After our scored discussion on how kidneys should be allocated, you wrote a reflection to capture your current thinking on the issue. I would like you to now access the following video on the organ trade in India. It is about 10 minutes long. On my computer the Quicktime "large" version works best, but you might have to play around with it.
http://www.pbs.org/frontlineworld/rough/2006/07/india_a_pound_o.html
Does this video change your thinking at all?
Write a response to the question, "How should kidneys be allocated?" using what you have learned. I would like you to keep your response to less than 10 sentences.
I think the government should definitely regulate kidney transactions, but the donor should receive some monetary reward. That way more people will donate kidneys, so more people can live, but the system should make sure all donors have proper health care. I also think the computer system could be used to alert medical personnel about available kidneys, but to preserve time, anyone in the top 10 or so of the waiting list who qualifies should be able to claim the kidney once it is available.
ReplyDelete-Elayne Johnson
I believe that kidneys, as well as other organs, ought to be legal to sell at the donor's will. If organ markets were legalized, the illegal black markets which operate throughout 3rd world countries would collapse, leaving little or no corruption in its wake. The shortage of organs would lessen tremendously and the waiting lists in most countries would decrease in size. Moreover, the organs would be fresher, as well as being in better condition, having been extracted from a live body and not a cadaver. There is a certain question of immorality going around, claiming that it is "immoral" to sell organs, as they are part of your body. I agree partly with this, but would like to propose a counterquestion: Isn't it "immoral" that wombs be lent for childbirth, sperm and eggs sold? A bigger supply of organs would then, in turn, help the computer systems and doctors make choices without having them worry about giving the wrong organ to the wrong patient, etc. I think that the computer systems are an incredibly efficient method of distributing organs, albeit having some problems (such as who to give the organ). Giving people the choice to sell their organs or not, especially in poorer countries, could benefit those in the nations which need aid, as well as sorting out the kinks in computer systems at hospitals.
ReplyDeleteIn my opinion legalizing a free market for organs would, despite being almost certain to eradicate the shortage in organs, be a false move on behalf of the government. Yes it would benefit the economic situation surrounding this topic, which is very positive; however it comes hand in hand with new problems. It has been predicted that once such a market is legalized the poor will be selling and the rich will be buying organs. People selling their organs in desperation to escape their economic situation is no solution, the problem is simply shifted from one area onto another. I envision this, perhaps a little melodramatically, as follows: the middle to upper class population will be fully satisfied with their new body parts; they have been the lucky ones to make a D tour around an early death, while half our planet, those in underdeveloped countries, are walking around with only one kidney in their bodies. Should the poorer, less lucky people really have to sacrifice a part of their body to a total stranger just because when fate rolled their dice they had a less fortunate outcome, and were born into poverty? What if someone donates a kidney, and decades later this individual is diagnosed with a kidney failure, will he have the means to buy back the kidney he once donated? If such a system would be legalized then the government should create some form of laws or regulations to possibly prevent people from making decisions whose consequences they aren’t fully aware of or refusing to acknowledge blinded by the reward they receive from this act of “altruism”.
ReplyDelete- Astrid V.
3, 500 people die each year waiting for a kidney transplant, which is a basic supply- and demand- gap. The government should create incentives for people to allocate their kidneys, so I agree with Elayne. This could be done by rewarding money, for example. I also think that if you allocate your kidney you should have to go to a class that explains all the risks. This would prevent any Kidneys allocators to proclaim they didn’t know the risks. I think that would decrease the shortage a lot but then there is another issue: who decide who gets the kidneys? A kidney is not usable after 4-6 hours and my personal opinion is that a computer should decide who gets the Kidney but if there is no decision made after 5 hours then the doctor has to make the decision. I do not agree with the conclusion that Amselm made because it only allows rich people to get the Kidneys if they are on a free market.
ReplyDeleteJung Hyun Kim said...
ReplyDeleteThe most important aspect is to try to get the most from a very limited supply of organs. The buying and selling of organs has a great advantage because it will even out the gap between the demand and the supply of organs, which means that most of the people in need of organs will be able to get one. The second advantage is that the commodification of organs provides an incentive for suppliers to sell their organs. However, as seen from the video, it is noticeable that most of the poor are suffering from lack of health care, and that some aren't getting fully paid from their endeavors. Therefore, I beleive that the government should provide education and awareness of the consequences of selling organs to the areas that have the most affluent supply. In this way, the poor will be able to make effective decisions to how they will deal with the aftermaths of selling the organs; or might not even try to sell their organs in the first place. Furthermore, the government should try to provide health care, but instead of doing it freely, it should reduce the costs for donors(e.g reducing the price from 30~50% for health care). This would benefit the doctors, donors and the recipients altogether. Lastly, the poor who supplied their organs should be paid directly after selling their organs to the recipient. In this way, there would be a circular flow in the economy, where money would flow around efficiently from households to government to businesses (in this case, hospitals) which would bring an advantage to all the people related to the issue of the buying and selling of organs.
Jung Hyun Kim said...
ReplyDeleteThe most important aspect is to try to get the most from a very limited supply of organs. The buying and selling of organs has a great advantage because it will even out the gap between the demand and the supply of organs, which means that most of the people in need of organs will be able to get one. The second advantage is that the commodification of organs provides an incentive for suppliers to sell their organs. However, as seen from the video, it is noticeable that most of the poor are suffering from lack of health care, and that some aren't getting fully paid from their endeavors. Therefore, I beleive that the government should provide education and awareness of the consequences of selling organs to the areas that have the most affluent supply. In this way, the poor will be able to make effective decisions to how they will deal with the aftermaths of selling the organs; or might not even try to sell their organs in the first place. Furthermore, the government should try to provide health care, but instead of doing it freely, it should reduce the costs for donors(e.g reducing the price from 30~50% for health care). This would benefit the doctors, donors and the recipients altogether. Lastly, the poor who supplied their organs should be paid directly after selling their organs to the recipient. In this way, there would be a circular flow in the economy, where money would flow around efficiently from households to government to businesses (in this case, hospitals) which would bring an advantage to all the people related to the issue of the buying and selling of organs.
