Giving The Gift Of Life? Well, What If You Want To Sell It Instead?
Kerry Howley writes in the LA Times about the booming business of organ donation, where somebody could make $100,000 from parting out your cadaver -- providing that somebody is a biotech company, not you.
And don't be trying to sell a kidney while you're still with us. Nope, that would be illegal -- meaning, as kidney donor Virginia Postrel has noted -- there are far too few people giving up kidneys relative to very sick people who need them. An excerpt from Howley's piece:
Tissue procurement organizations have a story they sell to donors, and it's one of medical miracles, not booming businesses. As the Ohio Department of Health explains on its donor recruitment website: "Through … tissue donation everyday citizens, just like you, have a chance to make a difference. To be a life saver. To be a hero."Well, that's half the story, and here's the rest: Within the biotech world, miracles and business are one and the same. There is nothing inherently wrong with biotech companies reselling donated tissues. Think of it this way: The Salvation Army — hardly a bastion of greed — sells donated secondhand clothes. Resale is often the best way to get donations to people who need them.
Then again, if you decide to skip the donation bin and sell your outdated suit on your own terms, no politician will stop you. The same should be true for tissue. But federal law has one set of rules for tissue donors and another for businesses.
Saner rules would treat the human body as the increasingly valuable property it is, allowing potential donors to will the value of their bodies as they do the rest of their assets. At the very least, donors should know they're giving to a system that will sell their parts, not a charity that funnels them to those in need.
The major objection to normalizing the tissue trade is already moot. Ethicists and policymakers worry that letting donors (or more precisely their heirs) profit from the market would encourage predatory behavior. But we've seen that behavior — from tissue procurement organizations looking to make a buck within the shadows of a gray market. Recent body-snatching scandals demonstrate the dangers of keeping this trade underground. In a transparent and regulated tissue market, plundering bodies would be harder — not easier — to do.
There is something inherently disturbing about slapping a price tag on a pelvis. But the question of whether it's right or wrong to sell human tissue has already passed us by. We're knee-deep in the body bazaar, and the only remaining question is whether individuals or corporations will set the terms of trade.
The way I see it, your body is yours to sell, rent, fill with drugs or do whatever you want with it -- providing you don't try to make the rest of us pay for it.
Yeah, sure, there will be abuses, but just as we don't ban alcohol because some people are drunk drivers, we shouldn't have laws against you selling a kidney to pay for your college education because some kidney buyers or sellers will engage in something shady.
That's true Amy, but this is the sort of thing where civilization needs to work out the best morality and implement it broadly, and perhaps a little intrusively. A fool who sells a kidney for a ski vacation at 22 could be a tremendous burden to us all as a 36-year-old dialysis recipient otherwise fit to survive another five decades. As with motorcycle helmet laws, it's not enough to say it's your body and you can do what you want with it.
I've made about 160 platelet donations, two per month since a friend died of cancer a few years ago. Two things to note about this. First, these products are in most respects a simple gift (formerly) to the Red Cross and (nowadays) to the UCLA medical center, who package and trade the tissues. These tissues are required by others less fortunate, and it's best if they can be had from people who aren't into drugs and (much) weird sex. Specifically, the community of doctors and patients who need these things can't pay for them without attracting the wrong sources. But the economics have to spark somewhere, and that means donors.
Second, the fact that the Red Cross sells this material does not mean that crass commercial interests are running the show. Treating these products as commodities which must be priced and marketed is what gives them value and makes them practical for distribution and exchange. I could move you to tears with a thousand poems about altruism and compassion, but the words wouldn't do shit for you as a burn victim on the second night; you'd need the fuckin' platelets.
We should resist rhetoric which causes people to think of their bodies and vitality as abjectly pecuniary assets from which clever presentation on Ebay can bring fulfillment. People are weird enough about the blood in their veins as it is.
Crid at March 8, 2007 7:41 AM
That's great that you donate platelets. Likewise, Virginia Postrel's kidney donation. I think a friend of mine is giving one to her mother pretty soon.
