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Last Updated: Friday, 5 December, 2003, 09:37 GMT
Should donor organs be up for sale?
The British Medical Association will be debating whether a radical change in medical law is needed to allow the NHS to buy organs from living donors in Britain and Europe.

Professor John Harris, from Manchester University, argues that people should get the right to sell a kidney, part of their liver, or bone marrow.

Some doctors have suggested that such a scheme, if properly run, could ease the huge shortfall in organ supplies.

But a spokesperson said that despite the discussion the BMA will maintain its long-held objection to creating a marketplace for organ donors.

Is it time for an open "ethical market" in organs? Would you put your organs up for sale?

The following comments reflect the balance of views we have received:

Just because something is already happening does not mean we should just legalise it
No and No, just because something is already happening does not mean we should just legalise it. Removal of a kidney is not a trivial procedure and has many have pointed out only the desperate would resort to this for money. I carry a donor card and am on the bone marrow register and I agree with the idea of an opt out policy with regard to donation. Also I choose to carry a donor card and do not believe my choice should be potentially overruled by a family member should it ever come about.

We are horrified by 17th century tales of the poor forced to sell their teeth for dentures or their hair for wigs, applauding ourselves for having become so 'civilised' in comparison. I think I rest my case!
Amanda, Paris, France

It is a fundamental principle of medical ethics that anyone undergoing a procedure such as donating an organ must do so entirely of their own free will. Selling organs sounds great in theory, but let's face it, how much free will is really involved if you're about to have your house repossessed and someone offers you a five-figure sum for a kidney? It is totally unacceptable for anyone to be put under pressure to donate organs, and that pressure would be simply unavoidable if money were allowed to change hands.
Adam, UK

This will just constitute a further divide between the affluent and poorer members of our society
Mia, North East, UK
Won't this just constitute a further divide between the affluent and poorer members of our society? Would those with money really sell an organ, when money is not a driver for them? No, the organs would come from impoverished people desperately needing an injection of money into their family homes. Exploitation comes to mind. Fair enough, it's our bodies and we should be able to do what we like with our organs, but not at the price of exploitation. Would these people pay the 'real price' later in life?
Mia, North East, UK

Has professor John Harris sold his organs? Or is it just for people who are so desperate for money that they would consider selling there body bit by bit. It wasn't long ago doctors informed us animal parts could be used, in which case there would not be the need for anybody still living to donate parts they are using.
Graham, UK

Everyone should by default be an organ donor when they pass away. If you don't want to be a donor, you should have to sign something to say so or carry a card. However, selling body parts should be completely illegal. It will most certainly create a system that will adversely affect the poorest parts of society.
Aejaz, UK

Well I was thinking of getting an organ donor card, gifting my organs to help others after my death. But since I may now be able to get a few quid for my extraneous organs, perhaps I'll do that instead. Plus of course I'll be alive to spend my cash windfall from the publicly funded NHS. Spleen for sale 800 o.n.o. - one careful owner. Strapped for cash hence advert. Well done the BMA - your stupidest idea yet.
Chris H, UK

My body, my right to choose
David Moran, Scotland/Australia
My body, my right to choose. I don't see why there should be any restrictions on someone selling an organ to a willing recipient any more than them selling an hour of their time to an employer. I certainly think that people's organs should be viewed as part of their estate at death, and the proceeds of the sale of these should be available to their relatives. Of course, there would be a need for stringent controls to ensure that live-donations were made without coercion and that the proper market-price was paid for them.
David Moran, Scotland/Australia

Removal of a major organs is a serious under-taking, involving weeks of aftercare and the possibility of complications and infections! People must be crazy to contemplate it. (David Russell, UK 'Your organs are part of your body - if you wish to sell them then why should anyone else have the right to tell you no?' - short of possibly making yourself ill!) Rather, we should have an 'opt-out' donor scheme. I won't be needing my organs where I go after this life.
Nick, UK

This is not a question of the rich 'buying' others' organs. It's a question of one's choice to SELL their organs - the choice is entirely in the hands of the seller. It's their body - let them decide what they want to do with it, provided they are aware of the ramifications and risks. Incidentally, I think the 'opt out' instead of 'opt in' idea for organ donation is an excellent one. The impact of the increased organ availability on the live organ sales market would make the question of live organ sales more of a non-issue.
Ryan D., England

Coming from the states with it terribly mismanaged health care system, this idea horrifies me. There are many risks associated with transplant donation, as previously stated. However, my biggest fear if something like this were implemented here would be that the price of an organ would be so high that only the very wealthy could afford them. Much the way many medications and procedures are here currently.

I would probably sell a part of an organ if money was tight
Sarah, Reading, UK
When I worked for a pharmaceutical company, I sold a unit of blood for their research. I felt a bit bad that I wasn't giving it to the National Blood Service, but I was a new graduate and money was tight. I would probably sell a part of an organ if money was tight again, but I'm already on the bone marrow donor register and I'm happy to do that for free. I think giving an organ should be as simple as giving blood, but that won't happen, and I think paying for them is the only way the NHS is likely to be able to meet the demand. Perhaps recipients should be asked to give a donation towards the cost of an organ if they can afford it.
Sarah, Reading, UK

Donating an organ is major surgery requiring weeks of recovery. Only the desperate would sell organs to strangers. A better choice would be to require organ donation of deceased as they do in Belgium. Many times the doctors don't even ask.
Kathleen, USA

Your organs are part of your body - if you wish to sell them then why should anyone else have the right to tell you no?
David Russell, UK