The video makes me realize that the kidney allocation problem is a lot more complex than I thought it was at the beginning. Giving away kidneys in any way can only work properly if there is a strong government control and if the system is not corrupt. I do not have a problem with the idea of poor people selling their kidneys to get out of debt, but if they aren't getting their money and are being denied proper health care after the transplant for the rest of their lives (which they really seem to need), the system is unfair, immoral and not beneficial. I think that the best way to allocate kidneys would be to have a kidney "trade" with two simultaneous operations (this is an idea from the packet we read). This system should be combined with a computer system that can look at the facts and medical information to see who should get the kidney. All of this should be controlled by a government agency with everything made public to reduce the risk of corruption and people making money.
ReplyDeleteMoritz Sturm
All over the world kidneys and other organs are scarce. An open market could possibly eliminate the shortage of organs; however it should be considered that there are not only ethnical conflicts occurring due to selling and buying organs, but also dangers and exploitations that could happen. The main dangers would be kidnapping and murdering people in order to get their organs and selling them for money ($45,000-$90,000 in the US for a kidney). Additionally, the exploitation of the poor class also means that the kidneys sold are not in the healthiest state due to possible starvation, diseases and drug use, which is higher in poorer classes than in any other class existing. Another point would be that the main reason for giving off a kidney would be to get money to get out of depth and buy a home, as mentioned in the video. As an example, there were 300 kidney sellers interviewed in India, 75% of them did it to get out of depths and did not succeed, 90% of them had health care issues afterwards and how could the government help so many people to get out of financial and health problems? This shows that the conflict of health care got pushed from one class to another. The current system of computers and doctors works very well, since the computer updates every 18 minutes, a kidney may survive 48-72 hours and doctors are becoming more advanced just like the medical technology and machines are. The organ shortage is a world-wide problem and although an open market would have many benefits such as getting rid of any choosing `who gets the organ first’ problems, there are also a lot of down-sides to it that should be carefully considered before making any decisions.
ReplyDeleteThe video portraying 'Present kidney circumstances in India' altered my perception on kidney sale entirely. Contrary to my original thoughts, which were maintaining the advantages of kidney sales due to their contribution in saving lives, I believe that human dignity is one of the most significant points leading to donations as the only acceptions. Mainly, poor people would be the ones giving out their kidneys to the more wealthy people. It is sure that they would gain financial inceptives which will be aids for their severe conditions. However, we should always look in the lives of minorities and think of their positions; allowance of kidney sales may put them in conditions that regardless to their opinions, they would have to pass over their kidneys, almost in exploitative levels. Moreover, the society today especially in undeveloped areas, just require kidneys without any insurances or taking-care systems. kidneys are not goods which means they can't be debated as commodities for market-sales, however, if the conditions are inappropriate and irresponsible, the selling systems even more lose their value of discussion. Looking back from adherence to economical logics and importance of human lives, kidneys should not be misused just as solutions for their shortage. Just as to think of moral senses, kidney-markets should be banned and we should approach them circumspectly. AS it's done presently and continuously, only people whose philanthropic thoughts are swelled from themselves should conduct the so-called "altruism" and help out people in desperate needs.
ReplyDeleteKidneys are with no doupt a scarce resource throughout the world and especially in the developed countries, causing developed countries such as India to be a manifest option of kidney exploition, especially in the slums. On one hand, a free market could cover the demand for kidneys in the world, since it offers an inscentive to nearly everyone to donate their kidney. It also gives the opportunity for poorer people to get out of debt or earn some money with a virtually unnessicary organ. Of course opposingly it is seen "unethnical" in many countries, and encourages kidnapping; or the commerce with unhealthy and therefore "dirty" organs. One also needs to consider that many donors, especially in India get cheated on their money, since the doctors use their authority to get around paying for the patients aftermath treatment or the kidney itself as the poor case of Gida who got carried into the trap set herself by her trust into the doctors? The computer system we have now on the other side does not allow that, since only causes donors to donate out of pure altruism, and then the computer tries to find a fitting patient on the list of waiting patients. The ideal case would be that the patient needing the organ the most would be able to receive it, which in my opinion is highly unlikely, since the computer is not able to consider facts as age, condition or circumstances. Although there are major advantages and disadvantages between a free market and a computer based system, the most sensible thing out of my view is without a doubt choice number one, since it causes the gap between supply and demand to close, catalysing the survival rates into unseen heigts. This will also solve the question about "who is first in line", since there will be so many kidneys available, there will be at least one that will work with the patient.
ReplyDeleteIn my opinion, kidneys should be handled as any other human resource, which is sought to benefit towards everone. The only way possible to accomplish this is simply to legalize a free market all around the world, since it enables everyone to obtain one and to sell one. Of course will the developing countries supply a great percentage of the organs as discussed in the video, but will it also be a founding stone in the lives of many indians, who buy themselves a car, or a house for their families and themselves. The computer based system's advantages and disadvantages clearly fall under the ones promised by the free market. Obviously does a computer search the database for the next in turn, but does not consider the age, condition of the kidney, and the circumstances of the donor, which can be much better regulated in a free market, since the kidney passes at least two doctors, who already can make themselves a picture of who will receive it. Additionally is it also very hard for the computer to find a right patient for the kidney, and often times they fail to deliver it on time, waisting another precious organ. Also with a free market will the government will also need to control the trade of kidneys very strictly too, since it also is statuated to ensure the patients security. Unfortunately, a free market will not only have its advantages, but also its disadvantages, such as a increased chance of kidnapping people for their organs, or the opportunity that a diseased kidney will pass through a loophole. Overall, by weighing the two things up against themselves, it becomes clear to me that a free market is solution supporting the needs of the most people.
