SOLUTION: Organ Sale Will Save Lives And Blind Spot About Guns Discussion

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JOANNA MACKAY Organ Sales Will Save Lives
In this essay, written for a class on ethics and politics in science, MIT
student Joanna MacKay argues that the sale of human organs should be legal.
There are thousands of people dying to buy a kidney and thousands of people
dying to sell a kidney. It seems a match made in heaven. So why are we
standing in the way? Governments should not ban the sale of human organs;
they should regulate it. Lives should not be wasted; they should be saved.
• • Clear and arguable position. 13 Arguing a Position 13 / Arguing a
Position ▲ 157 About 350,000 Americans suffer from end-stage renal
disease, a state of kidney disorder so advanced that the organ stops
functioning altogether. There are no miracle drugs that can revive a
failed kidney, leaving dialysis and kidney transplantation as the only
possible treatments (McDonnell and Mallon, pars. 2 and 3). Dialysis is
harsh, expensive, and, worst of all, only temporary. Acting as an
artificial kidney, dialysis mechanically filters the blood of a patient.
It works, but not well. With treatment sessions lasting three hours,
several times a week, those dependent on dialysis are, in a sense, shackled
to a machine for the rest of their lives. Adding excessive stress to the
body, dialysis causes patients to feel increasingly faint and tired,
usually keeping them from work and other normal activities. Kidney
transplantation, on the other hand, is the closest thing to a cure that
anyone could hope for. Today the procedure is both safe and reliable,
causing few complications. With better technology for confirming tissue
matches and new anti-rejection drugs, the surgery is relatively simple.
But those hoping for a new kidney have high hopes indeed. In the year 2000
alone, 2,583 Americans died while waiting for a kidney transplant;
worldwide the number of deaths is around 50,000 (Finkel 27). With the sale
of organs outlawed in almost every country, the number of living donors
willing to part with a kidney for free is small. When no family member
is a suitable candidate for donation, the patient is placed on a deceased
donors list, relying on the organs from people dying of old age or
accidents. The list is long. With over 60,000 people in line in the United
States alone, the average wait for a cadaverous kidney is ten long years.
Daunted by the low odds, some have turned to an alternative solution:
purchasing kidneys on the black market. For about $150,000, they can buy
a fresh kidney from a healthy, living donor. There are no lines, no waits.
Arranged through a broker, the entire procedure is carefully planned out.
The buyer, seller, surgeons, and nurses are flown to a predetermined
hospital in a foreign country. The operations are performed, and then all
are flown back to their respective homes. There is no follow-up, no
paperwork to sign (Finkel 27). The illegal kidney trade is attractive not
only because of the promptness but also because of the chance at a living
donor. An organ from a cadaver will most likely be old or damaged,
estimated 5 Necessary background information. • 158 ▲ GENRES academic
literacies rhetorical situations genres processes strategies research
MLA / APA media / design readings handbook ▲ to function for about ten
years at most. A kidney from a living donor can last over twice as long.
Once a person’s transplanted cadaverous kidney stops functioning, he or
she must get back on the donor list, this time probably at the end of the
line. A transplanted living kidney, however, could last a person a
lifetime. While there may seem to be a shortage of kidneys, in reality
there is a surplus. In third-world countries, there are people willing
to do anything for money. In such extreme poverty these people barely have
enough to eat, living in shacks and sleeping on dirt floors. Eager to pay
off debts, they line up at hospitals, willing to sell a kidney for about
$1,000. The money will go toward food and clothing, or perhaps to pay for
a family member’s medical operation (Goyal et al. 1590–91). Whatever
the case, these people need the money. There is certainly a risk in
donating a kidney, but this risk is not great enough to be outlawed.
Millions of people take risks to their health every day for money, or
simply for enjoyment. As explained in The Lancet, “If the rich are free
to engage in dangerous sports for pleasure, or dangerous jobs for high
pay, it is difficult to see why the poor who take the lesser risk of kidney
selling for greater rewards . . . should be thought so misguided as to
need saving from themselves” (Radcliffe-Richards et al. 1951). Studies
have shown that a person can live a healthy life with only one kidney.
While these studies might not apply to the poor living under strenuous
conditions in unsanitary environments, the risk is still theirs to take.
These people have decided that their best hope for money is to sell a kidney.
