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Nobel Prize Winning Economist: Legalize Sale of Human Organs
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.'"
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.
"You're right," Fisheye says. "I should have set it on 'whip' or 'chop.'"
How much longer until we can grow kidneys? Sure, they'll be expensive, but they'll be grown from your own cells so no rejection problems. A two-tier market would likely exist, new kidneys for the rich, and used kidneys for the non-rich. Eventually the cost will reduce enough to outweigh the cost of anti-rejection medicines, though, and then the human kidney market will disappear.
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?
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Before you go too far down this road, you might want to read some sci-fi Larry Niven wrote back in 70's (I believe). It was set in a future where the market for organs was booming and sale of organs was legal. And as a result, the death penalty had a good revival. After all, that convicted axe murderer could end up saving more lives than he took, if you disassembled him for spare parts. Given that we all want to live longer, who would oppose extending the death penalty?
People die all of the time. Why should someone who can afford to buy an organ be more entitled to live that some poor schmuck who can't?
Once you start allowing the trade, there will undoubtedly be instances of being being killed for their organs (or them being sold on the black market).
A Nobel prize winner in economics has nothing to add to a discussion of medical ethics -- because as far as I can tell, economists have no care or understanding of ethics.
In fact, based on what we've seen over the last several decades, economists have no real care or understand about how the economy works.
Economy is an ideology, and not facts. How you interpret how an economy is working is determined by how you believe it should be working.
And, just because someone believes in things like trickle-down economics or that tax cuts for the wealthy stimulates the economy, there's zero proof or evidence it does -- only your belief that it's supposed to.
Economists are idiots, and should STFU on the topic of medical matters.
The biggest reason why there is an organ supply problem is that there is no incentive for people to give up their own organs. The solution is to create a donor list: if you are on the list you will receive organs before none donors in the event you need one; if you are not on the list then that is your right, but its unethical to expect to receive an organ when you yourself are unwilling to donate. This respects freedom to choose, but it also respects that organs are not completely free; if everyone was willing to give their organs, there wouldn't be a supply issue.
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".
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.
What is it with these Nobel laureates that they are all a bunch of naive idiots?
Here is what is really going to happen. First, government will insist on controlling everything, by establishing regulations and then abdicating their enforcement responsibility to private corporations. Then those private corporations will be the state-mandated middlemen between donors and recipients, and organs will be sold to the highest bidder and harvested from the lowest.
Wealthy, white, and politically-connected patients will get organs, and poor and minority patients will die at higher rates.
Making a market for it, something for rich people could pay (even for cosmetic or fashion reasons, you can drink a lot, because anyway you can replace your liver with a new one) a lot, and poor people on economical troubles, extortion, threats, or media manipulation (to name a few) would sell, is something that will become corrupted very fast. What some countries are doing is opt-out organ donation on death, while that have no market around it should be free of abuses.
Organlegging: Technology needed to deal in illicitly obtained body parts.
Bill Christensen wrote: As far as I know, Niven was the first writer to really work with a topic that is just starting to become a problem, thanks to drugs that make transplantation viable.
davecb@spamcop.net
That strikes me as a MUCH better solution. Well, not quite solution, but it would help a great deal.
Part of the problem with trying to use market ideas to improve the situation is that available organs will always be in VERY short supply. The number of bodies that are actually in a condition to have organs harvested per day is pretty small (except for organs that can non-fatally be removed like kidneys), while demand is pretty high. No matter how good the incentive is, the supply will simply never be there, which means the market would shift to only the very wealthy being able to afford them while today the availably across the economic range is pretty good.
See parents reply:
But a fine example of when is it acceptable to now have a court make you sell a kidney to pay a debt? Slippery slope much?
Why make an incentive for a legal market for people to fence organs too?
There's a lot of issues with this. But at the same time they shouldn't be to much of a problem in a well developed civilized land. Unfortunately there is no such thing. We'll see how people deal with this.
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.
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.
Really, give me a working definition of the word voluntary, that will be universally accepted, that can be used in this context.
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.
You may believe the above makes sense, but I assure you it does not. How can something be both in oversupply, high demand, and unavailable all at the same time ?
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.
It's a bad idea because it will make easier to exploit people. "Go to the ospital, sell a lung, come back, give me the money or several bad things will happen to your family." Suddenly people which were safe because they don't have anything to steal are not safe anymore.
Oh yes and this would give rise to a new species of business plan: Groom the favelas and ghettos of this planet for the illiterate and hopeless, get them to sign a binding agreement, harvest the organs and then export them to the U.S.. If not legal in the country of origin, just fly them to whatever clinics they may have a contract with, harvest there and dump the human trash back where it belongs. This would solve the organ donor problem for just a nominal fee - and give all those valuable business students a great way to earn money... On the other hand those entities could promote organ donor-ship and try not to mess it up like in Germany (where hospitals manipulated the lists to get their patients/the highest bidder to the top of waiting lists and where organ donations have now dropped to an all-time low as a consequence of the scandal).
We have more people than jobs i.e. unemployment. We have a budget deficit.
We also have a shortage of organs for transplant.
I therefore suggest we butcher the unemployed in order to provide organs. Excess viscera will be sold on the open market in order to drive down prices.
echo -e 'global _start\n _start:\n mov eax, 2\n int 80h\n jmp _start' > a.asm; nasm a.asm -f elf; ld a.o -o a;
I met a man in South Carolina who claimed to have sold a kidney for crack. He displayed the most horrible scar, which I could very well have believed to be from the most amateur of surgeons. I remember that he said, "You know those stories that you hear about people waking up in a bathtub full of ice? Yeah, that happened to me."
But he said he'd kicked the habit.
Now, I make no claims as to this man's honesty, only to my own recollection, but surely while the implantation of an organ requires all that you mention, the removal of such is far simpler?
Those who advocate genocide deserve every protection afforded by law, and none afforded by common human decency.
The solution is to create a donor list
Actually, this solves nothing. The vast majority of people will never need an organ replaced, and it is something they just don't think about. Most people are non-donors because it is an opt-in system, and they haven't made the effort to check the box. A far better solution is to make donating the default, and require people to check the box to opt-out.
Another solution would be to repeal motorcycle helmet laws. Most motorcyclists are young and healthy, and death by a good clean head injury often leaves plenty of other organs intact and available for donation.
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.
At least in the US, this is 100% wrong. If you donate a kidney and later need one, you are automatically at the top of the list to receive one.
You must be a riot when you get pulled over for speeding.
Faster! Faster! Faster would be better!
Ah, but you must allow the State to control how you use your own body to protect you from making Bad Choices!
Freedom is not a Victimless Crime. :-)
"This post is an artistic work of fiction and falsehood. Only a fool would take anything posted here as fact."
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.
I think the idea is for freshly dead people to do the donating.
There are a lot of financial levers that might make it seem like people had no choice but to sell their organs. And those levers would quickly be used by death-by-spreadsheet monsters. The only thing that I think might mitigate this horrible idea is if the organ sale was for some other life-saving service. IE no money is involved, but a trade in organs or services. You give up this kidney which will save someones life, and in return you get medical care which will save your own life. Or your childs life. You give up your organ (that doesn't match) for someone elses that does.
But it should never be money. Money allows too much distance from the act. It provides blinders to the horror of it all.
And the military gets its support through state-sponsored propaganda at the public's expense. Do you want to be bombarded with ads about how you should "give up your kidney today" sponsored by your government?
