(Note: I’ve clipped and pasted some of the paragraphs from the articles I’ve linked to, but the only way to appreciate the full nuance of the arguments is to read the articles in full. Do not assume my clips are the most important or salient points.)
USA Today recently came out in favor of payments to organ donors.
“Please help! My daddy needs a liver.” A billboard with that stirring message greeted thousands of motorists recently on a busy Chicago expressway. It’s one of many pleas from desperate families seeking organs for transplantation. Classified ads shout their need. So do Web pages.
The sad fact is that patients needing a transplant are more likely to die waiting than to receive organs. The wait in many locations is five years, and it could double by 2010.”
The Op-Ed goes on to note some tenative steps states are taking to compensate — to a limited extent — organ donors (for example, paying for the travel and lost-wages expenses of prospective donors while they are being tested and, if a fit, donating).
The opposing view, offered by Charles Fruit of the National Kidney Foundation, says , in part:
“the National Kidney Foundation opposes any market-based incentives that financially reward donors or their families who offer life-saving organs. Even on a trial basis, introducing money into such a fragile human decision-making process would set a dangerous precedent. Once we start down the road of treating organs like commodities, there’s no turning back.”
Virginia Postrel, former editor of Reason, and now a columnist with the Atlantic, takes issue with Fruit:
“The argument that paying organ donors is “an affront” to unpaid donors is disgusting. Are unpaid donors giving organs to save lives or just to make themselves feel morally superior? Even in the latter case, they shouldn’t care if other people get paid. They can still hold their noses in the air. Underlying this argument, which the NKF loves, seems to be a nagging sense of guilt: The current system takes something valuable without offering anything in return. It is, in other words, highly exploitative. If that exploitation suddenly goes away, the people who’ve been exploited in the past will realize they’ve been used and be mad. Personally, I don’t think that’s terribly likely, because most of today’s donors are, in fact, motivated by sympathy for recipients. But the fact that defenders of the system keep making the argument suggests they know they’re doing something a little shady.”
None of us is doing PR for the NKF — I am not sure anyone is, since they are pretending the debate isn’t happening — but any one of you could end up there (or someplace like it). So..
- Sometimes the moral arguments of your organization are held up in the glare of economic arguments from outside critics. Luckily, few of us will ever have to face a Virginia Postrel, but what do you do?
- Sometimes a national newspaper questions your mission validity, pointing out plainly that — despite your best efforts — you’re not solving the problem… but what do you do?
- If the firm you joined assigned you to the NKF … or another charitable … account, how do you decide to join the team? Can you, should you, say “no” if the strategy seems wrong (note that I am not talking about a corporation; I mean a organization upon whom lives depend).
Theoretical questions, theoretical musings, but I am fairly sure my fellow Marcom Contributors have had to ponder them in the past. What do we do?
(I should emphasize that I am not picking on the National Kidney Foundation. They are just the example.)
27 comments
6/28/2006 at 2:12 pm
Christina Brasher
In this particular case, you always hear horror stories about countries overseas taking other peoples organs and selling them on the “black market.” Of course we have heard a few cases here in the US. This brings about the question of “if we let people get compensated for organ donations where would that take us?”
Of course in other cases, if your company/organization has done something in which you felt was morally enriching and then all of the sudden questioned what would you do? I think that the NKF did right by making a comment, but they are wrong because they are avoiding the issue. I am a firm believer that you must take a stance especially if you are being questioned by a national magazine and newspaper. The last thing a company, especially non-profit where you depend on the selfless doings of others, needs to do is dodge the issue and take a stand. I am curious to see how things will span out in the next weeks, months or how ever long it takes.
6/28/2006 at 11:38 pm
Barney
well I think in this regard first of all we have to be alert enough that if something has been opened for the good cause of human being then it should be used in a negative manner.
People do sell the human organs for the mere amount of money or they black market them, because of which those who are in need and can’t afford high price will suffer.
If this issue is solved I am sure that people will actively participate in it!!
