I've long supported the right to sell an organ, and when I read this article I thought to myself "If I could get fifteen grand for a kidney, I'd sell one."

Then I realized: I don't need compensation. With what I have right now (relative health + lots of vacation time) I can save somebody's life. Wow.

Well, Google for "black market organs" and you'll find a bunch of horrendous stories.

Hey, look, they need a kidney from a healthy pale redhead. I know where I can find one of those...

Good thing I think it's doing the best it can right where it is, huh?

"Normal and legal" is what we have in the US, where donorship, not sales, is the driver. "Price paid", when the market is illegal, includes stiffing the donor, as abundant links show.

Make no mistake about the term, "legal". If the possession of human organs is "legal" and the collection process is not thorough, you get murders and transplanted terminal disease anyway.

Paying for organs is a slippery slope. It's well documented that China and other countries farm out convicts (who can be whoever they want) to the highest bidder. ANd while I think taking care of the death penalty in a way that leaves their organs available is a good idea, I like a need-based system for distributing them.

On the other hand, letting a person sell their own organs? Maybe it would work, except then nobody would donate, and only rich people would get organs. There are a lot of not-rich children out there needing organs. I'd hate to think of some old guy getting a few more years over a child's whole life.

Make no mistake about the term, "legal". If the possession of human organs is "legal" and the collection process is not thorough, you get murders and transplanted terminal disease anyway.

I disagree. If it were legal to sell the organs of deceased relatives, shortages would disappear, the price would drop and there would not be enough profit to justify criminal activity.

The collection process should certainly be thorough anyway.

On the other hand, letting a person sell their own organs? Maybe it would work, except then nobody would donate, and only rich people would get organs.

The article discusses this: a transplant + a lifetime supply of anti-rejection drugs is cheaper than three years of kidney dialysis. Insurance companies would gladly pay, and even more people would be willing to "donate" in exchange for a five figure honorarium.

There is a large difference between donating and selling an organ. It is the selling that opens up problems. here are a few:

Quality control/warranty on an organ?

Can a sold organ be put up for collateral?

Can it be repo'd?

If you injure somebody in a way that prevents organ donation are you also liable for the potential loss of revenue?

Personally, I think this is a stupid idea. The problems it will generate will swallow the savings.

LoneStarJeffe, when those problems have occurred in other areas of life, solutions have been created. There's no reason why the same solutions, or better ones, can't be found for organs.

Here are my off-the-cuff answers:

Organ quality is established before it's removed, same as it's done now.

A person can't be mortgaged, so an organ could only be used as collateral if it were in external storage. Presently the technology for that is poor, but some tissues (such as gametes) are able to be stored indefinitely, and if they were found to have value, could be mortgaged like any other possession.

Yes, if you damage someone's property you face civil liability.

The savings are tens of thousands of human lives. None of the problems you've listed so far are equal in magnitude to that.

While not arguing with the sentiments expressed here, can I complain about the title of this post?

If your liver fails, it's the failing liver that kills you, not regulations. A transplant is a really complicated and difficult venture to execute, and it's likely to remain that way for most of humanity for the rest of Earthly existence.

I realize you were trying to be bluntly sarcastic, but sarcasm of that timbre is often lost on modern ears, which take no notice of our modern comfort and safety. Policy isn't always the problem... Sometimes, a bum liver is the problem.

It would be much, much better to say "Transplant regulations interfere with life-saving treatment."

just fyi. current organ transplant rules state that the donor for organs (not tissue, which is why i specify) must be brain dead, not heart dead, which means that the heart is still beating and the ventilator is what's keeping it going. that's actually really really rare, and usually only happens with traumatic accidents. so it's not just any random dead relative that would currently be able to donate. also, the oldest you can be as a donor (dead) is - i believe - 65. a lot of dead people are older than that.
organ transplant policy people are (last i heard) working on a protocol so that heart dead people could become organ donors. it would have to be within a certain number of hours of death, etc. but the restriction on type of death is a big reason for the shortage all by itself.
i think there are a lot of problems that would come from allowing the sale of organs. perhaps none that couldn't be remedied, but problems nonetheless...

As the death toll from the organ shortage mounts, public opinion will eventually support an organ market. Changes in public policy will then follow.

In the mean time, there is an already-legal way to put a big dent in the organ shortage -- allocate donated organs first to people who have agreed to donate their own organs when they die. UNOS, which manages the national organ allocation system, has the power to make this simple policy change. No legislative action is required.

Americans who want to donate their organs to other registered organ donors don't have to wait for UNOS to act. They can join LifeSharers, a non-profit network of organ donors who agree to offer their organs first to other organ donors when they die. Membership is free at www.lifesharers.org or by calling 1-888-ORGAN88. There is no age limit, parents can enroll their minor children, and no one is excluded due to any pre-existing medical condition.

Giving organs first to organ donors will convince more people to register as organ donors. It will also make the organ allocation system fairer. Non-donors should go to the back of the waiting list as long as there is a shortage of organs.