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
Crime should be illegal. (That's sarcasm.) The specifics of a criminal's threat are essentially meaningless. Somebody who is deranged enough to use violence or the threat of violence to get money will do so regardless of what specific mechanics are available. What's stopping these people from kidnapping loved ones and sending back body parts until the ransom is paid? That's a pretty classic one. Deranged, violent criminals are going to be deranged, violent criminals no matter what. The merits and detriments of a proposal such as this need to be evaluated outside of a context of law breaking, because, unsurprisingly, law breakers don't care about laws. That's kind of what defines them.
I support the Slashcott and will not be reading or commenting from 2/10/14 to 2/17/14. Beta is steaming pile of dog shit
The real solution is already known: organ donation should be opt-out by default. Studies have already been conducted that organ donation is above 80% or so in countries that adopt an opt-out default, and only 20% or so in an opt-in system. Most people simply don't take the time to opt-in, but they similarly wouldn't take the time to opt-out.
Higher Logics: where programming meets science.
Hell of a ballplayer, but it's evident he was not a decent candidate for transplant.
Happiness in intelligent people is the rarest thing I know.
Ernest Hemingway
Legalise it so that poor people will be incentivized to sell their under-appreciated organs and restore the balance.
Requiem for the American Dream
The butchering argument is one I hadn't thought of yet... And I'd say it's pretty much on equal footing with the "forced to sell kidney to pay debts" scenario. Good one.
The solution is to create a donor list: if you are on the list you will receive organs before none donors in the event you need one/
Not everyone who would benefit from a donation can be a donor. Those most in need of a donor are unlikely to find a place on your donor list.
if everyone was willing to give their organs, there wouldn't be a supply issue.
This isn't simply a problem of supply and demand but of time and place. Doubling the pool of potential - not actual - donor organs doesn't mean you have doubled the number of successful organ transplants.
> 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.
This makes no sense as an argument. An open market legitimizes the ability to choose. The choice is still there NOW, without the proposed market (i.e. the choice is the black market today).
Often wrong but never in doubt.
I am Jack9.
Everyone knows me.
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.
Well, yes, Wage Slavery is a known phenomenon although there doesn't seem to be a connection between wage-slavery and as you put it "postmortem ownership of a no-longer need part of your remains".
Requiem for the American Dream
This then creates an incentive to transition people from the state of living to the state of dead.
Requiem for the American Dream
An opt-out system has been considered here. The problem is that the relatives of the deceased often make trouble, for whatever reasons (religion, emotional issues etc). If the system is opt-out, those relatives can make a much stronger case that donations isn't really what the deceased wanted. If the system is opt-in and one has to make a conscious effort to sign up, the family is far likelier to respect the dead person's wishes.
The problem with the proposed system of giving priority to organ donors is that doctors hate to make decisions on non-medical grounds. If two donors are waiting for an organ and one comes up, it's easy to give the organ to the guy on the donor list, all other things being equal. But things rarely are equal. Might be a young vs. old guy, one might have a better chance to come out of the procedure ok, one might need it more urgently than the other guy, etc. These are facts that a doctor can weigh. But what if he also has to take the donor list into account? My guess is that he won't, and that the donor list status will always play second fiddle to medical considerations. Still, such a system might prompt more people to sign up.
If construction was anything like programming, an incorrectly fitted lock would bring down the entire building...
The solution is to create a donor list
Actually, this solves nothing. The vast majority of people will never need an organ replaced, and it is something they just don't think about. Most people are non-donors because it is an opt-in system, and they haven't made the effort to check the box. A far better solution is to make donating the default, and require people to check the box to opt-out.
My state gives you a discount on the cost of a driver's license if you check "yes" to be an organ donor. $15 for checking a box is motivation for a lot of people.
The only thing necessary for evil to triumph is for it to be pitted against a slightly greater evil
Agreed, but we should not make things easier for them. Legal sales of organs open up too many exploitation scenarios. That's enough for me to keep it illegal without even starting to discuss about the ethics of the thing.
=snip=
The solution is to create a donor list: if you are on the list you will receive organs before none donors in the event you need one
=snip=
And how do you enforce this "pledge"? I think the percentage of welchers might be a bit higher than the local PBS station gets.
Parent poster is not postulating "at the same time". "If the market crashed" is a conditional that itself indicates there are two times being considered, a before and after. "If the market crashed" also sets a condition - if the market for some item crashes, it can't be simultaniously stay in oversupply (it can theoretically start off in oversupply, it just can't possibly stay there). The supply drops precipitately, as nobody with the item wants to sell at those prices. Supply is therefore elastic (extremely so for organs - they'd make a great textbook example).
Demand, in this case, is inelastic if we are speaking of human need, but somewhat elastic if we are using formal economic terms the way some economists use them, as in some economic models only people who can afford what they want to buy at the current prices are considered to count as demand, and not the ones who are 'demanding' the item, but only at a lower price. If 'demand' means everybody who needs an organ, it's just about perfectly inelastic, while if we use the other definition, demand is elastic, but goes UP if price drops.
What, I think, is confusing about the original post is the phrase "and good luck getting a donation when you can buy one on the market.". I suspect the original poster meant 'good luck getting a donation when until recently you could buy one on the market'. This is more reasonable - massive price drops usually create a great deal of lag. People will stop donating gratis thinking the sales market is handling need, and they won't rush to fill out donor cards as the price drops because they will be thinking that dropping prices means the demand is lessening. The demand may in fact not be lessening at all, if the price drop is driven by other factors, (such as vendors evading anti-trust and trying to collude in driving prices down), but organ donation requires a lot of those organs come from people who don't know economics and simply don't act as "rational entities" the way an economist usually means that term.
Who is John Cabal?
There's a lot of this going around. From the top of my head: ...
* Gambling in its various forms: National Lotteries, horses, cards, roulette, dogs, etc...
* Cigarettes, alcohol, the various party drugs
* The cosmetics industry - playing on fear of being unattractive/old to turn a profit
* Firearms industry - playing on people's fear of safety and inability to perform drive-bys effectively
*
All heavily supported by advertising.
Requiem for the American Dream
Crime should be illegal. (That's sarcasm.)
Sarcasm? You mean crime should be legal? :-)
Somebody who is deranged enough to use violence or the threat of violence to get money will do so regardless of what specific mechanics are available.
Low level criminals do dumb, almost spur of the moment things, like rob banks. How dumb do you have to be to do that? There's so much security, and it's so high profile, that you might as well rob a police station instead.
Criminals who commit crimes that require serious planning are another story. For example, kidnapping is rare in this country because it's hard to get away with. Organ donations might be another story. If you choose random victims and plan it well murder is not that hard to get away with. Better yet, use imported organs. There are plenty of countries where, especially with the right connections, you could run a whole organ harvesting operation. Paperwork can always be faked, especially coming from such places.
Can you imagine someone choosing to lose a kidney rather than just declare bankruptcy? I can see the issue if the potential donor is an addict (drug/gambling) but would imagine a mental health checkout as well as the standard medical checks to confirm that a donor is suitable.
Depends on how they wind up dead.
Much of these doom scenarios are based on the assumption that the price of organs would stay high enough to kill people over. If trade in organs was legalized, it is likely that the value of an organ would fall dramatically. The donor box on my driver's license is checked, but I received nothing for that. If people were paid, say $20, for checking the box when they get their license, the number willing to donate would likely skyrocket.
That comparison is ridiculous. The linked article equates an hourly wage with a diluted version of slavery: "similarities between owning and renting a person". leaving out the fact that the "rented" person is not prevented by the employer from quitting.
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.
A random lung, liver, or kidney taken by a random mugger is useless to an individual without a pretty close match involving blood type, tissue type, and organ size.
Unless and until there is a database of citizen DNA, this is unlikely.
