Friday, December 9, 2011

organ donor market

As a firm believer in the right of an individual to make bad decisions I was in for a rude awakening when I realised the inconsistency of my opposition to organ selling with my belief that prostitution and drug use should be legal.

organ-donor-cardAlexander Berger, a research analyst for GiveWell, begins his article in NYT rather abruptly:

On Thursday, I will donate one of my kidneys to someone I’ve never met. Most people think this sounds like an over-the-top personal sacrifice. But the procedure is safe and relatively painless. I will spend three days in the hospital and return to work within a month. I am 21, but even for someone decades older, the risk of death during surgery is about 1 in 3,000. My remaining kidney will grow to take up the slack of the one that has been removed, so I’ll be able do everything I can do now. And I’ll have given someone, on average, 10 more years of life, years free of the painful and debilitating burden of dialysis.

Here’s the solution he endorses:

A well-regulated legal market for kidneys would not have any of these problems. It could ensure that donors were compensated fairly — most experts say somewhere in the ballpark of $50,000 would make sense. Only the government or a chosen nonprofit would be allowed to purchase the kidneys, and they would allocate them on the basis of need rather than wealth, the same way that posthumously donated organs are currently distributed. The kidneys would be paid for by whoever covers the patient, whether that is their insurance company or Medicare. Ideally, so many donors would come forward that no patient would be left on the waiting list.

In the end, paying for kidneys could actually save the government money; taxpayers already foot the bill for dialysis for many patients through Medicare, and research has shown that transplants save more than $100,000 per patient, relative to dialysis.

I am for legalizing prostitution and decriminalizing drug use for many reasons, chiefly because they should be personal choices and those we think of as “victims” would get better protection if their choice to victimize themselves would be legal – i.e., their choice would not push them outside the law. And yet I was instinctively opposed to organ donation not realizing that my position made no sense. The Economist states this succinctly:

It is odd that we consider this ethical dilemma when presented with the idea of organ sales, yet largely ignore it when considering similar transactions. What is so different about paying a young man for his kidney and paying him to go off to war or perform any number of jobs that harm his health? All rely, to some extent, on the desperation of the lower-class. In the mid-2000s, as the Iraq war reached its bloody peak, the Pentagon recruited heavily in economically depressed areas. And black-lunged coal miners are rarely the sons of millionaires. Yet there is something icky about organ sales that seems to set it apart.

I’m not a wide-eyed idealist: this emergent media blitz is probably driven by old farts who are tired of being fleeced for new organs. Perhaps the well-publicized health problems of Steve Jobs have also helped.

Such “donations” will happen anyway, but insofar as it is illegal, it’s opportunists and criminals who will benefit the most, while the poor donors, who the laws are seemingly trying to protect, will get screwed.

Sources / More info: eco-organ, bloomberg, nyt-sell, wp-pentagon


  1. "I think it can be fairly said that open-mindedness is a trait common to most libertarians. After all, most of us started out on the left or right wings of the political spectrum, yet moved to the classical liberal position once we heard the arguments in its favour. I have recently seen many members of the club shift their positions on intellectual property, and watch as all of us struggle to resolve the arguments for and against the death penalty or a woman’s right to abortion. Happily, there is an intellectual compass that comes from adopting libertarianism, and that renders most moral problems easily solvable."

  2. "Happily, there is an intellectual compass that comes from adopting libertarianism, and that renders most moral problems easily solvable."

  3. Why the hell shouldn't people be allowed to sell organs to each other? And why shouldn't they be allowed to choose who gets THEIR organ?


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