From Hope to Despair

Prepping for a lecture on economics and ethics, I stumbled upon this article by Drs. William Harmon and Francis Delmonico about organ transplants in Iran. Iran has a unique approach to organ donation: donors are paid, partly in cash and partly in the form of life-long health insurance. Unsurprisingly, 80% of donors are poor.

The Iranian model also makes evident what has long been anticipated would occur in a regulated market. There is a fundamental unethical construct that cannot be overlooked despite the attributes that we have cited regarding the Iranian system. It is the poor person who bears the burden of being the kidney source for transplantation. That exploitation becomes real in Iran (>80%) as it does in any other regulated market. The poor person is coerced to make this donation decision, as there are no other means available to obtain money for what becomes temporary personal or family support. This coercion violates the dignity of the human person who is used by those who are highly advantaged to undergo transplantation within the same society.

It takes an impressive amount of intellectual gymanstics to turn someone's best option into a source of their despair precisely because it is their best option.