In the US, as of June of 2013 (Wiki) about 96,000 of 119,000 folks awaiting transplants were needing kidneys, and 19 on the list die each day. OTOH, Iran started paying for kidney donors in 1988, and within 11 years cleared their waiting lists.
Happiness in intelligent people is the rarest thing I know.
Ernest Hemingway
People are already bought and sold for sexual and other forms of slavery. Now you're going to start a new underground business in which people are bought and sold for harvesting organs. Or maybe when they no longer provide satisfaction in the sexual realm because they've become too old, too scarred up, or just complain too much, they can still provide a return on the investment in them by harvesting their organs and selling them to the highest bidder. Hell, why stop at internal organs? You can probably make some nice leather goods from the skin, soap from the fat, and glue from the bones. Oh wait, didn't someone already do that?
Because it's exploitative, the way the act of performing surgery is not.
It is exploitative if someone is selling an organ to survive--I think nobody wants to see that. A better policy might be that you can donate an organ and be paid for it (or maybe have a donation made to a charity) if you go through a quick credit check to basically make sure you're probably not being exploited. (The downside is the people who couldn't get the money are the ones who most need it, but there's much less risk of exploitation.)
"Go to the hospital, sell a lung, come back, give me the money or several bad things will happen to your family."
Add regulatory burden.
Requirement for psychological evaluation; DNA sample + gene sequencing. Requirement potential sellers take a lie-detector test, show they are in good health financially and physically --- that they have the financial means to repay all debts, and confirm that they are conducting the sale willingly, not under duress, and not for booze money, or to repay some consumer debt or predatory loan.
Requirement, that if they are filing for bankruptcy, the bankruptcy must be completed first, and cash proceeds or assets purchased using dollars received from the sale cannot be held, frozen, or seized, and used to pay creditors, cannot be used to satisfy a judgement or unpaid dollars owed for alimony or child support, and cannot be used to cover a tax liability owed to the IRS, or other state or federal governmental entities.
Requirement to sign papers expressing intent to sell an organ and receive a secure document from the feds conveying individual sale approval, with a 6 to 12 month cooldown/waiting period, before a sale and transplant can be conducted.
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 ?
Think of debts due to hospital bills of a loved one, or having to choose between having two kidneys and letting your kid go to college. If many people started selling "redundant" organs, even for the best of reasons, then standards could shift so that others might do it for not-so-great reasons.. and we get a drop in the average health of poor people, for the advantage of those that are better off.
Hell, imagine having cancer and knowing it hasn't spread to some of your valuable, sellable organs yet... and you can't afford hospital bills the normal way. Most people would do it.
I know I'm invoking the slippery slope argument here, but I think it might be justified.
If you want to increase the supply of donor organs, forget what some idiot economist (oops, redundant) says. Do a sensible thing like start a public service campaign. In NYS you can volunteer to donate your organs after death when you get a driver's license. I've volunteered, and so have many people I know. I suspect a lot of other people just need a nudge. Don't forget lots of poor desperate people for the commercials. Involve clergy too. I'm not aware of any major religion that objects to this practice, and it would be helpful to let people to know that. I've even got a great slogan: Remember folks, your soul can get to heaven faster if you leave your organs behind! Catchy, huh?
You have a good point there! In time, the concept of selling organs becomes even more insidious.
Allowing a person to sell his organs makes his organs just another asset. When that person then declares bankruptcy, the creditors are entitled to his assets. Could that person then be forced to sell off his assets (body organs) to settle the debt? Probably not in the near future, but with the way things are going, a law would be written to mandate just this.
Great plan.
My son was born with only one kidney. According to your logic, it's unethical for him to expect to receive a kidney transplant because he's "unwilling" to donate one.
Many people who need transplants are victims of congenital disease.
The other states should implement this with a $15 increase in fee. :)
Wow, it looks like the mere idea has generated a visceral reaction. Generating awareness of the kidney shortage is perhaps what bothers people most. But I think they make a legitimate case, as follows.
1) It is a mathematical certainty that the current system will not produce the number of kidney donations needed. So as yucky as liberalizing the trade may sound, people on the front lines need people like these economists to be discussing the matter.
2) The authors bring up a very good point that the current restriction creates a bottleneck. One can only donate a kidney once. Most people therefore hold off, not knowing the "future value" of the kidney (e.g., if a closer friend or family member may need the donation). However, many of us who may be unwilling to contribute 100% to someone would possibly consider donating $500 or $1000 to someone. The current system makes a "kickstarter" donation system impossible. And if I'm paid for a kidney, and can put the money in the bank to draw interest, knowing I can buy another kidney back if necessary, it might make me more likely to give one up.
3) For all the hand-wringing about the poor people who will feel the pressure to sell a kidney, there is a very legitimate argument that those poor people should decide on their own if they want $50,000 for a kidney. What merits the state's law against them selling something they own? And what about poor people who need a kidney? Do they stand a better chance if there are fewer incentives, and fewer kidneys?
Stand down, /. mob. At worst, this discussion brings up the inconvenient subject of donation.
Gently reply
They're not taking care of their organs. We should lock them up so the organs are in good shape when someone important needs them.
John McAfee 'It was like that time I hired that Bangkok prostitute; to do my taxes, while I fucked my accountant'
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.
By law ?
So when someone has "changed their mind", strap people down on an operating table by force and anesthetize them? I guess we have precedent with the existing death penalty here.
"Another solution would be to repeal motorcycle helmet laws."
Also ban seat belts in cars and make texting while driving compulsory.
The biggest reason why there is an organ supply problem is that there is no incentive for people to give up their own organs. The solution is to create a donor list: if you are on the list you will receive organs before none donors in the event you need one
Or they could allow each actual donor to provide a short list of people that will be prioritized, in the event, that the donor's organs are harvested. First priority to actual surviving donors, Second priority to 1 extra person listed by the donor for every organ successfully transplanted (In the event any of those people are ever in the future requiring a transplant), Third priority to those who volunteering to donate their organs and their body to science upon their death and also have made a substantial financial contribution to medical research made on their behalf (Substantial = 2% of the person's annual income), and do these things at least 2 years before they are placed on any organ waiting list; Fourth priority to those who who just volunteer to donate their organs after their death.
The problem is the non-donor's condition could be more imminent; the donor might not be so sick. I believe the donor priority is decided mostly by compatibility, distance (geographical closeness), and immediacy of the need.
People who are "better off" - whether because they're smarter, can throw a ball farther, had rich parents, or - god forbid - because they worked harder, saved more, and lived more responsible - will *always* be in a better position than someone who isn't, whether it's for fair or unfair (to whomever's judging) reasons.
Yeah: if the money I'd get from a kidney gave me a chance to beat a much more fatal disease? I'd probably take it too. And that's a rational decision, and a choice not available while the sale is illegal. Correction: not available in the "First world" under good medical conditions.
I pointed this out in another response: you're claiming that two dead in need of organs is better than one.
You're saying that it's ridiculous to compare slavery to the situation of lowly-paid employees trapped in cycle of poorly-paid jobs such that they cannot afford to spend time acquiring skills needed to better their situation?
If so, please go ahead; ridicule the comparison - I dare you :P
Requiem for the American Dream
The economy seems to always adjust to whether people can afford stuff though. Otherwise nobody would sell anything. If people can afford another $30000 in emergencies because they have some organs to sell, the cost of the stuff an average person buys in their life would just go up by a total of $30000. In that way, being able to sell organs while alive would become just another insurance scheme: spend a bit extra over time, so you can afford something big when you really need it.
