The ethics of a regulated market for organ sales exploring context

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The ethics of a regulated market for organ sales
- exploring context concerns

• Michal Dick
• ACERH, ANU
• A presentation to the ACERH 2009 Policy Forum,
• Perth, 20 February 2009

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• ethics is a generic term for various ways of
  understanding and examining the moral life

Beauchamp TL Childress JF (2001)
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Overview

• Excess demand creates ethical challenges
• Justice
• Autonomy
• Body as property
• Risk harm
• Values enrich the debate
• Religion
• Cultural / historical
• Inform policy regulation

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Ethics Justice, equity exploitation

• Exploitation
• Organ market system inequalities
• Ensuring justice
• Are poor benefiting from the sale of kidneys?

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Ethics Autonomy Informed consent

• Does poverty coerce donors to sell their organs?
• Coercion and autonomous voice
• Coercion and the market
• Health cost
• Commercial benefit

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Ethics Autonomy Informed consent

• Autonomy
• Kantian rationality
• Sovereignty as a tool to promote ones interests
  (i.e. Financial)
• Restrictions
• Deciphering informed consent
• Sovereignty over our bodies - right to dispose of
  their organs?

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Ethics Identity, Human Dignity the Body as
Property

• Body and organs ours to sell?
• Inherent value vs. Market influence
• replacing values
• Commoditisation
• reductionism

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Ethics Patient-Physician-Donor triad Risk
Harm

• Risk autonomy vs. primum non nocere
• What level of risk is acceptable?
• Endorsement - professional group
• Balance of trust
• Intricacies of informed consent
• health organisations policy

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Other influences - Religion

• Altruism respect are prohibitive
• Catholicism , Shinto (Japanese)
• Individual choice
• Buddhism Hinduism
• Overarching value of life
• Islam Judaism

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Other influences Culture

• Leaders
• Iran
• Israel, Singapore
• Aversions
• Germany physicians during Nazi era
• USA slavery commoditisation of bodies
• Eastern Europe, India, China abuses of organ
  trade

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Case study multicultural Australia

• ACERH, ANU 2008-9 Survey
• lt1 morally appaled
• Only 0.7 of registered donors offended

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Implications for Australian policy

• Internal impact - Offended altruists
• Developing countries international
  relationships
• Fear of black markets alleviate or accentuate
  problem?

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