Wednesday, July 23, 2008

Great Singapore Organ Sale? Legalisation of Organ Trading

Let’s push within the current regime… but at the same time, let’s not write off an idea just because it sounds radical or controversial… We may be able to find a compromise which is workable and yet does not offend people’s sensibilities.
(Health Minister Khaw Boon Wan, quoted in The Straits Times, 21 July 2008, page H1)
While pondering on this quotation, I cannot help but to be skeptical. The minister’s concern is over the people’s sensibilities, but the alarming fundamental issue of this thorny matter concerns people’s lives rather than mere sensibilities.

By ‘lives’ I have in view that of the paid organ donor. Yet by no means I take the buyers’ life as less valuable. In fact it is precisely because the lives of the buyer and donor are as significant that the misery of the former should not be inflicted in any degree on the latter even though the latter willing to accept financial compensation.

Obviously, in the organ trade the term “organ donor” is an oxymoron for in a trade there is no compensation but payment, and there is no donor but simply owner. The relationship does not bear any altruistic meaning but pure commercial transaction.

The article ‘S’pore can take lead in legalising organ trade’ written by Jennifer Yeo and Madan Mohan, published in the 17 July 2008 issue of The Straits Times, propounded that organ trade is a “social relationship… which gives a new lease of life to both the stakeholders”. The authors conceded that the “law ought not to step in to criminalise and punish such relationships.”

The authors argued that given the “unclear” legal status of the human body, the treatment of our body is, therefore, accorded to and guaranteed by mutual consent.

The authors even compared prostitution among others with organ trading. This betrays the heightened commercial view that they have on humanity. In other words, they were saying that we can buy and sell our body (or parts of it) because we do not know who we are.

Here is where their careless hastiness betrays the prematurity of their judgment and suggestion. First and foremost, the status of human persons is not the result of a negotiation made by any one group of humans. We learned that through our experience with the Nazi regime.

The authors’ failure to recognize the status of the human body is not at all a contribution to the discussion of how should we treat our body, which is the underlying concern of organ trading. At best, their ignorance of the value and status of the human body can only serve as a ‘stop’ sign to alert us to the complexity of the matter and hence preventing any unnecessary, harmful, and hasty decision. Yet they ventured over their legitimate course.

The fact is that Jennifer Yeo and Madan Mohan’s premature contention for the legalisation of organ trade impels further commercialisation of the human body. And this is precisely the very exploitation that they want to avoid.

Probably their hastiness is due to their concern for the victims of organ failure. They wrote, “While altruists say that any sale of organs is unethical…we need to put ourselves in the shoes of the patient waiting desperately for an organ.” On this point, we have to question their preference for casting care on the victims of organ failure. Why should we put ourselves only in the shoes of the patient and not in those of the organ owner as well?

In a study conducted by World Health Organization, 78% of Egyptians who sold their organ experienced health deterioration, 78% of them spent their compensation within five months, and 73% reported weakened ability to perform labour-intensive jobs. In India, 86% reported deterioration in health, declined in average family income, 96% sold their kidneys to pay-off debts, and 75% were still in debt. 58% in Iran reported health deterioration, 60% reported negative effects on their physical activities, and 65% reported negative effects on their employment. So, it is reasonably to conclude that a normal person will not sell his or her organ. And those who traded their organ did it out of desperation.

Given the fact that virtually all organ owners traded their organ due to poverty, organ buyers is akin to opportunists who exploit others by harvesting their body parts through financial means. Often the exploitation is sugar-coated as ‘selflessness’ in a way that seems as though it is doing the poor a favour.

Is this the best the rich can do to help the poor, by buying their organs? The article suggests exactly that though under disguise: “If the State… cannot help the poor in overcoming their problems, it ought not to raise more barriers for them [by preventing them to sell their organs to the rich by law].”

It is easy to see through the masqueraded hypocritical ‘help-the-poor’ rhetoric in the quoted passage. Why do the State suddenly being charged as raising “more barriers” in preventing the rich from helping the poor only in situation when the rich is in need of the body parts of the poor? Why the rich cannot help the poor when they do not need their organ?

The obvious answer is that this is not a case where the rich wants to help others who are in crisis. Rather, the rich wants to exploit the poor given their desperate condition. Such is not merely an exploitation of other humans but also an inhumane discrimination of those who are at the lower rank of the socio-economic status.

Of course the attraction in legalising organ trade is the extension of widespread commercialisation over all spheres of reality. This is exactly what the rich wants because the more commercialised the world becomes, the more powerful they will be. Perhaps there are many other reasons for us to view our body parts as one of the marketable fascinations in the next Great Singapore Sales, but our ignorance of the status and value of the human body is definitely not one of them.


Augustinian Successor said...

A good post!


Shendy_HeeRi said...

I understand the physique of the donor will be weaken but it will not lead to death. Moreover, we have to understand now that we have this law, those poor who are poor are able to have a higher chance in the waiting after all the people who are rich get their organs.

This law was passed was because for the benefit of the society that there will be a decrease in number of people dying due to organ failure.

Moreover, we are living in a free society, we are rational enough to make decision for our own life. I think the reimbursement is a reasonable amount of money given to the donor and a long-term program to monitor the health of the donor is pretty reasonable because it will deter people from selling their organs.

Lastly, isn't it better to get an organ legally rather through illegal channels because you will never know what you will get through illegal channels. Moreover, two Indonesian donors have been caught by the Singapore government to stop the syndicate from increasing such in Singapore.

I think there will always be debate over whether it is good or bad. I think most importantly we have to understand how this can help the lives of people that we might never understand what life they have been going through. They have their right to choose how to deal with their life. We kept talking about freedom isn't this part of a freedom of the poor.

Analogy - What if they will be killed by loanshark because they owned them US$10,000 but they will be able to repay it through the reimbursement, isn't it a better solution that we are able to save 2 lives at the same time and the surgery they undergo will be much more safer than through illegal channels. I found out that this procedure is only open to its citizen which will not encourage organ tourism. It is just a system within a city-state.

Sze Zeng said...

Hi Shendy,

Thank you for your comment.

I believe most of the points you raised have been handled well in my post.

Perhaps the only point that I need to make further is your assumption that we are living in a "free" society and we are "rational enough to make decision."

The society is free is only in a limited sense, within the bound of the welfare of individuals and the society at large. For example, the leisure use of cocaine is forbidden even if that means individual's right is being compromised.

The existent of drug addicts show that there are among us who are not rational enough to make good decision for ourselves.

Thus, in this way, the State need to step in to do what is right and good for the society at large.

On your analogy of helping someone to get out from loansharks' debt, there are other ways to help them without risking their health. You don't help someone who are already in trouble by robbing their health.