I'm not suggesting anyone has all the answers neatly tied up on organ sales from the living -- just that we not reject it out of hand. Furthermore, why shouldn't YOU be able to sell your cadaver off when you die -- to benefit your kids or friends or whomever you want?
Amy Alkon at March 8, 2007 8:11 AM
Because the person who has the money for it might be a Republican. Or a Negro, or a Gay or a Kentuckian, or some other sort of person we don't like very much.
By the way, if you're a swishy conservative brother from Lexington, don't get mad, it was just to prove a point.
Crid at March 8, 2007 8:19 AM
I think Crid has a really strong point that selling off body parts and blood and etc. has potentially serious consequences in the long run - and that these consequences might very well end up making the rest of us pay (not making the rest of us pay for it is actually quite a high standard to reach - we're not nearly the islands that some libertarian thought assumes us to be - unless our society really opts to just let people starve, die without medical care or become indentured servants if things go badly for them): The poor single parent who sells a kidney, then becomes too ill to work, the homeless person who sells tainted blood that gets missed in the system and passed on to several others in surgery (along these lines - have you ever seen a plasma center? and where are these most frequently located? would blood bank$ be any different?), etc. Plenty of examples come to mind. Places where kidney sales are common (India, Brazil) are rife with examples of how organ sales create huge unintended problems, particularly among the uneducated and economically desperate. I don't see how it would be different in the developed West.
I'm with Amy that I wouldn't dismiss the idea of allowing organ sales out of hand, but any policy that permitted them would have to reach a high threshold before I could accept it. Cadaver sales, are a different story - I see no problem with that, and imagine that if such transactions were permitted it would greatly increase available supplies of kidneys, livers, hearts, corneas, and all of the other in-demand body parts.
justin case at March 8, 2007 8:36 AM
Maybe this is a naive way of looking at things, but if you can sell your body parts after you die, then no one will donate anymore right? So then the only people that will be able to receive transplants are rich people. Doesnt seem fair to me.
amber at March 8, 2007 8:40 AM
By the way, if you're a swishy conservative brother from Lexington, don't get mad, it was just to prove a point.
If so, I missed it. Maybe I'm slow because the coffee hasn't kicked in.
justin case at March 8, 2007 8:40 AM
Any experts on this in the house? It seems like cadavers aren't that precious unless they're young and firm and muscular and cute. I favor a somewhat paternalistic and heavy-handed policy about this because a wide-open approach unites two of the shittiest qualities in human nature; greed and a voodoo temperament about one's own body.
Crid at March 8, 2007 8:45 AM
> I missed it.
People who have money aren't necessarily the ones we'll want blessed with transfusions and transplants. It's not just cliche: some things are priceless.
Crid at March 8, 2007 8:48 AM
Well, some people donate their money to causes and some will it to their heirs. Why shouldn't it be your choice? I think people will still donate philanthropically.
Amy Alkon at March 8, 2007 8:49 AM
Do indigent people get transplants? Do the impoverished (except for perhaps, people with VA access) get dialysis or other expensive treatments? I'm not being snarky here at all, but I assume the answer to both of those questions is a qualified no. Not being an expert in these things, I'm totally speculating here, but I think that permitting people to sell cadavers to an organ bank wouldn't change the economics of who gets a transplant much. These things already cost hundreds of thousands of dollars. If anything, cadaver sales might have a perverse effect, and reduce the cost of transplants by increasing the supply of organs.
It's not just cliche: some things are priceless.
In the context of this discussion, I imagine a particularly ghoulish MasterCard commercial.
justin case at March 8, 2007 9:15 AM
Personally, I am all for selling cadavers as well as kidneys. Others profit handsomely for this practice, but we cannot? Seems a little ridiculous to me...
Addressing the point of looming longterm health problems due to those who donate: Personally, I believe the percentage would be quite low. The costs we bare in the health system for those folks who just cannot say no to the four or five Big Macs a week has *got* to be far greater (kidney problems, diabetes, heart problems, etc. etc. etc.)
