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Nobel Prize Winning Economist: Legalize Sale of Human Organs

timothy posted about 8 months ago | from the adults-making-choices dept.

Medicine 518

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.'"

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False equivalence much? (4, Insightful)

drinkypoo (153816) | about 8 months ago | (#46005021)

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.

Re:False equivalence much? (5, Insightful)

Anonymous Coward | about 8 months ago | (#46005173)

They're economists. They recognize that rich people are dying, while poor people could be paid to to take that risk instead. By removing artificial restrictions, the free market will find the efficiency maximizing solution. Because the solution that a free market finds is axiomatically the best one. /sarcasm

Re:False equivalence much? (2)

gbjbaanb (229885) | about 8 months ago | (#46005261)

yup, they're economists basing everything around economics.

They could have combined their findings with other areas of expertise - such as common sense - by saying "people are just fucking lazy, so we find that by making organ donation on death the default option, there will be many more organs available that used not to be collected because people were too lazy to fill out the donation form, they'll still be too lazy to fill out the opt-out form".

Any theory that ignores all but one aspect of human nature is ultimate self-serving. In this case, making money for someone.

Re:False equivalence much? (5, Insightful)

wonkavader (605434) | about 8 months ago | (#46005285)

Do they recognize you can kill political prisoners and make a fortune by selling their innards?

In the American south, prison labor used to be common. You'd pay the warden and he'd share that money downward to the guards and police, etc., and prisoners would be sent to work for you for no pay to them. Oddly, the prisons were always full of people who were guilty of being black. There was a financial incentive to keep the prisons full.

If we legalize pay for organs, there's a great incentive for people you don't like to not only wind up in prison, but for them to commit suicide, get shot trying to escape, have accidents, etc.

Re:False equivalence much? (4, Funny)

ebno-10db (1459097) | about 8 months ago | (#46005377)

Even this damnyankee knows the South isn't like that anymore. Wake up, this is the 21st century. You buy organs from China.

Pretty sure the rich/famous already get... (1)

rmdingler (1955220) | about 8 months ago | (#46005319)

some preferential treatment. I remember when Mickie Mantle got a liver transplant in 1995, when his own liver "looked like a doorstop" after 40 years of drinking. He had hepatitis C and cancer, but still got his new liver ahead of many who'd waited much longer, prolonging his life for about two months.

Hell of a ballplayer, but it's evident he was not a decent candidate for transplant.

Re:False equivalence much? (2)

hodet (620484) | about 8 months ago | (#46005423)

I for one welcome that an economist has put it out there. I am not for "organs for cash" but at some point somebody with the power to initiate change will put it on the table and I think its best to have the discussion now. Nobody should be skewered for putting an idea out there, no matter how terrible the idea is. If people actually start thinking about it now they will be better prepared if the idea ever gets any traction.

Would I give my left nut ... (0)

Anonymous Coward | about 8 months ago | (#46005025)

NO! But I would sell my left nut!

Re:Would I give my left nut ... (0)

Anonymous Coward | about 8 months ago | (#46005373)

Exactly why it shouldn't be legalized. People are too stupid for their own good.

Yes. (0)

therealkevinkretz (1585825) | about 8 months ago | (#46005027)

I have been saying this for years. If it's so repugnant to attach a cost to an organ, why isn't it disgusting for the surgeon, anaesthetist, and hospital to charge? The organ itself is the least supply and most demand of those things. Allowing a person (or their estate) to be paid for it will only make more available.

Re:Yes. (5, Insightful)

novium (1680776) | about 8 months ago | (#46005071)

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".

Re:Yes. (1)

Anonymous Coward | about 8 months ago | (#46005115)

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.

Re:Yes. (0)

therealkevinkretz (1585825) | about 8 months ago | (#46005139)

My agreeing to accept $X for my estate (family/cause/etc) for my liver/cornea/whatever is no more "exploitative" than any other transaction. Possibly less so, since I'll be dead and won't miss the part(s) you're claiming I'm being "exploited" out of.

To compare it to slavery is super-silly - if postmortem ownership of a no-longer-needed part of my remains is equal to "slavery" then so is the sale of an hour of my labor to an employer.

Re:Yes. (5, Insightful)

ShanghaiBill (739463) | about 8 months ago | (#46005219)

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.

