Wednesday, November 5, 2008

Should Radha's Sacrifice be Rewarded ?

Last week I had written the sad but glorious story of Radhakrisnan’s supreme sacrifice. I would like to bring to it a new dimension.
To understand the realities of life in the aftermath of sacrifice, let us go back to Radha’s story. Radha was a married man. In fact his first wife passed away after bearing two of his children. He remarried and has a 10 month old baby. His first two children are technically orphans, though I am sure his second wife will take care of them just like a real mother. The little one will never know the pleasures of a father. Radha’s wife now has the unenviable task of feeding, clothing and educating three children as a single mother. The economic burden is real. Reality comes when the TV crews have packed up and gone home, when homilies have been preached and paeans have been sung, when the public have clapped their palms to soreness. At the end of it all there will remain only the penury of a widowed woman and her three children. We need to examine what the family got out of all the publicity and praise. They got Altruism. Altruism is a nice word. Unfortunately you cannot eat or pay for groceries with it.
Yes! I am suggesting that his family should be rewarded. And why not? When you consider that the woman who received the heart transplant is a dollar millionaire and the recipients of the Kidneys and Liver are probably rich too. They will, hopefully, live meaningful lives because they could afford to pay for a transplant service. At the end of the day we must also remember that all these transplants cost money. The money goes to virtually everybody in the chain. The hospitals, the ambulance owners, the immunologists, the doctors, the surgeons and multiple small beneficiaries all make some money as professional or service fees. The drug companies in fact have a lifetime commitment from these patients with all kind of drugs. The immunosuppressant will ensure a steady prescription of long term medication. In all of this, only the donor or his family is expected to exercise the ‘noble’ virtue of altruism. In the transplant scenario, compensation is a bad word when it comes to rewarding the donor or his family. They are expected to be altruistic. Any benefit accruing to them would be stamped as being unethical, undignified and avaricious.
This question has been often addressed in the context of live voluntary donors who make up a significant number of kidney donors in our country. In this context I would like to address an issue that is different from Radha’s sacrifice. Adult voluntary donors should have the choice to donate their kidney or any organ which will not compromise their own lives. If this is legitimized it will cut out the criminal elements in our system. Malek, who teaches economics at San Jose State University, in an Internet post, questions the noise being made about paid transplants. He says “If money is the catalyst that relieves shortage, and if the money/organ exchange is voluntary, then why prevent this transaction? Obviously, I want the money more than an (extra) kidney, and the sick person wants the kidney more than the money. This is a mutually beneficial exchange.” Contrary to popular belief, these open transactions will cut out the middlemen and the benefits go to the donor and recipient (and of course, the hospital) only. Frank Adam et al., in Contemporary Economic Policy, April 1999 and William Barnett et al., in the Independent Winter Review 2001, ask the same rhetorical question “Who owns my body?”.......I hope it is clear that the answer is not, and should not be, the Government! The argument that the poor are incapable of taking decisions is a specious one. The same with the argument that there are surgical risks to the donor. Malek questions governmental concerns with, “-- but should Government legislate risk taking? Would driving a car be illegal? What about flying? Bungee Jumping? Roller Coasters? Where would it stop?” People may argue that health is all about welfare and ethics, but it is impossible to leave out economics. Henry Hazlitt’s ‘Two main points in economics in one lesson,’ tells us that “bad economists look at the short term, not the long term, and they look at the effect on one group, not all. In other words, good economists consider the unintended consequences of public policy legislation. Obviously, our policy makers do not have good economists advising them, or, if they do, they are ignoring them.” A well made out argument in favour of an open market has been suggested by Nancy Scheper-Hughes of Berkeley, California. She has personally visited and worked in 12 countries and collaborated with national governments to end trafficking of human organs. She argues that ‘everyone under the current system benefits, except the donor’. The patient gets a new kidney. The hospital and physicians are paid. The drug companies get to sell life long drugs. Why should only the donor be governed by altruism??”
Coming back to our present discussion we need to ask if Radha’s family should be compensated. I am certain that Radha’s family should benefit. It would be peanuts for the dollar millionaire to fund an educational scholarship for one of the kids over the next ten years. The same with the other recipients. The Government could chip in with a Government job for his wife. They do it all the time when it brings in votes. If somebody is listening, it might actually mean that Radha’s sacrifice will not only be meaningful to the men and women who got a new lease on life but also to Radha’s family which has been impoverished by the loss of an earning member and a loving father and husband.
George Paul