André-Tascha at March 8, 2007 9:56 AM
Your right to life must include your right to your body - and to sell pieces if you wish.
Crid's dialysis argument against assumes a nanny state healthcare system. I'd reject being my brothers keeper.
Jon at March 8, 2007 10:20 AM
> to sell pieces if you wish.
OK, but no tears. Don't come cryin' when you run out of something and need more, whether it's nickels or thrombocytes. You're a big boy, huh? Fine! Make it happen and leave the rest of us out of it.
Excellent.
Crid at March 8, 2007 10:31 AM
Amber,
The wealthy will always have full advantage in advances in bio-medicine, including longevity procedures, cloning and potential gene therapies.
Crid,
The price would matter on the person's health history. A family health history going back to 150 to 300 years. Also, the person's longevity. Do you want a 68 year old kidneys or a young 18 year old? Blood tests every 6 months would be mandatory.
After 9/11 with all the blood donations from everyone… the Red Cross had to get rid of a great deal of it, because of various blood diseases were detected. (HIV and Hepatitis C) So I am not in favor of mass donations. Remember folks… quality, not quantity. Presently, I am looking into the actual percentage amount of blood supplies the Red Cross had to get rid of because of infectious diseases.
The solution for organ donation is quite simple. Cloning via the I.V. process and long term storage (cloned hearts) in animals that share genetic similarities with humans. i.e. pigs
http://www.cnn.com/2006/HEALTH/conditions/04/03/engineered.organs/index.html
Joe at March 8, 2007 11:15 AM
9/11 had nothing to do with typical donation patterns: People gave blood as therapy. Cloning isn't simple, and it's never "quite simple." It'll never be cheap 'n' easy for darkest Africa or other impoverished places without infrastructure. Wait and see: We're always going to be counting on each other for intimate support as we do today with donations... If it's not one thing, it'll be another.
Crid at March 8, 2007 12:10 PM
"Any experts on this in the house? It seems like cadavers aren't that precious unless they're young and firm and muscular and cute."
Oddly enough Crid, not even an armchair expert here!
But the late Alistair Cooke (permanently elderly Brit author of radio's "Letter from America" since some date B.C. it seemed) sure wasn't YFM or C when they swiped him, presumably for someone to make some money somewhere?
(I still don't really understand the story but it just stuck in my brain.)
From wiki..."There is still a demand for corpses for transplantation surgery in the form of allografts, and modern body-snatchers feed this demand. Tissue such gained is medically unsafe and unusable. The broadcaster Alistair Cooke's bones were allegedly cut up by body-snatchers before his cremation."
Jody Tresidder at March 8, 2007 12:32 PM
I agree Crid. There isn't just one perfect solution. The actual solution will help a great many, but there will always be a percentage that will have an adverse effect of some kind.
My comments did not concern the therapeutic reasons behind the blood drive post 9/11. They were about the standards of the contribution and how it will effect the supply. My fear would be the same if there was an open and legal price on a person's organs. To use an economic term of flooding the market.
Joe at March 8, 2007 12:51 PM
Jody- That was an freaky story. Not that it was more forgivable for Chaplin, just somehow less surprising.
Crid at March 8, 2007 1:09 PM
Interesting note about Cooke and stealing body parts for tissue, but my guess is that the market value of (most)cadavers for organs is nil. My sister works for the Iowa Donor Network, and in order to be usable, organs must come from the body of a brain-dead patient who dies in a hospital with the facilities available to keep the organs alive until harvested (most hospitals in IA don't have this capability). So unless you pre-plan your death pretty carefully, your corpse isn't worth much medically.
Stephanie at March 8, 2007 4:43 PM
I think if I want to sell a kidney to someone
in extreme need, I should have that right. This could keep someone alive. I have 2 good kidneys
and if I feel safe enough to sell one I should be allowed to do so. I shouldn't have to wait until I am dead, plus this could help someone live.
I believe this is my right to do what I want to
with my body.
P. Gautreaux at June 30, 2007 7:41 PM
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