Medical professionals perform a specialist kidney operation for the first time in Tonga. The medical team are part of an AusAID-funded Pacific Islands Program (PIP) team visiting Tonga.

Should people be able to sell their bodily organs?

*Opinion, Public
Organ sales

Seems like everybody’s got a price

The case for a human solution

HUNDREDS of thousands of people wait anxiously for an organ transplant at any one time. That is unsurprising as not many people donate when altruism is the only reward. In almost every country, bodily organs cannot be bought or sold legally. The issues of organ sales and transplants also lack the hard emotional appeals of gay marriage and civil rights nor do they have the urgency of religious extremism; such absence of discussion meant that the Human Organ Transplants Act of 1989 has never been seriously challenged in Britain, and as a result, thousands of people die waiting each year. It really deserves more attention.

One reason why it isn’t already a global drama is that most people outright reject the idea of organ sales. Societies—even Western democracies—take the selling of one’s organ as an act of despair and unscrupulousness, and the word ‘sell’ has particularly displeasing connotations. Religious perspectives support this norm: the human body is, after all, a holy temple and its sanctity can never be transgressed. Television programmes also agree: organ buyers are gang-masters and villains who pay ridiculously to rob organs intended for the poor and needy. For the law though, a range of social and judicial arguments have to be heard.

First, the impression that organ trades allow more room for exploitation by the wealthy is correct to a large extent. Injustice is said to be furthered if organ sales are legalised because financial compensations are only relevant for the impoverished people, and while there are immediate gains, people who leave the surgery room with an organ fewer also have their work capability diminished, to say the least. Hence the trade of organs exacerbates poor people’s conditions in the long-term. Some may even feel pressurised to sell their body parts for money into a market where abuses are rife, just as the old is coerced to death if euthanasia was legal. This defeats the purpose of a fair, well-managed waiting list as well as the value of selfless giving, albeit there aren’t many of them.

The sense of aversion—amongst other gross intangibles feelings—against organ sales is also prominent in both Western and Eastern cultures. There is simply something forbidding about exchanging fundamental body parts for money that sets it apart from the selling of your hair, for instance. It assaults our moral sense in a way that cannot be put into words, just as the way most people deem prostitution to be inherently wrong. In truth, there are some tangible justifications for that feeling—the gruesome fact of transplants tourists rackets, for one, has no advocates for legalisation. Thousands of executed prisoners are said to have their organs looted in China, with “consent”, of course. Until its official ban in 2006, recipients from all around the world are suspected to have travelled to China.

What is undeniable, however, is that organ trades potentially save lives. To make it legal will most likely provide the privilege of living longer to many more than just China-goers. In some cases it accommodates both actors perfectly: a person with terminal illness may wish to donate his or her remaining (healthy) organs upon death, which not only greatly increases another person’s life expectancy, but also allows some money consolation for the relatives of the deceased. Besides, altruism comes as an additional bonus. This conjecture is consistent with a utilitarian worldview, with some supporters going a step further to say that organ donations upon death should be compulsory or at least presumed to be consented. In theory, this will greatly reduce our patients’ current waiting times.

The present system of organ transplants is indeed a sorry state of affairs. The NHS collated that an encouraging 4,655 organ transplants were carried between April 2013 and March 2014, but it also says that there are 6,900 still waiting by the end of 2014. That number is roughly 100,000 in America, and 4,400 names are added every month. The NHS’s quarterly statistics also showed that only 1% of people in the UK died in circumstances that they can donate. An even smaller percentage of that are registered donors. The logical conclusion from this is that in every part of the world more and more people will die from the lack of organ transplants as demand always outweighs supply.

Thus it can be said that—of all states—Iran has done an unimaginable feat in eliminating its waiting list in 1999, just eleven years after organ sales became legal. Since its conception, a kidney market flourished, and a fixed compensation was put in place for Iranian donors only. This model blatantly violates World Health Organisation’s 1991 Guiding Principles but it works. Iranians no longer go abroad for organs and, despite being illicit on paper, foreign recipients are attracted to Iran’s services. Similarly in the Philippines, where organ sales were legal to some extents until 2008, foreigners accounted for nearly half of its organ transplants. This demonstrates how supply increases drastically where organ sales are legal.

We don’t have to look to Iran to understand why legalisation works. There are existing markets of commodities which are entirely comparable to human organs. Alexander Berger, an analyst and whom himself donated one of his kidneys, wrote on the New York Times quoting a 2011 Circuit Court of Appeals ruling that legalised the sale of bone marrow in America, just as it has been legal for plasma, sperm and egg, and surrogacy.

