Commentary: Improving access to organ transplants

a/Opinion by

Every year, thousands of Canadians endure immense suffering waiting for organ transplants.  Despite encouragement from the government and civil society groups, the number of organs donated is inadequate to meet the need.  For example, in 2013, over 4,500 Canadians were waiting for a kidney, which is the most commonly transplanted organ. To ameliorate this shortage, which extends to all organs, the federal government should legalize and regulate the market for organs

While it is understandable that many would be uncomfortable with treating organs like commodities, this should not obscure the fact that given the mass shortage in available organs for transplant, the trade will inevitably continue. The shortage of organs results in a global black market that disproportionately affects the poor, who sell their kidneys without being able to access the service for themselves.

Almost every other country has prohibitions like Canada’s; however, in Iran, selling one's kidney is legal. The regulation of the kidney market is not complete. In the official market, there are still wait times, but the prices are regulated. Yet at the same time it is legal for donors to ask for a higher price. Canada should learn from the failures in Iran’s policy to ensure that a legal organ market is regulated so as to ensure that it is not just the poorest parts of society selling their organs—an open market should be accompanied by an increase in pro bono donations.

The status quo is failing. The huge need for organ transplants in Canada is not being met by voluntary donations. According to The Kidney Foundation of Canada (TKFC), over 23,000 Canadians were on dialysis in 2010, an expensive procedure that places a heavy mental and physical burden on patients. Additionally, the number of Canadians who will need organ transplants is poised to grow larger.  According to TKFC, 16 Canadians are told they have kidney failure daily.  In 2010, 82 Canadians died waiting for a transplant. There is therefore a need to increase the supply to meet growing demand for transplants.

The cost of dialysis—which for patients suffering from kidney failure is medically necessary—is approximately $60,000 per year. In contrast a transplant only costs $23,000, plus $6,000 per year in medication.  A greater number of transplants would save the health system an immense amount of money, and provide a higher standard of living for patients.

The status quo is failing. The huge need for organ transplants in Canada is not being met by voluntary donations.

Thus, the solution to dealing with the shortage would be to legalize and regulate the trade. While kidneys can be donated by living donors, donors could be compensated for other organs posthumously. After all, it seems illogical to argue that voluntary donations are good yet doing the same thing for monetary compensation is bad. A regulated market would also ensure that the decision to donate is made with all available information and resources of the government. Many still argue that allowing people to receive compensation for organ donations could lead to exploitation of the poor who may feel compelled to sell organs because of financial difficulty; however, a 2010 survey from the University of Pennsylvania found that while monetary compensation increased the likelihood of donating an organ, the effect was the same regardless of socioeconomic status. It also found that the monetary incentive did not affect the number of people willing to donate for free. A regulated market would make organ transplants more available and more equitable by ensuring that the poor have as much access to transplants as the rich, who can pay or travel to receive their transplants.The government could also ensure access to transplants for poorer Canadians by offering to purchase organs that could be reserved for low income individuals who need a transplant.

There is no way to stop the organ trade. As long as people need organs to save their lives, and others are willing to sell them, a market will exist. The best that the government can do is to bring the trade out of the shadows, to ensure the safety of all participants.  Though many may be uneasy with the notion of legalized organ sales, the fact remains that people are dying because they don’t have access to lifesaving treatments.  We should not let fellow citizens suffer and even face death when so many others are willing to donate.