Legalization of Organ Selling

The public sale of organs has been a hotly contested issue in recent times. The idea that someone can pay money to jump to the top of the organ donor list is clearly something that is controversial and worthy of discussion. Furthermore, the idea of putting a price tag on human body parts is a topic filled with dispute. Many ethical decisions and theories come to play in this scenario, whether we are all egoists, whether we believe in utilitarianism and what actually is the best for all, and more. In this paper, I will be arguing in favor of a free market for organ selling and buying. I will argue that egoism is the core feeling behind most, if not all, people and thus doing something that will clearly benefit both sides immensely (either getting a significant amount of money or receiving a lifesaving organ) is ultimately the best model and serves the utilitarian standpoint the best.

The most apparent problem with the current system of organ donors is the wait time, between 2003 and 2004 3 – 5 years was the average wait time for a kidney, the most common organ transferred between donors and recipients (US Department of Health and Human Services). An egoist would believe that all humans have their own interests in mind first and foremost and when there is a way to clearly improve their circumstances or situation they will do it, especially when it involves a potentially life saving/altering organ transfer. Psychological egoism is a descriptive form of egoism and describes what people are like, it says that people are basically self centered or selfish and do what is best for themselves. Unfortunately, there are many people living in poverty in the modern world, if they had an opportunity to sell a kidney to help themselves financially I believe they would. Fundamentally, people’s desires and will to survive/live overcomes any others and if they have an opportunity to sell their organs to make money for themselves they will, and they ought to have that choice.

Utilitarianism also takes a role in this controversial topic. Jeremy Bentham, a big initial promoter of utilitarianism, said that you should do whatever will increase your happiness the most and decrease your unhappiness the most. When that idea is applied to both sides of an organ transaction, the buyer and the seller, it makes sense to allow it. In the current system, only the receivers of an organ donation are attaining maximum utility. Furthermore, the average wait time for a kidney (the most popular organ donation) is 3 – 5 years (US Department of Health and Human Services) and many of those people are probably living extremely uncomfortably so happiness as a measure of utility is most likely not being maximized. The best way to maximize utility is to have people on both ends of the transaction receiving it. If someone selling a kidney receives 50 thousand dollars (a completely arbitrary number but commonly referenced) he or she could have just made three or four years worth of salary. That person clearly has produced a high net utility for him or herself. An important part of calculating maximum utility is to consider pain or unhappiness (pleasure – pain = utility of happiness). There are many misconceptions about the negative impacts towards the person that gives up their organ. For example, you usually only have to stay in the hospital for about a week after donating a kidney and within a month you can participate in most activities (National Kidney Foundation). This dispels the common misconception that you are completely unable to participate in athletic activities after donating or selling a kidney. Different people will face the negatives of donating an organ differently but in general its been widely accepted that it is a fairly safe and non troublesome procedure.

Evaluating the utilitarian argument of the sale of organs demands a view towards those who don’t benefit from a new system, those whose utility of happiness may go down as a result. A common argument against the sale of organs is that it punishes those who cannot afford to pay for an organ. That it would benefit someone who’s rich and wealthy and may have done serious damage to themselves (such as drinking constantly) and then buying themselves a cure compared to somebody not as well endowed who needs a new kidney or other organ for no reason they could control. I think there are several ways to combat this argument, first we must again look at the idea of utilitarianism and try and decide what will maximize happiness for as many people as possible. If the sale of organs were legal, yes, some of the less wealthy people on the list might not receive an organ as quickly as before, but it would also be helping those less fortunate by allowing them to sell their organs for money. There will never be a situation where everyone will be maximizing utility, it is a case of what is the best that can be done and what can maximize happiness for the most amount of people. Furthermore, its not as if those less wealthy will never receive the organs they need. There are several different options that could be enacted to make sure that they still get organs. The government, or private health care companies, could subsidize the cost of paying for an organ if an individual or family makes less than a certain amount of money or something along those lines. Also, I believe that there will still be a significant amount of people who are willing to sell an organ for significantly less or even nothing on a situation-to-situation basis. As said previously, there are sacrifices and costs to any decision that is made, the idea is to maximize the positive outcomes.