Personally, the thought of having to actually use that insurance freaks me out. We'd be better off just getting a mandatory regular insurance of said $30k or whatever those organs are worth.
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.
That you can't perceive the useless surgeries that doctors perform wholly for profit as "exploitative" proves that the term is meaningless. And just like suckers will forfeit even their lives to medical scams, people sell themselves into slavery all the time. It's called "getting a job," though these slaves paradoxically feel freer because they cower in fear of being fired...
You pledge that when you die (of natural/accidental causes), your organs will be made available to the first person on the list that makes a similar pledge and needs a donor. The law ensures that's the case. There's no "repo-man" type of organ retrieval. If someone changes their mind, they are removed from the list thus lose any transplant priority and have a chance to rot intact in their grave.
Yes, I absolutely ridicule the comparison of ownership of a person, including free rein to beat them and own their offspring, with the fact that people find themselves in difficult paycheck-to-paycheck situations in dead-end jobs.
Seriously?
My state gives you a discount on the cost of a driver's license if you check "yes" to be an organ donor. $15 for checking a box is motivation for a lot of people.
Which state is this? Is there any data published about how much this increases donation rates?
Where do you live? I'll be right there! :P
Requiem for the American Dream
And what do you do about the people who can't donate their organs for medical reasons? I've had a number of heart surgeries and can't donate donate my organs because of the medications that I take now or have taken in the past. Does that mean if I need a kidney some day, I should be put on the back of the list because I was "unwilling" to donate?
I believe that's sometimes the case. For example, the increases in available loans and grants for secondary education over the past three decades have resulted in university costs rising to absorb pretty much exactly what's available. Nobody should be surprised at this.
And people selling things doesn't (only) depend on the economy adjusting itself. People sell things to get better things (trade in used car for new car, sell house to fund better house) or to finanace a lifestyle (sell stuff, use proceeds to fund a year off somewhere).
FTFY.
If there's an express train to human dystopia, it's a booster-spice rat race, with the fittest undead gaining semi-permanent tenure in every elite economic and political station.
No, I mean... using logic, ridicule the comparison.
It's not enough to just repeat "it's ridiculous"; actually explain how it's not a similar situation, enforced by different means.
Requiem for the American Dream
So when someone has "changed their mind", strap people down on an operating table by force and anesthetize them?
Uhh ... the DMV donor list is for people that are DEAD. So if you die in an accident, the hospital staff can check the ID in your wallet, or do a quick lookup in a database, and see that you are a donor. Then they can quickly harvest the organs before they go bad (which can start to happen in minutes after blood circulation stops).
Dead people rarely change their minds.
I remember the choir of economists praising the virtues of "carbon credits" until everybody noticed that it was all about creating the opportunity for some "investment banking" firms to act as clearinghouses for such "credits" and make a hefty profit out of nothing. I'm wondering if this isn't something similar. Complete with some "high frequency trading" schemes. Remember, this is not some surgeons publishing in a medical journal. It's "economists" airing in WSJ.
But a fine example of when is it acceptable to now have a court make you sell a kidney to pay a debt?
That can be done now. There's no reason except the laws of the land and the near certain outrage of the public why judges in bankruptcy court can't order a bankrupt party to be harvested for their organs in order to pay off a debt.
Oh, that's funny. I was thinking about live donors of kidneys. Nevermind. I agree.
This then creates an incentive to transition people from the state of living to the state of dead.
That's probably the number one reason why people don't check off the organ donor box in the first place.
If that were unabashedly true then the second kidney would never have evolved - and remained - in the first place. Your argument doesn't hold blood.
Instead they're prevented by the society.
Not actually.
Capitalism has a vested interest in keeping an underclass of desperate people, willing to work for rock-bottom, unlivable wages.
But it doesn't have the power to make that happen. In practice, when peoples' labor gets exploited, their wages go up.
"of course you can quit, we have ten people lined up to do your job for less, good luck finding a better job"
And in a society where the employment of people isn't actively discouraged, this threat doesn't have much teeth. The employer has to pay considerable funds to hire and train a replacement, only to have that replacement up and quit.
Requirement potential sellers take a lie-detector test, show they are in good health financially and physically...
The point is that people who are in good financial health and well-enough informed to give legitimate consent don't generally choose to risk their lives to sell an organ for cash. Nobody says "I think I'll roll the dice on a 1 in 400 chance of death associated with this hepatectomy because I'd just like to see an extra twenty grand on my bank statement". Such sales will nearly always be to fulfill some unmet financial need or want.
You're also going to have trouble finding physicians and surgeons to carry out these procedures. Contrary to the perception of them as soulless, money-seeking robots, they tend to actually have pretty refined ethical senses. Speaking as a person who has made a voluntary, altruistic organ donation to a loved one, I have to say that I was thoroughly impressed throughout the process by the efforts made by the transplant team to ensure that I fully apprehended the risks associated with the procedure, and that my choice was entirely voluntary and uncoerced (including bribery or payments).
Among other steps, I underwent a psych screening, physical exams with a couple of doctors, and interviews with a couple of the transplant hospital's surgeons. One thing that very much stuck with me was a conversation with one of the transplant surgeons as part of the informed consent process. He told me that these procedures were already very difficult for these surgeons, ethically speaking, because a very big part of their training emphasizes not carrying out procedures that have no health benefit to the patient. For organ donors, the surgery will never make them better; it can only make them worse, and it may kill them. For surgeons, the absolute worst-case scenario in their line of work is to bring a perfectly healthy patient into the hospital, perform a medically-unnecessary procedure, and debilitate or kill that person who otherwise probably had forty healthy years left. The surgeon I spoke to noted that he hadn't lost any patients yet (knock on wood), but that he knew surgeons who had had the experience. He told me that it had changed them; that it had been enormously traumatic.
While it's not too difficult to find transplant surgeons who can reconcile the ethical dilemma in play when a patient is willing to risk their health for the benefit of a child, sibling, parent, spouse, or other loved one, I suspect that you're going to have a lot more pushback when you ask those same surgeons to hazard the lives of healthy people in exchange for mortgage payments or a new car.
~Idarubicin
Seriously, there is no Nobel prize in economics. There is however a prize setup by the Swedish bank hijacking the prestige of real Nobel laureates. Further members of the Nobel family have spoken out against it.
That's an outright lie. In perfect conditions you might be right. But a single mild poisoning that robs someone of 20% kidney function is completely recoverable with 2 kidneys and a death sentence with 1. There are many many ways to damage kidneys, from something as simple as taking one too many over the counter pills to a flu that results in some kidney damage from not drinking enough fluid. IIRC the average person has suffered almost 20% kidney damage by the time they die.
There is a reason why we have two kidneys. Donation of one is a big deal and an amazing act of generosity.
This is a nice, feel-good sentiment, but such a system would completely break down when you realize that many recipients of organ donation are unable to donate organs themselves because their organs are affected by illness -- that's why they need a transplant.
So, in your proposal, the people who need organs the most should be the people least entitled to them? Yeah, that would be a great system.
Why not just give people a small financial incentive to tick the "yes, I donate all my organs if I die in an accident" box when renewing their driver's license? Offer $50 of public money for ticking that box, and the number of organ donors would probably rise dramatically without putting anyone at risk of exploitation.
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That's right, we should encourage poor people to sell their organs because there are no jobs and the 1% need those organs, dammit.
I'd bet anything that this economist is a "free market" Austrian School type. More evidence that John Galt is a sociopath.
You are welcome on my lawn.
And if you simply allowed compensation for donors there wouldnt be a supply issue either.