The problem with surrogate mothers has traditionally been their emotional attachment to the child they bear and consequently they refuse to give the child to the biological parents. The introduction of a fee removes that barrier as the commercial aspect makes the whole process an inanimate one. This is also the case in prostitution, and can be the case in organ sales. Those who agree says mild monetary reimbursements to organ donors in Australia, Singapore, and some states in America is working and can progress further; those who disagree say that an organ, just as the bearing of a child, can never be priced.

The Nobel Prize winning economist Gary Becker begs to differ. He purported an economic model which quantified a kidney to $15,200 and a liver to $37,600. Small wonder that the poor are willing to part with their organs in order to procure just the sum to maintain decency, and the law should not penalise these choiceness reactions. Some say it is also an issue of rights: the fact that the selling of organs does not harm others meant that it is an act of private self-determination, no least an act that takes tremendous courage and worthy of respect.

What about donations? Would making organ sales legal not undermine that? The BBC reported a 10% yearly rise of organ donations in the past six years in the UK. Religious oppositions towards the issue have also dissipated; a bumper sticker reads ‘Please don’t take your organs to heaven. Heaven knows that we need them here on earth’. Yet social prodding on its own is no panacea. The law should change to allow organ sales, and there are good reasons for that.

As always, legal supervision is a tremendous advantage. Organ sales’ unlawful status everywhere bar Iran and our aversion to it has not stop them from taking place in black markets. Legalisation introduces regulatory effects that can halt human traffickers and kidnappers from bullying victims into selling their parts. Clandestine donors and recipients who expose themselves to numerous health jeopardies in order to evade prosecution will no longer be. The poor, who is most likely to sell their organs, needs to be protected rather than criminalised.

The opposition will contend that this slippery slope method of legalisation insults the integrity and independence of the law, which has to be well-defined and is not malleable to changing circumstances, such as whether organ trades are already going on. The moment it does, there is the danger of legitimating acts not according to its merits but according to the tyranny of the majority and circumstances. Yet that is exactly what laws are. Changing parameters do affect laws because, as rigid and well interpreted laws are, practicality is (almost ironically) one of the first considerations made by our highly held lawmakers, and subsequently, written into laws, and executed by judges.

Justice and the rule of law is undoubtedly of the highest priority. Nevertheless, the law takes into account how feasible it becomes in practice, and in the case of organ sales this swings in favour of legalisation. The fact that the selling and buying of organs does not infringe on the rule of law meant that the constructiveness of either criminalisation or legalisation becomes more relevant. Assertions such as legalisation brings protection, eradicates fraudulent organ rackets, and greatly reduces waiting lists also become more relevant.

The job now is to have the discussion on how to establish an effective system. While the immediate legalisation of organ trade may be improvident, long-term transitions beginning from the Australian and American model is sensible, and the presumed consent system in Spain is also worth exploring. Of course it makes sense not to allow people to sell their organs to the point of seriously endangering themselves (e.g. selling both kidneys) because, not needing to invoke arguments against suicide, the point of legalising organ sales is to persuade well-regulated donations which would ease demand and save lives. Death defeats that purpose.

I began this line of reasoning with the critical need of more organ donors in the real world as opposed to a legal judgement because there are always two sides to an argument, and the law often picks the lesser of two evils. The legal answer, in this case, is the human one.

Image credit: Department of Foreign Affairs and Trade
Gay agenda

The absurd idea that gay people are threats to society is still thriving in many places

