The National Post.com at 21.

07, 05/13/13

Don't Let High-minded Ideals Get in the Way of Saving Lives

By : Jesse Kline
TORONTO Is it immoral to buy and sell human organs? Thats the question explored by Canadian documentary
filmmaker Ric Esther Bienstock in Tales from the Organ Trade, which had its North American premier at Torontos Hot
Docs festival on Sunday.
Bienstock was quite candid about the journey she and her staff took while making the film. Going into the project, the issue
appeared to be black and white. After spending time with people in the Philippines who were counting on the money they
could make from selling a kidney to lift their families out of poverty, the director realized the issue wasnt so cut and dry.
The film profiled families in Canada and the United States who were in desperate need of a kidney transplant, as well as
people living overseas who were looking to sell their organs. The movie focused on kidneys because they are in high
demand, and the fact that people are born with two of them, but only need one to survive, makes them a valuable
commodity.
But not everyone thinks that body parts should be treated as commodities, which is why most countries have made the
practice of selling organs illegal. This has not stopped a thriving black market from developing around the world
especially in poor countries where people need the money.
This raises the question of whether rich people in Western countries are taking advantage of poor people in the developing
world. By speaking to people who are willingly giving up their kidneys in exchange for cash, the movie shows that the vast
majority of organ trafficking appears to be done on a voluntary basis. It also shows that there is a huge demand for organs
here at home, and that people are willing to go to great lengths, and incredible expense, to save their life, or that of their
loved ones.
There is a huge demand for kidney transplants in Canada, which is not being met by the current system of altruistic
donations. According to The Kidney Foundation of Canada, over 23,000 Canadians were on dialysis in 2010 a costly
procedure that drains the patient both mentally and physically.
At the same time, close to 3,500 Canadians were waiting for a transplant, and the list keeps getting bigger. Approximately
16 Canadians are told they have kidney failure on a daily basis. In Ontario and British Columbia the provinces with
the longest waiting lists it can take four to six years to make it to the top. In 2010, 82 Canadians died while waiting for a
transplant. (In the U.S., that number is much higher about 18 per day.)
For many patients, going overseas to receive a transplant is the only available option, as the alternative is certain death.
This can pose a tough moral dilemma, but so long as everyone involved in the transaction is doing so willingly, it is a winwin situation: The seller gets the money he needs to survive, and the buyer gets an operation that not only improves his
quality of life, but extends it immensely.
There are, however, risks to operating the system underground. One man who appeared in Tales from the Organ Trade sold
his kidney, only to find out after the fact that he had kidney problems himself and would eventually need a transplant of his
own. This is something that likely never would have happened if the transaction was allowed to take place above board.
The solution would be to legalize and regulate the practice of buying and selling organs. After all, how can donating for
altruistic reasons be good, but doing the same thing for compensation be bad? Allowing legal organ sales would not only
increase the supply of donors, thereby saving the lives of countless Canadians, it also has the potential to save the
government a considerable amount of money.
The cost of putting a patient on dialysis which must be continued until a transplant becomes available is
approximately $60,000 per year. Compare that to a transplant, which costs $23,000, plus $6,000 per year in medication.
Over a five-year period, the transplant will save the public-health system approximately $250,000.
Despite the fact that voluntary transactions are, by their very nature, beneficial to all the parties involved, many still argue
that allowing people to receive compensation for organ donations would amount to exploiting the poor a very easy
position for Westerners, who do not face the very real threat of starvation on a daily basis, to take.
Dr. Robert Klitzman, who spoke about this issue on CBC Radios The Current on Monday, worries that such a scheme
would primarily draw organs from poor people and crowd out altruism. Yet, a 2010 survey conducted by researchers at
the University of Pennsylvania found that monetary compensation increased the likelihood that someone would donate an
organ, but that the effect was the same regardless of socioeconomic status. It also found that the monetary incentive did not
affect the number of people willing to donate for free.

There is no way to stop the organ trade. So long as there are people who need organs to save their lives, and others who are
willing to sell them, a market will exist. The best we can do is bring the trade out in the open, to ensure the safety of
everyone involved.
This can be a tricky subject, but the fact remains that people are dying because they dont have access to life-saving
treatments. How many more people are we willing let die because some people think money is dirty?