How can we deny them the best opportunity they have? Some agree with Pope
John Paul II that the selling of organs is morally wrong and violates “the
dignity of the human person” (qtd. in Finkel 26), but this is a belief
professed by healthy and affluent individuals. Are we sure that the
peasants of third-world countries agree? The morals we hold are not
absolute truths. We have the responsibility to protect and help those less
fortunate, but we cannot let our own ideals cloud the issues at hand. In
a legal kidney transplant, everybody gains except the donor. The doctors
and nurses are paid for the operation, the patient receives a new kidney,
but the donor receives nothing. Sure, the donor will have the warm,
uplifting feeling associated with helping a fellow human being, but this
is not enough reward for most people to part with a 10 • • • • • • • •
Reason (donors need the money) supported by evidence. Counterargument
(donating a kidney is risky) acknowledged. Counterargument (selling
organs is wrong) acknowledged. Reason (altruism is not enough) supported
by evidence. 13 / Arguing a Position ▲ 159 piece of themselves. In an
ideal world, the average person would be altruistic enough to donate a
kidney with nothing expected in return. The real world, however, is run
by money. We pay men for donating sperm, and we pay women for donating
ova, yet we expect others to give away an entire organ for no compensation.
If the sale of organs were allowed, people would have a greater incentive
to help save the life of a stranger. While many argue that legalizing the
sale of organs will exploit the poorer people of third-world countries,
the truth of the matter is that this is already the case. Even with the
threat of a $50,000 fine and five years in prison (Finkel 26), the current
ban has not been successful in preventing illegal kidney transplants. The
kidneys of the poor are still benefit ing only the rich. While the sellers
do receive most of the money promised, the sum is too small to have any
real impact on their financial situation. A study in India discovered that
in the long run, organ sellers suffer. In the illegal kidney trade, nobody
has the interests of the seller at heart. After selling a kidney, their
state of living actually worsens. While the $1,000 pays off one debt, it
is not enough to relieve the donor of the extreme poverty that placed him
in debt in the first place (Goyal et al. 1591). These impoverished people
do not need stricter and harsher penalties against organ selling to
protect them, but quite the opposite. If the sale of organs were made legal,
it could be regulated and closely monitored by the government and other
responsible organizations. Under a regulated system, education would be
incorporated into the application process. Before deciding to donate a
kidney, the seller should know the details of the operation and any hazards
involved. Only with an understanding of the long-term physical health
risks can a person make an informed decision (Radcliffe-Richards et al.
1951). Regulation would ensure that the seller is fairly compensated. In
the illegal kidney trade, surgeons collect most of the buyer’s money in
return for putting their careers on the line. The brokers arranging the
procedure also receive a modest cut, typically around ten percent. If the
entire practice were legalized, more of the money could be directed toward
the person who needs it most, the seller. By eliminating the middleman
and allowing the doctors to settle for lower prices, a regulated system
would benefit all those in need of a kidney, both rich • • • • • •
Counterargument (poor people are exploited) acknowledged. Reason
(regulating organ sales would lead to better decisions). Reason (fairness
to sellers) followed by evidence. 160 ▲ GENRES academic literacies
rhetorical situations genres processes strategies research MLA / APA
media / design readings handbook ▲ and poor. According to Finkel, the
money that would otherwise be spent on dialysis treatment could not only
cover the charge of a kidney transplant at no cost to the recipient, but
also reward the donor with as much as $25,000 (32). This money could go
a long way for people living in the poverty of third-world countries.
Critics fear that controlling the lawful sale of organs would be too
difficult, but could it be any more difficult than controlling the
unlawful sale of organs? Governments have tried to eradicate the kidney
market for decades to no avail. Maybe it is time to try something else.
