Human Organs Debate | Vivienne Parry | Opposition

Summary

This speech argues against the legalization of organ sales, asserting it would not achieve its goals and would negatively affect donation attitudes. The speaker highlights the health risks for donors, the lack of comprehensive data on donor outcomes, and the potential for exploitation, especially of the poor and vulnerable. They also point out that payment systems have not proven effective in countries like Iran and emphasize the importance of non-monetary incentives for organ donation.

Takeaways

• 🚫 Legalizing the sale of organs is considered a backward step with potential negative impacts on society and the donation process.
• 🏥 There are moral limits to what can be commodified in markets, and organ sales cross that ethical boundary.
• 📈 Efforts to increase organ donation rates in Britain have been successful without resorting to payment, resulting in a 50% increase in transplanted organs.
• 💔 The health implications for living organ donors are significant and often under-discussed, with increased risks of kidney failure and other complications.
• 💰 The costs of paying donors for organs are not fully considered, especially the long-term health care needs that may arise for the donors.
• 🤔 Payment for organs could lead to a transactional mindset, devaluing the altruistic nature of organ donation and potentially increasing dishonesty in donor histories.
• 📉 The idea of organ sales being limited to kidneys is challenged, as the principle could extend to other organs with even greater risks.
• 👶 The concept of a market in organs is compared to the abhorrence of selling children, highlighting the devaluation of human life and dignity.
• 🏥 The current system in the UK compensates hospitals for the costs of organ transplantation, not the donors themselves.
• 🩸 Blood donation in the UK is successful without payment, suggesting that voluntary systems can work effectively compared to mixed paid and voluntary systems in the US.
• 🇮🇷 The example of Iran, where organ sales are legal, shows issues with coercion, exploitation of the poor, and long waiting lists for certain organs, indicating that a paid system does not necessarily solve shortages.

Q & A

What is the speaker's stance on legalizing the sale of organs?

The speaker is against legalizing the sale of organs, arguing that it would be a backward step and would not achieve its intended ends.

What was the purpose of the Organ Donor Task Force the speaker was a part of?

The Organ Donor Task Force was assembled to increase organ donation rates in Britain, which had been very low.

How has the infrastructure improvement impacted organ donation rates in Britain?

The infrastructure improvements have led to a 50% increase in transplanted organs in Britain.

What are the health implications for living organ donors, particularly for kidney donors?

Living kidney donors are 8 to 11 times more likely to end up in kidney failure compared to those with both kidneys, and they may face poorer circulatory health as they age.

What percentage of kidney donors in the US are lost to follow-up, and what are the implications?

35% of kidney donors in the US are lost to follow-up, which means the long-term health implications for these donors are not well documented or understood.

What are the potential complications and psychological issues faced by kidney donors?

20% of kidney donors have complications after surgery, and 30% suffer from psychological problems, which can be severe.

What was the estimated cost and benefit of paying donors $45,000 each for a kidney, according to a paper in the American Journal of Transplantation?

The paper suggested that paying donors $45,000 each for a kidney could eliminate the waiting list and save billions for society, but it did not account for the future health costs for the donors.

How does the speaker describe the attitudes towards organ donation when it becomes commercialized?

The speaker suggests that commercializing organ transplants can lead to a transactional view of organs as commodities, with potential for dishonesty about medical history and a lack of consideration for the donors' long-term health.

What are the risks associated with living liver donation?

There is a 1 in 200 chance of death during liver donation surgery and a 40% complication rate for living donors.

What is the current situation regarding children waiting for a heart transplant in the UK?

There are 16 children in the UK waiting for a heart transplant, and the country has run out of 'bridge to transplantation' pediatric beds.

How does the speaker argue that the best way to deal with organ waiting lists is not through payment to donors?

The speaker believes that directing money to prevent diseases like diabetes, which is the main cause of kidney failure, is a better approach than paying donors, as it addresses the root cause of the organ shortage.

What is the current payment system for hospitals in the UK when they perform a kidney transplant?

Each UK hospital that performs a kidney transplant is paid £22,000 to cover the expenses associated with the procedure.

What is the speaker's view on the potential unfairness of a market for organs?

The speaker argues that a market for organs would be unfair and exploitative, particularly towards the poor and vulnerable, and would devalue the precious gift of organ donation.

What is the situation with blood donation in the UK compared to the US?

