Why not allow the sale of organs?

1. Ask yourself: would you sell your kidneys? If you are reading this post, the answer is 99% likely to be no, regardless of the price.

2. If the answer is yes, it's because you are in some financial difficulties. Suppose the KTM gave you a million dollars, would you still want to sell? Answer is probably no.

3. The argument that it's a willing buyer and willing seller situation is quite bogus when the seller is forced by circumstances to sell his kidney.

4. To allow the sale of kidneys is tentamount to allowing the rich to exploit the poor. Frankly, it is unlikely that any Singaporean would be selling. The seller would most likely be some foreigner. If we want to allow it, we would be being pragmatic - but what we are doing will be no different from condoning our people in exploiting the poor folks from other countries.

5. Some people will then argue that nobody wants to work as maids if they can help it and we are already condoning the exploiting of poor people from other countries. Perhaps, but there's one minor by significant difference: a foreigner who comes to work as a maid can decide to quit if she changes her mind; it's not quite so easy to get a kidney back once it's been cut out.

6. The argument of "what if your loved one needs a kidney" is absolutely bogus. Does it really matter who needs the kidney? Our loved ones are more important than the poor? What does this argument really mean?

It is wrong to exploit others regardless of the reason. If people have to die, they have my condolences. There are many terminal illnesses for which there is no cure. That said, the KTM also believes that the law can afford to show some compassion and understanding to the kidney patients who end up flouting the law in attempting to buy a kidney.

Do not unto others what you do not want done onto you.

"it's not quite so easy to get a kidney back once it's been cut out."

Ask yourself why is it so important to 'get a kidney back'. A kidney, like a knee ligament, by itself has no intrinsic value. Of course, a kidney is more important than a knee ligament but it is not intriniscally so.

For example, many professional athletes will suffer crippling irreversible injuries to their limbs. Professional boxers are at a higher risk of getting Alzheimer's as a result of cumulative irreversible head injuries. Why is it then okay to pay people to get permanent head injuries?

"2. If the answer is yes, it's because you are in some financial difficulties. Suppose the KTM gave you a million dollars, would you still want to sell? Answer is probably no."

Actually, I would provided there is some form of affordable insurance against kidney failure.

Some people would say yes because they understand the (low but existent) risk of such operations.

"It is wrong to exploit others regardless of the reason."

Huh? Isn't employing maids a form of exploitation?

Fox,

Ask yourself why is it so important to 'get a kidney back' ... Isn't employing maids a form of exploitation.

The point here is not a matter of getting the kidney back. The difference between exploiting cheap labour and exploiting poor people for their kidneys is the one is somewhat "reversible", i.e. the person can decide to change his mind, while the other is not.

Actually, I would provided there is some form of affordable insurance against kidney failure.

You have misunderstood the KTM's point. The KTM is not offering one million dollars for a kidney. Point here is whether a would-be kidney donor would change his/her mind if he/she got a million-dollar windfall just before the donation. Simple as that.

Some people would say yes because they understand the (low but existent) risk of such operations.

Has there been a comprehensive study done? In any case, how many people do you think believe that we have two kidneys by accident? Why do we have only one heart and one liver and not two hearts of two livers? Do people really believe that we really have a "spare" kidney?

It is really disingenuous for people to argue that people can live perfectly good lives with one kidney. Fact of the matter is that many people suffer from kidney failure of BOTH kidneys. So, isn't it preferable to have a spare even if we can live with just one?

My comments are as follows:

Initially providing that all parties are governed strictly, there maybe no major exploitation.
However, the problem with these, once human beings organs can be considered as commodities. Let me blunt, there will be harvesting of organs from both willing, unwilling living participants. If there is no moral or ethical repugnance for such, there is nothing to stop anyone from raisng clones or babies for harvesting purposes. Unless all of us wish to have our bodies and parts tagged in Big Brother or ala Brave New World, we will likely head further towards that direction. If this is progress, count me out at this present time, I would rather hold to being denouced being reactionary

"The argument of "what if your loved one needs a kidney" is absolutely bogus. Does it really matter who needs the kidney? Our loved ones are more important than the poor? What does this argument really mean?"

Yes, as a matter of controversial ethics. When backed into a corner, the well-being of a loved one is more important than that of a stranger. Nobody likes to say it, but most people would feel it.

"To allow the sale of kidneys is tentamount to allowing the rich to exploit the poor."

Bleeding heart argument from the "pragmatic" KTM? :) There is exploitation and there is exploitation. Nobody "forced" the organ seller to sell his kidney. If the kidney seller does not like the price, he can choose not to sell and can resort to other means to prop up his finances. He has a hard choice, but a choice nonetheless. It is actually a seller's market to put it bluntly if the seller is aware of it. However, I do admit that the huge problem is that syndicates enter the market and that is where "exploitation" of both seller and buyer comes in. How to deal with unscrupulous syndicates? Regulation is the first step.

