Market and Non-Market Mechanisms for Procuring Human and Cadaveric Organs: When the Price is Right

Abstract

In the United States, as well as throughout the world, current demands for organ transplants far exceed the actual supply. Nonconsensual human donations, taken from minors, incompetents and prisoners are regulated carefully by the courts. The Uniform Anatomical Gift Act and the National Organ Transplant Act serve also as statutory frameworks for organ retrievals and allocations and place various restrictions upon each. Altruistically motivated donations at death continue to be an inadequate mechanism for meeting the growing demands of the market. Included among the various approaches to resolving the critical shortage of human organs for transplantation are post mortem harvesting, escheatage, prospective contingent sales and standard death benefit payments — with the latter being perhaps the most attractive in the United States. While ethical and moral principles can help develop a construct for resolving harvesting and transplantation conflicts, they must be tempered — in the final analysis — by a standard of practical need that recognizes unnecessary suffering and premature death from diseased and replaceable organs as undesirable.

The Commodification of the Body and its Parts

“…These include redefining the threshold of death and thus personhood, so that anencephalic and non-heart-beating cadavers can be donors; developing bioartificial organs and xenotransplantation; presumed consent laws for organ donation; advocating a direct market approach, where specialized procurement firms fill orders generated by transplant centers; and offering forms of "rewarded gifting" to surviving kin in the form of estate and income tax incentives and assistance with burial fees (Bowden & Hull 1993;cf Blumstein 1992cf Blumstein , 1993Brecher 1994;Daar 1992a;Hansmann 1989;Land & Dossetor 1991;Murray 1996;Peters 1991;Schwindt & Vining 1986;Sells 1992a). Such practices have been labeled by critics as nothing more than "paid donation," "rampant commercialism," or "frank entrepreneurial commerce" (Daar 1992b, Sells 1992b, Smith 1993; see Marshall et al 1996:8-9). Cohen (1999:146), assuming an international stance, refers to such open discussions of commercialization as evidence of disturbing forms of "flexible" or "purgatorial" ethics.…”