Another ethical theory that can be discussed is contractarianism. Thomas Hobbes view of contractarianism was that of a radical individualist who said that individuals come before society. A contractarian would argue in favor of the sale of organs because it serves to benefit individuals, either the seller or the buyer, rather than the overall public opinion or outdated rule of law of the sovereign. Kant’s Moral Theory can also be viewed as supporting the public sale of organs. The act of selling an organ is a two-fold action, both to benefit the seller (monetary benefit) and to benefit the person buying the organ. Kant would say that the intended meaning of the sale would make any unintended consequences ok.

While I believe that the public sale of organs is the ethically better decision, the current system of organ donation has its merits. The thousands of people who donate organs to complete strangers make it hard to argue that we live in a completely egoist society and that there are situations where people think of others before themselves, commonly referred to as altruism. Kant’s Moral Theory can also be adjusted to complement the current organ donation system as well as a new organ-selling scenario. It is clear that a person donating an organ has good intentions and any possible negatives or problems associated with the transfer ought not to be blamed on the donor.

The sale of organs does have negative influences and there are significant cons. A popular negative factor is the effect that selling organs would have on poorer people and how their position on the current organ donor list would be undermined because of their inability to pay to move up. We have already discussed that particular con, however some argue that selling organs dehumanizes those people who are the ones giving up their organs, especially those in troubled financial scenarios. The argument says that, “by permitting the sale of organs, society would make the parts of human beings and, by extension, people themselves, commodities” (JD Kunin Journal of Medical Ethics). This is an understandable argument but quick and easy counter arguments can be made. Primarily those that we have already made; it allows a legitimate way for those less fortunate to make money, the transfer of organs literally save lives, and the supply of available organs should theoretically increase. Altruism is another popular argument, and is discussed in length in a Stanford essay “The Sale of Human Organs” (2011). In this paper, the author mentions the argument that altruism – the principle that we act out of care for others rather than ourselves – could be diminished with the legalization of the sale of organs. I think that altruism would still exist and that people would still give and donate organs for free (or significantly lesser costs). Furthermore, I don’t believe that the only people that would sell organs would be completely for monetary reasons. They will clearly have the knowledge that they are potentially saving another human being’s life and that will be a profound and meaningful experience, whether or not their primary motives are to make money. So the lessening of altruism would not be such a negative thing if it were being replaced with feelings of satisfaction for saving someone’s life.

In conclusion, I think that there are multiple ethical arguments that can be made in favor of the legalization of selling organs. Primarily, utilitarianism comes to play because utility will be achieved on both sides of the transaction – happiness to both the person who is making money from selling an organ and the happiness of the person receiving an organ. This primary argument overcomes many of the disadvantages and problems with the sale of organs, at the most fundamental level selling organs would maximize happiness and benefit to the largest amount of people. Egoism also ensures that the selling of organs is something that the public would be attracted too. There is always a stigma against new things, but our egoist nature of doing what is best for us and nothing else will rise above all on both sides of the transaction. Lewis Burrows says in his paper Selling Organs for Transplantation, “But for the time being, while my patients are dying for want of an organ, I have accepted this libertarian, utilitarian approach. We do not live in ivory towers. In life, we have to make hard decisions and accept the consequences when all of our options have serious flaws. The current circumstances beg for a change and improvement in the availability of organs for the thousands of people who need them.” Arguments against the sale of organs such as the dehumanization and the disappearance of altruism are valid and worthy of discussion, but do not overcome the overwhelming positives that a society where you could buy and sell necessary organs would provide.

