Ethics @ Work: Eye for an eye

Extended program for organ donation deserves to be extended further.

By ASHER MEIR
Magen David Adom ambulances 311 (photo credit: Reuters)
Magen David Adom ambulances 311
(photo credit: Reuters)
Selling organs is illegal in Israel, as in most countries. But Israel has been a pioneer in the area of providing non-monetary benefits and official recognition for organ donors. One progressive step taken recently was to define specific criteria for priority in receiving organs for those who sign an organ donor card (and immediate relatives). Normally, priority applies only after a waiting period in order to discourage people from waiting until they see they might need a donation themselves. But as a special incentive for prompt participation, immediate priority was offered to those who signed up before the end of the year. The response was so overwhelming that operators were unable to register everyone who called, and now the deadline has been extended an additional three months.
Payment for organs is one of the most controversial issues in economic ethics issues. Many view this as a prima facie ethical breach, akin to selling human beings; others view it as an severe ethical problem that they are willing to countenance, if at all, only due to a utilitarian consideration: the extreme need for organs on the part of prospective recipients who are in true life-threatening danger.
My position, as I have elaborated in a number of columns, is that, on the contrary, giving donors fair recompense for their sacrifice is the a priori ethical desideratum. While a principled opposition to any organ donation would be a consistent ethical position, believing that organ donation is ethical and even praiseworthy but denying donors any recompense for a very significant personal risk and suffering is not a sustainable point of view.
Fortunately, in the case of donations after death, the discussion turns out to be mostly academic. We see from the response to the latest campaign that in-kind non-monetary incentives can be successful in bringing about a large donation rate, just as the insurance program for blood donors has been successful in sustaining an adequate pool of blood donors.
However, in the case of donations from the living, the case is different. Even though the benefits Israel provides to kidney donors are pioneering and meaningful, they are far from sufficient to provide organs for all the dialysis patients who need them, and by the same token, far from providing adequate and ethical compensation for those who donate.
Israel is to be congratulated on the creative steps it has taken so far to encourage organ donation; let us hope that further creative steps will be successful in motivating more people to make life-saving organ donations before they die.