Nobel Prize Winning Economist: Legalize Sale of Human Organs 518
retroworks writes "Dr. Gary Becker (University of Chicago) and Julio Elias (Universidad CEMA, Argentina) wrote a thought-provoking editorial in last week's WSJ, arguing that the prohibition on voluntary sale and trade of human organs is probably killing people. In 2012, 95,000 American men, women and children were on the waiting list for new kidneys. Yet only about 16,500 kidney transplant operations were performed that year. 'The altruistic giving of organs might decline with an open market, since the incentive to give organs to a relative, friend or anyone else would be weaker when organs are readily available to buy. On the other hand, the altruistic giving of money to those in need of organs could increase to help them pay for the cost of organ transplants.' Paying for organs would lead to more transplants, the article maintains. 'Initially, a market in the purchase and sale of organs would seem strange, and many might continue to consider that market "repugnant." Over time, however, the sale of organs would grow to be accepted, just as the voluntary military now has widespread support.'"
False equivalence much? (Score:5, Insightful)
Over time, however, the sale of organs would grow to be accepted, just as the voluntary military now has widespread support.
Over time, however, the sale of bananas would grow to be accepted, just as the Lil' Orphan Annie Fan Club now has widespread support. Wait, what? Oh, they're trying to draw a parallel based on efficacy, as opposed to such piffling concerns as morality. TFA goes on to say "Whether paying donors is immoral because it involves the sale of organs is a much more subjective matter, but we question this assertion, given the very serious problems with the present system." but problems with the current system don't excuse problems with the proposed system.
What could possibly go wrong??? (Score:5, Insightful)
The buying and selling of human organs is a very, very bad idea. May as well grow humans for the body bank if we are going to go down this route. And just like you have theft of other sold goods how long would it take before organ theft became the new wave of crime?
Re:Yes. (Score:5, Insightful)
Because it's exploitative, the way the act of performing surgery is not. Compare to how selling yourself into slavery is illegal, even though theoretically it's "your own body".
cadaveric yes, live no (Score:5, Insightful)
I think allowing the sale of cadaveric organs is reasonable; right now, hospitals and doctors effectively enrich themselves and frequently engage in fraud and nepotism. Getting that money to the family of the deceased is a good thing.
I draw the line at for-pay live organ donations. Taken on their own, they are likely to be beneficial to both recipients and donors. However, once there is a large market and medical facilities for for-profit live donations, the risk of criminal activity in this area becomes much larger, including blackmail and other forms of coercion, and that worries me.
Re:What could possibly go wrong??? (Score:4, Insightful)
The organ theft urban legend has been around for a long time, but organ transplant isn't just something any unethical surgeon can do in the back of a fan. You need to match a donor first, which needs access to a suitable laboratory. Then you need a highly skilled surgeon, and a sterile operating environment, a team of supporting surgeons and nurses, an anesthetist, lots of drugs that are hard to get on the black market (Anasthetic, immunosurpresents, potent antibiotics). Expensive and specialised machines to monitor the recipient*. If organ theft does/could happen, it would have to be an operation so sophisticated and expensive that it could only be the domain of the most powerful of organised crime organisations. The ones who can pay off hospitals to carry out an off-the-books transplant.
*Double that if you intend the donor survive. This part is optional.
Rust (Score:4, Insightful)
Re:Yes. (Score:5, Insightful)
It's not repugnant to perform the transplant and sell a medical service. What's repugnant is to coerce a man in difficult financial position to sell parts of his body that are essential to his well being and survival. It's a lesser form of selling one's own life for the benefit of the rich fuckers of the world.
Re:Yes. (Score:4, Insightful)
Because it's an issue of consent. They are charging for labor and skill. Consent is hard to establish in the case of organs, and it arguably matters much more than with something like a car, or even a house. Is consent present when an unemployed single mother sells a kidney for 30,000 dollars? How about when a guy sells one to pay his credit card debt? Should bankruptcy court consider your organs assets when you file? What about education? 22 year old with 60000 in non-dischargeable debt sells organs to pay off lenders? Do we want people selling organs for capital to start businesses (with a high chance of failure)?