When “desperately wanted goods” are made illegal, history has shown that
there is more opportunity for corruption and exploitation than if those
goods were allowed (Radcliffe-Richards et al. 1951). (Just look at the
effects of the prohibition of alcohol, for example.) Legalization of organ
sales would give governments the authority and the opportunity to closely
monitor these live kidney operations. Regulation would also protect the
buyers. Because of the need for secrecy, the current illegal method of
obtaining a kidney has no contracts and, therefore, no guarantees. Since
what they are doing is illegal, the buyers have nobody to turn to if
something goes wrong. There is nobody to point the finger at, nobody to
sue. While those participating in the kidney market are breaking the law,
they have no other choice. Without a new kidney, end-stage renal disease
will soon kill them. Desperate to survive, they are forced to take the
only offer available. It seems immoral to first deny them the opportunity
of a new kidney and then to leave them stranded at the mercy of the black
market. Without laws regulating live kidney transplants, these people are
subject to possibly hazardous procedures. Instead of turning our backs,
we have the power to ensure that these operations are done safely and
efficiently for both the recipient and the donor. Those suffering from
end-stage renal disease would do anything for the chance at a new kidney,
take any risk or pay any price. There are other people so poor that the
sale of a kidney is worth the profit. Try to tell someone that he has to
die from kidney failure because selling a kidney is morally wrong. Then
turn around and try to tell another person that he has to remain in poverty
for that same reason. In matters of life and death, our stances on moral
issues must be reevaluated. If legalized and regulated, the sale of human
organs would save lives. Is it moral to sentence thousands to unnecessary
deaths? 15 • • • • • • • Counterargument (controlling organ sales would
be difficult) acknowledged. Reason (fairness to buyers) supported by
examples. Concludes by asking a question for readers to consider.
13 / Arguing a Position ▲ 161
Works Cited Finkel, Michael. “This Little Kidney Went to Market.” New
York Times Magazine 27 May 2001: 26–33, 40, 52, 59. Print. Goyal, Madhav,
et al. “Economic and Health Consequences of Selling a Kidney in India.”
Journal of the American Medical Association 288 (2002): 1589–92. Print.
McDonnell, Michael B., and William K. Mallon. “Kidney Transplant.”
eMedicine Health. WebMD, 18 Aug. 2008. Web. 30 Nov. 2008.
Radcliffe-Richards, J., et al. “The Case for Allowing Kidney Sales.”
Lancet 351.9120 (1998): 1950–52. Print. MacKay clearly states her
position at the beginning of her text: “Governments should not ban the
sale of human organs; they should regulate it.” Her argument appeals to
her readers’ sense of fairness; when kidney sales are legalized and
regulated, both sellers and buyers will benefit from the transaction. She
uses MLA style to document her sources.
NICHOLAS KRISTOF Our Blind Spot about Guns
In this essay, which first appeared in the New York Times in 2014,
columnist Nicholas Kristof argues that if guns and their owners were
regulated in the same way that cars and their drivers are, thousands of
lives could be saved each year. If we had the same auto fatality rate today
that we had in 1921, by my calculations we would have 715,000 Americans
dying annually in vehicle accidents. Instead, we’ve reduced the fatality
rate by more than 95 percent — not by confiscating cars, but by regulating
them and their drivers sensibly. We could have said, “Cars don’t kill
people. People kill people,” and there would have been an element of truth
to that. Many accidents are a result of alcohol consumption, speeding,
road rage or driver distraction. Or we could have said, “It’s pointless
because even if you regulate cars, then people will just run each other
down with bicycles,” and that, too, would have been partly true. 162 ▲
GENRES academic literacies rhetorical situations genres processes
strategies research MLA / APA media / design readings handbook ▲ Yet,
instead, we built a system that protects us from ourselves. This saves
hundreds of thousands of lives a year and is a model of what we should
do with guns in America. Whenever I write about the need for sensible
regulation of guns, some readers jeer: Cars kill people, too, so why not
ban cars? Why are you so hypocritical as to try to take away guns from
law-abiding people when you don’t seize cars? That question is a
reflection of our national blind spot about guns. The truth is that we
regulate cars quite intelligently, instituting evidence-based measures
to reduce fatalities. Yet the gun lobby is too strong, or our politicians
too craven, to do the same for guns. So guns and cars now each kill more
than 30,000 in America every year. One constraint, the argument goes, is
the Second Amendment. Yet the paradox is that a bit more than a century
ago, there was no universally recognized individual right to bear arms
in the United States, but there was widely believed to be a “right to
travel” that allowed people to drive cars without regulation. A court
struck down an early attempt to require driver’s licenses, and initial
attempts to set speed limits or register vehicles were met with resistance
and ridicule. When authorities in New York City sought in 1899 to ban
horseless carriages in the parks, the idea was lambasted in the New York
Times as “devoid of merit” and “impossible to maintain.” Yet, over
time, it became increasingly obvious that cars were killing and maiming
people, as well as scaring horses and causing accidents. As a
distinguished former congressman, Robert Cousins, put it in 1910:
“Pedestrians are menaced every minute of the days and nights by a wanton
recklessness of speed, crippling and killing people at a rate that is
appalling.” Courts and editorial writers alike saw the carnage and agreed
that something must be done. By the 1920s, courts routinely accepted
driver’s license requirements, car registration and other safety
measures. That continued in recent decades with requirements of seatbelts
and air bags, padded dashboards and better bumpers. We cracked down on
drunken drivers and instituted graduated licensing for young people,
while also improving road engineering to reduce accidents. The upshot is
that there is now just over 1 car fatality per 100 million miles driven.