Re:Yes. (5, Insightful)

ebno-10db (1459097) | about 8 months ago | (#46005395)

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.

Re:Yes. (1)

easyTree (1042254) | about 8 months ago | (#46005407)

This then creates an incentive to transition people from the state of living to the state of dead.

Re:Yes. (1)

easyTree (1042254) | about 8 months ago | (#46005399)

if postmortem ownership of a no-longer-needed part of my remains is equal to "slavery" then so is the sale of an hour of my labor to an employer.

Well, yes, Wage Slavery [wikipedia.org] 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".

Re:Yes. (5, Insightful)

Anonymous Coward | about 8 months ago | (#46005117)

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.

Re:Yes. (1)

Jack9 (11421) | about 8 months ago | (#46005389)

> 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).

Re:Yes. (4, Insightful)

Anonymous Coward | about 8 months ago | (#46005123)

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.

Re:Yes. (1)

Anonymous Coward | about 8 months ago | (#46005145)

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 ?

Re:Yes. (5, Insightful)

gwstuff (2067112) | about 8 months ago | (#46005149)

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.

Re:Yes. (1)

Dekker3D (989692) | about 8 months ago | (#46005359)

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.

Re:Yes. (4, Insightful)

pmontra (738736) | about 8 months ago | (#46005157)

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.

Re:Yes. (2)

ElectricTurtle (1171201) | about 8 months ago | (#46005309)

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.

Re:Yes. (4, Insightful)

pmontra (738736) | about 8 months ago | (#46005441)

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.

Re:Yes. (0)

Anonymous Coward | about 8 months ago | (#46005221)

If it's so repugnant to attach a cost to an organ, why isn't it disgusting for the surgeon, anaesthetist, and hospital to charge?

Because if you're poor and desperate then you are a candidate for life altering exploitation. In the long run selling parts of yourself doesn't help your situation.

And another thing: if a sex worker isn't allowed to "rent" parts of themselves why should people be able to "sell" parts of themselves?

Re:Yes. (0)

Anonymous Coward | about 8 months ago | (#46005361)

Because if you're poor and desperate then you are a candidate for life altering exploitation. In the long run selling parts of yourself doesn't help your situation.

It could be abused, so ban it entirely. I love this logic.

And another thing: if a sex worker isn't allowed to "rent" parts of themselves

They should be able to. There, done.

Re:Free Market (0)

Anonymous Coward | about 8 months ago | (#46005297)

It should be based on supply and demand!

And it'll likely be for a limited time (1)

Anonymous Coward | about 8 months ago | (#46005033)

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.

What could possibly go wrong??? (4, Insightful)

penix1 (722987) | about 8 months ago | (#46005035)

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?

Re:What could possibly go wrong??? (3, Insightful)

SuricouRaven (1897204) | about 8 months ago | (#46005079)

The organ theft urban legend has been around for a long time, but organ transplant isn't just something any unethical surgeon can do in the back of a fan. You need to match a donor first, which needs access to a suitable laboratory. Then you need a highly skilled surgeon, and a sterile operating environment, a team of supporting surgeons and nurses, an anesthetist, lots of drugs that are hard to get on the black market (Anasthetic, immunosurpresents, potent antibiotics). Expensive and specialised machines to monitor the recipient*. If organ theft does/could happen, it would have to be an operation so sophisticated and expensive that it could only be the domain of the most powerful of organised crime organisations. The ones who can pay off hospitals to carry out an off-the-books transplant.

*Double that if you intend the donor survive. This part is optional.

Urban Legend? (1)

Tenebrousedge (1226584) | about 8 months ago | (#46005179)

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?

Re:Urban Legend? (1)

CanHasDIY (1672858) | about 8 months ago | (#46005223)

Uh, that sounds like more of a cautionary tale about smoking crack than organ theft...

Re:What could possibly go wrong??? (1)

SuricouRaven (1897204) | about 8 months ago | (#46005183)

And before someone suggests it can be done on the cheap: No, it can't. Black market organ buying does happen in some countries, but even there they have to use a real hospital.

Re:What could possibly go wrong??? (1)

Concerned Onlooker (473481) | about 8 months ago | (#46005425)

"The organ theft urban legend has been around for a long time..."

Urban legend? I think Charlie the Unicorn would disagree.

