Fraser Forum

The Arts: Black market organs—grisly practice or supply and demand?

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Television has long been an effective way to get a look at what’s on the minds of North Americans.

So it was no surprise when my Netflix browsing took me to an episode of the spy-thriller Blacklist about the black market for human organs. This particular black market has been the source of urban legend and inspiration for several grisly horror movies, so discovering that it’s now a topic for television isn’t startling.

What did startle me was the complexity with which the topic was handled. While the show doesn’t present arguments that approach the subtleties of books like Jaworski and Brennan’s recent Markets Without Limits, it seems the writers of the show may, at least, be familiar with some of those arguments.

As the show begins, we meet Dr. James Covington, wanted fugitive. He “was once a respected surgeon, got his M.D. at Yale, fellowship in cardiothoracic surgery at Vanderbilt… He had some kind of meltdown. According to this, he falsified a document and stole a set of lungs from the donor pool. Did some kind of experimental operation on a 10-year-old child.”

We discover, fairly rapidly, how Dr. Covington’s business plan works. His ring of legitimate surgeons illegally supplies him with donor organs from deceased individuals who have not registered as organ donors. He then transplants those organs into people who are not highly placed on the transplant waiting lists—either because of health issues or criminal records. The recipients “rent” the organs for $500,000 a year. If you can’t pay, the organ is “repossessed.”

It’s a grisly scheme, and we are revolted.

But when we meet Dr. Covington, we meet him in the middle of performing a transplant on a small child who has been kept waiting due to the lack of child-sized lungs. As Covington says:

There are strict rules controlling who gets access to donor organs and when. In the present system, they offer adult donor lungs to adults, even if there are children with a more urgent need…Okay, putting adult lungs into children is a risk. But I believe, in many cases, we have an obligation to try. And I’m not the only one. Times are changing. There’s even an official appeals process for these cases now… Look, you can think whatever you want about me, but every dime I’ve made on criminals like Paul Wyatt has been spent to build and operate this place. All that matters today is that there will be no tomorrow for this boy if I don’t do this transplant. The donor material is already here. If we don’t use it, it will die, just like he will.

All of a sudden our grisly bad guy isn’t so grisly, and may not be so bad, after all. And our late night spy show has a moral depth that we weren’t really expecting when we sat down to watch.

I think we are hearing, in this episode of Blacklist, the voice of a culture that is struggling with the hard questions of organ donation. How can it be done ethically? How can we ensure that the right people get the organs? How can we live with waiting lists that let people die? How can we say we have a “good system” if it pushes good doctors, good parents and good people to commit crimes in order to circumvent it? Is tighter prohibition the solution to a black market? Or is a legal market the only way to reduce or eliminate illegal trade?

Blacklist certainly won’t provide any answers to those questions. But because television is such a good barometer of our culture, we’re liable to hear a lot more of those questions asked and, perhaps, answered with surprising moral nuance in the near future. Because if we’re ready to tangle with these topics on our Netflix queues, maybe we’re ready for a serious public discussion.


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