ReplyDeleteThe allocation of kidneys is very subjective. Some people would argue in favor a computer generated list, while many other would support the free market theory. Even though using computers to decide has many disadvantages, for example creation of black markets for organ trading, it is still the more efficient and fair in comparison to a free market system. Going back to the basics, it can be argued that allocation of scarce resources in free market is subjected to three fundamental questions: what to produce, for whom to produce and how to produce. And since kidneys don’t fit in to this category, as there are not producible, they can’t be considered a sellable commodity. Therefore, kidneys should not be allocated using price mechanism (free market system) but on ethical and humanitarian grounds. The disadvantages would be black markets and organized crime. But this problem can be dealt with by reinforcing government regulations. But this cost is marginal compared with the cost the society, all a whole, will pay if we let organs be allocated in free market. Free market allocation would serve as an incentive for poor people to sell their organs. This violates human right as, in a democracy, they have equal rights as the rich but this system would increase the gap between the rich and poor. The influx of donated organs would dispose to the privileged section of the society which the poor, who would be incapable of paying for the organs, would be left to die. In this case the poor are very vulnerable and are likely to be taken advantage of. Involvement of third parties makes the transaction unfair by depriving the seller of their rightful payment. All in all kidneys and other organs are not economic commodities and should be allocated indiscriminately.
ReplyDeleteThe discussion clearly shows that there is no perfect way of allocating kidneys, as there was no general agreement. However, I personally believe that there are more positive aspects of a free market than an allocation according to need. The main argument against a free market is probably that poor people cannot afford to buy themselves a new kidney, and that the poor will give their kidneys to the middle and upper class. The first problem can be dealt with through simple rules of economics. As soon as the market will be opened, new organs will flood it. When the initial craving for kidneys is satisfied, the prices will inevitably go down, as a surplus is created. The second problem is more difficult, and I doubt it will be solved. Niels seems to have come up with a good idea to easen this problem though: anyone who is willing to sell their organ is required to take a class to address the risks that come hand in hand with selling a kidney. The WTO (World Trade Organization) could supervise the free market of kidneys, to ensure that the donors receive a fair amount of money, and give clarity to the trade. As already stated, there is no perfect answer, however in my opinion, the free market is the best of the possible ones.
ReplyDeleteMany people all over the world die each year because of kidney failure. I think the government should legalize the selling and buying of kidneys and other organs. This would help decrease the number of deaths each year because you could not get a kidney. This idea would help incentiveize the use of a black market economy. Now people will not have to kidnapp someone for their kidney or any other body parts. The people selling the kidney would not just save a live but they would recieve money for their organs. Another idea is that everyone in the world should be covered by health insurrance. This way the richer people would not be put at the top of the waiting list just because of what they have in their bank account. Around 3,500 people die each year cause they cant wait for a kidney. In my opinion I think it is time for a change.
ReplyDeleteAll humans are different; have different beliefs, have different priorities. This means there is no right way for allocating kidneys (organs) for each individual. Introducing a free market, which could maybe increase the organ supply, is seen as immoral for many people. A clash between rich and poor will happen.
ReplyDeleteIn the system we have now, there is too much demand than there is supply. This is because the people do not have the incentive to donate, and waiting for people to die, is that not immoral aswell?
In my opion,both ways are not the answer to our problems. We have to find a way that creates incentives, protects the poor and is moral enough to be expected. I don't know what the answer will be and if something like that could ever be created, but I hope for all people on the waiting list, no for everyone, that there will be someone who has the answer.
Clearly, there are many cons on both sides of the issue of having a free market for kidneys, which leads me to believe that the best solution is not an either/or but rather a compromise. As illustrated in the video and in the readings, many of the poor people who are selling their kidneys in desperation for money are not receiving adequate compensation monetarily or in terms of health care, nor are they properly informed as to the risks of the procedure and a life with only one kidney. I feel a promising solution to the problem of allocating kidneys would be to organize two compatible lists; one would list the patients waiting for kidneys, and the other would list people who have pledged to donate kidneys. The pledged donors would be required to undergo medical examinations and be fully informed as to the risks of donating a kidney. They would then be put into the system and matched up to the most compatible and neediest patient, and would be compensated with a fixed price upon completion of the procedure. The increased regulation of this market would ensure that people couldn't make a quick decision to donate out of desperation, and it would also ensure that potential donors are in adequate medical condition to be donating a kidney, and that they are not themselves at risk for future complications. Finally, it would ensure that patients are receiving the highest quality kidneys, kidneys that are the most compatible with their bodies and haven't been lying in a cadaver for hours. There's still the question of whether selling body parts is moral, but as the "Flesh Trade" article pointed out, the morality of this issue is relative; repugnance to similar processes- sperm and egg donation- has been overcome, and while removal of a kidney is not on par with removal of sperm (as kidneys cannot be naturally replaced) it is likely that this process too would be accepted in time. And besides, many would argue that a black market is also immoral, so isn't a moral system of regulating something immoral better than an immoral system of regulating something immoral?
