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The Shortage of Transplant Organs
The Wall Street Journal has a front-page article and a debate between Julio Elias and Alvin Roth on alleviating the shortage of transplant organs. This interactive graphic was good at explaining the idea of kidney swaps. Elias and Roth should have discussed no-give, no-take rules and Lifesharers.
I will be speaking to Congressional and agency staff about the organ shortage this Thursday at noon (this event is not open to the public.)
Addendum: Transplant surgeon Arthur Matas, mentioned in the WSJ article, is no libertarian but argues for live kidney sales in a new Cato Policy Report.
Posted by Alex Tabarrok on November 13, 2007 at 10:55 AM in Medicine | Permalink
Comments
While there are still some people who are ignorant or confused enough to oppose compensating organ donors because of some misguided "principle," I believe there are some intelligent, well-meaning people who are simply worried that allowing compensation for organ donors will lead to criminals killing people and harvesting their organs. That is a reasonable (although mistaken) objection that deserves to be respected and addressed.
Other than that, the first class of objections should simply be attacked by asking, "Are you opposed to compensating people who are generous enough to donate their organs? Shouldn't we at least provide them with free universal health care, or the equivalent? Or are you so cruel and heartless that you don't want to help these brave, selfless people? Have you no compassion??"
Posted by: John Fast at Nov 13, 2007 11:51:07 AM
Why should organ donors, particularly kidney donors, be the only people involved in the transplant process to not be compensated?
Posted by: Christina at Nov 13, 2007 12:07:41 PM
John Fast,
If I was willing to kill people in order to steal from them, there would be hundreds of things to steal that would be easier and more lucrative than selling their organs. I'm not sure how much respect that particular objection really deserves. It seems to me like one of many concocted justifications stemming from the bias for supporting the status quo.
Posted by: kebko at Nov 13, 2007 12:17:35 PM
Since there is obviously a shortage or kidneys and organs in general, I think is an intelligent idea to provide an incentive, being cash, to increase kidney and organ supplies. Both the supplier of the organ as well as the receiver of the organ would benefit from this idea although the benefits for the receiver greatly outweigh the monetary reward given to the supplier. The imbalance between supply and demand regarding organs, creating a life or death situation, inspires extreme ideas.
But another idea comes into play, is our society so selfish that it requires pay to donate an organ, in which you can give one up and survive without excessive health risks. This idea questions the lack of compassion and shows the greed among Americans. But will the greed exceed morals causing a new form of crime to arise, where thieves are killing people to harvest their organs. That would be a problem.
Posted by: Shannon2026 at Nov 13, 2007 12:55:44 PM
Re: the possibility that "compensation for organ donors will lead to criminals killing people and harvesting their organs."
If compensation were legally payable to live donors, I'm guessing the scenario would be that the donor enters the transplant center willingly, signs a zillion consent forms and the surgeons involved in the transplant do the harvesting. No back alleys, no unmarked cash in small bills, no "errand boys" rushing around with kidneys packed in cartons of ice.
Maybe with compensation for donations from deceased sources, rampant gang activity is "a reasonable (though mistaken) objection that deserves to be respected," but not in the case of compensation for live donors.
Posted by: Mike Giberson at Nov 13, 2007 1:04:59 PM
Leaving the question of live donors aside, I believe that being willing to donate one's organs at death is a moral issue. I would like all clergy, and all politicians, to tell us whether they have signed organ donor cards, and if not why not.
Posted by: Bernard Yomtov at Nov 13, 2007 2:04:11 PM
shannon,
our society so selfish that it requires pay to donate an organ, in which you can give one up and survive without excessive health risks
If the only way to save the life of a friend of mine was to get into a fight where I would surely get beat up and be hospitalized, with a slight risk to my life, would I do it? Yes.
Would I do it for a stranger? If I had to be honest with myself, I'd have to guess that my answer would be probably not. I'd call the police, but take a beating for nothing, and risk my life?
I'm sorry if you feel that is ignoble, but I am not the only one who feels that way. Replace "take a beating" with "give up a kidney", and the argument still holds.
Sucks, but there it is.
Posted by: happyjuggler0 at Nov 13, 2007 4:16:31 PM
By the way, my driver's license makes it official that my organs (and anything else they can get, like skin) can be harvested after I die. When you're dead you're dead, what difference doe sit make?
But try to tell me I am selfish for getting nothing but lost income while I recover (assuming I recover, which I probably will) from my surgery, at a time when the kidney recipient has a priceless gain, the doctors and nurses and other staff gain nicely, and the hospital gains nicely. I find the notion that selfish can be used to describe my attitude to be a gross misstatement.
Posted by: happyjuggler0 at Nov 13, 2007 4:26:15 PM
Being compensated for selling organs would create, in my opinion, a lucrative market for criminals. Looking at this logically, the demand for organs is high. And what happens when demand is high?? Supply generally increases to meet the wants. Normal people are only able to sell a few of their own organs without passing away, of course.. so how does a clever individual make a profit in this? By acquiring organs from other people by various means.
Perhaps giving one of your organs will be a way to pay off a bookie? You've run up a huge debt and the loan sharks are threatening to break your legs very soon. What to do!? I know what to do; since there is a shortage of donated organs, people should start being compensated for their generosity. In this way, I could fetch 25k for my kidney and the mobsters will finally leave me alone. If the debtor is faint of heart and doesn't want to donate, the criminals could take the organ by force. This sounds terrible, but it's better than having those same individuals murder you. So you wake up in a bathtub of ice, debt free though in pain, you call an ambulance and then life is good again. In the meantime, the mobsters/criminals have sold your organ to a hospital so some lucky child has a chance at a normal life.
I do believe that people should be compensated for all types of bodily donations. It will increase the supply, save more lives, and increase the income of generous people. The market will operate just as the economics would dictate. Supply-demand. Demand-Supply.
Please be wary of the possible black market. Don't run up large gambling debts to a guy name Vinnie who has a cousin who's a doctor.
Posted by: Chris at Nov 13, 2007 4:50:43 PM
Chris, why is the black market discouraged today when trading organs is illegal - and would be encouraged when trading is legal? Shouldn't it be the other way round?
Posted by: andy at Nov 13, 2007 6:31:23 PM
Great article, my 10 year old daughter pointed it out to me this morning.
Posted by: Chris Meisenzahl at Nov 13, 2007 8:31:10 PM
If the law allowed organs sales tha poor would be the seller and the rich the buyer.Then the result would be portrayed in headlines and opeds , In the New York or La Times ,as
" poor harvested for the eternal life of the rich"
Posted by: juancarlos at Nov 13, 2007 8:36:54 PM
Prohibition of organ sales drives up black market costs, and hence organ thievery, not the other way around. Allowance of organ sales would increase the supply of organs for sale, driving down costs, and creating less of an incentive to steal organs.
Remember, black markets always exist, and no organ thief could sell his loot to an honest clinic without being caught. So the number of potential buyers for black-market organs would not even increase. They'd go down along with the price of the organs themselves.
The real mistake is committed by people who expect political issues like this one to follow any sort of logic.
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