing, UNOS,
there are 122,540 patients in the United States alone who are awaiting a transplant. Twenty-one
people die daily waiting for an organ that never comes. Many others endure painful procedures
and measures to sustain their lives, while waiting for available organs. Other people turn to the
black market to obtain a life-saving organ. There simply is not enough supply to meet the
constant demand. The only viable, reasonable solution is to compensate donors or their families
utilize a system of incentives for organ and tissue donation.
In the United States, organ donation is done only with the consent of the family (after
death of a family member) or by the donor themselves. The current organ donation process
utilizes a national computer system and strict standards to ensure ethical and fair distribution of
organs. Donated organs are matched by blood and tissue typing, organ size, medical urgency,
waiting time and geographic location. Organs and tissues that can be donated include: heart,
kidneys, lungs, liver, pancreas, intestines, corneas, skin, tendons, bone, and heart valves.
Supply is scarce, largely because the circumstances in which organ donation occurs are
so limited. Organ donors must be young and healthy and typically die of a catastrophic event,
such as a car accident. Once the determination that an individual is brain dead, the hospital
contacts a local donor recruitment agency. The news and shock of a young persons tragic death
is typically not even an hour old when donation agencies arrive. Donor recruitment agencies are
famous for being aggressive. Organizations can spend days coaxing a family into consenting.

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Once consent is given, the process of procuring the organ(s) begins. This process can take up to
seven days, depending on how many organs are being donated. In order for the organs/tissues to
be transplantable, the hospital has to sustain the life of the donor, artificially, and keep
him/her alive until all the organs are carefully removed. Some families opt out of organ donation
for this reason alone. Some have moral or religious objections to sustaining their family
members life. For others, the additional week of waiting for their loved one to pass away
medically is too painful to endure.
Tissue donation, unlike organ donation, is lightly regulated and totally unmapped.
In the case of tissue donation, human tissue has never been more valuable. According to the
American Association of Tissue Banks, doctors perform more than 1 million transplants each
year. This fuels a thriving industry composed of tissue banks, biotech firms, and middlemen.
Tissue banks are non-profit industries that procure the tissue after death. Tissue banks then send
the tissue to another nonprofit agency, such as Lifenet. According to their website, the mission of
this group is simple To save lives, restore health, and give hope. A look at Lifenets 2013 nonprofit tax return, shows that their net income (Revenues all expenses) and assets totaled
$115,356,299. From this nonprofit firm, the tissue then enters the for profit system. Usually,
Lifenet will send the tissue to contracted companies that then use it for various reasons-such as
replacement skin for a burn victim or cosmetic filler for socialites suffering from thin lips. All
the while, not a cent of which will go to the families of the donors who provided the tissue
The shortage of available organs to an economist, is a basic supply-and-demand gap,
with tragic consequences. Compensation for donated organs would increase the number of
organs donated. A clear, regulated system of incentives and/or compensation for family
members would absolutely spur some families to reconsider their stance against organ donation.
It is not uncommon for a deceased individuals family to receive a bill of $20,000-$30,000 from
the hospital, even after health insurance pays their portion. Compensation would make a huge
difference in determining whether or not to donate organs. That money can be used to
offset exuberant hospital bills & increasing funeral expenses. An unexpected death can cause
a family financial crisis. Compensation for organ donation would help ease that burden.

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The majority of people who oppose compensation for organ donation are against it
mainly due to moral, ethical reasons. Detractors attest that having this type of system,
commodifies the human body. The National Kidney Foundation addresses compensation by
saying: Offering direct or indirect economic benefits in exchange for organ donation is
inconsistent with our values as a society. Any attempt to assign a monetary value to the human
body, or body parts, diminishes human dignity. But, what the Kidney Foundation fails to
acknowledge is that there are parts of the human body that already have monetary value and can
be legally sold. A person can donate plasma to blood banks in exchange for money, a man can
donate his sperm to a sperm bank for monetary benefit, and human tissue is cut from a deceased
persons skin legally by doctors and sold for profit. In fact, there is no law requiring doctors to
ask the family before removing tissue from a deceased individual. If you have a loved one who
has died, chances are they have had tissue removed without your knowledge.
By this process, the human body has already been commodified and assigned a value.
Hospitals, doctors, and organizations are already making money off of donated human bodies. If
a donation is made, the hospital benefits financially from each additional surgery that is required.
Doctors and nurses are required to perform the surgeries and financially benefit from the
additional hours worked. The transplant recipient receives the benefit of a longer, healthier life.
Why should the most instrumental piece of the donation process, the donor/donors family, be
denied monetary benefit while everyone is benefitting? Our bodies have become increasingly
valuable upon death, with advances in technology. Unfortunately, the current system, will not
allow the donor itself to benefit should our body parts be used after our death. While the current
organ donation system is supposedly set up to prevent the commodification of the human body,
the reality is that simply is not true.
Many will protest that an organ market will lead to exploitation and unfair advantages for
the rich and powerful. But, these are the characteristics of the current black market. Moreover,
as with drug prohibition today and alcohol prohibition in the 1920s, pushing a market
underground is the way to make it rife with violence and criminality.