Gay rights

Love’s agenda

GAY people have an outré agenda. They are equality’s masqueraders who seek to redefine marriage at all cost—the indoctrination and recruitment of children, the silencing of all things religious, the promotion of an exquisite lifestyle. Homosexuals, a mediocre group of minority, have the cynical objective of curbing rights of their counterparts. They will slowly and surly destroy traditional society as we know it.
Stop. The ferocity of the antecedent reasoning is striking. Consider the trend that homophobia is on the rise despite Western liberalisation. Consider also that gay people have been victims of an inordinate amount of violent crimes. The language used in vindications like this one is almost synonymous to hate speeches from the time of anti-Semitism and opposition to the 1960s Civil Rights Movement. You would anticipate such preposterousness coming only from an imbecile, who in all likelihood, was inculcated by improper upbringing from a cult.
You would be wrong. Rhetorics like this one are stolidly embedded in the anti-gay camp, including not only lobbying groups such as Westboro Baptist Church and Family Research Council but also stand-up conservative politicians in the West and elsewhere. Traditionalists base much of their case from religion. And despite efforts to renew its archaic policies, the Vatican has a mixed record when it comes to LGBT issues.
A few weeks ago Pope Francis said “the family is threatened” by gay marriage and that it “disfigures God’s plan for creation”. This comes despite the fact that he was lauded as a reformer (see article). In 2013 the pontiff ruminated “who am I to judge?”, and in 2014 he attempted to include welcoming language to gays in an official church report, albeit vetoed by the conservative bloc within the synod. That is evidence that religious denominations remain predominantly against the idea of gay rights.
It follows logically that people are more sympathetic in places that are more secular and, typically, more affluent. A study by PewResearch in 2013 made it clear that as a country’s religiosity intensifies—that is, for instance, to believe that it is necessary to accept God in order to be moral, and to pray at least once a day—tolerance towards gays slump. Russia’s unique model made it an exception to this rule. Under a despotism, Russia is neither a pious country nor does it countenance homosexuality.
One step forward, two steps back
A federal law (ironically) prohibits distribution of ‘propaganda’ that supports the LGBT cause among minors in Russia since 2013. The fact that it was expanded from existing child protection laws highlights the benighted idea that homosexuality connotes child abuse, or that gay people are inherently linked to AIDS. Likewise, more often than not, African nations display anti-gay sentiment in their laws. 37 out of 54 countries in Africa criminalise sodomy.
Uganda is home to the most notorious example. David Bahati, an MP, has publicised a bill dubbed “Kill the Gays Bill” since 2009 given a death penalty clause for the insultingly worded crime of “aggravated homosexuality”, oriented towards gay people who are HIV-positive and who engage in sexual acts with others under 18 years of age. It was signed into law last year: fortunately capital punishment was stroke out; unfortunately it was replaced by life incarceration and it ensued a 750% to 1,900% rise in homophobic incidents.
Bahati argues that the West are imposing a set of radical values on their godly state. Ugandans will never yield to ‘un-African’ policies, claim the zealots, and they gained popularity by drawing comparisons to the Western colonial rule. A local tabloid responded to criticisms from Western media by publishing pictures of 200 alleged gay people with the pernicious caption: “hang them!”. There is urgent need for the West to fathom the rationale behind such defiance to international norms.
The fact is, a large part of the world remains, at its core, fundamentalist whereas a few countries in the West have reinvented themselves states that are more forbearing in terms of social issues. In many places there is genuine public intolerance against homosexuality amongst other items in the ‘culture war’ (recreational drug use, abortion and women’s rights, other acceptable social behaviours). They are prepared to execute their fellow citizens to manifest their beliefs. Hence it makes practical sense for politicians to oppose gay rights, however ridiculous they will seem.
The underlying political motive is to arouse the conservative self of the public and to translate outrage with a progressive government into popular votes. This also explains the church’s hypocrisy. On one hand the church must reinvent itself to rescue its image problem with the disillusioned youth. On the other the church is under a sphere of rightist influence. Scriptures and their interpretation still serves the purpose in maintaining the church’s despotism. That is hard to change.
We will be victorious
There is hope that with the advance of democracy and generational replacement people will come to see gays as different but equal simply because they are fellow humans. Change is already in place. A survey, also by PewResearch, showed that young Catholics overwhelmingly endorse gay marriage. The number of states in America that recognises same-sex unions increases exponentially. And, in the interim, the Uganda law criminalising homosexuality is invalid owing to a technical error.
Adversaries of gay rights are shunned out of the forum for good reasons. Their antagonism and demeaning arguments comes tumbling down as gay people are no longer a feared species of pedophiles or indoctrinators. For me, it is nothing but a moral opprobrium to criticise a movement engendered by desires for equal treatment, the wish to be free from bigotry, and, above all, by love.
Image credit: Caretaker Cameron
Lady justice

What influence, if any, should religion and law have on each other?

*Opinion, Public
Church and state

Formidable opponent

The case for a common-sense solution

THE NATURE of religion’s influence on the law and the converse are different. The rule of law is overall well-defined and considered unequivocal, whereas religious convictions are ultimately a matter of choice, despite what fundamentalists may hold as absolute ‘truths’. A recent, curious case saw a pair Christian owners punished for turning away a gay couple from their guesthouse. The owners complained that their religion forbids such relationship, and the law should have no place in limiting the manifestation of their beliefs, while others argued that the Christian couple must not assume that their religion overrides the law of equality. The debate between separation of church and state has been reignited.