6/29/2006 at 11:05 am
brandie
After reading this post, I also immediately thought of the black market. I don’t know exactly how prominent this particular market is, but if a foundation actually encouraged such a thing, I can only imagine the increase we would see.
It is hard enough to get people to donate organs. It seems like such a simple concept: when you’re finished with your organs, make them available to someone else. But, for whatever reason, there aren’t enough donors to match those in need. And money can be a powerful motivator. So I don’t think the foundation is wrong in recognizing that fact. But money can also make people do strange things. People who are genuine and pure can do complete 180’s when money comes into play. So even if people in the past, present or future donate simply to help out someone else, if money were introduced then the reasons could change dramatically. I think they’re asking for trouble, and I think that the effects will snowball, creating more PR problems for, not only their own foundation, but others like them.
7/3/2006 at 5:35 am
Neel Willson
I know that market of human organs is really prominent. One can easily black market the human organs and that too at very high price!
Generally people don’t get ready to donate organs and if the black marketing exists then it would become more difficult to get organs for those who need it. we need to sort out this matter as soon as possible so that people can easily donate the organs for those who need it!
7/3/2006 at 10:03 pm
Meredith
Wow, what a dilemma. I’m not sure exactly how an organization is supposed to properly react in a situation like this one. While I do think that the NKF is behaving poorly by neglecting to speak about the issue, they are a well-respected organization that has been around much longer than I myself have been alive. Perhaps the NKF felt that the best thing for them to do was to stand in the shadows and not draw attention to themselves in a way they might consider “disrespectful” to their agency. Meaning that they might be somewhat set in “their ways.”
I do think that the NKF could benefit greatly from paying closer attention to the debate that is erupting and by taking a public stand, they might win over alot of their critics.
7/4/2006 at 7:51 pm
Annah Grace
I can appreciate the USA Today’s outside the box thinking. I agree that the current system of “demanding patience, when the price of delay is death, is no answer. It’s time to try new ideas.” However, I must agree with Fruit that the market-based incentives might create a slippery slope. In my somewhat idealistic mind, we should never flee from our own moral convictions. If a company that I adore working for goes against my moral fibers, I believe it is only right to stand for what I believe. If that means being unemployed, so be it. I could not do my best work for a company that I did not believe in, and they (and I) would deserve better.
When it comes to a newspaper or anyone questioning the methods of my charitable organization, I believe that I would come up with a response explaining my reasons. I believe in transparency. No one is perfect; no corporation, no non-profit. Let people see your mistakes, but explain them and you will gain credibility and trust which is crucial in a non-profit organization.
7/4/2006 at 11:03 pm
Patrick
First off, if you have an opinion about an issue, it’s yours and you can have it. This even means if it’s different from your company’s or firm’s. Second of all, newspapers live to ******** and gossip. They have no feelings for anything except themselves, and if you attack a certain newspaper, you’re wrong and they will always be right. So if a newspaper shreds your company’s image, so be it. Your company just has to prove the newspaper wrong. Thirdly, I believe that if you assigned to an account that you want nothing to do with, deny the responsibility. It’s your job and you should have to forced to do something that you don’t want to do. Do what makes you happy. Comprendé?
7/5/2006 at 12:17 pm
Shelby
Well needless to say this is a tough situation. Honeslty I am torn, if offering to pay for organs will save more lives then that is the right solution, because saving more peoples lives is the goal. however, if this will allow for more corruption and possibility of back-market organs, then I’m not sure we should open the gates to this idea. I don’t know enough about the NKF or the organ donor process to be able to manage this crisis, however if i was asked to join this team and their strategies or beliefs seemed wrong to me, then I would not work with them. I could never live with myself knowing that I was a factor in the reason for more people dying, or even be a part of an organization whose practices were shady.
7/6/2006 at 2:14 am
James Thompson
I agree with what Christina said that we have heard so many horrible stories that we can’t overcome our fear and decide what to do. I think that first we need to know that how much geniune the call is then only rely on something. it’s really not that easy I agree but we have to do something otherwise those who need it will never get it.