ReplyDeleteI think that the problem with the way that we allocate our kidneys now by computer generated waiting lists is that the computers don't have medical experience, and thus cannot make the decision based on the best fit for the patient, and have to just go down the list and possibly end up giving a 50 year old liver to a 20 year old patient, and this wont work. However, our old system of the doctors making their best medical guess doesn't work very well either, as doctors are prone to bribery, and can make incorrect decisions from time to time. I believe what we need to do is reduce the rigidness of the computer system that we use now, and somehow incorporate the use of our doctors' medical expertise and intelligent, informed guesses so that we get the correct match of fairness and the best case kidney for the patients as well. If we can find a middle ground between the ultimate fairness of the computer system, and the perfect fits of the doctor's best guess, then we can eliminate the need for the selling of kidneys to even be considered, thus avoiding all the negative effects of allowing the sale of kidneys, such as the taking and selling of kidneys without the donors consent. I think this middle ground is what we need to work toward and is the best solution possible for kidney allocation.
ReplyDeleteI find that Vivian touched an issue that should make it obvious to everyone that a free market in terms of organs would lead to a disaster. She mentioned that people would kidnap and kill just to sell the organs. I would like to take this a step further and say that a free market would encourage human trafficking. This is not only based on my fantasy. Something similar to this has happened in Asia for quite a while now, where families get paid a small amount of money for their daughters that then are taken to other parts of the world for prostitution. Besides that, the events in israel should all show us that bringing money into this matter would only end badly. A Swedish reporter wrote in an article that in Israel about 100 Palestinian bodies were found that did not contain any organs. This was denied by their government but several autopsies showed that at least to some extent this happened to be true. I hope that these two examples make everyone think a little more about what the outcome would be if there was a legal market for organs.
ReplyDeletePs: This is not my "less than 10 sentence" post..this is merely a reposonse toa few people
Especially in more economically developed countries, kidneys and many other organs are scarce and the number of people needing organ transplants is greater than the number of donor organs. Therefore, I believe that having a free market where there is no government regulations and no governmental monopolies would provide more incentives for people living in more or less economically developed countries to donate their kidney or other types of organs. This means that the person, who needs an organ, will be able to buy one. A further advantage is that people who live in poorer countries, such as Thailand have the opportunity to sell their kidney worth $45,000-$90,000 in the US, which will improve their living standard dramatically. A negative aspect of this would be that it is immoral to allow people to do serious damage to themselves for the sole purpose of money. In addition, the removal of a kidney involves major surgery under anesthetic, which is highly invasive. The arguments supporting organ sale need to be examined carefully. In the US, a computer system tries to allocate organs based on need. Regardless of income, age, race, gender or condition of kidney, anyone has a somewhat equal chance at getting a lifesaving transplant. However, the computer can't make medical decisions and life or death situations should rather be left to the government agent than to a computer system. Furthermore, I agree with Moritz that it is very hard for the computer to find the right patient for the kidney and often fail to deliver it on time, wasting another precious organ. Thousands of people wait everyday for their transplants, but fewer than 20,000 will actually get them, leaving 4,000 dieing waiting.
ReplyDeleteIn my opinion this computer system is a great method. It is as fair as no human could be, but I have to agree with a few posts on this blog that this system alone doesn't work as good as it could. In our reading it mentioned that often organs were lost while patients and doctors were being located. I think the organs should be allocated according to need as well as the compatibility of the patient and the organ. This would enable people to save time by not having to contact everyone on the lists, and it would decrease the cases where the patients’ bodies reject the organs. I don’t see why this system wouldn’t work, time is saved and less organs are lost.
ReplyDeleteI think buying and selling kidneys is not the best solution because only rich people benefit. Lives should be equally treated, but it is not good if some people buy kidneys while others are waiting for donors in a long waiting list. I believe that the actual fact making this problem is lack of donors, and ibelive that increase of donors is obviously an effective measure to solve the problem. To realize this, any incentives for donors are necessary. As we can see on the video clip, some people who sold their kidneys have caused health problems after transplant has been done, so there should be some kind of health care when there is an aftereffect. However, unfortunately I do think money is the most powerful incentive to incrase donor. Therefore some kind of 'reward' might be needed, and maybe it is good if that is payed from donation. If there is a donation which can be donated to the donors (there will be no excessed payment, and the patient does not need to pay money so the system can also be used for poor people), it may be an incentive for donors to offer their kidneys fairly and safely. Honestly, it is very difficult to think of a best solution, but I think it is important to make this 'kidney (organ) market' more opened and more well-known.
ReplyDeleteI believe that the allocation method that is now present is the best. The computer could have more information, such as the age and the weight of the kidney and the patient who needs it. This way no time is lost with doctor's decisions of such obvious facts. I do not believe that having a free market, for kidneys, is the right way. This is because I believe that each person, rich or poor, should have the same chances of an healthy life. Despite this discussion, the biggest problem is getting donors. Without donors no allocation method would work. I believe a reward for donors is the right way.
ReplyDeleteI believe there should not be a free market for kidneys, and kidneys should be allocated by humans. Firstly, the selling of human organs is an immoral act, albeit it is true that some sell their sperm or blood, but theses are all renewable tissues unlike a kidney. Moreover, nature has given us two kidneys for a reason, which is for a precaution measure, not for the gain of wealth. Secondly, donated kidneys should be allocated not by the computer system UNOS, but by a panel of doctors whose specific duties are to allocate kidneys to patients. The computer system, no matter how fair people perceive it to be, still makes mistake and lacks human intuition, which is fundamental when dealing with life and death. Even when a computer makes an error that results in a death of a patient, the family of the patient would not blame a computer. The doctors would ultimately take the blame. Therefore, whether or not it is a doctor or a computer that makes a judgment yielding a negative effect, humans would still be blamed, but we still triumph over computers with human intuition.
