Notes

Within the area of legislation, one concept that plays a vital part in all steps of the legislative process would have to be the notion of the cause and effect phenomena. Politicians and others who promote such legislation often proclaim that it will cause certain phenomena to occur and will have an effect which those proposing the legislation is beneficial. Once such legislation comes into place eventually than the notion no longer is theoretical but instead is now resulting in effects which may or not be what supporters proclaimed would happen. One current example of this cause and effect notion as it relations to current legislation would have to be the prohibition on organ selling as seen in most countries. As in the described example, such pieces of legislation were promoted on the grounds that it would have positive effects such as preventing the poor from having less access to organs they need for transplants and also to prevent potential unethical actions. Such legislation as adopted by many nations has been successful to many advocates who allege that it is such regulation in place which prevents harmful practices with regards to organs from growing. However, according to many economists and other officials, one issue which has risen from the prohibitionary regulation is that the amount of donors is lower than it would be if commercial organ selling was legal. Such claims are based on both theoretical arguments and data which shows that a legalized organ selling market would result in less of a shortage of organs needed for transplants. Thus as the cause and effect notion applies to organ selling, it can be said that such probationary legislation has the effect of lessening the number of organs available for transplants.

The notion that the prohibition on organ selling creates the effect of organ shortages is firstly supported on theoretical grounds. This is because organ donation (whether for profit or gratis), is can be thought of as occurring because the donor has some incentive to engage in losing his organ and giving it to another person. Common incentives within the current organ donation framework found in America would include such the fact that it is compassionate, that such organs are no longer needed (for deceased donors), or that the recipient is family. All such reasons are "legitimate" and serve as a valid reason as to why people would choose to voluntarily (as in without coercion) give up the organs that they currently have for the recipient to use them. The prohibition on organ selling, in turn, is lowering the number of organs available since it is preventing the potential incentive for financial compensation. If the selling of organs was legalized, then by virtue of more incentives for one to give up their organs there would be more organs available to those who need them. This notion is especially true as it responds to money since it is a very strong motivating factor for people to do things which they otherwise would not do if not for the compensation that they would receive. In turn, this would ultimately be beneficial since it would allow for the area of organs to receive the market-based mentality which is already in place for other areas where there are limited resources but a large need. However, notwithstanding any ethical concerns, one counterclaim theoretical claim made by opponents is that such legalized organ selling would result in people still not having access to organs needed. Such a hypothesis is based upon the notion that a large variety of people (mainly lower class) would lack access to organs for transplants since they would lack money to buy such organs on a potential "organ market". Despite the plausibility of such a situation, the argument fails to address the two points which ultimately harm its validity. First is that it assumes such gratis donation of organs would either starkly decline or that the organ donation landscape would change to one which is favorable to the wealth. This assumption is flawed since as noted there are many widespread reasons as to why one would choose to donate organs gratis preventing such a situation from taking place. Secondly, this argument overlooks the fact the potential increase of organs on the market would be able to balance out the organs that are available for gratis. That is because many people who otherwise would attempt to receive organs gratis would instead opt to buy them via the market (for convenience for example), causing the gratis organ system to remain stable and allowing the poor to have access. Thus on theoretical grounds, current legislation which prohibits selling organs has contributed largely to the organ shortage.

Another aspect to be considered when attempting to examine the effect which prohibitionary legislation has on the organ shortage would have to be current real-world examples of nations without such a prohibition. This because while considering the theoretical arguments is important, it is within real-world examples with empirical data which serve best when attempting to arrive at a conclusion. One way that this easily can be done would be by comparing two different nations, one with restrictive legislation regarding organ selling and another which permits organ selling, in order to see how the differences may or may not help the organ shortage. For the purposes of this paper, the two examples will be the United States and Iran since each serves as a notable example. The United States has legislation which is like that of much of the world since it prohibits the sale of organs and instead only allows for gratis donation. On the other hand, Iran can be thought as part of a pariah since it is the only which allows for some form of organ selling as the commercial selling of kidneys is allowed. Because of the limited scale of legal selling allowed in Iran, the comparison will solely focus upon kidney donation statistics in the United States in order to make for a better comparison.

With regards to the current situation regarding kidney donation in the United States, one word which would perhaps describe it would be "shortage". This is since the United States is currently experiencing a shortage of kidneys needed for transplants as seen from the current 100,000 people who are currently on the waiting list in order to receive a kidney transplant. Such the current status of the of the organ shortage has brought rather dire consequences as about 6% die annually while others must face the various hardships such as dialysis treatment and financial costs. This has ultimately led to kidney disease being considered a major public health problem due to the critical lack of organs available to the people, thus leading to calls for change in policy with regards to kidney donation (Allen & Reese, 2016).

This situation with regards to kidney donation in America, however, stands in stark contrast to the one which can be seen in Iran where such a crisis of shortage is non-existent. Originally within Iran, the country had enacted legislation which greatly regulated the practice of organ donating as it was only permitted between family members and was prohibited between strangers. This led to a situation in Iran which was so poor that a significant amount of potential kidney recipients often would leave Iran often to go to the United Kingdom to seek care. However, eventually, health care officials decided to liberalize the restrictions of organ donations to the current point where they are one of the most liberal nations with regards to the issue including allowing donors to be paid by the recipient. This has resulted in Iran having a very small waiting list compared to America (even when adjusted for population and other factors) and a donor pool which is great than the recipient pool (Griffin, 2007).

Thus the notion that legislation and policy which forbids the sale of organs under penalty of law has contributed to the current organ shortage crisis seems to be supported by current real-world examples. This is especially true once one also considers the fact that Iran had previously been in a situation such as America with regards to kidney donation until their liberalization of such policy and legislation began to help alleviate the matter. However many would naturally challenge such an assertion and instead proclaim that such real-world examples do not sufficiently prove that prohibitionary legislation contributes to the current organ shortage. Many make such a claim because of the fact that real-world examples of legalizing are extremely limited and thus do not provide enough data. Of course, such an accusation does hold a certain degree of truth since Iran is the only current real-world example of legalized organ selling albeit extremely limited since it only pertains to kidneys. However, in spite of the relatively low amount of empirical data which has been attained from the case of Iran, the results currently have been quite promising as it results in fighting organ shortages. Iran went from being where many citizens had to leave the country to receive care to achieving a satisfactory situation where Iranians do not have to struggle with long waits to receive kidneys needed for operations. Thus such promising even if limited real-world examples of legalized organ selling would be worth attempting to follow be trying to remove prohibitionary policy and legislation. So ultimately attempting to remove legislation which prohibits organ selling in America would be a good first step to attempt to alleviate such problems that America faces in the area of the existing organ shortage.


Ultimately, the notion of cause and effect can be seen within the area of the legislation as it pertains to the effect that current legislation has on the organ shortage that is occurring in America. That is since as noted from theoretical and real-world examples, such a prohibition on selling organs increases the phenomena of the shortage since people are less incentivized to give organs to those who need them. With such a cause and effect established within the area of organs, the question now should turn to what actions should be taken in order to create a positive effect to combat the organ shortage. From the points considered, one potential action which would be beneficial would be to legalize organ selling since doing so would be a great way to fight the shortage as seen in emprical cases like Iran. Of course such legislative changes mat receive criticism, however, given that probationary legislation has lessened the number of organs available for transplants such a change in legislation would be commendable.