Bibliography

• MacKinnon, Barbara. Ethics: theory and contemporary issues. 7th ed. Belmont, Calif.: Wadsworth Pub. Co., 1995. Print.
• Friedman, EA, and AL Friedman. “Payment for donor kidneys: Pros and cons.” Kidney International 69 (2006): 960 – 962. Print. – Just a short 2-page paper listing some pros (shorter wait time, more availability) and cons (unethical, high prices, dangerous).
• Kunin, J D. “The Search For Organs: Halachic Perspectives On Altruistic Giving And The Selling Of Organs.” Journal of Medical Ethics 31.5 (2005): 269-272. Print. – Discusses the Jewish legal position on selling organs.
• Cohen, I. G.. “Can the Government Ban Organ Sale? Recent Court Challenges and the Future of US Law on Selling Human Organs and Other Tissue.” American Journal of Transplantation 12.8 (2012): 1983-1987. Print. – In December 2011, in Flynn v. Holder the US Court of Appeals upheld the National Organ Transplant Act of 1984 from a constitutional challenge, but interpreted the act such that its prohibition on sale did not encompass “peripheral blood stem cells” obtained through apheresis.
• “The Sale of Human Organs” (2011) – http://plato.stanford.edu/entries/organs-sale/ – Another paper that lists the pros and cons of human organs. Spends significant time discussing altruism and how it affects the argument.
• Wilkinson, S. and E. Garrard, 1996, “Bodily Integrity and the Sale of Human Organs”, Journal of Medical Ethics, 22: 334–339. – A position that is in favor of organ selling. Discusses the risks that people will take to get money and says that if we can figure out how to mitigate the risk of selling or receiving an organ then it’d be good to do it.
• US Department of Health and Human Services – Organ Procurement and Transplantation Network Kidney Kaplan-Meier Median Waiting Times For Registrations Listed : 1999 – 2004 http://optn.transplant.hrsa.gov/latestData/rptStrat.asp
• National Kidney Foundation Q&A On Living Donation – http://www.kidney.org/transplantation/livingdonors/infoQA.cfm?id=7#7a

How Corruption is Hindering Democratic Process In Bulgaria and Hungary

Corruption is a word synonymous with much of Eastern Europe. It was rampant in the communist era; political elites spent their time stifling innovation and promoting elitist policies to keep themselves in power at the expense of public welfare. With the fall of communism in the late 80s and early 90s, there was newfound hope that the resulting ‘revolution’ would bring in an era of freedom, prosperity, and security. Unfortunately for many countries in Eastern Europe, this hope would not be fulfilled. Few Eastern European governments have successfully transformed themselves into strong democratic states. Many, including Hungary and Bulgaria whom I will focus on, find themselves meddling somewhere between the cracks, failing as democratic states. Hungary and Bulgaria have struggled to improve the welfare of the mass public since their transition to democracy; they remain countries that are run by corrupt rulers who are intent on widening the schism between the prosperous elite and the rest of the country.

Prior to the fall of communism, Bulgaria’s government, led by head of state Todor Zhivkov, was widely known for its horrific treatment to the minority Turks in the country. However before Zhivkov’s attack against the Bulgarian Turks, he was somewhat popular among his people. Mortality rate, education, life expectancy, and other key statistics were all increased during Zhivkov’s regime. Zhivkov also gained strides in the Bulgarian intellectual community by promoting the writers’ union heavily, which granted members high stature and privileges. While it cannot be said that the quality of life for Bulgarians was the very best, Bulgarian’s had a stable ruler who provided decent care to the public (until the later part of his regime).