I know a lot of people think it's a problem that these organs would be mostly coming from poor people, but think about it. You wouldnt get very far even with a donation system if you only allowed wealthy donors. And naturally offering money for something isnt as tempting to those that have plenty of money already as it is to those that are scraping by.
The whole point to a market is to enable trades that leave both sides better off. A has lots of money, needs a kidney. B has plenty of kidney, needs money badly. They get together and both walk away happy.
Sure, it doesnt work for the guy that has neither money nor kidneys, but then again no system would. That guy is just as screwed today as he would be if sale was allowed.
But a lot of other people, both rich and poor, would benefit. You'd rather have the rich ones die from organ failure, and the poor ones die from the diseases of poverty, rather than let them make a trade that would let both of them live longer? Why?
Does the thought of death disturb you deeply?
=-=-=-=-=-=-=-=-=-=-=-=-=-=-
Friends don't let friends enable ecmascript.
I suspect that you're going to have a lot more pushback when you ask those same surgeons to hazard the lives of healthy people in exchange for mortgage payments or a new car.
Which is why I suggest measures to make sure it can't happen -- place the money in trust, and ensure it can only be spent on wellbeing.
Medical payments for new procedures for the family of the donor would be OK.
Donating the money to a charity selected by the organ donor, would be OK.
That happened with tax deductions for business cars as well. Company directors complained that the purchase of a company car was eating into pre-tax profits, so they got the government to make the loan tax-deductible. The response of car manufacturers? To raise the price-range of their company cars.
Vintage computer adverts: http://www.vintageadbrowser.com/computers-and-software-ads
Am I the only one that EXPECTED to see a Chicago Economist involved?
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That comparison is ridiculous. The linked article equates an hourly wage with a diluted version of slavery: "similarities between owning and renting a person". leaving out the fact that the "rented" person is not prevented by the employer from quitting.
The funny thing is the income difference between the median US citizen and a 0.1%'er is greater now than the same difference between slaves and slave owners back in the days of Rome. Money wise, slaves had a better life than us "free" people.
The banksters and wall street hedge fund managers have taken all the money from the poor, and corrupted the government and have taken all the powers. They have devalued labor to nearly zero compared to the value of the capital, rent and carting. The only thing poor still have left in them to sell to the rich are their organs. They are going to go after that too. They have created enough shills for themselves by giving them Nobel prizes and installing them in Booth School of Economics in the University of Chicago.
sed -e 's/Chuck Norris/Rajnikant/g' joke > fact
Are you an Ancient Egyptian who feels he needs his organs nearby to get into the afterlife.
The world's burning. Moped Jesus spotted on I50. Details at 11.
Yes, the number two being that even honest doctors might be more inclined (without even being aware of it) to interpret ambiguous results as "dead" rather than "alive".
The Tao of math: The numbers you can count are not the real numbers.
The jobs those people tend to do don't require much training.
The Tao of math: The numbers you can count are not the real numbers.
and you'll find plenty of ex-patriot doctors from China talking about prisoners killed for their organs...
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He probably recognizes that being illegal is exactly what makes it a crime. So the obvious way to reduce crime is to legalize it. ;-)
The Tao of math: The numbers you can count are not the real numbers.
when my mother passed I was pretty broke. The mortuary offered to buy her remains from me (I said no).
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On the other hand, giving (resp. selling) an organ while you're alive is exactly what the article is about.
The Tao of math: The numbers you can count are not the real numbers.
You mean, by not wearing a helmet, they opt-in to organ donor? :-)
The Tao of math: The numbers you can count are not the real numbers.
Well, why not take a lesson from the Islamic terrorists and tell people that they'll get dozens of virgins in heaven if they donate organs? Heck, there's evidence they'll even agree to life-ending donations that way! ;-)
The Tao of math: The numbers you can count are not the real numbers.
Oh, that's funny. I was thinking about live donors of kidneys.
How dare you think a Slashdot discussion is about the topic of the article! ;-)
The Tao of math: The numbers you can count are not the real numbers.
Unless you're very, very wealthy. Our last president (Bush jr) signed a law into effect that makes it impossible to discharge debt under $100,000. If you stop paying you're credit cards they just sell all the debt to one company and sue you. When the banks got all that bail out money and no regulation they took that chance to buy up hundreds of smaller cards and debt. Used to be you'd have $10k in debt with 5 companies, and the $2k wasn't enough to sue over. Now there's only a few big players in the industry and they swap debt until they have enough to sue over.
In the South they've got debter's prisons back. The way it works is they company sues, the judge orders $X amount of money to be paid per month, and if you don't pay... well you just violated a judges order. He holds you in contempt of court until you pay, and you stay in jail until your family comes up with the money. Good times...
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if a country is nuts enough to consent to organ sales for cash then I don't think it'll be hard to make the regulations as loose as they need to be....
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What is needed is to expand the search for self donation. The part that they put in you, is you.
http://nvonews.com/2013/04/16/artificial-kidney-transplants-in-5-years-as-rat-kidneys-made-in-lab/ It's most likely a matter of time before improvements are made to allow people to donate to themselves.
Then we will eventually do away with the barbaric practice of removing parts from one person to another, and the idea of selling parts of yourself to support that barbarism unnecessary.
The shepherds did so well protecting the flock that the sheep no longer believed that wolves existed.
The corpratists have made sure the laws were changed so they could slap Made in America on it regardless of what is in it.
We manufacture stuff that is wholly done in China. Not all of the parts were made in China but none of them were made in the US.
All that is needed is some 'expert handwavium' such as a precision finishing touch or calibration, etc.
And as added bonus they can also slap "Union Made" on it.
I'd go on a Vegan diet but the delivery time from Vega is too long. --brownkitty
only a price with an unwieldy name that tries to profit from the official price.
Trust these worthless Chicago School shitstains to think of it.
Not content to rape Third World countries to death (General Pinochet and Chile, Operation Condor, death squads, etc etc), they foist this terrible, ill-conceived idea upon the world. Replacing a strong incentive with a weak one, and introducing many incentives for very bad, immoral behaviour.
Still, to these fucking autistics, the only incentive that matters is the profit motive -- probably because their joke "science" economics knows only how to model financial incentives.
Seriously, fuck the Chicago School, fuck Milton and fuck the Austrians.
It's painfully obvious that those with money can already buy what they want. The rest of us line up, and wait our turn.
It appears that Doc Becker is self medicating; again.
In the fucked up neoliberal world, "freedom" is proportional to how rich you are.
So when you're poor, and up to your arse in debt forced upon you by unscrupulous businesses, you are "free" to sell your organs, because otherwise you are worthless to a system that only measure the value of anything in terms of market value.
That's not the kind of freedom I want.
I have no problem with the harvesting of Gary Becker(head)'s organs, nor Thomas "three chins" Friedman's organs, nor anyone else's organs at the Hoover Institution, which Becker(head) is a paid member of, but once allowed, forced organ harvesting in a predatory monopolistic capitalistic society will be the order of the day, far worse than it now is!
http://online.wsj.com/news/articles/SB10001424052702304149404579322560004817176?mod=WSJ_hpp_MIDDLENexttoWhatsNewsFifth
http://en.wikipedia.org/wiki/Organ_transplantation_in_China
http://www.dafoh.org/
http://www.cbsnews.com/news/hospital-errors-lead-to-dead-patient-opening-eyes-during-organ-harvesting/
...of the rich addicted types who receive said organs before anyone else, and continue with their self-destructive addictions, when another more disciplined individual could have received it and lived far longer . . .
Extremely well articulated, good citizen!
