Property Rights

Would a Legal Organ Market Exploit the Poor?

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Radley Balko yesterday, in a post responding to a juvenile bit of organ-based libertarian-baiting from the Village Voice's Roy Edroso, briefly rebutted the argument that giving people the right to sell their own organs would lead to exploitation of the poor. Today, over at the Volokh Conspiracy, Ilya Somin, who teaches on the subject at George Mason University, gives a more detailed, four-point case against that one objection. Whole thing worth a read.

I'd add one point infrequently made during these debates: As Kerry Howley demonstrated in a classic, award-winning March 2007 Reason article, the buying and selling of body parts in the United States is a widespread, profitable phenomenon. In the words of her subhed: "Everyone's making money in the market for body tissue—except the donors."

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  1. I WILL SOME DAY ENJOY THE TASTE OF MATT WELCH’S LIVER!!

  2. If we can sell the parts can we sell the whole person?

  3. Would a Legal Organ Market Exploit the Poor?

    No.

    On to the next blog post.

  4. The exploitation concern might be valid if we were going to be handing over tens of thousands of dollars in exchange for warm kidneys.

    But if we think a little more creatively about the incentives, we could eliminate concerns about exploitation. What about offering non-monetary benefits like health insurance? Or payments to a donee’s next-of-kin for post-mortem donations.

    The REAL problem people have with paying for organ donation is not exploitation– there are easy ways to get around that– but because it feels somehow repugant. But as Richard Epstein has said on this issue, there are things much more repugnant than paying for organs, like seeing thousands of people needlessly suffer and die.

    That this continues to happen all over the world is one of the great tragedies of our times.

  5. I dunno, Emerson. Why would paying tens of thousands of dollars for a live-donor kidney (far superior, BTW, to a post-mortem kidney) be exploitation? Especially since your second kidney is essentially redundant anyway (your remaining kidney will take up the slack, and kidneys nearly always fail in pairs)?

  6. Wait. Do the poor have fewer kidneys than the rest of us?

  7. I know I’m being a broken record people, but really. Just die.

    No one clings to life more than a narcissist.

  8. I would think the exploitation would come up when the poor couldn’t afford to buy a kidney and I don’t see insurance companies surfing Ebay to get em one.

  9. Exploitation = can’t afford something? Interesting.

  10. Why does every reference to the Volokh Conspiracy always take the form of: “over at the Volokh Conspiracy”? I’ve never seen “over at the Weekly Standard” or “over at the Washington Post”? What gives?

  11. R C Dean, surely you can see that argument being raised if the private sale of organs from live donors comes to America. If I needed a kidney, I couldn’t afford to buy one. Does that mean I am being exploited? No it doesn’t. But the “protectors of the less fortunate” are certainly going to scream loud and long that it is just another travesty executed by those dirty rich people.

  12. “The REAL problem people have with paying for organ donation is not exploitation– there are easy ways to get around that– but because it feels somehow repugant. But as Richard Epstein has said on this issue, there are things much more repugnant than paying for organs, like seeing thousands of people needlessly suffer and die.”

    I agree with the latter half of your statement, though I thought I would comment simply on the ‘repugnant’ issue. Namely, basing public policy simply on what feels repugnant is almost categorically a horrible idea. A hundred years ago, I’d be willing to wager the overwhelming majority of americans found the idea of two dudes sleeping together to be ‘repugnant.’ Going back further, how many slave owners felt owning another person was ‘repugnant?’ My guess…not many.

    The point is, what is ‘repugnant’ is mostly a result of cultural xenophobia. Those things that aren’t familiar to us or common generally make us uneasy. How many Americans are horrified at the prospect of eating dogs or kangaroos? Does it make South Korea and Australia ‘repugnant’ societies because such meals are common?

    We don’t do ourselves, both as individuals and as a society, any favors by dismissing certain practices by giving into our human tendency to fear the unknown.

  13. New Law Gives People the Right to Sell Their Own Organs: poor hardest hit.

  14. The argument always seems to be the poor can’t be trusted to make the right decisions for themselves.

    But what is always left out of these discussions is the fact that organ procurement organizations in the United States have annual revenues of $4 billion. Total revenue for the entire transplant industry, including the payments to the OPO’s is $20 billion. A whole body donation to an OPO or Tissue Bank is estimated to be worth $1 to $2 million to these organizations.

    So it is a farce to say money is not a motivator for players in the system. What harm could come from a system that allows families to have the last and final medical expenses of their love one paid in exchange for donation of their organs?

    With the adoption of the 2006 Uniform Anatomical Gift Act by 37 states and the District of Columbia, harvesting organs couldn’t be easier. Under that law, it is assumed you are a donor unless they can find evidence to the contrary. The act allows for individuals to designate their preference to not be a donor, yet no donor registry run by the OPO industry will take a “no” selection.

    Those who scream the loudest about keeping the system pure and free from commercial free market influences are earning the biggest incomes. If we were talking about copper and Bolivia the issues would be crystal clear. Anytime the basic raw materials are free, abuses are going to happen.

    Check out the information at http://www.DoNotTransplant.com, an organ donor registry that allows any American to designate a “no” answer and allows for the flexibility of changing their designation should just compensation become law in the future.

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

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

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

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

  16. As the death toll from the organ shortage mounts, public opinion will eventually support an organ market.

    More likely, mandatory donation.

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