Unfortunately for Bulgarians, the aftermath of the communist collapse has turned Sofia into a political battleground as ex-communists, who remained in power after the first parliamentary vote in June 1990, battled against modern reformers to shape the country. It was obvious that things had not changed despite the government’s pronouncements of freedom and democracy. In fact, the Socialist party that won the first democratic election in 1990 was the previous ruling communist party who had just changed its party name.^[1] Pursuing political reform has been nonexistent in Bulgaria since there has been no incentive to do so. The country received plenty of monetary aid from foreign investors and the European Union, but much of it went to the private bank accounts of the political elite rather spread out to the public. An example of this is the Special Accession Programme for Agriculture and Rural Development, or SAPARD, a national initiative where the EU provided monetary funds to Bulgaria’s agricultural sector. Although field equipment in Bulgaria was poor and hardly functional, vast amounts of money instead went to Bulgarian farmers and their families to buy SUVs and other luxuries. When asked how to recognize somebody who has gotten a SAPARD grant a local simply said, “Just look for the people driving the most expensive SUVs.”^{[2] [3]} Another issue for the Bulgarian government is its blatantly corrupt judiciary. Judges were viewed as actors from the old communist regime and were accused of failing to prosecute cases of high corruption.^[4] A political tactic called telephone justice, “party functionaries let judges know their desires for particular case outcomes, and the judges comply with their wishes,” was commonly used, further evidence of unequivocal corruption. Judicial officials even confirmed that acts of unfairness did occur but attempted to excuse them by saying that they view themselves as bureaucrats just as much as any other political officer.^[5] This in itself is an issue that most would view as problematic, working completely against the popularly embraced concept of separation of powers. How can the Bulgarian public expect to live in security and freedom with such powers stacked against them? I think its more than obvious that things were not equal between the political elite and the public, and as we’ll see later, things could even be getting worse.

In the case of Hungary, corruption has been equally bad. A severe lack of effective political institutions and accountability has hampered Hungary severely, allowing the political elite to completely run over the public by cheating and scheming their way to the top. A new law was implemented in 2011 that allowed for unprecedented expedited law making.^[6] This new law allowed proposed bills to be pushed through parliament without any debate and can be adopted as quickly as the following day. Such a severe lack of accountability is a detriment to the Hungarian political system, and the public is left with an unstable political environment and thus is placed firmly at the mercy of the political elite. Further proof can be seen when the political elite cheats their way to the top, “cheating taxes is also part of the culture. Nobody likes to pay, taxes and everybody tries to live by one’s wits. One of the biggest political scandals last year involved a member of the government who rented a restaurant for an afternoon event. His assistant allegedly paid the fee in an envelope, without including the Áfa (value-added tax), directly to the owner. When the scandal became public, everybody denied everything, and there were no repercussions.”^[7] It is painfully obvious that a gulf remains between the rulers and the ruled in post-socialist Eastern Europe. In a poll conducted of businessmen in Hungary, nearly 20% thought that he or she had already lost business opportunities due to the corruption of his or her rivals.^[8]

Such corruption and problems in democracy has been hard for the people of Hungary who took part in one of the most peaceful and stable transitions into democracy among many other Eastern European countries. The Hungarian activists had such a successful revolution that they were able to ceremonially ‘rebury’ former Prime Minister Imre Nagy, the man who led the 1956 Hungarian uprising.^[9] Since then however, corruption has catapulted. Transparency International, a global civil society organization against corruption, uses statistics to give numerical scores to countries based on their corruption level. Their statistics say that nearly 80% of the public in Hungary believes that corruption has increased from 2007 – 2010. ⁶ That is a terrifying number for the public to hear and proves just how poorly the public feels about their situation. Furthermore, over 50% of the Hungary public feels that government efforts to curb corruption are ineffective. Bulgaria is not immune to these disastrous statistics either. A 2007 poll by the Eurobarometer revealed a public who was still wary of their government; the people’s trust in political parties was 7%, 11% in national parliament, and 16% in the government. Furthermore, 38% of Bulgarians were satisfied with the life they live, 17% happy with the economic environment, and more than 45% said that the country isn’t going in the right direction.^[10] In a public survey, Bulgarian university students provided numerous examples of professorial abuse that they had witnessed. In one such example a student was “able to procure a place in a prestigious university for $7000.”^[11] Similarly, the public’s level of trust in the government was very low.

