Markets In Organ Sales
In "Markets Without Limits," by Jason Brennan and Peter M. Jaworski, Professors of Strategy, Economics, Ethics, and Public Policy at Georgetown U's business school, they take on things many think should not be done. From the Amazon summary of the book:
May you sell your vote? May you sell your kidney? May gay men pay surrogates to bear them children? May spouses pay each other to watch the kids, do the dishes, or have sex? Should we allow the rich to genetically engineer gifted, beautiful children? Should we allow betting markets on terrorist attacks and natural disasters?Most people shudder at the thought. To put some goods and services for sale offends human dignity. If everything is commodified, then nothing is sacred. The market corrodes our character. Or so most people say.
...The question of what rightfully may be bought and sold has a simple answer: if you may do it for free, you may do it for money.
Brennan explains this as it relates to organ sales in the Pan Am Post:
Markets in kidneys are illegal. The government sets the legal price of organs at $0, far below the implicit equilibrium market price. Thus, an economist might say: of course there is a shortage, whenever the legal price of a good is set below the equilibrium price, the quantity demanded will exceed the quantity supplied.Many philosophers and economists thus think that markets in organs will eliminate the shortage. You aren't kind enough to give away your extra kidney to a stranger, but you might do it for $100,000. Defenders of organ sales believe it will save hundreds of thousands of lives annually and will help make the poor richer.
Making kidney markets illegal is quite literally killing people.
Many people think that markets in kidneys would have certain undesirable or exploitative features, but these problems can be overcome by designing and/or regulating the market appropriately.
Consider this: some object that if markets in kidneys were legal, then the price of a kidney would be so high that only the rich could afford it. But, in parallel, some poor people can't afford food. We don't as a result forbid markets in food.
Instead, we subsidize the poor by issuing food stamps. We could issue means-tested kidneys stamps as well. Further, on a free market in kidneys, the price would likely be much lower than it is on the current black market.
Others object that the poor would be exploited by the rich. Even if so, this at best shows not that markets in kidneys should be forbidden, but that only people who are sufficiently rich -- for instance, who make over $60,000 a year -- should be allowed to sell kidneys.
Others object that people will rush to sell kidneys without a full understanding of the risks involved. But, again, at best this shows we should require would-be kidney sellers to be licensed. Before being allowed to sell, they must pass a test, akin to a driver's license exam, showing they understand the costs and benefits.
In the end, some people feel that selling kidneys is just plain wrong, because it somehow violates human dignity or the integrity of the body. But this kind of disgust at kidney markets is quite literally killing people. There is no wisdom in repugnance.
Many things we now regard as normal or the hallmarks of responsibility -- such as life insurance, anesthesia, or being willing to work for a wage -- were once seen as undignified, or disgusting, or "commodifying life." People's lives are at stake here. It's time to grow up and get over our primitive aversion to kidney markets.
Markets in kidneys (and other organs will save a lot of lives). And I suspect it won't stop the deeply generous from giving their kidneys away free.
Kidneys themselves are pretty worthless. All the testing and the transplant surgery is what is expensive.
I will be quite thankful when lab gown organs remove this issue from public debate.
I know a fairly young guy with kids who got guilted into donating a kidney to his dying alcoholic mother years ago. It was a bad choice then, and he is feeling the health effects now, years later.
Isab at August 25, 2019 6:43 AM
I don’t have a problem with selling organs, but I am for regulation. It needs to be worth the donors sacrifice so in my opinion, the amount should be potentially life - changing. Perhaps $200,000 or so at least. That could buy a modest home in middle America or pay for a college education.
What worries me is that the money would be tempting for someone on fire straights but leave them worse off than they were before.
Jen at August 25, 2019 7:27 AM
There are, or should be, certain common sense limits to libertarianism.
Legalizing the sale of organs will legalize the exploitation of the desperate.
While people should be free to make their own decisions - even stupid ones - and live with the consequences, will society also declare that someone who sold his kidney and had the remaining one fail should be left to die if he can't afford his own dialysis? Or will society concede that the exploited should be subsequently cared for on the taxpayer dime?
Conan the Grammarian at August 25, 2019 8:10 AM
Yeah, we have labor laws and such for a reason, and that reason is things were hell for the poor before we did. While I agree that some licensing stuff goes far, "Don't buy kidneys from the desperate" seems like a good rule.
NicoleK at August 25, 2019 9:50 AM
It is issues like this that really reveal the weak arguments of strict libertarians. A society that is unwilling to let people live and die solely by their own choices, and assumes some general responsibility for bad outcomes and poor decision making then has the hard task of decided which behaviors it is going to permit in the name of individual freedom, and which it is going to discourage because of either the perverse incentives those choices create or the unintended consequences.
We don’t live in a closed country. Until we can lab grow organs, the Chinese and the drug cartels in a largely unregulated market will be selling us kidneys, and everything else either harvested from their slave population or grown to order.
I think we need to keep the money out of organ harvesting.