Re:What could possibly go wrong??? (1)

ShanghaiBill (739463) | about 8 months ago | (#46005105)

And just like you have theft of other sold goods how long would it take before organ theft became the new wave of crime?

This makes no sense. Illegal black market goods are more likely to be stolen than legal goods, both because the price is higher, and because the theft is less likely to be reported. Criminalizing things does not reduce crime.

Re:What could possibly go wrong??? (0)

Anonymous Coward | about 8 months ago | (#46005243)

You can go to the police and tell them your organs were stolen. You can't go to the police and tell them your crack was stolen (if you have any sense).

Re:What could possibly go wrong??? (1)

dbIII (701233) | about 8 months ago | (#46005147)

how long would it take before organ theft became the new wave of crime

There's already a black market in material from corpses in the US. Alistair Cooke, who spend half a century telling the UK once a week how weird and wonderful America is, ended up being part of that strangeness himself when his cancer ridden 95 year old body was dug up and bones taken to be used in bone grafts.
http://en.wikipedia.org/wiki/Alistair_Cooke
http://en.wikipedia.org/wiki/Biomedical_Tissue_Services
Then there's whatever was happening with organs of executed prisoners in China and the suspicion that some were killed for the organs instead of the crime.
A bad idea, but it's a bad idea in progress.

Re:What could possibly go wrong??? (1)

pr0fessor (1940368) | about 8 months ago | (#46005225)

People have been selling blood for years, granted your body makes more and you can sell it again next month but I don't think selling organs would end up making some weird sci-fi horror come true.

Re:What could possibly go wrong??? (0)

Anonymous Coward | about 8 months ago | (#46005371)

Organ theft and sale is already a thing. But it is already only available to the most powerful and richest in the black markets.
Every good thing has a bad side to it. Not doing good because it has possible bad sides is stupid.

Making organ sale legal won't do much to make it cheaper because it is everything AROUND organ transplantation that makes it expensive, not the actual organs themselves, the knowledge, the equipment, the preparation, the medicines and drugs to prevent the person from dying on the table, and the maintenance period to make sure it isn't rejected. (which requires even more medicines)

Read Larry Niven's stories about "organleggers" (1)

murdocj (543661) | about 8 months ago | (#46005057)

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?

Re:Read Larry Niven's stories about "organleggers" (0)

Anonymous Coward | about 8 months ago | (#46005213)

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?

The super-healthy would become scapegoats for the worst kind of criminal activity, so that they may be caught and given the death penalty to provide for the harvest.

(I didn't read the book, but I'm curious if it delved into this dark realm. Reality likely would.

Re:Read Larry Niven's stories about "organleggers" (1)

ShanghaiBill (739463) | about 8 months ago | (#46005265)

This sci-fi scenario makes no sense. If there was a free market in organs, the supply would rise, and the value of an organ would go down not up. So there would be less incentive for the state to execute people to get their organs.

Re:Read Larry Niven's stories about "organleggers" (1)

citizenr (871508) | about 8 months ago | (#46005337)

This is already happening in China.

People die ... (1)

Anonymous Coward | about 8 months ago | (#46005063)

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.

Re:People die ... (0)

therealkevinkretz (1585825) | about 8 months ago | (#46005097)

"Why should someone who can afford to buy an organ be more entitled to live that some poor schmuck who can't?"

Right, better two die than one, right? By that measure a good surgeon shouldn't be able to charge more than a mediocre one.

"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."

It's not his job to decide the ethics. His area of expertise allows him to tell us that paying people for their organs will result in more of them being available. Which isn't really in dispute.

Re:People die ... (0)

Anonymous Coward | about 8 months ago | (#46005163)

It's not his job to decide the ethics. His area of expertise allows him to tell us that paying people for their organs will result in more of them being available. Which isn't really in dispute.

So why is he publishing anything at all when the thing he is qualified to say anything about is not in dispute? Seems like he's cheating.

Re:People die ... (1)

Daniel Dvorkin (106857) | about 8 months ago | (#46005171)

Which isn't really in dispute.

Er, yes it is. You can't just make this assertion and expect it to be accepted as fact. (Or rather you can, as the authors of TFA have done, but you shouldn't.) As things stand right now, humans can each produce two kidneys, one heart, one liver, and two lungs over their lifetimes. That's it. The supply is inelastic, and will remain so until we can produce artificial organs, at which point the donation argument becomes irrelevant anyway.