The statistics paint an ugly picture about the situations in Bulgaria and Hungary, but not all is bad. In 2012 Hungary published it’s anti corruption program aiming to target corruption by creating new lobbying laws.^[12] The new program also provides protection for whistleblowers, a very important thing for anyone in the public who doesn’t have connections to the political elite that can bail them out of trouble when needed. The State Audit Office of Hungary has also made progression towards curbing corruption by enacting a national strategy to control corruption. ^[13] Bulgaria has also made some strides, albeit slowly and arguably unproductively, towards success. The Copenhagen European Council’s conclusion in its 2004 report on Bulgaria’s progress towards accession: “Since the Opinion, Bulgaria has made steady progress and has achieved a high degree of legislative alignment. The administrative and operational capacity of the National Customs Agency improve considerably, although at a slower pace, especially as regards implementation and enforcement.”[14] This statement alongside with their previous statement in 2002 that described Bulgaria as having a “functioning market economy” eventually led to Bulgaria’s successful entrance into the European Union in 2007. These positives can promote the idea that the divide between the political elite and the public is not so bad, and even that corruption in general is not the issue that it’s been made out to be. This theory can be supported by multiple statistics and polls done in the early 2000s. However, they do not, and cannot, account for the negative progress made since Bulgaria and Hungary have ascended to European Union status, the double dip syndrome.

The largest problem for Bulgaria, Hungary, and other Eastern European countries, is preventing the double dip effect. After struggling with democracy initially, many countries have bounced back. This can often be attributed to these countries attempting to fit the European Union’s strict accession requirements. However, once entrance to the EU has been accomplished, Hungary in 2004 and Bulgaria in 2007, countries can fall back into their previous habits of corruption and political destabilization. Venelin Ganev discusses this syndrome in his paper Post-Accession Hooliganism: Democratic Governance in Bulgaria and Romania after 2007.[15] He notes that Bulgaria has reached a turning point after their accession to the EU and is currently falling back into their political trappings of the early democratic period. Bulgaria has had predictable electoral rules since 1991, a healthy sign of democracy and stable government, until the rules were changed suddenly in 2009. This has allowed the political elite to take advantage of the political system and has put the public at a disadvantage and at their mercy. Furthermore, there has been an abandonment of informal rules used throughout the government. While this may not seem so detrimental, the breaking up of political stability creates massive waves of issues that reverberate throughout the entire country, all because of selfish, corrupt political leaders.

In conclusion, both Bulgaria and Hungary have serious work to do before they can say that they have eliminated the culture of political elites cashing in at the expense of the public. Multiple examples have proven that corruption still presents a serious problem for both countries, especially in Bulgaria, and a change in political culture is needed to solve the problem. Furthermore, a double dip effect has already happened following these countries admission to the EU, and it is of the highest importance that these countries stabilize again and begin to make progress forward.

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^[1] Nichols, Philip, George Siedel, and Matthew Kasdin. “Corruption as a Pan-Cultural Phenomenon: An Empirical Study in Countries at Opposite Ends of the Former Soviet Empire.” Texas International Law Journal 39.215 (2004): 215-256. Print.

^[2] Freeman, Colin. “Inside Europe’s corruption capital: how Bulgaria’s crime mafia plunders EU grant money – Telegraph.” Telegraph.co.uk – Telegraph online, Daily Telegraph, Sunday Telegraph – Telegraph. N.p., 15 Nov. 2008. Web. 8 Nov. 2012.http://www.telegraph.co.uk/news/worldnews/europe/bulgaria/3463957/Inside-Europes-corruption-capital-how-Bulgarias-crime-mafia-plunders-EU-grant-money.html

^[3] Council Regulation (EC) No1268/99 of 21 June 1999:  http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:1999:161:0087:0093:EN:PDF

^[4] Fish, M. S. and R. S. Brooks. Bulgarian democracy’s organizational weapon. East European Constitutional Review 9: 69–77.

^[5] Melone, Albert. “The Struggle for Judicial Independence and the Transition Toward Democracy in Bulgaria.” Communist and Post-communist Studies 29.2 (1996): 231-243. Print.

^[6] Transparency International. (2010). Transparency International, Transparency International Country Overview Hungary. Retrieved at November 1^st, 2013

^[7] Vajda, Éva. “Hungary.” Global Integrity Report . N.p., n.d. Web. 1 Nov. 2013.

^[7]<http://report.globalintegrity.org/reportPDFS/2008/Hungary.pdf>.