Bet rich people right now are flying to Asia for this sort of thing. Doesn’t mean that we should condone it here.
Isab at August 25, 2019 9:50 AM
"Don't buy kidneys from the desperate" seems like a good rule.
The desperate being people who really need the money?
Ken R at August 25, 2019 10:34 AM
Or are the desperate the ones who really need a kidney?
If you're buying a kidney, chances are you're pretty desperate yourself and the issue is one of survival, not of moral ambiguity or of rules made by others with functioning kidneys.
Conan the Grammarian at August 25, 2019 10:40 AM
I once worked for a biotech company that made wonderful things out of human plasma. They bought plasma from people for $15 for the first donation and $30 for the second within the same week. It took two to four hours each time. People came twice a week for months or years in a row. There was never a shortage of people wanting to sell their plasma at that price, even though we rejected 80% of the people who wanted to.
When I worked for a clinical drug research organization, somehow a rumor got started that we wanted to buy testicles for a research study. We had young men coming in wanting to sell their testicles.
After I explained the risks of taking the study drug to one healthy young man screening to be in a first-in-man study, he said, "From what I understand, the worst thing that could happen to me would be severe, permanent brain damage. I'm really not concerned about that."
Part of my responsibilities at both of the above jobs was catching and disqualifying people who wanted to be in a study but didn't tell us... or denied... that they were taking medications that could interact with the study drug, confound study results, or be made ineffective by study procedures or plasma donation; were taking medications or using illicit drugs that could contaminate plasma or blood and harm other people; had illnesses that could be exacerbated by the study drug, study procedures or plasmapheresis, or confound study results; had HIV, hepatitis or other infectious diseases that can contaminate plasma and blood and harm other people; were pregnant; had serious mental illnesses; couldn't read or write.
Ken R at August 25, 2019 11:33 AM
... Because legalizing prostitution and drug use "with rational regulation" has worked so well.
/libertarian quatsch.
Ben David at August 25, 2019 1:07 PM
I know a fairly young guy with kids who got guilted into donating a kidney to his dying alcoholic mother years ago.
Luckily due to the half dozen near death experience before I was twenty I am pretty much bereft of default guilt and sympathy for people who want me to sacrifice myself for them
Assuming we make organ sales legal, and suicide already being legal, could a man decide to sell all his organs for cash for his family?
If one kidney is 100K what is a heart worth? of a few feet of bowel?
lujlp at August 25, 2019 1:23 PM
Coming next: Antifa conducts a violent riot in favor of organ redistribution.
Gog_Magog_Carpet_Reclaimers at August 25, 2019 5:06 PM
"Legalizing the sale of organs will legalize the exploitation of the desperate."
Naw, government will be in charge of this. What could go wrong? It's not like they'd repeat the decision of the VA, to let people die to reduce their workload...
The sci-fi people have already explored this, and the Chinese government has made it real:
"Some of the more than 1.5 million detainees in Chinese prison camps are being killed for their organs to serve a booming transplant trade that is worth some $1 billion a year, concluded the China Tribunal, an independent body tasked with investigating organ harvesting from prisoners of conscience in the authoritarian state."
Surprise! Did you know you were so far behind this issue?
It's totally OK, though. They're "detainees", not prisoners!
Radwaste at August 26, 2019 8:24 AM
@book summary: ...The question of what rightfully may be bought and sold has a simple answer: if you may do it for free, you may do it for money.
That's a good general rule, but I can think of cases that break it. As written it would mean both cops and congresscritters are free to make "bribe me for X favor" deals with anybody. (Of course that's effectively already true, since the only people with the power to prosecute those officials are all crooked too.)
@Ben David: ... Because legalizing prostitution and drug use "with rational regulation" has worked so well.
Yes, actually, it has.
jdgalt at August 26, 2019 8:08 PM
Of course there is a very simple middle ground that would probably be rather more acceptable. Allow the family of dead people to be compensated for the organs they donate. This might help people who are in a very bad situation -- perhaps they have lost their breadwinner or don't have the resources for a funeral. I know that for me, should I die and leave my family without resources, I'd be happy for them to sell a few of my body parts before they rotted, to easy their burden. But somehow those same body parts are only allowed to leave the burden of some stranger in need or an organ, but not my own family? That is baloney. All the better if some rich person gets it in preference and consequently my family gets more money to support themselves rather than some death panel making the decision.
I don't know how much a kidney would go for, presumably in such an environment the price would be pushed way down (but even if high would still be a tiny fraction of the amount paid to the hospital or doctors.) But a kidney, heart, two livers, lungs, corneas, skin, and other parts would presumably add up into the five figures -- something that could easily help out a family in desperate need.
You could go a level further and allow people to sell future contracts on their organs so that they get the money now, and give up their organs once they are certified dead.
And of course for renewable bodily materials like livers or blood there seems to be little reason to stop it. (Where I live in Illinois selling blood plasma is illegal, but an hour north in Wisconsin it is perfectly legal)
Joe at September 5, 2019 7:41 PM
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