Exactly, pmontra, exactly! As a previous president (unfortunately, it was Jimmy Carter, on whose first presidential campaign I worked as a volunteer) overturned federal anti-usury regulations and laws, with the predicatable outcomes, so this too has an obvious and predictable outcome, where the same type of judge (and there exists plenty of corrupt bastards and bitchez out there of this stripe) who ruled the hedge fundster who illegally ran over a bicyclist didn't have to bother to show up for the court trial (although the bicyclist did) because the hedge fundster was such a busy fellow so also will such swine judge scum rule that in order to pay off "debts" a person must sell their organs, now recognized by law as an asset (similar pattern was legally done with pension funds of bankrupt corporations, etc.)!
I suspect most doctors would be horrified at being suspected of this but I agree with your assessment; unconscious bias is tricky.
Requiem for the American Dream
You said it all, dude! You said it all......
greater now than the same difference between slaves and slave owners back in the days of Rome. Money wise, slaves had a better life than us "free" people
That's totally incorrect, do you have a source for that stat because it sounds completely wrong. The wealth of the Dives vs someone who was a slave is probably the greatest wealth separation in history. Lookup the structure and wealth of Rome and figures like Marcus Crassus or Tiberius Claudius Hipparchus.
One thing missed in all of this is that we are close (relatively speaking)[1][2][3] to being able to grow a number of organs. It's entirely likely that this entire debate will a be a footnote in a future wikipedia article.
By the time infrastructure to support organ sales, the associated legislation, and oversight could be put in place, we would probably be well on the way to therapeutic use of many these advances. In the meantime, it could detract from funding and research efforts if there were an inexpensive (in a strictly financial sense) alternative to synthetic organs, which will likely be expensive initially.
1. http://www.npr.org/blogs/health/2013/07/04/198110553/scientists-grow-simple-human-liver-in-a-petri-dish
2. http://www.nature.com/news/2006/060403/full/news060403-3.html
3. http://www.popsci.com/science/article/2013-08/scientists-engineer-lab-grown-heart-tissue-beats-its-own
This is why we don't let CHICAGO economists run the world.
There are economists out there who don't believe that the market always knows The Answer.
There are good econometrists in Chicago, but when it comes to the broader economy, or even policy recommendations, they seem to fail as much as Minnesota economists. Or, as Larry Summers put it:
"There'd be a set of economists who would sit around explaining that electricity was only 4% of the economy, and so if you lost 80% of electricity you couldn't possibly have lost more than 3% of the economy, and there'd be people at Minnesota and Chicago who would be writing that paper, but it would be stupid!"
I suspect most doctors would be horrified at being suspected of this but I agree with your assessment; unconscious bias is tricky.
There is plenty of evidence that doctors will alter treatments for their own financial benefit. Most doctors work in fee-for-service practices, and have an incentive to keep their patients sick. Doctors working for HMOs are often paid bonuses for keeping costs down by minimizing treatments and discouraging repeat appointments. So HMO doctors are more likely to prescribe preventive treatments. Dentists that work for HMOs, or organizations with similar incentives like Britain's NHS, are four times as likely to use dental sealants (a very effective way to prevent cavities) as dentists in fee-for-service practices.
The idea of there being a database of most citizen dna is not that unlikely, I don't know about the USA but in the UK taking dna samples of anyone arrested (and not necessarily convicted) is routine. Collecting dna is no harder than collecting finger prints and that seems to becoming increasingly something done in schools with little regard to the consequences.
I think it used to be the case you couldn't be catalogued without breaking some law but that no longer seems to be relevant.
Blarney Quality Restaurant, Plants
No, it doesn't do that at all. Have you ever looked at the exclusion criteria for living donors? It's fucking long. They make it long like that because the transplant team want to GUARANTEE that the donor will live the rest of their life without seeing any negative impact.
Careful with names containing L slashdot.org/~AiphaWolf_HK slashdot.org/~AlphaWoif_HK slashdot.org/~AiphaWoif_HK
That's a horrible argument. Your house is an asset even if you own it free and clear, same with your car, yet bankruptcy courts won't even bother looking at how much those are worth even if you live in a mansion - it's completely off limits. So why would they look at an organ as an asset when they already ignore real estate and cars?
Careful with names containing L slashdot.org/~AiphaWolf_HK slashdot.org/~AlphaWoif_HK slashdot.org/~AiphaWoif_HK
This then creates an incentive to transition people from the state of living to the state of dead.
This incentive already exists. There are huge profits in harvesting organs. A kidney transplant can generate $250k in fees. A heart transplant can cost over $1M. It is just that, under current law, none of that money can go to the donor or to the donor's family. The medical system gets to keep it all.
Here is a list of transplant costs, including the cost of "procuring" the organ.
Stupid: rich people don't donate organs FOR MONEY. I said nothing about emotional or philanthropic motivations.
yup, they're economists basing everything around economics.
True, but the proposal is not just economics but economics with a political bias thrown in. For example you could allow selling of human organs to encourage supply while requiring that they are sold to a central agency that then distributes them to hospitals based on where they will be most effective. This would be using economics to encourage supply while still maximizing the life saving potential of those organs by directing them based on medical need and prognosis rather than bank balance. It would probably also work well in the majority of countries which have a national health care system.
While I'm still not sure I really agree with even this it would be one way to use economics to address the stated problem of a lack of supply. Of course it would not let rich people use their money to get preferential access to organs but surely this was an unimportant, unintended side-effect of the original proposal, right?
The "Hello, can we have your liver?" sketch should be changed into something more along the lines of "Give us your liver! This is a robbery!".
Economists are the witch doctors of our times, they have already had too much influence - and I don't mean the Nobel prize banker award winners; which only reflect the banker's agenda at the time they get it-- and it should mean something when they pick the kind of guys they have been in recent times - it has to be getting extremely bad when they pick more reasonable ones.
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"ridicule" does not involve logic:
ridicule
ridikyool/
noun
noun: ridicule
1.
the subjection of someone or something to mockery and derision.
"he is held up as an object of ridicule"
synonyms: mockery, derision, laughter, scorn, scoffing, contempt, jeering, sneering, sneers, jibes, jibing, teasing, taunts, taunting, badinage, chaffing, sarcasm, satire;
adding everybody that to the "at death" organ donor list and giving them an option to opt-out? Of course it would have to be ruled out that the person was killed for the sake of the organ donation. Other safe guards would have to be put in place too, but you get the point.
What kind of asshole would opt-out of donating their usable organs after death to those in need? The dead person wouldn't be needing the organs anyway...
People who most need organs (sick people) cannot be donors. People better suited to donate (healthy people) do not need organs.
__
Men with no respect for life must never be allowed to control the ultimate instruments of death.
GW Bu
Meanwhile, you could study the Spanish National Transplant Organization that achieves the highest rate of transplants/inhabitants in the world. Its model requires:
__
Men with no respect for life must never be allowed to control the ultimate instruments of death.
GW Bu
Not exactly, the article is proposing a solution to a shortage of transplant donors. The solution it proposes is a market in organs, which is clearly insane to anyone with a functioning brain.
jythie's proposal is a much saner solution to the same problem, in which (and here I'm putting words into the poster's mouth, but I feel I'm pretty safe) the decision to be on a donor list would be binding, and only those on a donor list or below the age of consent would be eligible for transplants.
That sounds pretty sensible to me.
Dr House (md)
Dr House is fictional character who, if ever made real, would kill probably 90% of the cases he managed.
Ooops. Fed the troll.
What harm to people? Well: generally ensuring someone with a useful organ dies far before their time (gives best quality organs) and have that organ harvested. If there's money in it someone will do it.