5 10 13 / Arguing a Position ▲ 163 Yet as we’ve learned to treat cars
intelligently, we’ve gone in the opposite direction with guns. In his
terrific new book, The Second Amendment: A Biography, Michael Waldman,
the president of the Brennan Center for Justice at the New York University
School of Law, notes that “gun control laws were ubiquitous” in the
nineteenth century. Visitors to Wichita, Kansas, for example, were
required to check their revolvers at police headquarters. And Dodge City,
symbol of the Wild West? A photo shows a sign on the main street in 1879
warning: “The Carrying of Fire Arms Strictly Prohibited.” Dodge City,
Kansas, 1878. The sign reads, “The Carrying of Fire Arms strictly
prohibited.” 164 ▲ GENRES academic literacies rhetorical situations
genres processes strategies research MLA / APA media / design readings
handbook ▲ The National Rifle Association supported reasonable gun
control for most of its history and didn’t even oppose the landmark Gun
Control Act of 1968. But, since then, most attempts at safety regulation
have stalled or gone backward, and that makes the example of cars
instructive. “We didn’t ban cars, or send black helicopters to
confiscate them,” notes Waldman. “We made cars safer: air bags,
seatbelts, increasing the drinking age, lowering the speed limit. There
are similar technological and behavioral fixes that can ease the toll of
gun violence, from expanded background checks to trigger locks to smart
guns that recognize a thumbprint, just like my iPhone does.” Some of these
should be doable. A Quinnipiac poll this month found 92 percent support
for background checks for all gun buyers. These steps won’t eliminate
gun deaths any more than seatbelts eliminate auto deaths. But if a
combination of measures could reduce the toll by one-third, that would
be 10,000 lives saved every year. A century ago, we reacted to deaths and
injuries from unregulated vehicles by imposing sensible safety measures
that have saved hundreds of thousands of lives a year. Why can’t we ask
politicians to be just as rational about guns? Kristof argues that because
regulating cars has made them much safer, guns should be regulated
similarly. He supports his argument with data on fatality rates and the
history of automobile and gun regulation in the United States.
ANDREW LEONARD Black Friday: Consumerism Minus Civilization
This essay arguing that advertising for day-after-Thanksgiving sales has
gone too far first appeared on Salon, where it includes several videos
and links to other websites, which are underlined in this text. The online
version may be accessed via wwnorton.com/write/fieldguidelinks. Here’s
a Thanksgiving recipe guaranteed to deliver a nervous breakdown
impervious to even the most bleeding-edge psychopharmaceutical wonder
drug. Go to YouTube, search for “Black Friday 15 13 / Arguing a Position
▲ 165 commercials,” start watching, and then, once you’ve sated
yourself on grown men screaming at Justin Bieber, remakes of Rebecca
Black’s “Friday,” and, most distressingly, the continuing adventures
of the Crazy Target Lady, ask yourself this question: What does it all
mean? I stared into this heart of retail panic darkness, and the more I
clicked and pondered, the more confused — (mind-boggled? fascinated?
flabbergasted?) — I became. The Crazy Target Lady, so proud of her OCD
— obsessive Christmas disorder — is not funny. She’s scary. She’s why
people trample each other to death. She is wrong. There is a point in our
culture beyond which camp and kitsch no longer make the least ironic sense,
where consumerism loses its last mooring to civilization, where even
seemingly legitimate protest devolves into farce. That point is Black
Friday. Let me be clear. I am not opposed to vigorous sprees of re …
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