Living Organ Donors Should Be Allowed to be Compensated

Hi again. I thank my opponent for his prompt response in the previous round. Firstly, you said: "I disagree that establishing alternatives, even preferable ones, to allowing compensation for living organ donors is not sufficient to win Con's case". Whether or not it was your actual intention, I feel that here you're making out that I'm dodging the primary issue and attempting to "win" the debate by establishing better alternatives. I never stated, nor implied, that I felt merely pointing out better alternatives was sufficient to win the debate. Clearly you're misinterpreting my question of whether or not your position happens to be that compensation for organ donors is the BEST (I'd use italics rather than caps, but the feature doesn't seem to be available on this site unfortunately) solution, or whether it is a viable solution among other potentially superior solutions. Also since you, either deliberately or inadvertently, failed to answer my question, I'll assume that you concede that your proposal is the inferior option in both an ethical and practical sense to other proposals but still feel it is viable. If this is not your position please correct me, as I do not wish to go on knocking down straw men. I'm sure any fair-minded reader would agree that I did in fact begin to demonstrate problems with your proposal before offering alternatives. My reason for even proposing alternatives at all was to show that, apart from being grossly unethical, your proposal is also far from the only solution, or even from being the best solution to attempt at this point. I wanted to ensure that when assessing this debate readers wouldn't agree your proposal is flawed but consider it a necessary evil, so to speak. However, I grant that it may very well be the case that your proposal could be trailing several others in practicality (as I would say is certainly the case) but still be worth implementing. Therefore, as well as describing superior alternatives, I will address the problems with your proposal also. You go on to say: "On this first point, regarding whether organs donated from the recently deceased are just as good as live donors, a number of medical professionals disagree." Again, I feel this is an obvious caricature of my opening statement. And again, I appeal to the fairness of the readers: did I in fact claim that cadaver kidneys are "just as good" as those from live donors, or did I merely propose that various strategies to make better use of cadaver organs was a better strategy than financial compensation? However, since you brought it up, cadaver organs are only slightly less reliable than those obtained from living donors. At present, patients obtaining kidneys from living donors have a 97.9% survival rate after one year versus a 94.5% survival rate afte one year from cadaver donors [1]. I'd say that's more than an acceptable difference given that cadaver donations do not inflict massive negative effects on donors, since they are coming from the recently deceased, which I'll discuss shortly. The case of Iran's waiting list for kidney transplant being reduced to zero certainly seems impressive at first glance, no doubt about it. However, it's not so clean cut. Sure, everyone needing a kidney transplant got one, and everyone who donated was compensated for it, albeit only a petty and insufficient sum of approximately $1,200, according to my opponent's sources. The mistake my opponent makes is that he looks at this scheme, notices that the waiting list has been abolished, and stops investigating there, concluding that this is a win-win situation. As I mentioned in the previous round the primary concern is the exploitation of the poor. The poor are clearly the ones that will be pressured into selling off their organs for money. In Iran, for example, of those who participated in the kidney donation compensation scheme, only 13% were employed full-time [2]. The World Health Organization (WHO) shares my opinion that organ markets are vehicles to exploit the poor. They conclude that "research shows that the underlying motivation of most paid kidney donors is poverty, and that lasting economic benefit after donation is limited or even negative because of the limited employability of such patients and the perceived deterioration of their health ... Paid kidney donation is also associated with depression, regret and discrimination. Paid kidney donors do not receive follow-up care, due to financial and other reasons"[3]. Following donation, 65% of donors suffered negative effects on employment status [2], and over 70% suffered significant depression and feelings of isolation. Most donors felt ashamed, 94% of whom not wanting to be publicly recognized as donors [4]. 68% of the families of donors strongly disapproved of the organ sale, leading to domestic complication, and 21% of families getting divorced shortly after the procedure [4]. 80% of donors were greatly dissatisfied with their level of physical stamina following the donation [4], and given that the majority are unskilled labourers this is immensely significant. In fact, even the Iranians that my opponent holds up as proving his case would disagree with him! Given the choice again, 85% of Iranians surveyed say they would not have sold their kidney and a stunning 76% even say that they think the practice of compensation for kidneys should be banned, and that they'd trade 10 years of their life for their kidney back [5]. Keep in mind this is coming from the mouths of the majority of the very Iranians that my opponent is citing. Reports by the reformist Iranian press also indicate that the these samples obtained are a good representation of other Iranian donors [5]. It seems the most accurate assessment my opponent gave of his Iran case study was that "Iran may not seem like a model for social justice". I believe I've shown that it's pretty clear that compensation for organ donation will not, as my opponent claims, properly solve the very real problem of organ shortages. It will serve to create an inevitable mechanism by which the less fortunate are exploited for the gain of the wealthy. Even if there were no alternatives, my opponent's proposal would not only be unethical and immoral, but downright disastrous. However, fortunately there are much better alternatives. For example, the two that I mentioned in the previous round (the 'opt out' approach of having every citizen a donor by default unless they choose not to be, and a preference given to those on the NHS waiting list who themselves have opted to be an organ donor in the event of their death. As well as that, another good suggestion is to reform the waiting list to make it more balanced. For example, Nancy Scheper- Hughes, professor of Anthropology at UC Berkeley and founder of the organization 'Organs Watch', notes in a radio interview - [6] - just how imperfect the waiting list currently is. For example, younger patients should have a preference over people ages, say, 55+. Also people can be listed multiple times on multiple regional lists, as well as people deemed inoperable also being listed. Clearly, the NHS waiting list could do with some cleaning up before we consider desperate approaches such as the proposal my opponent has put forward. References: [1] http://www.kidney.org... (table at point 20) [2] http://www.who.int... [3] http://www.who.int... [4] http://www.ncbi.nlm.nih.gov... [5] http://www.ncbi.nlm.nih.gov... [6] http://www.wnyc.org... (Fast forward to around 20mins in for relevant comments on organ selling). It's quite a good discussion, I recommend it.