Re:People die ... (0)

Anonymous Coward | about 8 months ago | (#46005205)

Right, better two die than one, right? By that measure a good surgeon shouldn't be able to charge more than a mediocre one.

Fine only one should die, but you think bank balance is good deciding measure?

Re:People die ... (1)

Rockoon (1252108) | about 8 months ago | (#46005427)

Fine only one should die, but you think bank balance is good deciding measure?

Since the human being that performs the transplant wants to be compensated for his efforts, yes. Anything else, no matter how you slice it, is called slavery.

Make organ donars have priority access to organs. (5, Interesting)

icndvl (1091207) | about 8 months ago | (#46005067)

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.

Re:Make organ donars have priority access to organ (2)

jythie (914043) | about 8 months ago | (#46005103)

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.

Re:Make organ donars have priority access to organ (0)

ColdWetDog (752185) | about 8 months ago | (#46005227)

It's not a very practical or useful solution for solid organs. Let's say you're signed up for the list - you have agreed that if somebody needs your kidney you will drop what you are doing (for renal failure which is typically slow and progressive, you would have a fair warning), have a giant slice taken out of your side (along with a kidney), spend a couple weeks in recovery and then spend the rest of your life as a person with a solitary functioning kidney.

Such folks can and often do lead normal healthy lives but they are at significant risk since they have half the kidney reserve that they used to have. So now, 20 years later, your solitary kidney starts to go (too many Doritos raising your blood pressure) - back to the transplant hospital, this time to get a kidney. Oops. No match, wait a bit. Ooops, no match. Wait a bit. Rinse, lather, repeat.

The number of people that would voluntarily sign up for this would be an interesting moral and social study. Off the top of my head (or more accurately, out the back end), I don't think it would fly. Now, for blood cell issues, volunteer tissue banks work great since grabbing another liter of blood doesn't carry much of a downside. For kidneys, no.

Re:Make organ donars have priority access to organ (1)

Anne_Nonymous (313852) | about 8 months ago | (#46005287)

I think the idea is for freshly dead people to do the donating.

Re:Make organ donars have priority access to organ (0)

Anonymous Coward | about 8 months ago | (#46005125)

People who have donated organs while living are ineligible to receive organ transplants.

Re:Make organ donars have priority access to organ (4, Informative)

BZWingZero (1119881) | about 8 months ago | (#46005237)

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.

Re:Make organ donars have priority access to organ (2, Interesting)

ShanghaiBill (739463) | about 8 months ago | (#46005187)

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.

That's right. (0)

Anonymous Coward | about 8 months ago | (#46005267)

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.

And many times when folks get into accidents with helmets on and subsequently saving their life, they wake up with severe mental impairments such as: anger issues, sexual issues - like finding children sexually attractive and even molesting them, and some minor issues like speech problems, motor coordination problems, the list goes on and on and on. And the survivors have very tough lives and their families go through hell - sometimes forcing the survivor into an institution - if they're not jailed first.

There are times when dying is best for all concerned.

Re:Make organ donars have priority access to organ (1)

JaredOfEuropa (526365) | about 8 months ago | (#46005417)

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.

Re:Make organ donars have priority access to organ (1)

Nidi62 (1525137) | about 8 months ago | (#46005437)

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.

Re: Make organ donars have priority access to orga (0)

Anonymous Coward | about 8 months ago | (#46005445)

My DMV automatically made me a donor without my consent. I had to ask them to remake my license without the donor symbol on it, they are opt-out.

Thought this through, have you? (2)

westlake (615356) | about 8 months ago | (#46005381)

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.

Re:Make organ donars have priority access to organ (0)

Anonymous Coward | about 8 months ago | (#46005447)

The problem with that approach is that people who need an organ will immediately signup on your list AFTER discovering they need an organ. So you need somekind of minimal waiting period, let's say 10 years during which your priority gradually increases. At that point, it's less of an incentive to signup on the list because most people do not act on a hunch they will need an organ 10 years from now.

I think the post-mortem financial incentive is an interesting way to solve the problem, it will make much more organs available. It's either that or presumed consent, like in Austria, where you need to opt-out of the list of organ donors, at the same time opting out of ever receiving a transplant. This makes allot of organs available without resorting to what many believe to be a repulsive trade.

