1990s >> 1999 >> no-1140-august-1999

Transplant organs for sale?

Even Margaret Thatcher balked at the sale of kidneys but now it is being discussed as a serious possibility.

When BBC2’s Newsnight programme broke the story about Northern General Hospital in Sheffield accepting a stipulation from a donor’s relatives that his organs could only be used if they “didn’t go to a coloured”, the debate that raged afterwards concentrated on whether racist pre-conditions should be tolerated given the severe shortage of transplant organs. And whether medical staff accepting such ifs and buts might be breaching the Race Discrimination Act. Did anyone in the media realise this issue was not fundamentally about ethics or legality, but class?

What is it that suppresses natural altruism in people to the point that this may necessitate compelling organ donations through a new involuntary arrangement? What causes next of kin to see donor organs as exclusive property to grant or withhold, rather than collective property from which anyone may benefit? And what makes those who do behave unselfishly towards others get called “losers” and “saddos”? Might it be a materialistic, dog-eat-dog, I’m-all-right-Jack mentality necessary for survival and “success” under capitalism?

The source of people developing a hatred for other human beings with merely a darker skin colour is also found in the competitive market. Those desperate to find a reason for, and an escape from its poverty, unemployment, housing problems, inadequate welfare benefits etc, can readily blame any group that they are led to think of as being different and outsiders. Such thinking will generally be toned down or encouraged—depending on whether the economy is doing well or badly—to fit in with the capitalist class’s needs to increase available labour and boost workforce competitiveness or to divide society and divert blame. But sometimes as in this case racist thoughts can rebound on the ruling class.

A kidney transplant costs around £10,000 just once, whereas haemodialysis costs the state (funded by businesses) £25,000 every year per patient. If “different” ethnic groups start attaching conditions to donations, other non-racial provisos will creep in; administration will become more difficult and expensive; would-be donors will be put off, and fewer transplant operations will result. And with organs already in increasingly short supply, both the pressure on government to act and the financial burden on capital could only get worse. But any New Labour solution is bound to involve hypocrisy.

Already, Frank Dobson has blustered “I haven’t been an opponent of apartheid all my adult life to see it being introduced in the NHS. It never occurred to me that a rule would be necessary to keep racism out of blood transfusions and donations.” Maybe the Health secretary will explain later why his new rule, while not allowing people to choose who gets hearts, lungs and kidneys according to colour, will allow any capitalist to choose the best food, goods and services according to money. Preventing discrimination against the differently coloured with desperate clinical needs, but permitting discrimination against the poor with desperate social needs exposes the iniquity of a private property society and its requisite two-faced laws. Dobson won’t have costly racism in health care, but “apartheid” in access to enjoyable work, the best food, decent housing, utility services . . . That, too, has “never occurred” to him—and probably never will.

Class ownership of vital assets is behind divisions in society, but because those who govern capitalism have no intention of tackling this root cause of racism, its political servants now instead merely put on a concerned act, conduct sham enquiries and plan to tinker with its laws to avoid the controlled majority behaving too much like the dominant asset-owning minority.

But why are so many people in dire need of organ transplants in the first place? How much smaller would be their number if those in various industries (chemicals, oil, tobacco, pharmaceuticals etc) had not poisoned and polluted our bodies for profit for decades?

Some media writers actually suggested that if the poor were encouraged by payments to sell organs to hospitals while still alive, then both they and those in desperate need of transplants would benefit.

The Guardian’s Polly Toynbee asked:

Why shouldn’t the NHS buy organs for its patients? . . . ask the tough question—if it’s OK for us to let millions of people die around the world with hardly a thought about it, why isn’t it OK for some of those people to choose to sell a kidney in order to improve their families’ chances of survival? The medical risk of donating a kidney is relatively low while the cash reward would be enough to change a family’s condition beyond all recognition . . . If the world cannot give them the means to survive, why should they be denied the right to sell the only thing they have of great value? (9 July).

In Toynbee’s mind, the “means to survive” is money, while in reality such means are industries, utilities, natural resources etc which, if directly and collectively owned by us all—and not a privileged ruling minority—would bring about an end to all those millions of deaths from deprivation.

And if she thought harder, Toynbee would realise that poor people selling bits of themselves would not escape the gutter, as the capitalist market that she tolerates—and regularly cashes in on with reformist let’s-tinker-with-it-this-way and that-way articles—will always find buyers at the most competitive prices. And with billions world-wide possessing sod all, that’s what organ purchasers will be able to pay then as the going rate.

Legally, we don’t even own our bodies. According to the Medical Ethics and Law Department at Imperial College (Broadcasting House, BBC Radio 4, 11 July), the seventeenth century philosopher John Locke established the principle on which the law still operates. They pointed out “we don’t own our bodies because didn’t create our bodies. Locke said God did”. Consequently, “we can own things that we have created through our labour . . . that we have property in our person, but definitely not in our bodies”. This is doubly daft, since not only did some supreme being never make us, but we manifestly do not have full property rights in what we create through our labour, otherwise exploitation by employers for profit would be impossible.

However, such exploitation will end—together with all today’s others social miseries—when we perform a transplant operation on capitalists at the ballot box, and shift organs of production from their persons to ours.


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