7/6/2006 at 8:03 am
Lee
Hi. Allan and I will be discussing this very topic in our next ‘chat’ (#11) later today/tonight. Stay tuned for our thoughts — especially Allan’s as he posted this moral conundrum!
7/6/2006 at 5:31 pm
Monica
In this particular case, one could easily be for or against paying for kidneys, or any other organ for that matter. In cases where people are desperate to save the life of a loved one, one will do almost anything.
The NKF case is one of the most classic “Catch 22″ examples I can think of. Hypothetically, let’s say that you are against paying for organs; however, your organization believes that if someone wants to buy a kidney from someone else, it should be allowed. So, what do you do? Do you stand up for your beliefs and voice your opinion and risk your job and/or respect from co-workers? Or, do you sit back, keep your mouth shut and go allow with what your company does?
The first scenario allows for power and conveys the image that, that particular person is assertive and strong-willed. While some companies may support this personality, some may not, and respect (along with the job) run the risk of being lost. The second situation maintains job security, but creates internal turmoil because one did not stand up for what they believe is right.
In any case, I think it is best to evaluate the individual organization that you work for and see how open they are to people taking a stand and going against the grain. Also, before taking a huge risk that could be regretted, evaluate the situation to determine how important it really is to you and your beliefs.
7/10/2006 at 12:00 pm
Kristi
After reading your post about the organ donations and some of the other articles I just really don’t know where I stand. This is such a difficult situation. I found this article on MSNBC about a Limo driver who gets a big tip: A Body Part. It’s very interesting, everyone should check it out.
http://www.msnbc.msn.com/id/13768709/
7/10/2006 at 4:10 pm
Allan Jenkins
When I threw these questions out, I was hoping it would excite just the sort of thoughtful discussion it has prompted. I didn’t, and still don’t, have answers to them that perfectly satisfy me, and am not sure I will.
I believe the first question is the key one: what do you do when an economist takes on your foundation, asking why it does not structure itself according to economic rules?
You can agree with Postrel or not — but the NKF should have had, should have, an answer that addresses the economic question head on: is it more efficient (will more kidneys reach those who need them) to have a donor system (like today) or a market-based system?
And it is obvious: somewhere, someone is willing to pay a great deal for a kidney he or she is not going to get. Somewhere, someone — perhaps someone with a melanoma or a brain tumor — is willing to sell one. So there is a market.
By simply dismissing, out of hand, the idea of a market-based system, the NKF runs right into Postrel’s argument: the whole donor system is based on a guilt-trip of sorts. And doesn’t answer why the system is so inefficient. And makes the life of its PR agency perfectly miserable.
(Again, given the “emotion” factor of this topic, I’d like to say again that I am not picking on the National Kidney Foundation.)
7/11/2006 at 3:19 pm
Jaclyn
This is a very intriguing topic to me. It is a very ethical dilemma. If one would choose to allow people to pay for organs, then it would make other questions arise. What about if someone wanted to pay for someone else to have organs. Well, in ethics you would have to ask yourself what would benefit the most people? I think that letting people buy organs for others would be a good thing not a bad one. Although it will probably increase the sales of organs on the blackmarket.
Furthermore, the NKF should address the situation instead of acting like it does not even exsist.
7/12/2006 at 8:27 pm
Tricia
This is an interesting debate. Everyone is certainly entitled to their own opinion, but will there be negative consequences if that opinion differs from their organization’s? As someone who is about to enter the job market, this question hits especially close to home. Sadly, I’m not sure what the correct answer is. This NKF situation is a good example of things that are going on. In our society, money is a powerful motivator. Should it also guarantee a life-saving organ? Is a wealthy person more deserving than a poor person? Of course not, but how do you ensure fairness? On the other hand, I don’t think that it is so wrong that donors are taken care of while they are in the process of giving up an organ. I’m not sure what the answer is, but I think this is something that will continue to come up in the future.
7/17/2006 at 9:09 pm
ashley
We could probably all fill this screen with stories we’ve heard about people donating kidneys and saving a life, brothers saving brothers, and mothers saving children. It is such tangible evidence of knowing you are literally saving someone elses life. Giving blood is regarded in the same way. If you are healthy and the right blood type, giving your blood can literally save a life.