Re:Make organ donars have priority access to organ (1)

aviators99 (895782) | about 8 months ago | (#46005451)

=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.

cadaveric yes, live no (4, Insightful)

stenvar (2789879) | about 8 months ago | (#46005073)

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.

Re:cadaveric yes, live no (0)

Anonymous Coward | about 8 months ago | (#46005135)

I have a feeling that the money will be basically eaten by the hospitals for patience on their deathbeds, rather than go to families.

Re:cadaveric yes, live no (0)

Anonymous Coward | about 8 months ago | (#46005291)

That's not such a bad thing. If you don't have the money to pay for your treatment and the hospital says: "We can continue treatment if you consent to name us your post-mortem beneficiary of any organ sale", then it's an extra option you can take or not. You are not coerced and the alternative today is to receive no treatment because you are a useless bum. You can see it as way rich people in need of organs contribute to the expenses of dying bums - some of which might even recover.

It's a major conflict of interest for the hospital though.

Think of the homeless (-1)

Anonymous Coward | about 8 months ago | (#46005075)

They now have a reason to exist.

Re:Think of the homeless (0)

Anonymous Coward | about 8 months ago | (#46005311)

"Can you spare some change?"

If you can spare a kidney. (Rimshot!)

Two different issues mixed together (0)

loonycyborg (1262242) | about 8 months ago | (#46005087)

1. Can you use money to manage use of organs? I think no. Due to their scarcity only qualified medical personell can decide where to allocate them, not market forces that would happily let 90 year old rich men to get organ transplant at expense of everyone else.

2. Can we allow people to sell their own organs? No, because they'll sell them to get an iPad or something.

Typical naive idealism (1)

Anonymous Coward | about 8 months ago | (#46005089)

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.

Re:Typical naive idealism (1)

Anonymous Coward | about 8 months ago | (#46005199)

Free market economist thinks the market can solve any problem. Film at eleven.

Rust (3, Insightful)

gmuslera (3436) | about 8 months ago | (#46005093)

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.

And thereby create a black market in organs... (3, Informative)

davecb (6526) | about 8 months ago | (#46005099)

Organlegging: [technovelgy.com] 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.

Selling is going to kill other people (0)

Anonymous Coward | about 8 months ago | (#46005111)

No thanks.

Slavery (0, Troll)

little1973 (467075) | about 8 months ago | (#46005127)

Everyone should have total control over his/her body. If you are not at liberty to sell your organs that means you do not have total control.

If you do not have total control that means you are a slave. You are a property of the state.

In short, I totally agree with the article since I am against slavery.

Re:Slavery (1)

ColdWetDog (752185) | about 8 months ago | (#46005239)

You must be a riot when you get pulled over for speeding.

Re:Slavery (1)

couchslug (175151) | about 8 months ago | (#46005253)

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. :-)

china may take them from people on death row (0)

Joe_Dragon (2206452) | about 8 months ago | (#46005129)

china may take them from people on death row but they cover up the real numbers on that.

define voluntary (1)

Anonymous Coward | about 8 months ago | (#46005133)

Really, give me a working definition of the word voluntary, that will be universally accepted, that can be used in this context.

Fantastic idea (0)

Anonymous Coward | about 8 months ago | (#46005153)

This idea is great! Rich people can help poor nations people by bying their hearts and livers and boost their economy. This is the true way of getting rid of this pesky exploitation on third world countries because they will be stinking rich when the organ doning industry starts to boom.

Great plan for "businessmen" (3, Insightful)

nava68 (2356090) | about 8 months ago | (#46005159)

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).

Re:Great plan for "businessmen" (1)

nava68 (2356090) | about 8 months ago | (#46005167)

slash code just ate the < SARCASM > around "dump the human trash where it belongs"....

A modest proposal (1)

Hal_Porter (817932) | about 8 months ago | (#46005169)

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.

Re:A modest proposal (0)

Anonymous Coward | about 8 months ago | (#46005289)

Actually, we could get better quality organs if we would butcher the 1 percent, such as bankers, lawyers and congressmen and supreme court justices,although it might be hard to find a heart among them and some of them are gutless and spineless. This would also free up their estates to trickle down to the needy.