ReplyDeleteI do not think that the option for a free market is an unethical decision to increase the supply of kidneys for transplants. Jaspers' idea of a free market is one that would hopefully fufuill the needs of the consumers of kidneys by leaving it up to economics. Although this may turn out to be beneficial, in my opinion we have one other possibility. That is to regulate the kidney market. Jasper touched on this by suggesting that the WTO could supervise, but I think that a more active supervision of the market would be more beneficial. The governng body could control the pricing to make sure that an incentive would be given to donors and that kidneys are not too expensive for the patients in need of a transplant. Also, the government would still use the computer to decide the appropriate recievers of the kidneys. I also agree with Niels' idea of a compulsory class to warn and school the donors of the risks of donating (or selling) a kidney. This would make the health hazards more known and probably reduce the amount of problems that come with the surgery to remove an organ. The free market idea is one that would be beneficial, but, in my opinion, government policies or regulation of the kidney market may become necessary.
ReplyDeleteIn an economic point of view, a free market for the allocation of kidneys should be legalized in order to eliminate the excess in demand.
ReplyDeleteBut even though a lot of people who would have died waiting for a kidney, had the chance to survive there are many problems associated with the open market form.
As Barnali pointed out ,,black markets and organized crime´´ could be one possible disadvantage.
Further on, most of the donors are born and raised in poor areas and didn´t have the opportunity to experience a good education, they weren´t told about the dangers of living with only one kidney.
I agree with Niels that it would be a good idea to send everyone who wants to sell their kidney to a class where all possible risks are explained. Here in Frankfurt there is an iniciative which is called the ,, Aids-mobil´´ which is basically a group of people which are going from school to school and explaining who AIDS can be transmitted and how you can prevent it. A ,, kidney-mobil´´ could inform people about the dangers so they learn about the consequences of selling their kidney.
Adrian Radzyminski
In developing countries such as India, there are many poor people who need money desperately. A good way for them to earn quick money is to sell a kidney. This system really benefits the poor there, but there are some problems with it. The poor are not treated fairly - they are not given all of the money that they are promised and they can put their own health at risk. Therefore, the govt. should legalize and regulate the selling of kidneys more. The poor should get a health check before the opretaion to ensure that no harm will be done if the sell a kidney. Further government control should ensure that the poor recieve their money and that they don't get exploited.
ReplyDeleteThis system would benefit the poor and would prevent them from getting health problems or getting exploited.
In developed countries like Germany, both a free market system and a computer-allocation system should exist. The (rich) people with private health care insurance should be able to buy the organs. This system would provide an incentive for others to sell their kidneys, which would increase the supply of them.
The poorer people with public health care insurances should not be deprived of being able to get kidneys. For them, the computer system should be used to allocate kidneys. The computer system should take the health status and the age of the kidney supplier into account, as well as the age, need/urgency of the patient who needs the kidney. The baseload/normal supply of the kidneys would come from donors, while in special cases the public health care insurance pay for a person who wants to sell his kidney for a relatively low price for a person (who has a public health care insurance) who urganetly needs a kidney when there is a lack of supply.
With a 'combined system' (computer allocation system for the people with public health care insurance, and a free market system for the people with private health care insurance, would take the advantages from both system and combine them, benefitting both the rich AND the poor.
I would also want to make a comment about the so-called 'immorality' of selling one's kidney. First of all, there would be a greater supply of kidneys, since there is a greater incentive for sellers to supply kidneys. This higher supply of kidneys saves more lives than if there is only a computer-based, non-free martker system. More lives are saved, so what is immoral about it? Secondly, the computer system used at the moment has many flaws, and could keep patients waiting for their death or could allocate a kidney of an old person to a young patient. Therefore, the free market system is 'no more' immoral than the computer allocation system, to say the least.
In my opinion kidneys being a scarce resource should be allocated based on the number of expected life-years from transplant , or number of extra years that a transplant recipient could expect to live with a donated organ compared with staying on dialysis to ensure the full and correct use of the available kidney. Also the decision should not be biased that is to say that it should not be based on the person's economical position and should not be star-strucken at all.The sale of organs should be legalised and should be regulated by the government or a government organisation which also ensures that the donors will receive proper health care post donation.This will not only reduce black markets but will also save countries from corruption and ensure that the donor gets the deserved money for the donation.Also,if the concept of artificial kidneys can be brought into use,the gap between the available kidneys and the kidney patients could be reduced to a great extent. This concept could bring about a revolution in the field of science.
ReplyDeleteIn my opinion the kidney allocation is a very delicate topic because there are pros and cons for each and every argument you can make. The computer system would only work in a industrialized country like the western are only because every citizen is registered. In that case i do agree with constantin where on the other hand in a poor country there are very few registered which makes it hard to keep track of everything. Also the list used by the doctors is something very debatable since some people who might have a chance of surviving have to wait till they get to the top of the list to get a kidney where on tghe othere hand the 1 person at the top might have a higher chance of dieing... so should we let both of them die or should we give the person with the higher chance of living the kidney to ensure his life? This 'immoral' question is something we cannot answer. To a completely different point a few people brought up which was the comparison of a kidney with a womb. People say this is 'immoral' aswell but we just cannot compare these things in a situation like this because this is exactly what makes our economic problem! A kidney is a must for a few people to survive; there for a need, where as a child is a want right? a child is NOT something you absolutley need to survive! there are just so many pros and cons that i my self cannot come to a solution
ReplyDelete-christopher luetz-hawranke
In my opinion, there are many pros and cons for both sides of this issue.
ReplyDeleteIn the free-market, the donor would get money for the kidney they give. But for example the people who need a kidneys the most, wouldn’t perhaps get one. It is also a big decision if one wants to give their organs to save someone else’s life, with that you could put yourself into risk, you could become unhealthy through that. If you think if you donate a kidney, you would solve a problem isn’t right, you could make new problems. It could also happen, that poor people say that they want to donate their kidney, only to get money for it, but it could be that their organs are unhealthy and that they wouldn't help the people who need a healthy and young and good kidney.
For the waiting list, the most needy gets a kidney, but the donors don’t get anything for the kidney they give, they should receive a proper reward. And also, the list would help the last people, if the list is very long.