I don’t know about compensating someone for donating organs though. It seems more like a bribe or a black market scheme than anything else. I think people that give their organs should give their organs and the reward should be someone elses life, not $300.
I also have the vision of the TRUTH commercials about the cigarette companies spending so much more time and money telling people about the good they are doing rather than just doing it. Like, “I AM HOLDING AN UMBRELLA FOR THIS PERSON” into a bull horn so everyone knows.
Giving an organ is a precious gift and those people should be taken care of, but is bribing them the right way? And does this price come at the recievers expense? It is already mentally and finachially straining enough. I don’t see the need for the added expense.
7/18/2006 at 12:38 pm
Meredith
In response partly to what Christina Brasher said about organs being sold overseas, I had this to respond. I recently read an article in People magazine about Americans going overseas to have an operation performed for cheaper than what it would cost in the United States. Of the four stories, each person had a positive, life-saving experience and saved thousands of dollars in the process. While I agree with Christina that there is a black market for organ selling, I think that the rest of the world is quickly catching up to the U.S. and perhaps the NKF should start to look overseas for examples.
7/18/2006 at 2:28 pm
Kristen
Wow, this is a huge dilemma. First off, the NFK maybe apprehensive in regards to this topic, but shouldn’t try to hide in the shadows. It makes them look weak and scared of what’s going to happen.
Second, trying to compensate money for organs is just crazy to me. As an organ donor myself, I don’t understand why you would need some type of material in compensation. Giving the gift of life should be enough in itself. I love the feeling that if anything happened to me, I could still live on through others (hypothetically speaking). Our society is too caught up in money and materials…can’t we just do things out of the pure joy of how it effects SOMEONE ELSE positively?
I also thought of the commercials Ashley brought up. Doesn’t anyone find it utterly sad that we have commercials that tell us to be kind to others?! Like giving someone an umbrella, whose car just broke down in 5 o’clock traffic!
As for what to do, I am still not sure. Looking overseas is a pretty good idea! NFK should take a look at that. But people shouldn’t be rewarded for doing good, it cheapens the whole deal.
7/18/2006 at 4:25 pm
Allan Jenkins
I’m surprised that so many of the commenters are walking into Postrel’s argument: voluntary donors should NOT care if other donors are paid, if the ultimate result is more recipients getting kidneys. If “free” donors don’t like it, why are they donating in the first place? Every donation, free or fee, adds to the supply.
Here’s where the NKF could speak out: We welcome every donated kidney. While we wholeheartedly support voluntary free organ donor programs, our only goal is to ensure that as many donated organs reach recipients as possible.
If you were the NKF’s spokesperson, and were asked “If you could save a relative by buying a kidney on the black market, would you?”… what do you say? If you are the NKF’s PR person, you say “no”, but that’s a lie for most of us.
7/20/2006 at 5:26 pm
Tim Hicks
Science fiction author Larry Niven addressed this many years ago. I think he coined the term “organlegging” for the black market. He also introduced the idea that the punishment for certain crimes should be loss of an organ to the donor bank. Where the penalty was a kidney, for example, he was very clear that if the same criminal did the same crime again, the punishment would still be one kidney; now there’s an incentive not to reoffend! Niven had this punishment applied at first only to major crimes, but of course as the demand for organs increased, …
8/7/2006 at 1:28 pm
john
Federal Government employees qualify for two weeks paid leave if they donate an organ. (paid). A single mom working for most companies would have to handle the expenses of living while recovering from surgery. (free). Many people on dialysis fear getting a kidney because three years after the operation they must be able to afford $1k a month for drugs. Many people on dialysis qualify for diability they might lose if they were to receive a kidney. So the distinction of free and paid is complex as well as containing many variations of moral and ethical
8/20/2006 at 10:38 pm
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8/28/2006 at 10:43 am
Danielle
Hey Allan,
Being a college student, and appropriately filling the stereo-type of a poor college student, once or twice my friends and I have joked about selling a kidney.