In the UK, 40% of the population gives enough blood for all transfusion needs voluntarily, while the US has a mixed economy of paid and voluntary donations and still suffers from shortages.

What are the issues with the organ donation system in Iran, where payment for organs is allowed?

In Iran, there are issues with young women being coerced into organ donation by their families, and 50% of the donors are in poverty, highlighting the unfairness and exploitative nature of a paid organ market.

Outlines

00:00

🚫 The Ethical Dilemma of Legalizing Organ Sales

The speaker argues against the legalization of organ sales, asserting that it would not achieve its intended goals and could have detrimental effects on society. They highlight the health risks for donors, citing studies that show increased likelihood of kidney failure and complications post-surgery. The speaker also points out the moral limits of markets and the corrosive effect of commercializing organ donation, emphasizing the importance of maintaining the altruistic nature of the act.

05:01

💼 The Consequences of Commercializing Organ Donations

This paragraph delves into the implications of treating organs as commodities, including the potential for dishonesty in donor medical history and the ethical concerns of incentivizing risky behavior. The speaker discusses the ineffectiveness of paid systems, as seen in countries like Iran, and the coercive nature of organ sales, particularly affecting the poor and vulnerable. They also address the complexity of legal and financial aspects surrounding organ sales, such as who would receive compensation in the event of a donor's death.

10:06

🙅‍♀️ Opposing the Legal Sale of Organs as an Unethical Market

The speaker concludes by reinforcing the argument that the legal sale of organs is unethical and should be opposed. They emphasize that payment for organs commodifies a precious gift and undermines the altruistic spirit of organ donation. The speaker suggests alternative solutions to address the organ shortage, such as focusing on preventative healthcare to reduce the need for transplants. They also draw parallels with other societal values, noting that certain honors and achievements cannot be bought, and neither should organs be.

Keywords

💡Organ sale

Organ sale refers to the practice of buying and selling human organs for transplantation. In the video, the speaker argues against legalizing organ sale, stating that it would not achieve its intended ends and would have a corrosive effect on attitudes towards organ donation. The script mentions that there are moral limits to markets and that organ sale is beyond that limit.

💡Donor task force

A donor task force is a group assembled to address issues related to organ donation, such as increasing donation rates. The speaker was a member of such a task force in Britain, which aimed to improve infrastructure and increase transplant rates, resulting in a 50% increase in transplanted organs.

💡Kidney donors

Kidney donors are individuals who donate one of their kidneys, typically to someone in need of a transplant. The script discusses the health implications for kidney donors, noting that they are more likely to end up in kidney failure compared to those with both kidneys, and that many have complications or psychological problems after surgery.

💡Commodification

Commodification refers to the process of treating something as a commodity, which can be bought and sold. The speaker argues that treating organs as commodities, as would occur with organ sale, is problematic because it changes behaviors and attitudes, potentially leading to dishonesty and exploitation.

💡Coercion

Coercion is the act of forcing someone to do something against their will. In the context of organ sale, the script mentions that payment can lead to coercive situations, particularly for vulnerable populations, such as young women in poverty who may be pressured into selling their organs.

💡Dialysis

Dialysis is a medical procedure that removes waste products and excess fluids from the blood, typically used by individuals with kidney failure. The script discusses the potential long-term health consequences for kidney donors, who may eventually require dialysis or transplants themselves.

💡Transplantation

Transplantation is the medical procedure of moving an organ from one body to another to replace a failing organ. The video discusses the infrastructure improvements related to transplantation that have led to increased organ donation rates in Britain.

💡Market in organs

A market in organs refers to a system where organs are bought and sold. The speaker argues that such a market would not only fail to solve the problem of organ shortages but would also be unfair and lead to exploitation, as seen in the case of Iran, where payment for organs has not eliminated waiting lists.

💡Moral limits

Moral limits are boundaries that define what is considered ethical or acceptable behavior. The speaker asserts that there are moral limits to markets, and that the sale of organs crosses these limits, suggesting that some things, like organ donation, should not be subject to market forces.

💡Sugar tax

A sugar tax is a levy imposed on sugar-sweetened beverages, intended to reduce consumption and address health issues like diabetes. The script suggests that directing money towards preventative measures, such as a sugar tax, could be a more effective way to deal with organ waiting lists than paying for organ donations.