> As the death toll from
> the organ shortage mounts...

And there it is again. Y'know, almost nobody is born without all the organs they need. There's no "shortage". Any number of people are born without perfectly-formed, high-performance bodies such that they die on the tennis court in their 105th year. To call it a "death toll", as if some new scourge is about, is dishonest. Quite the reverse is true. There are some magnificent new treatments out there, but they have profound ethical implications for all parties, and so we're moving slowly as the rules for their distribution are forged.

The fact that you think you're right and everyone else is wrong doesn't mean you get to tell lies.

(See also, gay marriage supporters.)

And there it is again. Y'know, almost nobody is born without all the organs they need. There's no "shortage".

The shortage is not of organs inside babies, but of replacement organs. It's perfectly accurate to use "shortage" to refer to a situation where demand is greater than supply.

Actually, in cases of biliary atresia, or renal agenesis, the person ISN'T born with all the organs they need. That argument is specious.

Let alone the folks who need hearts, lungs, kidneys, and pancreases because they stop working later in life.

careful, crid, you might want to change your opinion. i actually agree with you.

> The shortage is not of organs
> inside babies, but of
> replacement organs.

Oh! Why didn't you say so... Is that's all you mean... It's just "replacement organs"! Golly, how are we to fill this need? We'll just dial-in the marketplace, like we did for mortgages....

(I've got, absolutely got to tone down the sarcasm one of these years. This is exactly the cause of exaggerations like the one in the title of this blog post.)

(Well, not really... I think the common habit of rhetorical overreach is a response to other forces, not the popularity of Letterman-style smirking. But I still feel bad...)

(Shux, I'm going to leave it in anyway.)

Try to take a view longer than that of a single afternoon in the life of a well-fed, American Consumer Reports subscriber. Meaningful transfusion of any tissues –meaning blood, of course– didn't really start to go well until almost exactly a hundred years ago. Even today, it's not the sort of project that you can do at home or without years of study, specialized materials, and teams of support. We're not talking about those little yellow turn signal covers that cost so much to replace when you have a bad day in the parking lot at Wal-mart. Your casual phrase "replacement organs" would have seemed laughable to your grandfather. They're not something we've learned to make, they're something we've learned to take (in rare cases, precious conditions, and at tremendous expense) from other people... Often living ones, as in the case of Postrel (whom I've always admired tremendously). For fuck's sake, we're speaking of flesh, and our wording should match the sanctity in which we regard our own.

Aside from biological complexities, the ethics of this are tentacled and delicate... Simplistically applying the mentality of mundane commerce is not a good way to go.

> Actually, in cases of biliary
> atresia, or renal agenesis, the
> person ISN'T born with all the
> organs they need.

Your examples seek to convey much more importance to such cases than their rarity can afford. Yeah, sure... Voyager 1 is 10 billion light years away... Nonetheless, 'what goes up must come down' is a powerfully helpful principle in everyday life.

I understand that birth defects are bad news, and have mentioned them here a couple times. But these exceptions carry little weight... Both because they're so infrequent and because the ethical considerations of birth defects are an enormous matter of their own accord, and deserve separate discussion. That some people are occasionally born without something-or-other is not going to be enough to convince anyone to risk or warp our modern practices & policies.

> That argument is specious.

Watch your mouth, you contention-monger!

> Let alone the folks who need
> hearts, lungs, kidneys, and
> pancreases because they stop
> working later in life.

That answers nothing and only raises more questions. How did they "stop"? Was it like the livers of recipients Larry Hagman and David Crosby, showbiz figures who squandered the privilege of their health with alcohol? What do you mean, "later in life"? What are you calling a "life"?: How will we know when it's merely "later" and when it's really just time to die?

Throughout our history, and through the entire development of conventional morality and righteousness, the failure of the organs you list was nature's way of saying goodnight. Being pro-science isn't nearly enough: I don't think humanity's made any sudden strides in our appraisal of the worth of a life to authorize glib, impulsive approach to these matters.

(Quite the reverse: You'll have noticed from this morning's headlines that sensible thinking about responsible healthcare is hard to come by.)
_______________________________

> i actually agree with you.

Poof! I take it back.

(You don't see the same corrupted logic at play in the gay marriage lunacy?)

Hmmm? Why yes, now that you mention it... I did make my twentieth platelet donation of the year yesterday, and thanks for asking. Also, please consider this photograph of a naked woman, and the caption below.

Oh! Why didn't you say so... Is that's all you mean... It's just "replacement organs"! Golly, how are we to fill this need? We'll just dial-in the marketplace, like we did for mortgages....

I applaud your awareness of the fact that a marketplace is the least efficient way to distribute goods. What we really need is a government bureaucracy to provide transplant organs for those in need. Though now that we have elected Obama, fewer and fewer people over time will become sick, eventually making the issue moot.

i agree with you on the organ transplant issue, crid. don't push it.

Nobody's running for office here. Years of pandering by lefty politicians may have confused people about this this point... We are not here to lull you into touchy-feely submission.

Parts is parts.