This is not necessary (-1)

Anonymous Coward | about 8 months ago | (#46005175)

I have volunteered to donate my organs many times. Yet no body has bothered to harvest my organs yet. This can only lead me to believe there is a conspiracy by the medical establishment to keep organ prices high. Who would not willingly give a kidney if it could help save a life. Yet there is this supposed organ shortage. I am thinking the establishment is not looking hard enough. Pick me. Pick me. I have an extra kidney that I am not doing anything with. Yet day after day, noone calls asking for my kidney. I call bullshit. It is just like the war on drugs. There is no war. There is a state mandated scarcity that is used to ensure drug prices remain high, cops have plenty of money, and prisons are always well staffed. Stop playing games. You don't need to legalize the sale of human tissue. You just need to stop pretending there are not enough donors. There are plenty of donors, around 6 billion of them.

In our dystopian future.... (0)

Anonymous Coward | about 8 months ago | (#46005195)

Our corporate masters will tell the poor "Hey! You can always sell your organs for cash!" and then use that as a basis for eliminating unemployment insurance, food assistance, or minimum wage. Remember the poor ain't poor truly poor if they have a refrigerator, cell phone, color TV, transportation, a full set of kidneys, lungs, corneas, their entire liver and GI tract. The poor will have to literally be living outdoors in a cardboard box with half their body parts harvested before the elite will consider them "poor enough" to need help, but by as soon as they are seen on the streets they will be called "homeless by choice" and are ineligible for any form of assistance. Thus they are damned if they do, damned if they don't.

much simpler solution (0)

Anonymous Coward | about 8 months ago | (#46005209)

change driver license opt-in for organ donation to opt-out (supply will go up as people tend to go with the default)

those who opt-out are not eligible to receive transplants (demand will go down)

simples.

IIRC, economists from Chicago are generally considered evil... additional sample supporting conjecture aquired!

More supply? (1)

amightywind (691887) | about 8 months ago | (#46005235)

Why allow the sale of organs when there are so many Chinese 'volunteers'?

A non-egalitarian death (0)

Anonymous Coward | about 8 months ago | (#46005251)

The proponents argue that such a policy would save lives and 'on the face' they are most certainly correct. However the economic disparity between buyers (rich) and sellers (poor) would only mean that different segments within the population would be dying, and those people fatally impacted would be much more difficult to document, e.g. a man dying earlier then he might have otherwise because he donated in his youth. Right now death is rather egalitarian, coming equally to all. Were this policy adopted it would be much less so..

i am against this idea (0)

Anonymous Coward | about 8 months ago | (#46005269)

Due to the severe wealth inequality (which is largely the result of ill gotten gains by way of crony capitalism, taxpayer funded initiatives, and flagrant abuse of the system), such a program would be biased in favor of poor people harvesting their own organs. Therefore I am not a fan. However if there was a reset of wealth distribution (which would leave nobody unscathed) then I would be in agreement.

Economist thinking (3, Insightful)

Livius (318358) | about 8 months ago | (#46005275)

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.

One thing might mitigate the hideosness (1)

Marrow (195242) | about 8 months ago | (#46005295)

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?

Too evil. (3, Insightful)

RyanFenton (230700) | about 8 months ago | (#46005301)

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

The real solution is opt-out by default (4, Informative)

naasking (94116) | about 8 months ago | (#46005317)

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.

Great for the rich, not so much for the poor (0)

Anonymous Coward | about 8 months ago | (#46005327)

If they legalized the sale of body parts, only the poor would be selling and only the rich would be buying. Exploiting poverty and addiction for the rich, nice.

nobel winner? (0)

Anonymous Coward | about 8 months ago | (#46005347)

ya, he's a millionaire.. what does he have to worry about. even now, the rich already have easier and faster access (despite what the list keepers and/or law might say) to transplants.. lets just make it so donor organs can go to the highest bidder... what a stupid fucking idea.

Killing people (1)

easyTree (1042254) | about 8 months ago | (#46005353)

"prohibition on voluntary sale and trade of human organs is probably killing rich people"

Legalise it so that poor people will be incentivized to sell their under-appreciated organs and restore the balance.

I beg to differ (0)

Anonymous Coward | about 8 months ago | (#46005449)

Given away a kidney for a relative is free. Given a relative enough money to buy a kidney on the free market is going to be too expensive for most. I might give a kidney to a relative or a dear friend for free. However, when I sell it to a stranger, I want at least a million dollars...

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