💡Gift aspect

The gift aspect refers to the notion of giving something without expecting anything in return. The speaker emphasizes that a paid market for organs devalues the gift aspect of organ donation, which is a precious and selfless act that should not be reduced to a mere transaction.

Highlights

Legalizing the sale of organs could have a negative impact on attitudes towards donation.

There are moral limits to markets, and the sale of organs may exceed those limits.

A 50% increase in transplanted organs in Britain was achieved through infrastructure improvements, not consent changes.

Kidney donors face health implications and a higher risk of kidney failure compared to those with both kidneys.

35% of kidney donors in the US are lost to follow-up, highlighting the lack of long-term monitoring.

Paying donors $45,000 for a kidney does not account for the future health costs they may incur.

20% of kidney donors experience complications after surgery, and 30% suffer psychological problems.

Commercializing transplants can lead to a transactional view of organs and potential dishonesty in medical history reporting.

The idea of selling organs could be extended to other organs, with significant risks and ethical concerns.

Payment for organs has no application for the majority of organs and does not address the root causes of organ failure.

The NHS would be financially burdened by the need to pay donors upfront, potentially restricting organ transplants.

In the UK, blood donations are sufficient without payment, unlike the mixed economy in the US which suffers shortages.

Iran, which has a payment system for organs, still experiences waiting lists and issues with coerced donations.

Payment for organs can be unfair and exploitative, particularly towards the poor and vulnerable.

A paid organ market reduces the value of the precious gift that is organ donation.

The speaker urges opposition to the motion of legalizing the sale of organs, citing ethical and practical concerns.

Transcripts

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ladies and gentlemen and students of

