After the fall

Huge waiting lists for kidneys and other organ donations sometimes can drive those in need to other methods outside of hospitals and the legal system. (See Allow incentives for donating organs.)

Levy Izhak Rosenbaum of Brooklyn stands accused of conspiring to broker the sale of a human kidney for transplant at the cost of $160,000 to the recipient. According to a federal criminal complaint, Rosenbaum said he has been arranging such sales for 10 years.

Buying and selling organs is illegal in the United States, but sometimes people will go overseas to have such an operation and then return for post-operative care. No hospital in the United States is allowed to transplant a purchased organ, but one way around the restriction is to designate a recipient and claim the person is a friend or relative. Many hospitals will perform such transplants, although doctors may be skeptical if the donor and recipient are strangers, said Randy Cohen, The New York Times Magazine’s “Ethicist” columnist.

He can understand why someone in need of a transplant would buy an organ. Understanding, he added, is not condoning.

“The argument against it is,” Cohen said “no matter how you regulate it you’re setting up a system where people with money get to harvest the organs of people without money.”

Cohen dismissed the idea that selling organs could be legalized as a source of money similar to donating plasma. According to some studies, he said, people in dire financial straits who have sold their organs soon find themselves back in the same predicaments but in worse health.

“You could continue to regenerate plasma at no risk to your health,” he said. “When you sell an organ you put yourself at serious long-term health risk.”

Cohen suggested two alternatives to the illegal system.

The United States has an opt-in system for organ donation, meaning people have to specify that they want their parts donated after they die. Europe, on the other hand, has an opt-out system where donation is assumed unless otherwise specified. This results in many more organs available than in the United States, Cohen said.

Second, many of the people who require organ transplants later in life had poor health care earlier on. Improving health care in people’s early years could lessen the need for transplants later on, he said.

“Those two approaches seem far likelier to succeed without horribly exploiting people without money,” Cohen said. “No matter how you regulate organ sales, what you’re saying is people with money get to take the organs of people without.”

Organ donation has traditionally been a gray area among the religious Jewish community. Organizations such as the Halachic Organ Donor Society, however, have fought to change that perception by encouraging Jews to become donors.

For more information, visit www.hods.org.

Cover Story

Selling organs: Jewish values vs. market value

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