According to the National Kidney Foundation, there are currently more than 99,000 individuals in the U.S. on the waiting list for a kidney transplant. On average, that list increases by nearly 2,500 people per month. Every day, 14 people die while awaiting a kidney transplant. Those on the waiting list are faced with a decreased quality of life, dialysis and an early death.
There is, however, one country in the world that has had no waiting list for kidney transplants since 1999. It isn’t Sweden, Japan, France, Iceland or any other of the 36 countries ranked before the U.S. in quality of healthcare; it’s Iran. Iran is also, coincidentally, the only country in the world that allows the for-profit sale of one’s kidney.
Yup, it’s true. If you’re an Iranian citizen sick with kidney disease and can afford it, you don’t get dialysis – you get a kidney. This isn’t to say that all kidneys transplants in Iran are for-profit, but opening up the market to kidneys creates more of a possibility that voluntarily donated kidneys will find their way to those who may not be able to buy one.
The U.S. outlawed the sale of human organs (which includes kidneys) with the approval of the National Organ Transplant Act on Oct. 19, 1984. While many other countries followed suit, the mid-1980s is when kidney sales in Iran started becoming commonplace. This can probably be attributed to anti-Western sentiment coming from Iran at the time.
Whatever the motivation, Iran serves as a case study of the legal human kidney market. They have achieved something the rest of the civilized world has failed at accomplishing. But yet, we pay them no heed.
People claim that only the poor or disenfranchised would be willing to sell their kidneys, and that a legal market for kidneys would inherently prey on these people. To that, I say, those who would choose to sell their kidneys are adults. It is nobody’s choice but theirs what they do with their kidneys.
If the poor are the hypothetical main demographic of kidney sellers, people may claim that in order to sell their kidneys or to earn more money, the poor will lie about their medical history. For some reason the masses in America tend to consider the poor underhanded and mistrust them.
These people should look to the early days of the HIV/AIDS epidemic and the state of the blood donation business back then. Hemophiliacs are treated with blood-clotting factors derived from donated blood in order to try and maintain their health. According to the National Heart, Lung and blood institute, approximately 90 percent of individuals with severe hemophilia were infected with HIV by 1985.
This is relevant because, during this time, there wasn’t a foolproof way to test for HIV, and there was also no concrete evidence linking it to any particular culture or activity. We now know that there are certain groups that are more at risk to contract the virus than others, such as intravenous drug users. In order to reduce the risk of receiving contaminated blood through donations, these people are permanently deferred from donating. However, this was not the case several decades ago.
The Centers for Disease Control and Prevention announced several cases of hemophiliacs contracting HIV who had received clotting factors in 1982. This suggested that the virus may be blood-borne and prompted the CDC to recommend that blood banks institute a deferral program for at-risk donors at that time – namely, homosexual men. The American Red Cross, American Association of Blood Banks and the U.S. Food and Drug Administration all rejected this suggestion.
It is simple to see why they would have rejected such information. Since they received blood by a strict donation-only basis, their success was measured in strictly how much blood they gathered. Whereas, if they were collecting blood to sell for profit, they would have to pay donors and their success would be measured in profit.
The CDC announced in 1983 that the development of HIV to AIDS was, at the time, the second leading cause of death in hemophiliacs. Despite this evidence, volunteer-dependent blood banks and those representing their interests continued to rebel against donor deferral. Even in the face of the data presented, the New York Blood Center’s Dr. Aaron Kellner maintained, “We must be careful not to overreact. The evidence is
tenuous,” over concerns that screening donors would cost too much.
Dr. Joseph Bove, at the time a chairman for the Food and Drug Administration’s Blood Products Advisory Committee and Director of the Blood Bank at Yale University Medical Center, who had previously said, “there’s not enough evidence
to finger any population or subset of individuals and say ‘This
group should not be allowed to donate blood,'” maintained his position.
Eventually, regulations changed and donor deferral was instituted for high-risk groups. However, this example illustrates the downfalls of relying on volunteer donations. If your success is measured in dollars and not quantity of product, the game changes. People wouldn’t pay good money for bad blood, or kidneys. So, it would be logical to say that a for-profit facilitator of kidney transplants would take the steps to ensure the safety of its recipients and donors to maintain its profits.
When it comes down to it, it seems really counter-productive to keep a market for human organs illegal. Basic economics dictates that when there is a demand for a good or service, a supply will come to meet it. In this specific case, this is illustrated by a black market for organ trafficking. With the illegal kidney market alone being worth anywhere from $514 million to $1 billion a year, it’s no wonder that illicit organ vendors are known to engage in kidnapping and murder in order to maintain a supply of organs.
Personally, I would rather take money away from the black market, give people more access to life saving transplants and let capitalism do its thing. We need to stop telling people what they can and can’t do with their bodies, especially when it’s beneficial to all parties involved.
Jacob Valdez is a sophomore in mass communications. Please send comments to firstname.lastname@example.org.