According to the Kidney Foundation of Canada, one in 10 Canadians has kidney disease. Moreover, the number of Canadians being treated for kidney failure has tripled in the past two decades – and each day, 16 people are added to that list. Of the roughly 40,000 individuals being treated for kidney failure, almost 60% are on dialysis.
For those individuals, that means at least 12 hours a week spent having blood pumped through a dialyzer to remove water and wastes. Research shows that ideally, such patients should dialyze five to seven times a week, for six to eight hours a time – or, in other words, 30 to 56 hours. It’s not just like what you imagine when you picture someone donating blood. The needles used in dialysis are too large for patients’ veins, and would risk blowing them. As such, patients have their arms cut open and a vein brought to the surface. Doctors then make a loop with an arterial vein and a normal vein, which increases the pressure in the normal vein and allows for the needles to be inserted. This is called a fistula. You can check out what it looks like here.
If picturing such life conditions doesn’t move you to think about the plight of those living with kidney failure, I’m not sure what will. Perhaps you reason it will never happen to you, as you’re young and healthy. Well, consider the fact that 47% of renal failure patients are 64 years of age or younger.
Aside from the toll dialysis takes on patients’ lives, the costs are considerable. Hemodialysis costs the Canadian health care system approximately $60,000 per patient per year. Add on to that the economic output lost as these individuals, in many cases, are not able to fully participate in the workforce. Dialysis requires employers to make special accommodations, and often times employees are no longer able to fulfill their duties. The median wait time for a kidney donation is around 3.5 years, reaching up to 5.5 years in B.C. and 5.2 in Manitoba. This means that, on average, the government spends $210,000 on hemodialysis, and another $23,000 for the donation procedure. This adds up to $233,000 in healthcare expenses. Then there are the economic losses. The average Canadian makes $48,250, so for every patient not working, losses over a 3.5 year period are upwards of $400,000.
Around 80% of Canadians on the waiting list for an organ transplantation are waiting for a kidney. It might seem noble to expect donations to be entirely altruistic, yet it is rather naïve. Demand outpaces supply, and donor rates have stagnated since 2006. As a matter of fact, even though the majority of Canadians are supportive of organ and tissue donation, less than 25% have actually registered to donate. Science has progressed magnificently in allowing for organs to be transplanted, but our judicial system has not kept up with such progress. It persistently ignores the fact that shortages are created by below-equilibrium prices. As a matter of fact, legislation has imposed a price of zero on organ donations. At such a price, it is not surprising that there aren’t enough donors.
If the price of kidneys could rise to market rates, in equilibrium – and this is econ 101 – supply would equal demand. The government would still be saving money – and, most importantly, lives – if it were willing to pay six figures for an organ donation. Moreover, it – or, in the case of a private market, hospitals and insurance providers – could offer healthy individuals substantial sums for consenting to post-mortem organ and tissue donation. This would lead both living and post-mortem donations to increase substantially.
You might say life is too priceless to put a price tag on, and thus kidney sales should be kept illegal. Why? In our current donation system, everybody gets paid: the doctor, the nurses, the anesthesiologist. The only person who doesn’t is the one without whom no life could be saved: the donor. If there is a system that can increase the number of donors, reward good deeds, and, most importantly, save lives, why aren’t we adopting it?
Some find the concept of organ sales morally abhorrent. I find it hard to understand how anything can be more abhorrent than death, but either way, freedom means that those who do not wish to participate don’t have to. The right of ownership to our own body means disposing of it as we see fit. In consensual activities, whether society approves or disapproves of them, there should be no place for third parties to interfere. Or we aren’t, after all, the owners of ourselves.
Others object on the basis that individuals will be forced to sell their organs. They picture horrifying situations such as those faced by refugees who are coerced into organ trafficking. Although their hearts are in the right place, they are confusing legal and illegal markets. Organ trafficking is the result of the latter, which our current laws foster by prohibiting supervised, safe and legal sales.
Whatever the reasons for opposing organ sales, with an ageing population, public opinion is poised to change. Once upon a time, acts that today are legal and no longer much of a moral issue were seen as slippery slopes. Our ancestors cringed at the thought of equal rights for men and women, legalized drinking, abortion and same-sex marriage. But things changed. We evolved enough to respect individual liberties and allow for such activities to take place legally – and the world did not come to an end. And we will, too, evolve enough to allow more lives to be saved. I just hope that evolution comes sooner rather than later.
If any of this inspired you – or if you just want to prove me wrong, and show that altruism is enough – you can get started here.