So what do you do when the urban legend of waking up in a bathtub with no kidneys happens for real, because thousands of dollars and the small matter of whether the donation was voluntary are trivial to someone who really needs one?

Apologize?

How about other organs?

This reminds me of the people who are outraged that the possession of eagle feathers - or a dead eagle - is a crime, not realizing that the law was passed to keep people from denuding or killing the birds for profit.

There is nothing someone will not do for money, and as you, yourself have pointed out, when you encourage an activity, you should not be surprised when people do it.

Oh. Hmm.

There's a big hang-up people have -- it's OK for you to liquidate your assets and consume immediately, but if you liquidate your assets to maintain your life, the government steps in. Like Quebec and paying for medical treatment.

@Radwaste:

I always think you should make policy around extreme cases like that. There's nothing like giving up freedom to live in fear.

That's worked well when you treat all fathers as potential molesters, and you make sure men can't work in any profession that involves children, right?

We've already seen the part where all abortion policy is set by the fear of ever giving birth to a child of rape or incest. America can't have a single limit on abortion because, well, you know, we need partial birth abortion to protect against the child of incest seeing the light of day.

I read a story in the news just last week of somebody putting semen in dairy products. Maybe we should put those behind the counter and require a DEA waiver for those?

Read Red Market by Scott Carney - he explains why the laws changed in America (hint, hint: unintended consequences coupled with legislators eager to be heroes = disaster) and how that's completely changed the organ donation system.

I don't know Amy. As a libertarian, I respect the rights of individuals to manage their own lives, including any and all decisions regarding their body.
However, as a health care worker, I can see some very bad consequences coming to fruition from auctioning off organs to the highest bidder. Does a reformed alcoholic who happens to be a millionaire deserve that liver more than a teen from the Appalachians simply because he can pay cash to the potential donor? (you can donate parts of your liver and survive just fine). How would we incorporate cash pay options for organ donation while still ensuring those who are deserving but cannot pony up 20 grand still have a chance?

UWG--Steven Jobs got a liver transplant thanks to his fortune. And see how well that worked out?

Personally, I think organ donation should be opt out rather then opt in.

As for burial, I'd like to see a systme where bodies forst go to medical labs for training docs and medical testing, then cremantion, and then burial. Also an opt out system rather than an opt in. Too much good land is taken up by corpses

I confidently predict bad things will happen and people will die, regardless.

The rich will take up medical tourism and the problem is solved, for them. The rest of us can watch some judge or bureaucrat decide that a prisoner is more worthy of donated organs than our loved ones.

Somebody is going to choose. Those in power don't want it to be you.

I saw a PBS (I believe it was actually produced by the BBC) documentary recently about a lack of organ for transplant and body donation for medical research. They presented an interesting stat that if you were able to harvest all the skin, nerves, organs, muscle, etc. the total dollar amount of a cadaver is $250,000.00.

It seems to me that if you allowed an individual, while still alive, or their family after death to be paid for their organs you would probably have more people willing to donate. There would still be disparities in who receives the donation, but if there were an increase in donation it seems more people would benefit.

see, Raddy, this law doesn't change what happened in India, because people with criminal intents don't follow the law.

IT's STILL Illegal to violate a person without consent, regardless if you take the paying for it away.

the real worry for the misguided law is that rich people will remove potential candidates from the donation pool by buying into it.

Still, more people would be IN the pool if it was worth something to them. And rich people will just globetrot.

Also? The government will violate it's own rules if it thinks there is a reason> Jake Adelstein broke the story of Yakuza from Japan getting Liver transplants at UCLA in exchange for information...
http://articles.latimes.com/2008/may/30/local/me-ucla30

I'm a firm fan of opt-out rather than opt-in on donation. I wanted to be cremated, but now I'm thinking burial at sea. Re-enter the food web, take no space. NOt even pollution from burning. I think it may be the way to go.

"see, Raddy, this law doesn't change what happened in India, because people with criminal intents don't follow the law."

Of course they don't.

And we have absolutely no prescription drug crime in America, because prescription drugs are already widely available. Right?

My point is that organs aren't like anything else. However one gets taken from you, you're not getting it back, and I don't see anyone protected, not even by lower risks, by just saying, "OK. Sell 'em!"

On the topic of what to do with our remains when we kick off, Mary Roach wrote an interesting trio of books, called Stiff, Spook, and Bonk. Stiff explores all the gooey things that happen to our bodies when we die, Spook explores our search for an afterlife, and Bonk explores our quest to understand human sexuality (or something like that, I never finished that one). In either Stiff or Spook, she talks about a researcher who is developing a technique that reduces our body to essentially a powdered fertilizer. I kind of thought that would be a nice way to dispose of my remains once the researchers were finished with it.

"However one gets taken from you, you're not getting it back" Radwaste.

I'm not getting your point here. There are laws against you having something taken from you without your consent. This law doesn't address that in any way... It just says you can't be paid for it.

If a criminal wanted to remove your kidney to give it to a yakuza member, what would stop them?

Is your body not your possession? Who is to tell you that you cannot sell something of it?

Can't you sell your eggs? I know you can sell semen, blood products? That's why they want to get a marrow transplant changed to similar to blood, because noone seems to have a problem with that.