There should be no disagreement in recognising the immense influence of religion on Western laws in the past centuries, from the time when religious doctrines were executed as laws by the ministry, until the time when philosophers had fabricated rules for society, with religious principles such as the sanctity of life in mind. We can even say that modern British and Western laws emanated directly from religion. The question remains: should religion’s influence go beyond, in this day and age?

Leading secularists are likely to reject religion as a force that hinders progress, albeit precipitating a heavier response from grassroots social conservatives. Religion’s influence over the law is explicit: evident from the rise of the Tea Party movement in America and UKIP in the United Kingdom, there are more people who see the ‘liberal agenda’ as destructive to their broadly religious traditions and they are not afraid to manifest their beliefs, going as far as conducting a Ugandan anti-homosexuality bill that originally consisted of the death penalty for some practices. Here, the spirit of the law was reduced to a passive, driven role amidst an autocratic religious supremacy.

Yet even in the modernised West the law appears feeble and its allegiance is claimed by both ends of the spectrum. In a typical debate, say women’s right to abortion or the Christians’ right to deny services to gay couples, both sides feel their counterpart is more privileged by the legal platform. Everyone is accused of imposing their values, be it religious or secular motives. To make a judgement, we must therefore look to the ‘natural’ state, one that is intrinsically free of any prerogative.

People with religious convictions will point to the historical interdependence of church and state—something I have already argued in favour of. But this becomes trivial compared to what opponents assert. Look at the well-known First Amendment to the United States Constitution, they say; the unambiguous edict of “Congress shall make no law respecting an establishment of religion” in conjunction with the idea of “everyone has the right to freedom of thought, conscience and religion” under the (even more broadly accepted) Universal Declaration of Human Rights meant that the ‘natural’ state we seek is earthly, even temporal.

A 2014 poll showed that only 24% believed being Christian was an important component of being British, thereby echoing the aforementioned definition. Diversity of beliefs in Britain and the world strengthens this point of view further. Hence it must be true that the law treats religion precisely the same way it treats other deeds: equally.

In reality, established religions are granted with a profusion of privileges. Strikingly, despite tax exemptions and 26 bishops who resides in the House of Lords, religious people still complain of receiving ‘less favourable treatment’ and they feel ‘marginalised’. This is the reason, they say, the law must be governed by religion to a larger extent. I am convinced that the law has no responsibility to provide a further sense of ‘inclusiveness’, not to say favouring or promoting one single religion.

Under most laws, religion is ‘influenced’ by the law equally. This is problematic because religion has the unique nature as being indescribable by scientific evidence. It is also indefinite as, like science, religion changes with time because it is contingent on interpretations. Adherent to the 2010 Equality Act, the law should present itself merely as an observer to the religions of the world, so far as religious expressions are not criminally polluted and does not interfere with others. Laws act as the minimum necessity in a democracy to maintain public safety and, more importantly, the liberty to pursuit other beliefs.

By extension, as long as the beliefs are genuinely held and ‘does not interfere’, the government must display toleration and accommodate religious people and organisations by making special impunities; the religious convictions’ authenticity should be judged by reason, logic, and experience. Not all boundaries of the law can be relieved—I must reiterate the freedom of religion and its successive free speech comes with an inviolable wall. Religious actions are tolerated by the law until they become intolerable to the greater, social good that is partly based, I suggest, on a limited view of utilitarianism and humanism.

The final front of confrontation lies over extreme ideologies. While some people directly attributes Muslims as terrorists, insisting at its core, Islam is a poisonous and violent religion, the new generation has come to detest orthodox churches with the likes of the Westboro Baptist Church, a group more commonly known by a homophobic slogan, unduly repulsive to be quoted here. Laws should cope with these as impartially as before. Unlike religion, the law has no discrepancies and is indiscriminate; religious beliefs are exclusive via a personal choice, while the law should have unreserved and complete warrant. Similarly, there is no need to assess the validity of religions, both realistically and legally speaking.

Holding religious beliefs do not make believers legally transcendent; it is not permissible for them to commit atrocious, prejudice behaviour or hate speech because they are biblically based. Our law can never surrender its place in the judiciary to any supernatural. But given the undeniable influence of religion over the public and subsequently, laws, it is not a cliché for me to say that compromises have to be made on a human level for parity to prevail. Our law should also acknowledged the feat of some established religions. The 26 lords should stay. And the room for negotiation can be handled with common sense—our law must instruct the Christian owners to provide equal hostel services to people of different sexual orientations. Gay couples will simply not take up their offer.

Image credit: Jason Rosenberg