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Friday Night Dialogues: Paying organ donors – is it ethical?

There are two sides to every issue. Should the controlled sale of human organs be legalized in the United States? Should the controlled sale of human organs remain illegal in the United States?

The Friday Night Dialogue at the Shelter Island Library on November 30 presents Andrew M. Flescher, Ph.D., from Stony Brook University, to introduce us to the ramifications of this dilemma and illuminate his perspective as supported in his recent book, “The Organ Shortage Crisis in America.”

The statistics surrounding this crisis are compelling – according to organdonor.gov in 2017 there were 114,000+ candidates for transplantation on the national waiting list and only 42,609 organs donated. Every 10 minutes a new name is added to the list while an average of 20 men, women or children die per day waiting for an available organ.

The shortage is especially disconcerting given that since organ transplantation became sound medical treatment, we have never had better technology — while so little occasion — to avail ourselves of it. In response to the crisis it has become vogue among transplant surgeons to furnish novel, compelling arguments for legalizing the sale of kidneys among living donors to provide incentives for increasing the available pool.

Doctor Flescher argues that this response, seemingly appealing from the perspective of utility, not only invites familiar ethical concerns about safety, commodification and social justice that it did when the sale of organs was originally proposed; it also contains shortcomings in terms of the exclusively pragmatic goal of recruiting informed, willing donors. In contrast to previous critiques, he makes the case against legalizing the sale of organs on these utilitarian grounds, exploring solutions to alleviating the shortage crisis by emphasizing the motive of altruistic fellowship over capitalist incentives.

Can we address the organ shortage problem the way we have historically dealt with the blood supply shortage despite the fact that organs are considerably harder to replenish (and therefore arguably more precious) than blood? Doctor Flescher argues “yes,” not by recommending a purist’s approach to disallowing any form of self-regard in altruistic motivation, but by exploring ways in which sacrificial giving is the upshot of the formation of social bonds and exchanges.   

Professor Andrew Michael Flescher is a member of the core faculty program in Public Health; professor of Family, Population, and Preventive Medicine; and professor of English at the State University of New York, Stony Brook. A member of the United Network for Organ Sharing Ethics Committee, he is the author of several books, including “Moral Evil” and “Heroes, Saints, and Ordinary Morality,” both from Georgetown University Press.

At 7 p.m. on Friday, November 30, Professor Flescher will present both sides of the issue as well as looking at alternate solutions to the crisis drawing on the fields of moral psychology and economics and fleshing his argument out with scores of interviews with living donors. Please join us, learn and become part of this important discussion — admission is free, donations gladly accepted.