Globally we are facing the problem of our ever growing population, but more importantly our aging population. As our citizens continue to grow older, there has been a drastic increase in the need for organ donations. In Western Europe, around 40,000 people are awaiting a kidney transplant; between 15% and 30% of them will die while they are in the queue. A solution must be found immediately to stop these easily preventable deaths and suffering.

Although there have been many breakthroughs in the science of artificial organs and the possibility of ‘growing’ organs in the laboratory, these prospects are still in the distant future and many years away from being implemented in everyday life. Therefore alternative solutions must be addressed.

Britain currently has an opt-in system for organ donation whereby donors chose to carry a card that gives permission for their organs to be donated if they die. This has had reasonable success, however has failed to catch up to the increasing shortage of organs. Looking into the future, this policy is likely to change as Wales will become the first UK nation to introduce a policy of presumed consent (people will now have to opt-out of organ donation) by December this year. Despite this being a great advancement in meeting the organ shortage, it cannot contest with the increasing number of donations required each year.

A viable solution to the problem is a state system which allows people to sell their organs to the government and a select number of non-profit organisations. Organs would be limited to the kidney and liver as there has been substantial evidence that proves that the donor can live a full and healthy life after the transplant. By providing a significant financial incentive, the NHS is likely to experience a drastic increase in the number of organ donations which may even eliminate the current waiting list. This would not only prevent death and suffering of those in need of the organs, but would also save the government substantial amounts of money due to a decrease in the number of patients needing kidney dialysis. Given Britain’s current economic situation, and cuts being made to the NHS it is unarguable that such a system must be looked upon.

This is a liberal minded approach to the problem that promotes the idea that if we should have the right to manage our own bodies, then we should also have the right to sell our organs. As can be expected there have been many moral questions raised on this argument.

Many have presented the issue of the wealthy being the only ones who can afford the transplants and therefore having complete control of the market. However in a system run by the government, whereby the government is the sole broker between the one selling the organ and the patient, this market cannot be monopolised. The market can be efficiently incorporated into the National Health Service which will allow all citizens, regardless of wealth, to be eligible for a transplant. Should patients have to pay a portion of the price it is unlikely anyone will not be able to have the transplant. Altruism will still exist within the market and non-profit organisations would be likely to donate organs to those who cannot afford them. Furthermore, it is not inconceivable that patients will not even have to pay for their transplants. A year on kidney dialysis can cost the taxpayer up to £35,000 a year, per patient. When comparing this to the cost of a kidney transplant (about £17,500 per patient) it would even be cost effective to pay someone up to £80,000 for a kidney.

With such high rewards for those willing to sell their kidneys, the market is likely to attract those in poorer situations. There are dissenters who argue that having a monetary driven system will exploit the poor as they will be the most tempted to sell their organs for the financial benefits. However what they fail to consider is that those in a desperate situation will always look for opportunities to help themselves despite the high levels of risk or danger to themselves. This can be seen by those who turn to crime to make a living, but also to those that enlist in the army or work in coal mines. If there are legal professions that require workers to risk their lives on a daily basis then how can you prevent someone from selling their own organs – in a secure and well regulated environment – that could lift them out of poverty whilst benefitting another?

There are, however, moral questions that cannot be easily contested such as the loss of trust in doctor-patient relationships. Being central to the practise of healthcare and being something those in the medical profession value highly makes preserving the doctor-patient relationship of the uttermost importance. In a market where doctors and nurses would be using their skills to help people ‘harm’ themselves for money may result in distrust for those in the medical profession. However, if this would suggest that doctors would recommend selling a kidney then this argument is invalid. In the process of donating an organ every party gets paid excluding the donor and the patient – although the patient does receive a priceless benefit that could be compared to payment. Therefore it would seem unreasonable to imply that doctors would encourage patients to sell their organs if they will not be getting the substantial financial gain compared to the one selling the organ.

Doctors often encourage family members of patients to donate kidneys as they are more likely to have a match. Yet it would not be unreasonable to suggest that they would expect them to due to their assumed close emotional connection. This puts pressure on family members to donate even if they do not wish to. Doctors are then faced with the dilemma to ensure the best care for their patient, but also that of the family member who could donate. Creating a market for selling organs would alleviate this pressure on family members as an alternative kidney could be found. It can therefore be argued that having this option available, could improve doctor-patient relations.

There is also the extent of the ‘harm’ falling on the person selling their organ that needs to be addressed. Those that willingly donate organs are often seen as heroes. Yes, it is undeniable that what they have done has significantly benefited another individual (may even have saved their life), however the harm associated with the transplant is much less that most initially think. Medical reports have shown that when one kidney is removed the other grows to compensate for the loss. This results in many people being able to live a healthy life with one kidney. Similarly, the portion of a liver removed for transplants grows back with minimal scarring. Therefore, whilst there are risks associated with any intrusive operation, removing either the kidney or a part of the liver can be compared to donating bone marrow or even blood due to the lack of future impactions to the donor.

The argument for the ability to sell organs has not yet considered the possible negative consequences that could occur in the future. Many view putting a price on humans as repulsive as it devalues human life; they would see this market as the first step towards the moral degradation of society. They would argue that as fellow beings, society should prevent each other from harming others and ourselves. However, to what extent do we have this right? To many the greatest value in life is the right to free will. Therefore could preventing this market impose upon our rights to our own body? While protecting the sanctity and dignity of human life is important, by not allowing a market for organs we are not avoiding putting a price on human life. Economists can tell you that the true cost of something isn’t the price you pay, but what you forsake to buy it. By having the current system which relies on altruism, the opportunity cost can be quantified in the lives lost, extended suffering, and unnecessary cost of dialysis. If selling an organ allows a destitute person to save other’s life, and help life themselves out of poverty, then is anyone really harmed? And if so, do the numerous positives compensate for the negatives?

Ultimately, with no legal market for organ transplants in the UK, and currently no policy of presumed consent in England, demand will only grow due to the aging population. The problem we face today will only get worse until change is made. To save the lives of many, we hope that day arrives sooner rather than later.