Nov 21, 2019 in Research

Organ Sales Will Save Lives by Joanna MacKay

We live in a world where a great number of people who need a kidney transplant die every day. One of the authors who are not indifferent to this problem is Joanna MacKay. In her article “Organ Sales Will Save Lives” she raises the question of the right to sell and buy kidneys on a legal basis. Thus, she calls to legalize kidney donation. As the arguments of her idea, MacKay uses the ineffectiveness of the existing legal practice of organ donation, practical benefits for both parties (the buyer and the seller) in the case of legalization of buying and selling kidneys, as well as the moral aspect of the problem. From my point of view, her arguments are worth paying attention to, as they cannot be considered to be unconvincing, given the literacy approach of the author to the problem. In her article, MacKay addresses a wide audience including representatives of both the public and political elite as well as ordinary people.

Initially, MacKay provides the reader with a terrible statistics, according to which "about 350,000 Americans suffer from end-stage renal disease1, a state of kidney disorder so advanced that the organ stops functioning altogether" (1). Then she analyzes one of the main solutions to this problem, namely dialysis. She draws our attention to the fact that dialysis is a "harsh, expensive, and, worst of all, only temporary" (1). MacKay comes to the conclusion that dialysis is not an effective way to solve the problem, because it creates a lot of inconvenience to the patient, limiting him/ her in their functions and movements. Using the method of comparison, the author compares dialysis with kidney transplants, which is in compliance with all the requirements and the use of medication "is both safe and reliable, causing few complications" (1).

Next, MacKay again draws the reader's attention to the terrible statistics, according to which “in the year 2000 alone, 2583 Americans died while waiting for a kidney transplant; worldwide the number of deaths is around 50,000” (2). Thus, she grounds her every statement with the obvious data. The researcher provides the reader with information about the ineffectiveness of the current practice of donation, given the number of people who are waiting to receive a kidney. They get into a long list of patients who are actually waiting for someone to die, and because of someone’s death, they will be able to receive a kidney. The problem, in this case, is that the number of people who want to give a kidney for free, that is, to become a donor, is very small. Moreover, often the relatives of the sick person cannot help him by becoming a kidney donor for him. The list of patients waiting for kidneys is very long. As noted by the author, “with over 60,000 people in line in the United States alone, the average wait for a cadaverous kidney is ten long years” (2). What sick people then have to do in order to improve their chances of survival? They are forced to turn to illegal methods of solving this problem by “purchasing kidneys on the black market” (2). MacKay again provides statistical data so that the reader could have a complete picture of this terrible situation. She outlines the scheme for obtaining a kidney through this method, and its advantages for the patient, as “there are no lines, no waits” (2). The attractiveness of the illegal kidney trade lies not only in its efficiency but also in the fact that the use of kidneys from living and not from the dead people greatly increases the chances of saving the patient.

The further study of this method of receiving a kidney, namely, the illegal purchase is to analyze the market of kidneys sellers. The author points to a large number of people who can and want to sell their kidneys. First of all, these are people from poor countries. Because of the need to feed themselves and their families or to pay the debts they consider the option of selling their kidneys as a way to solve their problems. MacKay suggests the idea that there is no problem in buying a kidney given a large number of those who want to sell it. MacKay admits that such operations have a risk for the owners of the kidneys. However, the author asks a question if one can deprive poor people who simply are not able to afford food or pay their debts from the possibility that allows them to solve their problems, at least partially.

MacKay does not shy away from the moral aspect of this type of receiving a kidney. In response to those who argue that “the selling of organs is morally wrong and violates “the dignity of the human person”, she answers that in this case, we are talking about help to the poor people who have little or no opportunity to buy even food. MacKay continues her argumentation by referring to the shortcomings of the existing legal practice of receiving a kidney. She draws our attention to the fact that “in a legal kidney transplant, everybody gains except the donor” (4). The bottom line is that few people want to give up a kidney for free. Consequently, in this case, the patients' chances of receiving a kidney are very small, and yet every minute of waiting is vital for the patient.

In my opinion, MacKay is reasonable to ask if “we pay men for donating sperm, and we pay women for donating ova” (4), so why do not we pay for donating a kidney? She concludes that the legalization of the process of selling and buying kidneys would solve a lot of problems and provide a host of benefits. Firstly, with regard to people in poor countries, it will allow them to receive a decent financial reward for the sale of kidneys. Secondly, “if the sale of organs were made legal, it could be regulated and closely monitored by the government and other responsible organizations” (5). Third, in terms of legislative regulation of the sale and acquisition of the kidneys, each of the parties would be informed about the features of this procedure. As noticed by MacKay, “before deciding to donate a kidney, the seller should know the details of the operation and any hazards involved. Only with the understanding of the long-term physical health risks can a person make an informed decision.” (5). Moreover, the legalization of kidney donation would eliminate the intermediaries between the seller and the buyer and provide the seller with more opportunities for a higher financial reward, rather than illegal kidney donation.

Anticipating possible criticism of legal donations from those who think that “controlling the lawful sale of organs would be too difficult” (6), MacKay asks them a question: “could it be any more difficult than controlling the unlawful sale of organs?” It provides MacKay’s argumentation with a greater degree of credibility, since it has not a monologue, but a dialogical character. As one of the arguments in favor of the legalization of kidney donation, MacKay refers to the fact that a ban on the sale and purchase of kidneys used in many countries does not give any results. Based on the method of contradiction, the author concludes that legalization would solve the existing problem of shortage of kidneys for sick people. “Legalization of organ sales would give governments the authority and the opportunity to closely monitor these live kidney operations” (6).

The legalization of kidney donation will undoubtedly benefit both to those who need a kidney and those who can sell it. MacKay finishes the support of her main idea by referring to the moral side of the issue. If the state cannot provide sick people with the required number of kidneys, has it any right to prohibit the purchase of kidneys? Is it moral not to give people the opportunity to save their lives? The following appeal to readers reinforces the pathos of the problem: “Try to tell someone that he has to die from kidney failure because selling a kidney is morally wrong” (7). I think that the words of the author have a great value: “In matters of life and death, our stances on moral issues must be reevaluated. If legalized and regulated, the sale of human organs would save lives. Is it moral to sentence thousands to unnecessary deaths?” (7).

From my point of view, MacKay's argumentation of the need to legalize kidney donation is pretty convincing because of the use of different methods. These include comparison and contradiction as well as a dialogic character of the article. In addition, the author turns to the statistics that confirm her words. The assessment of the problem in the aspect of its practicality, feasibility, justifiability, and compliance with moral concepts and principles has a special significance as additional funds of MacKay's argumentation. The familiarity with this article enables a wide audience to reflect on this issue and take an individual position. Each of us must realize the importance of this problem, on the effective solution of which thousands of lives depend on.

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