Organ Donation and Social Amelioration A Two Pronged Approach to Organ Tra ffi cking
This paper explores a model for reciprocating the contribution of organ donors to a health care system characterized by inadequate resources and faced with the challenge of trying innovative ways of providing much needed health care. A conceptual framework is proposed that recognizes a soft altruism being manifested in the contributions made by people who donate in the context of a social amelioration scheme. In order to bring out some of the characteristic features, a comparison is made with a presumed consent regime, which, while focused on cadaver organs, would appear to take advantage of the vulnerabilities of the poor when implemented in economically disadvantaged countries. The model makes it possible for people to make their organs available for transplant while receiving benefi ts under a social amelioration program. The aim is to enable poor organ donors to emerge from the transactions in better health than otherwise, without loss of dignity, and having taken part in a collective undertaking that promotes the interests of organ donors and recipients alike. An alternative model is off ered that could be compared to better known methods for encouraging more people to donate organs for transplantation. Its merits can be seen in the following: (1) compared to other proposals based on the provision of incentives, it is less likely to be seen to regard human organs as mere commodities or to legitimize market transactions; (2) it involves a system for monitoring behavior of organ donors after transplant, ensuring post transplant health care; (3) it off ers a set of benefi ts that are already part of a social amelioration program in countries around the world; (4) rather than merely providing incentives, it seeks to ameliorate the conditions of the donors on a sustained basis; and most importantly, (5) it seeks to remove the donors from the exploitative conditions that have encouraged the poor to participate in human organ trade as vendors.