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Body parts for sale

By Mirko Bagaric - posted Tuesday, 12 June 2007

There are about 20 million spare kidneys in Australia - one for each man, woman and child: and a kidney given for financial gain works just as well as one donated benevolently. That’s why it is obscene that there are thousands of Australians who spend years on dialysis, waiting for a life-saving kidney that often never comes.

Netherlands based TV program Big Donor should be commended for highlighting the dispiriting plight endured by people with kidney failure. In the show, a terminally ill woman with the assistance of viewers was to select one of three candidates to receive one of her kidneys.

The show turned out to be cleverly crafted hoax, designed to draw attention to the shortage of donor kidneys. The donor was in fact an actress rather than a terminally ill cancer sufferer.


Prior to being announced as a stunt the show attracted world-wide international condemnation. Dutch legislator Joop Atsma blasted the show because it allowed the audience to play “referee on what could be a matter of life and death”.

To the contrary, the program should be praised for illustrating the highly questionable choices that we as a community condone regarding cardinal moral issues.

Doctors and hospital make decisions regarding life and death daily. Life saving body parts are in scarce supply, as are expensive drugs and certain forms of medical treatment. Who should live and who should die is the most fundamental moral issue of our time - and indeed at any time in history.

Decisions of this nature involve highly controversial and contestable judgments regarding the worth of human life. The line that all human life is intrinsically important doesn’t cut it when there is one life-saving kidney but 100 needy patients. In such circumstances it is necessary to decide which life is most valuable.

Momentous decisions of this nature are acutely difficult, but that is all the more reason that they must be made within a transparent framework, which engages the preferences and wisdom of the entire community, as opposed to the whims of well- intentioned, yet sometimes ethically barren medicos.

When we are confronted with difficult ethical choices, in my view the morally correct decision is the one that will maximise net human flourishing, where each person’s interests count equally. In the donor situation, this means preferring the potential recipient who needs it most (i.e., is closest to death) and who, on the basis of age and talent, is likely to contribute most to the community.


Many people will disagree with this framework. And it is exactly for this reason that we need wide-ranging community debate on the issue. Big Donor will no doubt fuel this discussion.

Moreover, the show will highlight the incalculable and unnecessary suffering that our medical system inflicts on sick patients.

In Australia about 9,000 people are alive on dialysis and only about 5 per cent of patients are offered a kidney transplant in any year. The average waiting time for a transplant is four years. About one patient a week dies waiting for a kidney. The cost of dialysis is over $500 million per year.

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About the Author

Mirko Bagaric, BA LLB(Hons) LLM PhD (Monash), is a Croatian born Australian based author and lawyer who writes on law and moral and political philosophy. He is dean of law at Swinburne University and author of Australian Human Rights Law.

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