And what happens when the price of organs goes down, because there are so many poor people with this one valuable asset to sell and they sell in large numbers? If the market crashed, it would die, because nobody would be willing to sell, and good luck getting a donation when you can buy one on the market.
Re:Yes. (Score:5, Insightful)
A surgeon charges for his services. What makes selling organs disgusting is the idea of treating the human body as hunks of meat that are priced based on their quality. From a philosophical standpoint it is dehumanizing. From a religious standpoint it is offensive (I'm an atheist though, so maybe I should have skipped this point). From a social standpoint it can be devastating - imagine people starting selling parts of themselves if they need, or just want the cash.
From a pragmatic standpoint it's alarming to think that a mugger now has a financial incentive to butcher me, rather than just taking my wallet and moving on.
Re:Yes. (Score:5, Insightful)
Great plan for "businessmen" (Score:3, Insightful)
Re:False equivalence much? (Score:5, Insightful)
They're economists. They recognize that rich people are dying, while poor people could be paid to to take that risk instead. By removing artificial restrictions, the free market will find the efficiency maximizing solution. Because the solution that a free market finds is axiomatically the best one. /sarcasm
Re:Yes. (Score:5, Insightful)
My agreeing to accept $X for my estate (family/cause/etc) for my liver/cornea/whatever is no more "exploitative" than any other transaction.
I think most people arguing against a market in organs are mainly against compensation to living donors (for their second kidney or whatever), and would be less opposed if compensation was restricted to the families of dead people.
Economist thinking (Score:4, Insightful)
Everyone knows money motivates people. There are other considerations in the prohibition against the sale of organs.
This is why we don't let economists run the world.
Re:False equivalence much? (Score:5, Insightful)
Do they recognize you can kill political prisoners and make a fortune by selling their innards?
In the American south, prison labor used to be common. You'd pay the warden and he'd share that money downward to the guards and police, etc., and prisoners would be sent to work for you for no pay to them. Oddly, the prisons were always full of people who were guilty of being black. There was a financial incentive to keep the prisons full.
If we legalize pay for organs, there's a great incentive for people you don't like to not only wind up in prison, but for them to commit suicide, get shot trying to escape, have accidents, etc.
Too evil. (Score:4, Insightful)
What is evil? I like the AD&D definition - a scale of more and more willing to allow harm to others for your own benefit. Of course, what is seen as harm that matters is the rub.
Would an open organ market save lives - oh, yes, and prohibiting it does cost lives - so one could certainly argue like here that the prohibition is evil.
But allowing such a market will create a society that allows much more willful harm for profit. Right now, organ illegal organ harvesting exists, but is somewhat rare and difficult to make a safe profit from. The legal 'market' is based on donations - so there is no prohibition on the act of getting organs, there's just more people with failing organs than people dying with healthy organs.
The results of allowing an organ market would be an opening bubble resulting in increased harvesting amongst the ethically 'invisible' (poor/isolated), and a greatly increased demand for 'donors' either desperate or false (in order to launder organs). Some of this will be caught, but much of it would become institutionalized.
The endpoint would be a lot of poor people across the world dead and permanently disabled, a lot of wealthy and older people living a few months longer, a relatively few children of the wealthy saved, and a HUGE number of people financially invested in the organ market through their banks and mutual funds.
This last part is the big evil thing - markets always, ALWAYS demand more - more organs, more secrecy, more profitability. They thrive on multiplying evil in terms of harm ('externalities') in order to create better profit ratios.
The whole pattern is just far to evil for me.
I'd suggest putting more money into single-organ cloning (there's been some amazing developments lately), but if there's one thing the market process is HORRIBLE at, it's doing scientific research - it always seems to abandon anything long term, treats it only as marketing, and destroys far too much (to prevent helping 'competitors'.) Taxes, though a limited kind of evil, tend to be much more productive over time for the same result.