How will people abuse organ trade?
First off, you can go and kill people who aren't in a good position to defend themselves and who won't be missed and harvest their organs. Who? Take e.g. runaway children or orphans, illegal immigrants, homeless people, generally anyone without a social network, and (as previous posts mentioned) people in Mexico, Latin America, and certain countries in South America who antagonise someone who can arrange a murder.
Secondly, offer poor but otherwise healthy people who desperately need money for their children or spouse the following deal: we'll buy your organ (for a reasonable amount), we'll give your family the money, but you agree to be put to sleep so that we can harvest your organ. Illegal in the US, but who cares? You can always take a (voluntary) trip to Mexico or to Columbia to fulfill your end of the bargain.
And how would you like for e.g. the FARC (Google Columbia) to collect its "revolutionary taxes" by kidnapping "enemies of the people" and cutting out their organs? The market doesn't care where the product came from, right?
Besides which the whole idea is totally redundant.
Simply make organ donorship the legal default and you'll have lots of donor organs. And legislate that only people who themselves have signed a legally binding agreement to be a donor after they die (regardless of their families' wishes) qualify for donor organs.
This whole idea is "free market" taken outside the area where it's beneficial.
I'm not so sure that you're right about that. If, say, at eighteen one chose whether or not to be a donor, and that the consequences of that choice were as described above, then many people would choose the donor option. In the UK at least, one makes that choice when applies for a driver's licence (AFAICR). The problem is that the choice isn't binding, as already mentioned by several posters in this thread and others. If that particular ethical dilemma could be navigated and the donorship became a choice of and only of each individual donor, then I think the parent's solution would work.
Currently, I can declare myself a donor - as I and many others already have done - and have that extremely personal decision reversed by traumatised family members. This should not be possible.
Well, since this suggestion is about the current organ donor scheme, which only kicks in when you're dead, I'm not sure that there would be a big problem.
If your medications mean that your organs are no longer in a fit state to be useful to another, then I guess they don't get donated.
The extremely simple suggestion proposed by the GP seems to have generated a great deal of very silly discussion, chiefly from ACs - is there a clever troll around somewhere having a bit of fun?
How? That does't make any sense.
If you are willing to donate organs after your death, you sign up to the list. The list is binding. This means that if you're on the list and you die, your organs are harvested and then the hollow corpse is handed over to the family for an undertaker to stuff with sawdust. Your family is not consulted, the process is automatic and driven solely by a) Your death, and b) Your prior decision.
Once you're on the list, you are eligible for transplants, should they ever become necessary. If you're not on the list, then you're not eligible - unless you're under some age of consent limit. Maybe there's a grace period of a year say, during which you need to make the choice but are still eligible for transplant.
Where's the problem? Or is your comment written under the misapprehension that the GP's proposal applies to live donors, whereas it in fact applies only to dead ones?
Medical payments for new procedures for the family of the donor would be OK.
Wow, that's just sick, and the worst kind of not-OK. "Sorry; your wife's health insurance doesn't provide sufficient coverage for her breast cancer treatment. But we now have an E-Z Pay option where you can sell us your kidney in exchange for a couple of rounds of radiation therapy."
Sick, sick, sick.
~Idarubicin
Well, yes, Wage Slavery is a known phenomenon
Like the Easter Bunny is "known". Just because some claim it exists and others fail to adequately object doesn't make it any more true than the Tooth Faerie. Though, it is true that many have asserted its existance. But as a wage slave, I'm not subject to beatings, and I may quit at any time, without notice. Most of the "bad" connotations of slavery don't exist for wage slaves. All that's left is trading work for livelihood, and that happens even if you are non-slave labor (such as a self-employed tradesman or craftsman). You are a slave when you do something, even if you are a slave to yourself. There is no non-slave, anywhere, if "wage slavery" exists.
Seems those who talk about wage slavery are perfectly ok with slavery, so long as you are your own master, and that's a different issue, but not addressed, as it would reveal their other arguments to be silly.
Learn to love Alaska
A CEO making $10,000,000 per year is a "wage slave" just as much as the janitor. That's another reason why "wage slave" is a silly movement. There exists no non-slave wage. Working is slavery. Working for wages is being a "wage slave". It doesn't matter the type of work or conditions, nor the pay.
Learn to love Alaska
You wouldn't say that if YOU needed an organ...
Or a doctor could have the opposite view, if you're a selfish organ-hoarder, maybe he'll just let you rot.
My idea is: if you are over 23, you can only receive an organ transplant if you have been a registered donor for the prior five years.
In the pool, or not in the pool.
Johnathan Swift himself once proposed something similar to this plan in his work, "A Modest Proposal."
Actually, this solves nothing. The vast majority of people will never need an organ replaced, and it is something they just don't think about.
Well, I think "If you're in a terrible accident and needed a organ transplant, would you like to be at the top or bottom of the recipient list?" will get more attention than "If you die in a terrible accident, woul you like your organs to help save other people?" Of course a lot could probably be achieved by simply making it required to say yes or no when signing up for a health insurance, which seems a rather natural time for it.
Live today, because you never know what tomorrow brings
There is no ethical dilemma. The ban is on organ sales is killing people. The example from Iran clearly shows that selling organs will increase the supply and may also reduce net cost since the long term costs of dialysis exceed the transplant cost (not to mention the lost productivity of someone on dialysis or dead.)
But we now have an E-Z Pay option where you can sell us your kidney in exchange for a couple of rounds of radiation therapy."
You think that's worse than, "Sorry; your wife's health insurance doesn't provide sufficient coverage for her breast cancer treatment.";
"We have to discharge her now. Unless you deposit the cash, there is nothing further we can do."
Of course, it must be remembered that:
there's no such thing as a Nobel prize in economics!
See Fake Nobel
That can be done now. There's no reason except the laws of the land and the near certain outrage of the public [...]
Umm, so in other words it can't be done now?
That's literally every reason apart from physical impossibility. I don't understand the point you're trying to make.
Ah yes, we can't eliminate murder, so let's make it legal.
Are you going to advocate that? No one else will.
I'm merely pointing out that people are dying because we as a society are too stuck up to create regulated markets in organs. We already have unregulated markets in such things so it's not like we're gaining anything on the legal or moral front by banning this.
Logical endpoint of libertarian philosophy
Not at all. I imagine if you had ever tried to understand the philosophy, then you'd find that you would have better things to do with your time than mischaracterize it.
That's literally every reason apart from physical impossibility.
None of which makes the outcome impossible. Hence it is possible for a court to do just that. Supposedly, some Chinese courts have actually done these things, for example, despite the absence of a regulated market in organs.
I don't understand the point you're trying to make.
The original poster was suggesting that the existence of legal organ markets would magically spur courts to harvest organs of bankrupt people. I'm merely pointing out that most courts won't do those things in that scenario for the same reasons they won't do them now.
If health care were better, people wouldn't have to make that decision.
Learn to love Alaska
Sarcasm? You mean crime should be legal? :-)
Sarcasm is "a sharp, bitter, or cutting expression or remark; a bitter gibe or taunt."
Sarcasm is not necessarily ironic.
Learn to love Alaska
I think I asked this somewhere else: in your version of better heath care, would a good surgeon be able to charge more than an average one?
Yes, I would. In the advent that I had enough money to pay someone to give me an organ, I'd still be aware that the point at which someone is will to violate their bodily integrity for money is someone who is so hard up for cash that the issues of consent become irreparably fucked up.
The issues are different if we're only talking organ donation from corpses, but as other people have pointed out, even that creates extremely perverse incentives.
At the very least a rebate on death duties should the family allow organs to be transplanted would be a big incentive.
