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Nice Harvard degree, so how much are you worth? Whether or not you’re booked on the next Greyhound south to begin your finance career, that figure may be higher than you think once you consider the value of your unique biology. “Human commodification” is a nebulous term which has peppered debates on everything from prostitution to genome patenting to selling your “soul” on Ebay; but what remains undeniably clear is that markets in “personal” goods will always exist and continue to mature. We need to reevaluate our justifications for limiting the rights we afford people over their natural endowments, and in particular, their organs.
How much you are worth depends in a large part on which country you live in and your gender. In Iran, for example, you could legally sell your kidney for upwards of $6,000. Iran currently has no renal transplant waiting list, a credit to this policy legalizing the organ trade. In the U.S., where organ sales are illegal, the present waiting list of kidney transplant candidates numbers around 75,000. These individuals rely on the uncompensated charity of living organ donors, or, more commonly, the consenting donations of deceased persons. The average wait time is over five years and demand for donated kidneys is constantly unmatched by supply, leading to a current mortality rate of about 30 percent of transplant waiting list candidates.
In the U.S., females are allowed, however, to ‘donate’ their eggs for an average compensation of about $5,000—while Harvard women may be able to land 10 times that amount. California Cryobank, a sperm repository in Cambridge, pays approximately $75 for each sperm donation by Harvard males who meet specific requirements. Governments decide which parts of our bodies are saleable, and they are in the business of drawing lines. Unfortunately, these lines are sketching quite a blurry picture of the control we possess over our own bodies. Americans can sell their eggs, sperm, blood, hair and souls, but their organs are off the market.
Many Americans hold that certain forms of human commodification, such as organ sales, should be illegal on the grounds that they violate human dignity. Even if we accept this idea of dignity—which is somehow desecrated by the sale but not the donation of kidneys, and which applies to these organs but not the other aforementioned body parts—is the preservation of this abstract idea worth restricting a person’s control over his or her body and putting another person’s life at risk? We must base the law, not on these disputed and amorphous moral principles, but on the real social costs of different legislation.
One commonly used argument against compensated kidney donation is that people in poverty would be most likely to sell their organs. While perhaps true, this concern neglects the fact that we already allow people with low-incomes to make their own decisions regarding the sale of their sperm, eggs and blood. Both kidney and egg donation are invasive procedures that come with associated risks. The decision whether or not to sell an organ would also not be made in a vacuum and one would expect medical professionals to fully present the associated (albeit minor) risks of kidney donation before surgery.
Moreover, this attitude reflects a paternalistic view of the decision-making capacity of the poor. One cannot assume that the decision to sell an organ is myopic or irrational when a poor person makes it. While some could potentially sell their organs out of desperation, it is likely that they would rather have the money—which could provide them with food, shelter, or medicine—than have both kidneys. Prohibiting such a sale will not alleviate the other problems they face; in fact, it will exacerbate them.
Compensation to living kidney donors will save lives by increasing the supply of kidneys available for transplant—but most Americans probably value their kidneys at more than $6,000. Even more effective would be a system that allowed persons who consent to donate their organs upon death to bequeath their compensation. Currently only 35 percent of licensed drivers and ID card holders register to be organ donors. One would expect many more Americans to register if it meant that this would swell the inheritance they leave behind by several thousand dollars.
Issues of human commodification will continue to frame debates in the future with the advancements of biotechnology. This has already begun in conjunction with genomic research, cloning, and the commodification of DNA. We will need to consider the practicality and efficacy of our legislation more so than people’s moral indignation at certain activities. Legalized compensation for organ donation is a clear starting point.
James M. Wilsterman ’10, a Crimson associate editorial chair, is an economics concentrator in Lowell House.
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