I think that both of the systems are not the right way to solve the problems which develop through the allocating of the kidneys.
In my opinion, every person should be able to determine the rights of their own body - for that is the one true thing in life that we should have 100% control over! By making selling your kidney an open market one would eliminate the black market completely - however to do this specific laws and regulations would need to be re-viewed and changed so that people could not alter and find loopholes to change the deals so that it could give them an advantage of some sort. Also the problem of paying people would need to be more strictly watched, everything in writing and officially so that poorer classes would not be able to be exploited so badly as at the moment. However there is the problem with the actual state and health of the kidneys being donated. Most of the time, as in poorer countries the majority of the doners are poor and their organs not in perfect state. This is just hurting the doner by giving their kidney up, and the recipient who is not being given a healthy kidney. When people want to donatea their organs, then they must be able to meet certain regulations and they should undergo specific tests and health scans to make sure that the donation would be useful both ways. THe computer system seems to be working all right, however the incorporation of the doctors opinions is important - doctors, unlike the computer, are humans with prejudice and can judge and sometimes analyze certain situations better than any computer. To save more time, organs and lives, the allocation of kidneys, like constantin also said should be allocated according to need, the donor and patients compatability and the doctors personal view.
ReplyDelete- Julia Welford
A free market, where initially there is profit on all sides, sounds like a great solution to the issue of allocating kidneys and the kidney shortage. At first I was positive that a free market would be he best way of dealing with the allocation of kidneys as both sides profit (the donor gets money and the recipient gets a kidney; which corresponds to our understanding of the free market economy: good against money), however after reading the handouts and materials we got in class, discussing the issue and watching the movie I've become more and more aware of the negative sides or flaws of a free market. I think the biggest issue with a free market is the exploitation of the poor. This is a hard issue to tackle because how is one going to control the greed of the individual, the instinct of survival if that is what you can call it.
ReplyDeleteI think it is just as utopian to solely have faith in the altruism of people as it is to believe in a flawless free market situation. This shows the main conflict; on the one hand the free market brings along undesirable incentives such as exploitation and on the other hand there is a lack of altruism and because of this lack of altruism Normada rightfully reasons that nothing will stop the trade with organs. Therefore free market is the only solution, but it has to be flanked so that it becomes more effective and fair. I propose that (like Niels already suggested) informative projects on organ donations (as education is the weapon against exploitation) are to be launched and laws are to be passed to prevent the exploitation of the poor.
Another problem I’d quickly like to address is the issue of whether it is immoral to sell body parts and as an answer I’d like to suggest that as this is a highly subjective argument and I think the decision whether the donor acts out of altruism and therefore does not demand money for it or whether he takes money for it should be left to the individual donor.
I also want to add that reducing the health care costs for donors (like Jung-Hyun said) may be an ideal idea, however if I may ask, from where does the government obtain the money that they lose?
The Allocation of kidneys is a very “Hot Topic” and decides on life or death. Organs are an essential part of the human body and therefore very limited on the global market, thousands of people demand transplants everyday, but fewer than 20,000 will actually get them, leaving 4,000 dieing waiting. I personally agree with Constantin von Schantz who says “this computer system is a great method” and also Patrick Frech you stated that “Regardless of income, age, race, gender or condition of kidney, anyone has somewhat of an equal chance at getting a lifesaving transplant. The Computer program is by far the most unbiased way of allocation kidneys, because it focuses on the medical aspect of the patient only and not income, age, race, gender or condition of kidney. I disagree with having an open market for kidneys, although this would allow many poor to make up to 90.000$ for their organs, however such big business could easily consult in crime were people are forced to sell their kidneys. This could take place in the developing countries where there is a poor justice system, these kidneys would then be sold to wealthy costumers in the west. Even in developed countries most people would not be able to afford an organ. Points have been made where it was said that an open market would increase the supply of organs, however due to the high prices only the very top earners would be able to buy a kidney. Which is why I belief that the US computer system should be set up in each country and then guarantee on a national base a fair process of an allocation of kidneys.
ReplyDelete--Leonard Gorbac--
If the shortage is removed, then the allocation problem disappears. In order to solve the shortage problem, I agree with some of the previous posts that the government should provide a compensation to all donors. A small amount given to all donors equally would mean people who have greater financial backing wouldn't receive greater priority to available organs, but would also create more incentive for people to donate their unused organs. As for the problem in India and other similar countries a similar solution might create less of an incentive for the rich to exploit the poor who are willing to do anything for money, because there would be more kidneys available from people who are more likely to have more healthy organs and people who need a kidney would more likely want one that has a better chance of functioning well and lasting a long time.
ReplyDeleteFinding a perfect solution for the issue of allocating kidneys is close to impossible. The best we can do is to find ways that benefit the majority of the people. Legalizing the selling of kidneys would definitely reduce, if not, completely get rid of the scarcity of kidneys, saving countless patients, who otherwise would have died waiting. However, the problem of purchasing kidneys appears with this solution. If kidneys can be sold, then someone has to buy them. Not everyone would be able to afford buying a kidney in addition to paying for the surgery. The organs would be sold by the lower class and bought by the upper class. Although this solution is not perfect it is the best we can do. If everything stays the way it is (with the computer system and doctors deciding on who gets the kidney), then there will be too many people, dying just waiting for the organs.