^[8] “Corruption Still a Fact of Business Life.” Budapest Sun 25 Sept. 2008: 1. Print.

^[9] “1989: Hungary reburies fallen hero Imre Nagy.” BBC News. BBC, 16 June 1989. Web. 14 Nov. 2013. <http://news.bbc.co.uk/onthisday/hi/dates/stories/june/16/newsid_4522000/4522407.stm&gt;.

^[10] Eurobarometer 68 2007 http://ec.europa.eu/public_opinion/archives/eb/eb68/eb_68_en.pdf

^[11] Nichols, Philip, George Siedel, and Matthew Kasdin. “Corruption as a Pan-Cultural Phenomenon: An Empirical Study in Countries at Opposite Ends of the Former Soviet Empire.” Texas International Law Journal 39.215 (2004): 215-256. Print.

^[12] “Official Journal of Hungary.” Hungarian Gazatte 6 Apr. 2012: 1 – 80. Print.

^[13] “In the international arena, the SAO activity against Corruption .” Integritas.asz.hu.

http://integritas.asz.hu/index.php?page=hirek&id=132 (accessed November 14, 2013).

[14] Copenhagen European Council Report on Bulgaria’s Accession Progress (http://ec.europa.eu/enlargement/archives/pdf/key_documents/2004/rr_bg_2004_en.pdf)

[15] Ganev, Venelin. “Post-Accession Hooliganism: Democratic Governance in Bulgaria and Romania after 2007.” East European Politics and Societies and Cultures 27, no. 1 (2012): 26-44.

 

What Is The Value of a College Internship?

It’s fall. What does that mean for most people? Well, for many it’s baseball playoffs, school, fall weather and a break for the heat of summer, FOOTBALL, football (soccer), and many more things. What it also means is the long painful hunt for internships or jobs for the next summer by college students and high school upperclassmen. What used to be a unique piece of an application, internships are increasingly becoming a necessary component of any student’s application to graduate school and even undergraduate schools in some cases. The problem is that employers are becoming increasingly aware of the fact that hundreds (if not thousands) of students will be knocking on their doors looking for an internship to pad their resume. This has led to a sort of unpaid labor system that teaches the student nothing and produces a company, in essence, free labor.

This quote from an article written last February by an undergraduate student at The College of William and Mary in Williamsburg, VA gives good insight into a dilemma that is becoming more and more apparent among undergraduate college students,

“I’ve only applied for about fourteen, which, when compared to many of my peers, isn’t nearly enough. My struggle to find motivation to write cover letter after cover letter probably stems from the fact that most of the internships are unpaid, so once I factor in my living expenses, I’ll actually be losing money.”

The situation in many instances goes like this; a student applies for an unpaid internship at an unnamed company, he/she is granted an interview and is eventually accepted to the position. The student is excited because they think they will be gaining valuable experience that will not only help them on a resume but also give them knowledge in a field they might want to pursue. They arrive on the first day at work excited and prepared. Whoever is in charge of them at the company seems nice and introduces them to everyone on the floor. They start with some easy stuff and the student is having fun. This goes on for a week or so and both the student, and the company employee, seems to be invested in the internship experience. But then something happens, the employee begins to lose interest in the student and focuses on his/her job. The student is relegated to monotonous busy work for hours a day.

This sort of behavior has become rampant among companies all over the United States. An article from the New York Times Opinion section cites “politics, media and entertainment, to name a few,” as the key industries exhibiting this behavior. My question from the title still stands, what exactly is the value of a college internship? Sure, they help you get a job or get into grad school, but what exactly is the student learning? The current system not only hurts the student interns, but the millions of jobless people all over the United States. The unemployment rate for youth (those aged 16-24 and are working or looking for work) hovers around 17%, thousands of jobs are being occupied by unpaid interns instead of others who may not be able to financially afford an unpaid internship and are in desperate need for work.

This is a broken system in which companies are acting unchecked as they trade hours of unpaid labor for a simple line on a students resume. Something needs to be changed.