Monday, July 27, 2009

Trafficking in Human Organs

Imagine a loved one who is lying in a hospital with a life threatening illness. She suffers from kidney failure. All attempts to secure a donor for a kidney transplant have thus far failed. Dialysis is no longer affective. In short - she has been given only a few days to live if she does not find a viable donor. God forbid any of us ever experiences this tragic situation.

The question must be asked, what if there are donors who could save this woman’s life by donating one of their two healthy kidneys -but are not inclined to go through the risks of surgery. If I understand the Halacha correctly here, there is no obligation for anyone to too take even a relatively minor surgical risk to save another life. Although it is probably a great Mitzva to do so.

It isn’t only the surgery itself that is a risk. There is another factor to consider. It is the problem of being left with only one kidney. Although a person can live a completely normal, full and healthy life with only one kidney - what if it fails? It does happen. One kidney fails and the other one takes over. A donor with two healthy kidneys need not worry. But for someone who donated a kidney, he is now in a life threatening situation. The donor then becomes the victim of his own generosity.

On the other hand looking at it from the perspective of the person who faces almost certain death without a transplant - this seems to be very unjust. Factoring in all the above considerations - why need they face almost certain death when there are so many people with two healthy kidneys walking around but are unwilling to donate one of them?

Therein lies the question. What is the ethical position here? This is a difficult question for me. I do not have an answer.

Let us look at what is considered to be a very unethical – even disgusting – practice. One that is illegal: That of buying and selling kidneys.

From the perspective of a terminal patient who is willing to spend whatever it costs to save his life – is it even a question? Of course he is entitled to save his life as long as it does not involve endangering another. If one person is willing to sell one of his kidneys – an organ that one can live without and as a result another person will live – as disgusting as that may sound - why shouldn’t this transaction be legal – even ethical?

The answer I often hear to that question is it that will create an unsavory industry of selling vital human organs. And that could lead to things much worse. Once it becomes a commodity then all kinds of unscrupulous people will get in it for the money and all kinds of questionable practices will result.

A good example of that happened last week.

It is illegal to traffic in human organs. But that doesn’t mean a black market doesn’t exist. And an industrious Chasidic slime ball of an entrepreneur has probably made a fortune trafficking in them. The Chilul HaShem this fellow caused by his clear identification as a religious Jew is perhaps the biggest one coming out of last Thursdays money laundering arrests.

A co-operating witness offered him money to get a kidney. He not only agreed and took the money, he bragged about how long he has been doing it and his 100% track record of success in procuring kidneys! This was all recorded via a ‘wire’ placed on the witness by the FBI.

According to reports, he went to poor Israelis and offered them $10,000 dollars for their kidneys. He then turned around and sold them for $160,000 dollars to black market recipients. And there have been reports that when a donor changed his mind after the deal was made, he would force the donor at gunpoint to go through with the surgery.

This is so disgusting, that it is beyond comprehension! That anyone who calls himself a Jew would stoop to such a low level makes me wonder if this fellow is even human. That he is someone who is supposedly religious in his ritual practice seems obvious from the way he looks: long beard, peyos, the long black coat and felt hat – all symbols of the kind of piety associated with Chasidsm.

This is a man who very likely would not dream of using any dairy product that is not Chalav Yisroel. But trafficking in human organs…preying on impoverished Israelis to sell vital organs – sometimes at gun point (if the reports are true)… no biggie! I have been writing about the over focus on ritual and the under focus on ethics in these communities. But I never fail to be surprised at just how low some people parading as religious Jews can sink.

But if one factors out the seedy circumstance of this case, I’m not so sure it is all that unethical to buy a kidney from a healthy donor – especially when the result is that a life is saved.

As long as it is done in an equitable way with all the possible consequences spelled out for the donor - as unsavory as it may sound - why limit the possibility for saving life?

Perhaps a solution would be to make it legal and regulated. It goes on anyway in the black market and is unregulated. That is the worst possible scenario. Why not make it legal, safe, and strictly regulated so as to prevent the kind of abuse perpetrated in this case? That – it seems to me - is the most disgusting thing of all.

All this said, I must admit that the thought of buying and selling organs still seems pretty disgusting. But should that prevent instituting a public policy that could save many lives?

Just asking the question.