Wednesday, 7 April 2010

The moral case for kidney markets

Luke Malpass helpfully points me to some work by philosopher Jeremy Shearmur in the CIS Policy journal.
It can still be argued that all this [allowing a regulated market in transplant organs] simply sanctions something that, morally, should not be taking place. I agree there is something distasteful about the ‘gaze’ of the rich person who looks on others as something like collections of alienable body parts. But bear in mind that other pressures bear on potential live donors, that the shortfall in kidney supplies from voluntary donors will be increasingly dire, and that black markets are liable to generate outcomes that are worse than we could expect from legal and regulated or certified markets. In the face of this difficult problem, we would do best to embrace incomplete commodification, and to try to arrange that our regulations or systems of certification deliver the best outcomes possible in difficult circumstances. There remains something morally unattractive about kidney sale and the commodification of the body. But it is far more unattractive for us to let our moral scruples about this condemn others to die from kidney failure, or at best a long period of misery on dialysis.
Read Shearmur's full argument here and here.

Michael Laws writes sensibly on problems in the New Zealand system about a month ago in the Sunday Star Times (HT: Andy Tookey)
Stupidity. In specific, a fatal combination of medical mindlessness and cultural ignorance. All wrapped into one piece of PC legislation called the Human Tissue Act (2008). The act was supposed to make organ donation simpler and numerous. It has had the opposite effect because it allows relatives to overrule the intent and wishes of the dead. It also elevates superstitious gibberish and cultural gobbledegook to the same pantheon as reason and logic.

Add a failure of leadership at Organ Donation New Zealand Dr Stephen Streat making Corrections' Barry Matthews look like some kind of Harvard genius and you have what you have. Hundreds of desperate Kiwis awaiting the chance for life, and tens of thousands of New Zealanders going to the grave, intact and entire.

Streat's performance is central to the failure of organ donation in this country. He opposed the sensible suggestions contained in National MP Jacqui Blue's 2006 private member's bill that would have created a central register for organ donations. He was instrumental in the construction of the Human Tissue Act and remains a resolute defender of the relative veto. Despite it being his job to find new donors, the total number dropped to just 31 last year. All he now needs is the imprimatur of State Services Commissioner Iain Rennie to be wholly condemned.

1 comment:

  1. I like the idea of being able to move up the recipients list if you are a registered donor but we would (and should) need to remove the relative veto.
    When I go they can recycle anything not damaged beyond repair. Maximum utilization of precious resources.