But joking aside, it has become a real issue. I have to agree with USA Today that “demanding patience, when the price of delay is death, is no answer. It’s time to try new ideas.� But when it comes to an idea, I draw a blank. It seems inevitable that we will eventually be forced to pay for a needed organ.
From the PR view, the NFK took a stand that I believe is a righteous one, depending on the morals of humans; hoping that they will donate. But they cannot escape the problem. People are dying every day because they don’t have enough time to wait for the occasional organ donor to die. A solution is needed.
In my idealistic world, there would be no need for that because people would donate out of the kindness in their heart. People would realize that you don’t need your lungs when you’re dead, but some little girl with Cystic Fibrosis does. In my mind, donating an organ is the best gift you could ever give. Once you’ve past on, giving the gift of life to someone else… You’ve impacted someone else’s life more than you could ever do alive.
But sadly, we do not live in my idealistic world. People do not see things the way I do. But when I die, someone may see with my eyes.
9/3/2006 at 3:57 pm
Rachel Dresher
I will definitely have to say that the selling of human organs is a pretty disturbing issue. I am sure some people think it will increase the chances for there to be more organs available to patients. You made a good point that the majority of the people who are donating organs do it for the sympathy for the patients, and they do not care about being compensated. However, it is so sad that the majority of people waiting on these organs will die rather than get a successful transplant. Clearly, other options are going to be explored. Eventually, it may be that people do get paid for donating organs. In this society, it is evident that people will do anything for money so maybe there will be more people who decide to become organ donors if they are to be compensated. It is scary to think that this could lead to a black market in the U.S. for organs. This seems to be a very delicate subject with pros and cons for both sides. It will be interesting to see what happens in the future.
10/2/2006 at 2:39 pm
Wade Cothran
Hi Allan.
This has become quite an issue hasn’t it? Obviously stem-cell research is the answer. We could HARVEST kidney’s instead of waiting for donors, but that’s an entirely different argument.
I think innocent human life is one of the most sacred things on earth, and anything that can be done to save one is almost worth another. (I hope that makes sense) Being said, anything a prospective kidney donor could do to get his kidney into someone else should be done.
As far as the “black market” is concerned; Would I buy a kidney on the black market to save a relaitve? Yes! Buy kidneys. Buy them by the dozen. They’ve already been taken so why not use them for something good, like saving lives. Sure, it might make a couple of bad people rich in the process, but I think it will be worth it in the long run. Think about it. We start buying up all the kidneys on the streets, the bad guys are going to need more kidneys. When they start stealing more kidneys, people get afraid and donate them to keep them from getting stolen.
Problem solved.
10/2/2006 at 3:00 pm
Rachel M
The selling of human organs is quite the issue. Ethically and morally it seems wrong but unless you have been on that list waiting for an organ donor to save your life then you really do not know what you would do. What the NKF did was righteous but they are still faced with the fact that people are dying everyday waiting on a kidney. There are some people in this world that are greedy and do not want to give up their organs but maybe they would for money. Not saying that this is the right thing to do but if it is to save a life then everything possible must be done.
1/2/2008 at 7:03 pm
Bree
hi
i beilive this is the correct thing to do because i have a left side kidney im am 14 years of age and it happens every night around 4pm till early hours in the morining the pain is unbeilable it would be like a knife stabbing into your back ive been drinking water for a while now only have a coffee a day and no achole what so ever if the kidney dosnt fix its self ill will have a acute kidney maybe could fix but if not i could be on a machanie to moderate them or even worse get it taking it out. once you kidney is taking out and you have only one left on your body youll never be able to drink achole and maybe coffee nothing sugary. just filtered water. which is sucked becuase i anit even 18 yet and there wont be a great time which i like it to go. my kiddneys have been going like this since new years i have taken 2 glasses of cowboy shake and 4 beers and then i had realised the next next i have serve pain i am scared i last night started crying and cuddling my cat outside and sooking to him becuase my parents will not take me to the docors they are too busy with their own lives.