ReplyDeleteMartin Paul
The allocation of kidneys is very complicated because there is a shortage in kidney supply and an ever growing demand; however this problem can be fixed. Kidneys should be traded on a free market; however, when an organ is bought there should be one uniform government controlled contract for all donors which mean to sell their organs. Any transactions using other contracts should be made illegal. This contract will have to legally guarantee health care to all of the involved, it should also commit the donors to be fully educated about the risks of kidney donation; it will have to be essential that donors pass an exam verifying their education and assuring that no donor is misinformed like the people in the video. In addition the contract should allow the price to be variable and based on a percentage of income of the recipient, allowing the best and fairest price for all who buy kidneys. The amount of money for a kidney should be heavily controlled by means of very tight price floors and price ceilings; it shouldn’t be dependent on the wealth of the recipient which would cause conflict between the donors. If a very wealthy recipient pays off his kidney the excess cash he paid can go into a fund from which people with a smaller income can draw support from; this way organs are also available to the poorer classes as the whole group of recipients rich and poor support each other. The donors have a need for security and this is satisfied by means of the contract, creating incentives for not just the poor but everyone. This should attract more donors from various classes which would like to earn some money or simply do some good. This solution might only work in a westernized county with certain medical infrastructure.
ReplyDeleteDownsides of the current computer system that have been repeatedly discussed are that they are not efficient, not fair and can create black markets. If we examine disadvantages of the free market system, it is ‘immoral' and it puts donor's health at risk.
ReplyDeleteTherefore there is no perfect solution even though both of these provide some what good sides as well as mentioned several times by other students above.
I share common opinion with Sanneke; I believe that there must be an alternative method that provides economic incentives, protects the poor and is moral all at the same time. The solution is 'artificial kidneys' (expected to be commercialized by 2015-now going under scientific testings)
Artificial kidneys are moral and they provide incentives. However, insurance companies must support the cost of transplantation of the artificial kidneys especially for the poor.
Then what is going to happen from now till 2015? We need compromise, taking advantages from both methods. How about setting up government funded and regulated, paid kidney donation programme along with WHO
(world health organization)'s supervision that give equal opportunity to rich and POOR people?
-christy choi
There can be a compromise between a free market and the computer system seen in today's US. By first of all implementing the "opt out" system, meaning everyone is an organ donor unless they opt out. This could increase the amount of kidneys coming from cadavers. Having a free market for kidneys will greatly decrease, if not eliminate the gap between supply and demand of kidneys. To make sure people are donating their kidney for the right reasons, why not have them go through similar steps as the person who is receiving a kidney? Talking to a financial counselor about the reason for selling their kidney, and having a doctor make sure that the donator is fully aware of all the risks. A person getting a transplant having to go through psychological and social testing and having the donor go through tests as well, eliminates the problem of people donating their organs for the wrong reasons. If testing is made a standard procedure before every transplant, and also having the donor and recipient meet before the transplant, then both the doctor and the patient can be sure that it's not a stolen kidney. Basically, a free market would benefit those in need of kidney transplants in the Western world, but the situation differs on other continents. For example, at this point in time Asia would not benefit from a free market in organs, but instead needs another solution of how to allocate kidneys.
ReplyDeleteThe biggest issue of allocating kidneys is that kidneys are scarce human resources. Supply and demand are unbalanced which causes problems. In fact, 3500 people die each year waiting for kidneys. Clearly, there are no perfect methods. I think that allocating kidneys with computer system is the efficient method. This is because computers decide who will get the kidneys first fairly. They will just look at the medical information about you. It is true that people cannot fully rely on computers, but human also does mistakes. I would choose, therefore, the computer system. I am against legalising the free markets because it does not really solve the problems. Firstly, poor people cannot get the kidneys because there is just a few supply of kidneys which makes them very, very expensive. Secondly, it does not actually decrease the black markets. People will just secretly keep on selling the expensive kidneys for their benefits. Then, how can we increase the supply? I suggest that making a law might help solving the problems. For example, governments could make a law that if you die and have healthy kidneys, you have to donate them. This would decrease the shortage a lot. I learned from this discussion that there are lots of problem, concerning kidney allocation. Governments should, therefore, regulate kidney transaction to save as many people as possible.
ReplyDeleteThe facts are clear, there is a higher demand for kidneys than there is supply, causing, as previous people have mentioned, around 4,000 people to die waiting for a suiting transplant each year. What needs to be considered is that for every donor their are certain risks, which include that if one of the donors kidneys fails, the donor lacks one. And I do not think that, as Niels Krause said, that educating these risks would decrease the shortage, it would rather increase it as it would scare people away even more from donating. So in order to create an incentive for a donor to donate their kidney over the risks of donating one, I think there should be a free market to decide, in terms of money. And of course, the first thing that comes to mind is selling and buying the organs is immoral. But for whom are we to decide that it is immoral for OTHERS to sell their kidney, if we are not in the situation that person might be in (financial trouble, etc.), that made him/her decide to sell their kidney? The only problems I see in this is if for example a poor person need a kidney, a richer person would be the one who would receive the kidney, because he/her is able to pay a higher price. Not to mention that this could also create crimes, for which the government of developing countries (In which kidney sale would be the largest) are not ready for, as Leonard Gorbach said. So I think the incentive should not be money, but should be a right, the donor gets the right that, in case he is in trouble caused by a lack of his kidney (that he donated), he has priority of receiving a donation. And as other people like the idea of integrated computers to avoid bias, this system of allocation could also be strengthened by computers. In conclusion, the system I suggest, is not liable to bias, amount of money a person has, and it also increates an incentive for donors. This might not be the best solution, if there is any, as sanneke mentioned, but unless we figure out how to grow kindeys in a laboratory, I would go for my solution.
ReplyDeleteby Lucas Hess
In my opinion, the kidneys should be sold more opeonly in the market. Obviously, this creates another problems. However, as we discussed in the class, there are always disadvantages in any methods. There are people in the world, who really have to sell their kidneys to survive, it does not matter if it is illeagal or not. Than why not making it leagally? This makes the "poor"people safer, if everything is done officialy. There are some advantages in this , and the most important part is they will get the money surely.(and not half like in the video.)
