How would you feel if you needed an organ transplant to keep you alive, but could not get one? How would you feel if someone you loved had to stand in line for years waiting for a transplant that might never come? Would you be willing to pay for a liver or a kidney if you could find a seller? I would. But neither you nor I can buy one-not from a living man, nor from a dead one. The government forbids it. And so we may die, needlessly. The National Organ Transplant Act of 1984 prohibited “any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation.” Two years later, in 1986, the government set regulations for the assignment of organs and gave a monopoly over their procurement and distribution to the United Network for Organ Sharing, a nonprofit company based in Richmond, Virginia.
Seventy-four thousand people are currently on their waiting list for organs, while the number of donors is not expected to exceed ten thousand this year. Since donors contribute an average of two organs each, fifty-four thousand people will agonize one at least one more year without getting the transplants they so desperately need. And more than six thousand people will die this year while waiting. The tragic fate of these people could be easily avoided if a mere three thousand people, instead of taking their organs with them to the grave, would arrange for their donation or sale before dying. The waiting list would disappear altogether if another twenty-four thousand people decided to do the same.
But as the law stands, there have not been enough people willing to part with their organs to meet the demand of the sick and dying. The law allows us to donate our organs but forbids us to sell them. Why?
The reason is that our legal code is heavily based on the moral code of altruism. According to altruism, giving away your organs to save another person’s life would be a good and praiseworthy act, and thus should be lawful, while selling your organs to save that same person’s life would be an evil and despicable act, and thus should be forbidden. The sad irony is that altruists-who claim that their goal is to end human misery on earth -are ultimately causing people to suffer and die.
Altruism is no solution to this life-or-death problem. Indeed, the altruist appeal has found very few takers: less than five thousand Americans, out of the two and a half million who die every year, make arrangements to donate their organs before they die.
The real solution to the scarce supply of human organs is to accept the ethics of self-interest and the politics of self-ownership. The moral and legal case for the commerce of organs is straightforward: individuals should own their bodies and therefore have the right to decide what to do with them, in life and in death, and according to their own interests. To deny a person the right to dispose of his body or its parts is to deny him his right to his life and his freedom to make choices. Of course, the decision to sell an organ is a very serious one, and should not be taken lightly. But it is a serious mistake to think that people aren’t smart enough and shouldn’t be free to make such important decisions on their own.
It is true that most of us would cringe at the idea of selling part of our bodies; but we should recognize that freedom imposes on each of us the responsibility to think through our actions to their consequences, as well as the obligation to leave others free to think and to do with their lives and bodies as they please.
Many Americans would certainly be willing to sign a contract that allowed their organs to be sold once they had passed away-if the law permitted it. They would find in doing so an opportunity to save another person’s life, and at the same time a chance to provide their families or friends some financial support. The supply of organs would easily exceed the demand of those needing transplants.
We must reject the morality of altruism and the idea that a person may not profit from his actions. We should also reject the politics of state control and the idea that a person may not have ownership over his body. If we want to get rid of the waiting list once and for all, and save those whose lives depend on organ transplants, we should revoke the National Organ Transplant Act of 1984 now, and establish freedom of choice in its place. Our own lives, as well as the lives of the people we love, may depend on that.