If this is allowed, how long before people in debt are expected to sell their organs? Perhaps the bailiffs will come and take them forcibly? I am aware that the trade does go on in other countries, but we are supposed to be a civilised country! I do carry a donor card and I think that everyone should, but no-one is getting my organs until I am dead.
Helen, Exeter, UK

Guidelines have to be put in place to protect the interest of the donor
Karuna Gomes, Canada
If I wanted to put my organs up for sale, I should be allowed to do so. I would rather go through a recognised scheme rather then fall victim to the underground world of organ trading. Like everything else from Test tube babies to cloning, ethical standards and guidelines have to be put in place to protect the interest of the donor and the recipient
Karuna Gomes, Canada

I agree that it is necessary to obtain a greater quantity of organs for transplantation, but the "ethical market" put forward is anything but, and as such, is the wrong way to tackle the problem. A better, and less discriminative direction would be to consider an "opt out" policy in which members of the public who would not be willing to donate their organs after death could specify this; and possibly carry a "non-donor card" about their person. This would increase the number of organs available. Some may argue that the increase would be insignificant as permission would still be asked of the family out of courtesy. I disagree. Considering the statistics: the waiting list for kidneys, for example, is around 6000, and over the last year around 400 patients in need of a kidney have died whilst on this list. This constitutes approximately 7% of the 6000 waiting. It is difficult to believe that an opt out policy would not raise the number of donated kidneys significantly enough to cover this proportion. This argument applies equally to any organ donation.
Harry Orlans, UK

Live organ donations would be unnecessary if UK law changed from an 'opt-in' to an 'opt-out' system. Anyone wishing to exercise their right to opt-out of organ donation should have to register their intention with the Department of Health, who should be responsible for maintaining a list. Naturally, by exercising this prerogative, such individuals would forfeit their right to be first in the queue should they need an organ themselves!
Lawrence Brown, Sheffield, UK

Do you honestly believe that the selling of organs to the highest bidder isn't already happening all around the globe? Without a doubt those that can afford it can have anything they want - legally or illegally. To put it out there to be regulated makes far more sense - then at least there will be a "going" price for the organs and it will reduce the disadvantages to the poor.
CindyLu Webber, USA

This could be a good way for students to pay their university top-up fees without getting into debt.
Brian W, UK

I wonder whether eventually we'll be able to buy them supermarkets?
Is there limit to the depth that some members of our society are prepared to go to make quick and easy "buck"? This isn't about helping the sick, it's about making money out of other peoples misfortune - how ethical is that? I wonder whether eventually we'll be able to buy them supermarkets.

People supporting this proposal have not thought enough about the morality of it. Organ donations for payment are usually from poverty stricken people desperate for money. Donation of a kidney, and especially part of a liver, is a major surgical procedure with known morbidity rates. The operation is not risk free to the donor. Whilst many people survive quite well on one kidney, loss of a kidney inevitably shortens life expectancy. It is an ugly world where rich people harvest the organs of the poor.
Brian Sanderson, UK

Having read John Harris's work, he puts forward a very persuasive argument. Organs are very much needed and those willing to sell them would not be doing anyone any harm - they will actually benefit financially from the decision.... it would certainly reduce the transplant list, lift an immense pressure from the NHS and save lives. The government would just need to ensure it was properly regulated.
Anon, UK

In Belgium, organ donation is compulsory: if you die, your organs will be taken unless you notified that you did not want this to happen when you were still alive. I think it is a better way to deal with the shortage, without involving money again! But then again, we've got identity cards too...
Gene, Belgium

How about a National organ lottery - "Come in Mr Smith of Bournemouth. You're time is up."
Rick, UK

As long as the vendor is actually willing then where is the harm? It would automatically curb the illegal trade plus ease the shortfall
Mark Ryan, UK

How about the NHS picking up the cost of a funeral and Gordon Brown offering a tax break to donors after death if their organs are used for transplant!
Richard, Leeds, UK

Surely many of those that will offer their organs will have been pushed to this by severe financial difficulties and desperation to raise finance.
Bell, UK

Last week there was the report of women who can't receive money for donating eggs. How does this current proposal morally differ?
Ingrid, UK

Why not? If I knew I could save a fellow human beings life and earn a few dollars in return where's the harm? Should my remaining organ fail I could always buy a new one, not to mention the fact that by the time it may fail I will be able to purchase a manufactured organ.
Chase, Canada

Provided they are properly screened, absolutely. Anything which increases the supply of donor organs is welcome.
Damian Leach, UK

As a 3 times transplanted patient, I think the main objection I would have to 'buying' an organ for transplant is that there is a no money back guarantee! Other than that, It's worse on the body for the donor than it is for the recipient.
Andy, UK

Offering a financial incentive could just tip the balance for people
Emma Taylor-Smith, England
If you donate an organ to someone outside your family you are putting yourself at great inconvenience and a hospital stay to do so. Understandably many people don't bother. Offering a financial incentive could just tip the balance for people who want to help but are unsure.
Emma Taylor-Smith, England

If people want to sell their organs, why shouldn't the NHS be allowed to buy them?
Andrew Sharp, Scotland

Yes, I agree. Let the market decide. If this brings benefits (i.e. more people cured) then I am all for it. I suppose the morality police amongst us will be all over this like a rash. If we leave this to unscrupulous organisations and corrupt surgeons then the present system of exploiting impoverished third world people will continue. Controlled, open, ethical and fair are the buzz words here.
Roger, England

Moral questions or not it's already happening now, across the world, it's underground and without any safety or blood-borne disease checks, resulting in Hepatitis and HIV being spread. Make it legitimate and that brings in the existing high NHS standards for organ donation.
Ken, England

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