Organ transplantation is a rather delicate topic, and the state policy regulating the laws of this field of medicine is usually guided not only by legal but also moral principles. Altruism has always been considered one of the key aspects in this sphere as giving an organ to another person who needs it is nothing else but a sign of kindness and disinterestedness. Nevertheless, physicians are increasingly faced with various cases when organ donation is not altruistic but mercantile. Some people require material rewards in exchange for their help, thereby turning this procedure into a so-called business transaction. Therefore, altruism in transplant policy is not always the central moral principle, and the reason for it may lie in changing the values of the society and striving to make money by any possible means.
Limited Participation in Transplant Programs
The case described by Satel (2009) is quite a vivid example of how imperfect the system of donation is. According to Satel (2009), a person who wanted to help another man for free faced difficulties and, as the author notes, the transplantation program “turned him down” (para. 2). The reason why Mr. Thompson could not become a donor was that he was not Mr. Davis’ relative (it was that man to whom he was going to sacrifice his kidney). This imperfection of the program led to the fact that Thompson had to prove that he was going to this step independently and was ready to be a volunteer. Perhaps, such an approach to the organization of the entire procedure makes it clear that the doctors were not ready for the fact that a person can participate in the program of assistance to the needy without compensation. Probably, that is why the above-described case is an example of bureaucracy and distorted views about morality and human values that have become a part of contemporary society.
Personal Experience of Altruism Manifestation
Satel (2009) tells about the case that she faced personally. The fact is that she needed a kidney transplant, and when she found out that there was a woman who was ready to sacrifice her health, she was convinced that this person acted solely from altruistic motives. Satel (2009) notes that her “glorious donor was moved by empathy” and admires the courage and kindness of this woman (para. 6). Nevertheless, the author claims that she has never believed that such actions happen in real life. She highlights that, in her opinion, a free donation is almost impossible; otherwise, people will just refuse to help others (Satel, 2009). This example makes it clear that a person is subconsciously prepared for the fact that any service must be paid according to a legal cost, especially when it comes to such a procedure as organ transplantation. Altruism fades into the background, giving way to material interests, and it was the act of Satel’s donor that surprised the author most.
Possible Arguments against Donation
In support of the fact that the popularization of altruism is hampered by some factors, the author cites the ideas of Michael Sandel, a political philosopher (Satel, 2009). For example, the desire for enrichment can be the only reason why some people are willing to sacrifice their healthy organs. Besides, the lack of non-monetary compensation, for example, accident insurance or the provision of tax credits also hinders the manifestation of free assistance. As Formica and Newell (2016) note, a person’s voluntary desire to help others should be recognized by society; otherwise, this desire will disappear in the future. Moreover, this approach to the problem allows saying that even if a donor decides to assist others for free, the government should encourage such decisions and make efforts for more people to learn about such actions. Perhaps, altruists do not seek fame and recognition. Nevertheless, public approval is a rather good incentive for continuing donor activities and helping those in need.
The factor of Duty and Compulsion
There is one more nuance that is rather controversial and at the same time difficult to explain. The fact is that regardless of whether the relatives of a certain patient are willing to become organ donors or not, society imposes responsibility on them. A popular prejudice is that people from a close circle should be responsible by default for the health of those who feel the need for transplantation. According to Cherry (2015), at the same time, not everyone likes this moral compulsion that often leads to the feeling of guilt. Sometimes, people are not ready to sacrifice their health just because one of their relatives needs treatment. Such a factor of responsibility is probably the reason that most part of the society is not ready to participate in helping others (Bollen et al., 2017). It is not a justified conviction that only relatives must act as donors. Moreover, it may be impossible not only for moral reasons but also because of the health status of particular people. It is necessary to conclude that the authorities should review the policy of silent coercion and make sure for as many people as possible to know about voluntary donation; otherwise, any attempts to educate a humane society will be in vain.
Attempts to Romanticize Donation
One of the most common problems is the desire to present voluntary participation in transplant programs as something romantic and worthy of social approval and praise. At the same time, these attempts may not be the best way to attract public attention to this problem. Satel (2009) gives an example of the fact that the state policy regards the participation of citizens in such medical programs as an act of courage. However, as Thornton (2017) claims, if a person knows that his or her desire to help another is not the manifestation of the highest degree of nobility but a correct civic position, the prevailing opinion will probably change. When some people do this or that act for the benefit of others, it seems to them that society should be grateful for it. Perhaps, there is some truth in it. Nevertheless, it is unlikely that recognition is an adequate reason to become a donor voluntarily. Maybe, a correct position is a sober view of the situation and the awareness of the fact that it should be a natural desire of almost any citizen to think about others’ needs.
Support from the Government
In her article, Satel (2009) notes that the government’s influence on the perception of issues related to organ transplantation is unconditional. The current situation “can be addressed with good policy” (Satel, 2009, para. 11). Cases, when the state discourages the desire of some people to participate in donor programs, are direct evidence that the healthcare system has several wrong guidelines. The article says that a person sometimes does not have the right to donate his healthy organ voluntarily if he or she does not have the necessary social documents and permits (Satel, 2009). Certainly, good health is an essential condition to become a donor. However, some conventions with papers hardly should be the reason that patients can die without getting the organs that they need (Carney, 2017). Official laws regulate only the duties of donors, not taking into account that people who are ready to participate in the procedure of donorship sacrifice their health and probably even lives. Based on this assumption, it can be noted that the state’s participation in the sphere of medical transplantation should not interfere with citizens’ desires to manifest their active position and help those who need it.
Satel’s discussion of the stated topic was quite adequate to claim that altruism in transplant policy is not always the central moral principle. The author remarks that a public position of the society should not depend on any prejudices and the state should encourage those who are willing to participate in donor programs. The arguments in the article are quite objective to note that a sincere desire of citizens to help the needy should not be stopped by any bureaucratic or social prohibitions. Intolerance or excessive pressure in such a sphere is unacceptable. Donorship should not be obligatory; however, at the same time, everyone should have access to this system to become a part of the mechanism that allows helping all the afflicted.
Bollen, J., de Jongh, W., Hagenaars, H., van Dijk, G., ten Hoopen, R., Ysebaert, D., … van Mook, W. (2017). Organ donation after euthanasia: A pure act of altruism fulfilling the patient’s last wish. American Journal of Transplantation, 17(3), 843-844.
Carney, E. F. (2017). The psychology of extraordinary altruism. Nature Reviews Nephrology, 13, 383.
Cherry, M. J. (2015). Kidney for sale by owner: Human organs, transplantation, and the market. Washington, D.C.: Georgetown University Press.
Formica, R. N., & Newell, K. A. (2016). What is the price of altruism? American Journal of Transplantation, 16(3), 741-742.
Satel, S. (2009). When altruism isn’t moral. Web.
Thornton, V. (2017). Lives and choices, give and take: Altruism and organ procurement. Nursing Ethics, 1-11.