Organ trafficking revisited.

The case of Sarah Murnaghan brings to mind a question I once posed in the comment thread of my post on organ trafficking. You can re-read all that stuff if you’d like, but I’d like to re-pose the question. So here it is:

3. Here’s a loaded hypothetical:

Situation A. Imagine that five people need kidneys, that organ sales are illegal, and that there is only one kidney available. The poorest of the five gets on the waiting list first and gets the kidney. The other four die.

Situation B. Imagine that five people need kidneys, that organ sales are illegal, and that there is only one kidney available. The richest of the five gets on the waiting list first and gets the kidney. The other four die.

Situation C. Imagine that five people need kidneys, that organ sales are legal, and that there are two kidneys available. The two richest people buy the two kidneys. The other three die.

Again, it’s a loaded hypothetical, but which of these three situations bothers you the most? Heck, you can even throw one out and tell me which of the two leftovers bothers you most.

If I can remember how to make the poll thingy work, I’ll do that.

5 comments

  1. Oh I’m gonna catch so much flack for this but…while A and B seem to be equal, situation A bothers me the most and here’s why. Presumably* the rich man is rich because he offers the greatest benefit to society and therefore can make the best use of the kidney and continue contributing to society. In situation B, a seemingly less efficient outcome occurs. The poor man gets the kidney but is presumably poor because he contributes less to society and therefore does not make as good of use of the prolonged life as the rich man would. Situation C is still optimal.

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  2. Does Donald Trump offer a greater benefit to society than a doctor or lawyer working in a nonprofit setting? Or greater than that of an educator? It’s a false dilemma to assume that wealthy persons contribute more or are more beneficial to society.

    That being said, Situation A bothers me most because of the implication that that ever actually happens. I’m going through a kidney transplant ordeal now, and the dirty secret of the (legal) organ trade is that in order to make it onto the list, you have to be financially vetted to ensure you can afford all care prior to transplant, during transplant, and after transplant. And to afford that, you have to be wealthy. Poor (or even middle class) people, are rarely the recipients of any transplant, regardless of whether there is a viable living donor, or whether there is a viable chance of success on the list.

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  3. @Anonyomous:

    1. I hope your transplant ordeal has a happy ending. Let me know if there’s anything we can do to help out beyond mere hopes and prayers.

    2. It may be mistaken to assume that a wealthier person contributes more or is more socially beneficial than a less wealthy person, but is it a safe generalization?

    3. The loaded hypothetical question above makes more sense in its original context. My point wasn’t to justify saving the rich before the poor, it was to see whether “saving as many lives as possible” was more important than “ensuring that rich and poor are treated equally regarding organ transplants.”

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  4. Forgot to put in my name when I originally posted.

    1. Thank you! All should be well. My step-father, luckily, is making a very comfortable living as a lead researcher and bio-chemist for a huge conglomerate and passed the financial testing. My mother has recently concluded all testing to become his donor, and hopefully we’ll hear from the board soon. When he needs another one in 10 or 15 years, I’ll start the process myself (he’s marrying into a good pool of healthy & matching kidneys, hah).

    2. I don’t think it’s a safe generalization, even still. I think there are more examples which would disprove the generalization, than examples which would support it. I can’t accept that a CEO of a company contributes more than their skilled labor does. But I guess that then becomes more a philosophical discussion on what contribution actually is.

    3. I’m also unwilling to accept that there cannot be a marriage between treating the poor and the rich equally, and saving as many lives as possible. Being that there are many times more poor than there are rich, wouldn’t it be mathematically more sound to conclude we should treat the poor in higher regard during organ accruements in order to save the highest number of lives? I’m not advocating that, I prefer an equality of chance wherein financial status has no relevance, but just an idea.

    But yeah, the financial means that a person has to have is a bit ridiculous. I’m the caretaker for my step father and mother following their transplant, so I had to take a class at mayo. The majority of the patients accepted onto the list are white, and are male. Not because they’re white or male, but because they’re the ones who can afford it. And not only do they have to be able to afford all of what I’ve already stated, but the vast majority have to relocate to Jacksonville/Ponte Vedra for up to two years so that they’re near mayo clinic if they receive a match. Not only does the sick person have to relocate, but so does a minimum of two caretakers (for heart, lung, or liver transplants… kidneys only require one). This means that the caretakers have to put their careers on hold (the nice way Mayo puts it, really it’s quitting, because no company is willing to let you take an indefinite leave and then accept you back a year or two later), have the financial means to support themselves while relocated including food and housing, and the recipient has to be able to afford to live without working, etc. Following the transplant, my step father will be on medication that will cost him around $600/month (with his incredibly generous insurance, without he would be looking at over $10,000/month most of which is the cost of a single medication he’s required to take). I feel extremely lucky, and I’m sure he does too, that he has the financial means to get through this ordeal. But so many people don’t, and it’s kind of infuriating.

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