ReplyDeleteDaigoro Kato
I agree with what Constantin wrote before about how a free market, not controlled by the government, would be adisaster, leading to human trafficing. Yes, a free market would provide more incentive for people, but one has to think about if this is fair. A free market would result in only those people with enough money getting a kidney transplant. People who do not have as much money will not be able to pay the same amount which others might be offering. Therefore, I again agree with Constantin on the computer system, which was mentioned in the handout we got, being the best solution to kidney allocation. As Leo already said, it is unbiased because it mainly focuses on the medical situation of the patients, and not on race, age or the financial situation.
ReplyDeleteAnother issue which I think is important, is what Viola mentioned. She wrote about if it is ethical to sell one's organs. There are probably enough people who think it not ehtical to sell your organs.
So, in conclusion, I think that a free market would bring more negative than positive results. The computer system, which is used in the US should be introduced in every country as it proves to be by far the fairest solution to allocating kidneys.
Nicholas Burandt
To define what is immoral and what not is almost impossible, but I could ask everyone this; Would you sell, let's say a present you've got from a friend, just to increase your pocket money?
ReplyDeleteSelling kidneys aren't as simple, but in my personal opinion has something similar to this, and won't be much to equal the sacrifice made.
Although kidneys could cost from $45,000 to 90,000 in the US, in South Asia, it is estimated that only $1,000 to 1,200 reaches the donor. Even more, high rates of donor mortality is observed from lack of medical care to donors, and 90% of them reports worsening health.
Discluding the point in immorality, there is no advantage in the free market of kidneys. Rather than arguing about whether we should open a free market or not, let's all get a donor card.
I believe that a free market should be legalized. However a way to eliminate the corruption every transplant has to go through the hospitals. This way if only poor people donate and rich people buy the organs, the doctors can make sure that it is more even by not accepting every offer. Also if every donor gets a health care packet from the government it will give them an incentive for donating. I can see how this method would cause complications financially so I also agree with the computer system. Even though is is not perfect it is the best system that has been developed so far.
ReplyDeleteI agree that their are many ethnical problems and dangers that must be considered if a free market of buying and selling organs was made. But i also think that a free market is a possible way of saving many lives each year. I agree to Moritz S. that a kidney trade with two simultaneous operations would also be a very good way to allocate kidneys. When doing a simultaneous operation, both families benefit, and no one can change their mind, because both operations are done at the same time. I also think that it would be a good idea for germany to also use the "opt out" system. Germany is using a system were people need a pass, which says that there organ can be used after there death. If all countries would use the "opt out" system, it would increase the number of organs which could be used after people have died.
ReplyDeleteIn the case of a free market i agree to Jaspers point, that a free market must be supervised to that people are sure to get the right amount of money for the organ which they donated.
The discussion we had in class showed me that each method has its pros and cons. I think that it is very hard to find a way that is fair to everyone, and at the same time eliminates the shortage of organs, and therefor saves many lives.
The limited supply of kidneys has triggered a lone waiting line. This became not only economic problem but also a social problem to be solved which seems to be economic sense vs moral sense. I would support a moral sense; computer system. Even though free market will supposedly satisfy the economic demands, the exploitation from poors, risk of kidnap, and moral reluctancy to commodification of organs causes the free market to be still doubtful. In contrast, computer system 'fairly' organize the list from how urgent the patient needs, and how much possibility to live the patients have. Furthermore, our economy can be set when the moral mind is set, therefore I support the computer system rather than the free market system.
ReplyDeleteThis was answer to the question of which one of those are better, computer system? or free market?
However I think that we should merge the free market system and the computer system. Both of the system has advantages and disadvantages, however, to decrease the dispute, we should select the best choice, and the best choice would be the combination of the two. We can arrange the list that is fomulated by the computers, and make it also 'manipulatable' by the doctors. Furthermore, if we hold a free market that is controled and observed under government. In this way, we can settle the controversies and meet the demands and supply so that the equalibrium is set.
To all who disagree with me, or anyone else of the opinion that there ought to be a market for organs, I have two points. Firstly, whether or not you dislike the idea of a free market, the black market concerining organs CANNOT be stopped. People will always be in need and therefore we will need a constant supply of fresh organs. Secondly, imagine one of your close relatives, parents, siblings or grandparents; if they were in drastic need of an organ, and were put onto the local hospital's waiting list, what would the chances be of them receiving an organ in time? Especially with the shortage of organs, I doubt they would stand much of a chance. Would you like to see your relatives undergoing dialysis, hooked up to a machine which keeps them alive 24/7? I don't think so and hope you don't either.
ReplyDeleteLike many medical problems allocation of kidneys had also conflicts due to the moral reasons. We cannot say that UNOS systems is the best way, however until we get a better way of dealing with this problem we should use this computer system to be fair. The happening of the famous baseball player is a example. People were not satisfied with the doctor who gave the kidney to the 'old man'. But the moral sense is that all people are equal. Therefore if people can't decide who to give the donnated kidney, they should lean on the computer system.
ReplyDeleteaccording my view there is a way to allocate as convenient sollution which is safe and in favor of both groups
ReplyDelete_to allocate an organization to control monitor this issue
for example all the patients and the people who demand kidney would apply to such organization and register themself as buyers.the donors will do the same and all the information including medical histories will gader in this office.the price for each case will be negotiated under monitoring of this center,and they will introduce donors and the buyers to a qualified hospital to do the transplant surgery.
after transplant for a while both patient and donors will be under control of doctors!
this solution will have following result;
1:the money will go in pocket of donor and there will not be any brokerage
2:the surgery will be safe for both side(the hospital can take some experimentation of each person)
3:any consrquence of such medical treatment will be under monitoring and control of qualified center
4:a data base will providefor both groups
Ashkan Mohammadi