There is obvious opportunity for problems with this. Like the kid in china who sold a kidney to buy an iPad. What is the best fundamental way to deal with them?

To say you can donate something you own, but you can't sell it?

Do you want to live in a country where the poor are an organ farm for the rich? Because that's what a free-market solution to the organ-donor issue is.

Bill Gates is not going to sell a kidney for $20 grand.

So you can outlaw the buying of organs across the board, or tie the selling of organs to someone's wealth. Say to how much they spend in a 4-week period. Is a kidney worth $900 to Joe Shlabotnik? Is it worth $90K to Bill Gates? Fine, they can donate an organ.

But pretending $10 or 20K for an organ means the same thing to all Americans is bullshit. Common decency is more important than the free market, and if you can't see that, I probably can't make you.

@Amy: I don't agree with all of Carney's views, but his book is a good overview of some of the weirdnesses of organ donation and does a good (and quick) job of explaining how laws governing organ donation had unintended consequences in the American medical system.
He does a fairly good job of keeping his opinions out of the book, and thought it's not a perfect work, it's still a useful place to start for people curious about why we have the laws that we do about organ donation.

Franko, you are letting perfection be the enemy of the good. How is this possibly an either/or proposition? Are we saying there is no third way?

How is it not altruism for a person to donate the money to an interested party, so that their friend can have a transplant that friend can't afford?

I understand your criticism, and Raddy's as well, but our current system guarantees that people die waiting for donations, and that people who could donate, don't. All to make sure that rich people can't game the system. As if they won't just play medical tourist outside the US.

There has to be a transactional way of doing this, that doesn't unfairly disadvantage anyone. But when you play the poor people organ farm card, you are making sure that no-one will come up with something new, because it's all about emotion.

How many people do you suppose would make sure to have all their organs donated if that would pay for their funeral costs? Does THAT transaction work better for you? It would still be illegal.

Find a way to FIX it, don't just tell me how immoral it is.

I'm sorry, but if you don't see the purchasing of a living person's organs as immoral, then you have no moral compass. It intrinsically implies that the lives of the wealthy are more valuable than the lives of the poor. (I suspect some regular commenters here actually believe that.)

I don't know how you FIX the illegal selling of organs, but I suspect the ethical fix to this problem lies in stem cell research, and eventually the growing of new kidneys, lungs, hearts, etc. in a lab.

> It intrinsically implies that the lives of the
> wealthy are more valuable than the lives of the
> poor.

No, it "intrinsically implies" that money might mean more to some of us than organs or other tissues.

One or two dozen times a year, I donate a pint of platelets... For the cookies at the end, and for the thrill of participating in modern medicine.

If some people wanted to pay me $1,250 for them and others wanted to pay $1,322, what would be the sin in going with the higher bid?

I've already gone with one donation site over another because the commute is easier. Is this not a cost to the site I've avoided?

Commerce, Babe! Values. Pricing. Can't escape it. And when you try to the force markets to conform to your preciousness, they go subterranean. You really don't want that to happen in this case... Getting blood donations to work is tough enough as it is.

Bill Gates is not going to sell a kidney for $1,322. A single mother with four mouths to feed might.

Is that OK by you, Babe? If so, you're kind of a dick.

Well, look at the title of this thread.

Yet, without another government agency with interstate powers policing this, some people are going to be defrauded.

The goal of selling is money, not anyone's welfare.

A single mother? What powers of reasoning got her into that position? Who is caring for her and her offsprung during the recovery?

And let us quit pretending that operations always go well, and that you really have a spare anything to donate for the equivalent of a Toyota Camry.

> Is that OK by you, Babe? If so, you're
> kind of a dick.

See, that's the second time that it's been phrased that way... Not as a clear and specific moral failure, but something pouty, personal and inarticulately schoolyardish.

Yet I don't think you're a decent enough person that your grade school judgments need to be trusted. Since that's how you've phrased them, we have to guess where your concern lies.

Well, yeah... The richest man in the world will always have better options than the impoverished. That's not troubling to me. I don't pretend to live in some magical realm where, because it means so much to us, excellent health care is uniformly available to each of us.

Health care excellence comes from the work of some of the best people, talents who expect to be PAID for giving their effort to that work instead of to financial services or street prostitution. I want them highly motivated; I want people to EARN their health care, every last fucking penny's worth. If we'll all have to work as hard as Gates has, we should get started right away... Boyfriend was famously industrious.

(And for the record, single mothers are almost never my idea of the most deserving poor.)

So, Babe--- Take my dick, and "kind of" shove it up your ass.

That was fun. FRIDAY, Ever'body!

Now that Steve Jobs is no longer alive and gone, we hope that his great work continues to live on as they impact positively on the lives of people.

Funny how many people here think it's their decision as to whether the single mother / poor etc. should sell their organs. Stop trying to control other people, for G-d's sake. Mutually voluntary trade between consenting adults is mutually beneficial - if it wasn't, it wouldn't occur. For busybody third parties to impose bans on those trades by definition is to the detriment of those parties.

"Does a reformed alcoholic who happens to be a millionaire deserve that liver more than a teen from the Appalachians simply because he can pay cash to the potential donor?"

The way you frame the question implies it's somehow any of your/our/my damn business; the assumption of total control over the lives of others is deeply ingrained.