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Regulating this industry, would reduce if not totally eliminate the black market trade of
harvested organs. This seedy industry is growing with each day, and without changes, the
industry is likely to grow to the size of the illegal drug trade. As it grows, so will the horror
stories of people making risky, dangerous decisions in order to simply live longer. In the
illegal market, there are usually at least three people involved a middleman or broker
who arranges the procedure, the doctor who performs the surgery, and the seller of the organ.
The doctor receives the largest cut, the broker receives a decent cut, and the seller
is left with the smallest cut. Regulation would protect the buyers of these black market organs
from dangerous operations and protect sellers by ensuring they are compensated fairly. A
controlled, regulated system that pre-determines prices would prevent brokers and third parties
from taking advantage of the buyers and sellers of organs, the most instrumental piece in the
equation.
Critics of a regulated organ market claim that controlling such a market would be too
difficult and costly. Such an argument can be dismissed immediately by looking at Iran,
the only country in the world has been successful in eliminating the shortage of transplant
organs. It is the only country that has a working and legal payment system for organ donation.
The way their system works is fairly easy to manage and maintain. If a patient does not have a
living relative or who are not assigned an organ from a deceased donor, they apply to an
organization called Dialysis and Transplant Patients Association (DATPA). The
association establishes potential donors, those donors are assessed by transplant doctors who are
not affiliated with DATPA. The government gives compensation of $1,200 to the donors and
give them one year of limited health insurance. Additionally, working through DATPA, kidney
recipients pay donors between $2,300 and $4,500. Most importantly, it is illegal for the
medical/surgical teams involved or any middleman to receive payment. Charity donations are
made to those donors whose recipients are unable to pay. By implementing this fairly simple
system in 1988, they had eliminated the shortage of kidneys by 1999. (Ghods) Within the first
year of the establishment of this system, the number of transplants had almost doubled. This
system could be used a guideline to implement similar programs around the world.

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While there will always be arguments against compensation for organ donation, most of
those are seeded in morality. Allowing donors and their families to participate in the monetary
benefits would affirm the authority of persons over themselves. Compensation itself does not
destroy the act of generosity that occurs in organ donation. It would simply allow the crucial
element, the donor, to fairly receive monetary compensation. The need for donated organs is not
going to go away and a solution needs to put into action. The truly decent route would be to
allow people to give their organs freely, especially upon death, in exchange for money.
Thousands of lives would be saved and thousands more benefit financially. What is really at
stake is our civil liberty and the significance of our authority over ourselves and our bodies. Yet,
we are deprived both, with the horribly unfortunate consequences, just to maintain the pretense
of state-enforced propriety.

Works Cited

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Cherry, Mark. Kidney for Sale by owner: Human Organs, transplantation, and the Market.
Washington D.C. : Georgetown University Press. 30 March 2005
Howley, Kerry. Who owns your body parts? Everyones making money in the market for body
tissue-except the donors. Reason Mar.2007: 20+. Opposing Viewpoints in Context. Web.
2 Oct 2015.
Gods, Ahad J. Iranian Model of Paid and regulated Living-Unrelated Kidney Donation.
Clinical Journal of the American Society of Nephrology. (November 2006).
Organ Procurement and transplantation Network. http://optn.transplant.hrsa.gov/. U.S.
Department of Health & Human Services. Retrieved 11 October 2015.
Financial Incentives for Organ Donation. Archived from the original on 17 May 2013.
https://web.archive.org/web/20130517121252/http://www.kidney.org/news/newsroom/po
sitionpaper03.cfm