Build a Man a Fire, and He'll Be Warm for a Day. Set a Man on Fire, and He'll Be Warm for the Rest of His Life.
Or you could find a way to make barter more efficient perhaps? It wouldn't really be that hard to set up a "kidney exchange" where a family or relative who is willing to donate but incompatible could put their kidney on the exchange and in return get one that is compatible. It's not exactly rocket-science. It never ceases to amaze me just how far behind the times economists and other so-called experts really are.
If your only solution to crappy healthcare coverage in the United States (alone among civilized countries) is to sell the organs of the working poor to the wealthy, then you're part of the problem.
~Idarubicin
Easier solution: Just assume *everyone* is ok with donation, unless they have previously expressed their desire otherwise. Allow them to do so via register, carried document, a veto by the next-of-kin or (For the really worried) a 'hands off my organs' tattoo. Hospitals don't take organs from unidentified patients anyway, as there is no medical history. They might be carrying bloodborne disease.
But there'd be a massive decline in Lupus cases, because IT'S NEVER LUPUS (except that one time).
Set-up a morality credit system...where a transplant recipient assumed/presumed/deemed immoral could earn/buy/receive morality credits for sanctioned acts committed/perpetrated/consecrated in their name.
I don't recall being asked that, so you may have asked, but I didn't see. In the socialized medicine I live under, yes, but not while under contract to the government. So you can set up your "private" hospital and charge whatever you want. But if you take a shift working for the government, you get paid the rate contracted regardless of the value you think you are worth, but yes, "better" ones will get higher contract rates.
Learn to love Alaska
It's more along the line that people really can't give up their organs while they're alive and often enough, their death is ultimately due to the failure of one or more of those organs.
Thanks for this, but I hope you don't mind:
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 decrease the surplus population.
FTFY ;-)
You will not drink with us, but you would taste our steel? - Walter Matthau, The Pirates
Some countries have opt-out programs. 80% of their population are donors. They still have a shortage.
Except when the employer and his peers have manipulated the economy to the point where quitting is not a viable option.
No, I don't mind at all. We're all just surplus if we're not on the top of a heap.
I asked because you said "if health care were better, people wouldn't have to make that decision" but it sounds like even when it's 'better', the best care comes at a premium.
No, not "except" then. Even in that case, your employer isn't allowed to beat (or kill) you if he feels your work is sub-par. And there's the thing about his owning your offspring.
That you're even making the comparison is hideous.
Going from what we have to "better" should cost us less than today.
it sounds like even when it's 'better', the best care comes at a premium.
Only because that's what you choose to hear. I had a trip to the hospital and was attended by the best brain surgeon in the country. He happened to be on duty for that shift. I paid less, and got the absolute best care possible.
Learn to love Alaska
In it's place there is homelessness as a threat. No minimum wage employer would even consider buying a slave these days since it would mean providing them with adequate food, clothing, and shelter with no way to push that off on society through food stamps and welfare like they do now.
No, it's not what I "chose to hear" - you said that better surgeons charge more.. That's great that you got the best surgeon in the country by chance. If you wanted to be *certain* you'd get the best, wouldn't it cost more?
Oh, stop it. Homelessness is still a universe apart from being owned by another person.
Right, it's ownership by a group of people, only they don't have to take any level of responsibility for you.
Patchwork Girl, by L Niven.
The better ones don't necessarily charge more. The ones with a private practice do. That you equate the two is your choice, and you've not presented anything to support that. Please do, otherwise, I'll assume you are trying to manufacture attacks on socialized medicine without regard to reality. Perhaps those with a private practice do so because they are inferior, so the private market will result in a poorer result for higher cost, on average.
Learn to love Alaska
Eventually, the advantages of allowing payment for organs would become obvious. At that point, people will wonder why it took so long to adopt such an obvious and sensible solution to the shortage of organs for transplant.
If it's such an "obvious and sensible solution" why did the author require 27 paragraphs to sell it?
Why would he be unwilling? If he's unable, then he'd not get asked to donate, even if willing.
Learn to love Alaska
So since you are so dumb to not understand the difference between unwilling and unable, then this scheme is unworkable?
Learn to love Alaska
In short, I totally agree with the article since I am against slavery.
So, if I can't sell myself into slavery, then the government owns me? You are against slavery so much you are for slavery.
Learn to love Alaska
No, here's why:
http://libertynow.wikia.com/wi...
Government cannot make man richer, but it can make him poorer. - Ludwig von Mises
The same thing applies to organs. The point of the article you linked to was about changing your mind. So what happens if you sell an organ, then change your mind?
Learn to love Alaska
As with any property by selling it you transfer ownership.
So, you can buy it back or if it is not possible you can buy a "new" one.
Government cannot make man richer, but it can make him poorer. - Ludwig von Mises
If you sold yourself into slavery, why couldn't you buy a replacement slave or buy your freedom if you changed your mind?
Learn to love Alaska
Idiot.
I never said anything about a private practice, and I'm not trying to target socialized medicine, only making the point that you can't equalize everything.
I asked whether a better surgeon could charge more and you said they could, and now you say they don't. Is that genuinely true? Are there not a particular hospital or doctor or surgeon that are considered better, which people seek out?
I asked whether a better surgeon could charge more and you said they could, and now you say they don't. Is that genuinely true? Are there not a particular hospital or doctor or surgeon that are considered better, which people seek out?
Nearly all socialized medicine countries allow for private practices. Most also allow for some negotiation to participate within the socalized scheme.
No, there are not "better" places where people seek out. The closest to that is when the system will send you somewhere else for free. The burn units are better in the bigger cities, so smaller regional hospitals will often stabilize and give initial treatment, then ship the patient off to the larger hospitals for recovery and grafts and such.
You word your questions like you are trying to find fault. So I'm deliberately not describing the system in its entirity. When you compare two systems, one will always have some benefit over another. If you were genuinely interested, there are piles of sites describing the systems, so if you were just curious, you could look elsewhere. If you are trying to elicit an expected response to attack it on a forum, then you'd aske the questions you are.
There's nothing that prevents private practice, so the better doctors can charge whatever they like. And there are incentives within the socialized system to reward good doctors. No idea if they are logical or effective, but they would satisfy your "can they charge more" question, though they don't cost more to the patient.
I asked whether a better surgeon could charge more and you said they could, and now you say they don't. Is that genuinely true?
A doctor (good or bad) may elect to not join the socialized system and charge whatever they like. As you've now said "I never said anything about a private practice" then you are asking if the better doctors can negotiate with the government for arbitrary salary, which is not true.
If that doesn't answer your question, please re-phrase. I obviously don't understand what you are asking. There is no such thing as a cap on doctors fees, so they can charge whatever they like. But then, when you add in the "not privately" constraint, that substantially changes the initial question.
Learn to love Alaska
Sigh... not getting it. Many people who suffer from chronic illness cannot donate organs because they are not healthy organs, so they cannot be put on the list. Yet, these are the very people most likely to require an organ. Yet, legally (in this "list" scenario), they cannot receive an organ because they are not on the list. How is that not obvious?
I doubt there is a single person alive who cannot donate anything. And even if there are, they can still be on the list, and they probably would have been since before they got sick too.
You made an assumption, which was that you can only be on the list if you can donate an organ upon your death (which like I say, is probably everyone. You'd have to be pretty damn sick to not even be able to donate a cornea). No-one, apart from you, has suggested that you can only be on the list if you are likely to be healthy enough upon your death to donate an organ. If that were the rule, I agree, it would make no sense. But I don't think it's what's being suggested here.