Oxford in your third week of term can I

just say hearing you cough I'm not

having your

lungs now I want to show you that LE

legalizing the sale of organs would be a

backward step that it would not achieve

its intended ends it's a very limited

application and that it would have a

corrosive effect on attitudes to

donation and I hope to make it apparent

that there are moral limits to markets

and that organ donation sale of organs

is beyond that limit now I was a member

of the organ Dona task force it was put

together to try and increase donation

rates in Britain which were appalling

and I'm delighted to say that by a

series of measures related to the

Improvement of infrastructure not about

consent about the infrastructure and

transplantation there's been a 50%

increase in transplanted organs I've got

enormous sympathy for people on the

waiting list I've met lots of those

people I've interviewed many of them

their courage their plight never fails

to move

me but we always highlight don't we the

benefits to the recipients because of

course they're in such a terrible state

but we never

really highlight the implications for

the donors and I'm talking about the

health implications we talk about

kidneys oh we've got two you can do with

just

one it's like spare parts you've got a

spare well I've got two arms ladies and

gentlemen actually this one is not spare

it doesn't mean that if you've got two

that you can do without

one now worldwide organs have been taken

from living donors for over 60 years but

Registries that uh record what happens

to donors are less than 20 years old the

UK has one it's only 15 years old as one

kidney takes on the work of two it

begins to scar and FiOS what it can cope

with at the age of 25 or 40 even in good

General Health begins to falter with the

poorer circulatory health of old age and

remember that a

50-year-old we people in our Prime we

expect to live at least another 30 or

perhaps even 40

years in the US where lots of the

figures about donor Health come from 35%

of kidneys donors are lost to followup

but amongst those we know about compared

to those with both kidneys kidney donors

are 8 to 11 times more likely to end up

in kidney failure in a jam that's a

journal of American Medical Association

paper in 2014 a followup of just seven

years was already demonstrating an

increased risk of kidney failure but

it's okay right they were paid for their

kidneys so

tough in a paper in last month's

American Journal of transplantation the

costs are calculated of benefits of

society of paying donors

$45,000 each for kidney that was the

kind of the cost benefit equipo

elimination of the waiting list Savings

of billions for society not a single

mention not a mention and certainly no

calculation of future costs of carrying

for a generation of donors in 30 years

time when lots of them are going to need

dialysis and transplants and this is an

illegal Market

remember a a legal uh situation by the

way no mention that 20% of kidney donors

have complications after surgery or that

30% suffer psychological problems many

very severe so payment replaces one

problem with another which has not been

properly

Quantified now let me tell you about the

attitudes that go with commercializing

transplants a month ago I was in

Manchester I got talking to a taxi

driver he was British he was 40 he had a

young family his kidneys had failed just

like his dad he was on dialysis three

times a week very unusual tissue type

chances of actually finding a donor

pretty slim he thought he'd die on the

waiting list just like his uncle back in

Pakistan he said where his family came

from I could get a kidney for

£4,000 and they guarantee a 90% chance

of

success what if the Man donated it

developed kidney failure and was in just

the same state as you and he thought

about that for a bit and he said well

that his

Lookout once you've paid money for a

kidney it's a transaction like any other

it's a commodity a kidney from a smoker

do I get a discount does that earn the

donor less a donor lies about their

history can they be sued and if you

really want and need the money there is

much more incentive to lie about your

medical past which isn't always

available or obvious to doctors and I

know you mentioned HIV I could agree to

give my kidneys today I could sleep with

six HIV positive men obviously all

gorgeous uh tonight and actually no one

would

know Money Changes behaviors of course

the idea of sale could only be

considered for kidneys surely you

wouldn't suggest it for a liver where

there's a if you're a living donor

there's a 1 in2 200 chance of death

during surgery and a 40% complic ation

rate in the UK right now there are 16

children waiting for a heart transplant

the UK has run out of what are called

bridge to transplantation pediatric beds

these children aren't going to be helped

by a market in organs payment has no

application for the majority of organs a

market in children's Hearts oh please

let's just change the law and sell

children and of course we don't sell

children children do we even though of

course if you have them they're yours

and you possibly can I've seriously

considered selling mine

sometimes but you don't because it would

devalue their uh their the whole concept

of children and if we were to pay the

Sterling equivalent of that

£30,000 that $45,000 which is about

£30,000 to each of the 6,000 people on

the kidney waiting list and remembering

that the saving envisaged are years in

the future the NHS would be bankrupted

by the need to pay donors UPF front and

organizations organization organ

transplants rather would have to be

restricted and of course it also ignores

a fundamental truth that the best way to

deal with a waiting list is to direct

money to stop people getting diabetes

which is the principal reason for kidney

failure sugar tax

please but let's stick with the UK

figures at the moment each UK hospital

that takes a kidney for transplantation

is paid £22,000 which covers the

expenses of doing so because they don't

necessarily get benefit but there's a

lot of cost attached to uh the

surgery what if you switch that sum to

the donor families if they agreed to

donate at

death who'd get the cash one of them all

of them only the ones that agreed to the

donation but not the ones who didn't

what about the situation where you have

a man and indeed my uh husband's uh

father was uh died on the job um and he

had his both his mistress and his wife

turn up uh in accident and emergency

ladies and gentlemen who gets the death

money

then what do legal sales in other areas

of medicine tell us in the UK 40% of

population give enough blood for all our

transfusion needs for nothing but a cup

of tea and a rich tea biscuit and if

you're not from Britain a rich tea

biscuit is a piece of sweetened

cardboard in the US there's a mixed

economy of paid and voluntary donations

and their system suffers shortages ours

does not and works much better here we

allow payment for

Seaman one off the wrist will earn you

£3 35

gentlemen however is is there a good uh

lot of donors no there are just nine

after a whole year of trying to attract

donors what about Iran payment and no

waiting list indeed remember that Iran

has waiting lists just as long as we

have for Heart and Lung and for liver

and its population is much younger than

ours their median age is uh 24 here it's

over 40 fewer older people with kidney

disease many younger fit people

where the donors come from there in the

Iranians say that 50% of those donors uh

are in poverty they have a big issue

with young women coerced into donation

by their families and that's the most

iniquitous aspect of payment for organs

the unfairness and corrosive effect of a

market in something which should not be

commoditized when someone when all

someone has is their health is it right

that they are paid to give it away

especially when for many the require

healthy lifestyle following donation is

unattainable in principle I defend the

right of women to sell their bodies but

in practice it's coercive exploitative

of the poor and vulnerable and leads to

trating and all sorts of crimes organ

donation is the same more than that a

paid for Market reduces the value of the

precious gift that's an organ

donation that me in in summary I hope

I've shown you that the payment replaces

one problem with another has no

application for the majority of organs

that paid for systems manifestly don't

work and that payment is unfair and

corrosive of the gft aspect you cannot

buy a place at Oxford you can't buy a

Nobel Prize you can't buy friends the

legal sale of organs falls into that

same category and I urge you to oppose

this motion

than

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