Human Organs Debate | Vivienne Parry | Opposition
Summary
TLDRThis 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
🚫 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.
💼 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.
🙅♀️ 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.
Mindmap
Keywords
💡Organ sale
💡Donor task force
💡Kidney donors
💡Commodification
💡Coercion
💡Dialysis
💡Transplantation
💡Market in organs
💡Moral limits
💡Sugar tax
💡Gift aspect
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
[Music]
[Music]
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
[Music]
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