Ryan Fenton
Re:Yes. (Score:5, Insightful)
I think most people arguing against a market in organs ... would be less opposed if compensation was restricted to the families of dead people.
Depends on how they wind up dead.
Re:Yes. (Score:5, Insightful)
Re:False equivalence much? (Score:5, Insightful)
If all you have is a Nobel Prize in Economics, everything looks like an expense. [wiktionary.org]
Re:Yes. (Score:5, Insightful)
An open market to sell yourself into slavery also legitimizes your ability to chose that sort of life, that doesn't mean most people using it are not coerced. Financial coercion is just as good as physical coercion for taking a man's liberty away. There's no "free choice" between selling your organs and dying of hunger or seeing your children suffer because you are unable to provide for them.
The black market argument is morronic. There's a black market in just about every despicable activity we can imagine, say child prostitution. Should we legalize child prostitution because we already have a black market choice on the matter ?
They're arguing to legalize more class "warfare" (Score:4, Insightful)
Rich people don't donate organs in exchange for money. EVER. Poor people do. So yeah, let's help those economically poor people become even poorer in body and hasten their exit by letting them sell off pieces of themselves, and good riddance.
Re:Make organ donars have priority access to organ (Score:4, Insightful)
"Another solution would be to repeal motorcycle helmet laws."
Also ban seat belts in cars and make texting while driving compulsory.
Re:False equivalence much? (Score:5, Insightful)
Over time, however, the sale of organs would grow to be accepted, just as the voluntary military now has widespread support.
Over time, however, the sale of bananas would grow to be accepted, just as the Lil' Orphan Annie Fan Club now has widespread support. Wait, what? Oh, they're trying to draw a parallel based on efficacy, as opposed to such piffling concerns as morality.
A voluntary military has the same moral problem. If you pay people to fight wars, you're going to end up with poorer people dying in your wars.
problems with the current system don't excuse problems with the proposed system.
No, but surely he is arguing that the good (reducing deaths resulting from a scarcity of organs) outweighs the bad (problems associated with an organ market).
He is making two different points, first that an organ market would be beneficial, and second, that it could become acceptable in the same way that paying an army has become acceptable, despite the fact that the latter presents a similar moral concern. One might disagree with these assertions, but they do not appear to be as incoherent as you imply.
Economists (Score:4, Insightful)
Now they presented us with a spirited defense of high-tech cannibalism. That is no surprise to anyone at the least familiar with those people. The whole profession of economics is morally and intellectually suspect, and the Chicago school - particularly so.
Re:False equivalence much? (Score:4, Insightful)
Considering that china puts people in prison and harvests their organs, for nothing more than their religious affiliation, it seems reasonable that the market will lead to other "externalities".
Al Roth has done great work with market design, and how to get organs to the people that need them most, by matching incompatible donors reciprocally, however this is another chicago-school "free market fixes everything" nonsense.
Considering the "quality adjusted life years" are coming from somewhere, and most dead people can't consent or benefit from a sale, unless of course you put them into indentured servitude first and "collect" assets upon death.
Re:False equivalence much? (Score:5, Insightful)
What problems? You seem to think that there's some "immoral" reason against the sale of organs. But we have here an example where something which is supposedly "moral' kills a lot of people each year through organ shortages.
Okay how about this problem: In a world where human organs are bought and sold, where do most of those organs come from? The poor. And since they will be expensive, where do they go? To the rich.
Here is another one: In the poorest corners of the world will people have children for the purpose of eventually selling all their paired organs?
Here's a hell of a problematic question: Who gets the money for a heart or any other single organ? And another: When it is legal to trade in some kinds of ivory it is hard to distinguish the legal stuff from the poached stuff. How will we prevent organ poaching? Do we really want to create a strong financial incentive to murder, or worse farm people for their organs?
Saving a life is not always the highest moral result.