Wang,

"Let me blunt, there will be harvesting of organs from both willing, unwilling living participants."

Why should the legalization of paid kidney donation lead to the harvesting of organs from unwilling living participants? Explain to us the logical progression.

"If there is no moral or ethical repugnance for such, there is nothing to stop anyone from raisng clones or babies for harvesting purposes."

Suppose we do legalize paid kidney donation. Why should it lead to the raising of clones and baby for harvesting purpose? Again, please explain to us the logical progression.

I believe most people who support paid kidney donation base it on the principles that:

1. Kidney transplant poses very low risk to the donor.
2. Multiple studies have shown that kidney donors do not have any increased risk of any major health problems after donating their kidneys.
3. The recipient is most likely to die without a kidney transplant.
4. The quality of life on dialysis is far inferior to that of life after a transplant.
5. The kidney donation is made on the basis of informed consent by the donor i.e. the donor should understand the risks and consequences of donating his/her kidney.
6. There is a willing buyer and a willing seller.

Obviously, taking kidneys from babies or unwilling people violates some of these principles and is a no-no.

We don't make decisions/policies in accordance to ONE principle.

For example, our labour policy is generally based on the principle that people should be free to work for whichever employer they choose and and employers should be free to choose the people they hire. In practice, that is not really true. We don't allow child labour even though naive reasoning based on the aforementioned principle suggests that we should. The reason is because our labour policy also takes into consideration another principle: namely that children should be in schools.

You see where I am going by asking you for all those logical progressions?

Cheers.

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KTM,

Has there been a comprehensive study done?

Yes. Multiple studies have been shown that donors are not, in general, at greater risk of any major health problems relative to the rest of the population.

Statistically speaking, kidney transplant is as safe as childbirth.

In any case, how many people do you think believe that we have two kidneys by accident? Why do we have only one heart and one liver and not two hearts of two livers?

Well, one obvious explanation is that like most other mammals, whose ancestry we share, we inherited the physiology of two kidneys, which might have proved useful in the mammalian past. Now, even if having two kidneys did provide a survival advantage in the East African Savannah where Homo Sapiens evolved in the distant past, this advantage is most probably greatly diminished in modern day lifestyles. 1 in 750 humans is born with 1 kidney. There is no evidence to suggest that they live shorter lives compared to their 2-kidney fellow humans.

I quote from Angry Doctor:

"How many donors actually require renal replacement therapy due to trauma to their single remianing kidneys? How many donors go into chronic renal failure due to diseases which would not have affected both kidneys equally had he not donated one anyway?"

Do people really believe that we really have a "spare" kidney?

Based on medical evidence, most people, excluding those with existing kidney ailments and conditions that might predispose them to kidney diseases (hypertension, diabetes, etc), with their modern day lifestyle can live with one *without* any increase in health problems.

TVD,

Yes, as a matter of controversial ethics. When backed into a corner, the well-being of a loved one is more important than that of a stranger. Nobody likes to say it, but most people would feel it.

Agree that it is natural for people to think that their loved ones matter more. In this instance, we are debating about the merits of a policy. Policies need to be considered w.o. reference to one's interests. Policy makers need to make decisions on the basis of public interest.

If something is good/right, it is good/wrong; if it's not, it's not. It cannot be true that something is good/right only if it benefits one or his/her loved ones.

Bleeding heart argument from the "pragmatic" KTM?

Nope. KTM does not subscribe to bleeding heart arguments.

Legislation has a protective element. Otherwise, why do we outlaw child labour or pornography? Also willing buying and willing seller what. Those who argue for the legalization of organ sales should also argue for the legalization of child labour and pornography using the same logic. Better still, child labour and pornography is typically a source of income that doesn't require stuff to get cut out of someone.

Fox,

Multiple studies have been shown that donors are not, in general, at greater risk of any major health problems relative to the rest of the population.

Do us a favour: cite those studies and highlight the circumstances of those studies. How many of these studies involve low-income donors from third world countries? I would be inclined to believe that white collar workers from first world countries can get by with one kidney.

Remember the story of the Indonesian kidney donor who is in a lot of trouble now because with one kidney, he can no longer do the strenuous jobs that he used to do?

Well, one obvious explanation is that like most other mammals, whose ancestry we share, we inherited the physiology of two kidneys, which might have proved useful in the mammalian past....There is no evidence to suggest that they live shorter lives compared to their 2-kidney fellow humans.

Well, the KTM was once training for his IPPT, pushed himself too hard and found blood in his urine. This is evidence to the KTM that strenuous activity puts extra strain on the kidneys, so yeah, perhaps if you sit in front of the PC all day you only need one kidney. It doesn't mean therefore that everyone needs only one, esp. the manual labourers.