Wall Street Journal: Cash for Kidneys: The Case for a Market for Organs

[Clark]

http://online.wsj.com/news/articles/SB10001424052702304149404579322560004817176

Cash for Kidneys: The Case for a Market for Organs
There is a clear remedy for the growing shortage of organ donors, say Gary S. Becker and Julio J. Elias

N.B.: One more time.

[Clark]

http://marketdesigner.blogspot.com/2014/01/cash-for-kidneys-case-for-market-for.html

Cash for Kidneys: The Case for a Market for Organs. Becker and Elias in the WSJ

Gary Becker and Julio Elias have a reprise of their 2007 Journal of Economic Perspectives paper in this weekend's Wall Street Journal, in a cogent column called Cash for Kidneys: The Case for a Market for Organs.

Their 2007 JEP paper was called  Introducing Incentives in the Market for Live and Cadaveric Organ Donations (slightly more direct link here).

N.B.: Well worth following all the links to grasp the complexity of where this concept is these days.

[Clark]

http://www.lifesitenews.com/blog/organs-for-cash-hurts-the-poor

‘Organs for cash’ hurts the poor
BY WESLEY J. SMITH

In the spirit of the times, let’s call it organ inequality. If organs are for sale, the rich will buy and the poor will sell. Supply and demand.

The Wall Street Journal has an advocacy piece by two economists urging that people be able to sell their kidneys. I don’t want to run long, so let me cut to the hub. From “Cash for Kidneys,” by Nobel Prize winning economist Gary S. Becker and Argentine professor Julio J. Elias:

Our conclusion is that a very large number of both live and cadaver kidney donations would be available by paying about $15,000 for each kidney. That estimate isn’t exact, and the true cost could be as high as $25,000 or as low as $5,000—but even the high estimate wouldn’t increase the total cost of kidney transplants by a large percentage.

Would Becker and Elias sell their organs for $15,000? Hell no! The well off aren’t about to put themselves through the rigors and potential health consequences for such a relative pittance. That’s for desperate people, easily exploitable.​

And heck, if we induced enough poor people to sell their body parts–and include the destitute in developing worlds –why just think how low we could get that price to be! And if a few are hurt, well, they signed the contracts, they knew the risks.

It galls me that these kinds of articles advocate surrendering – rather than standing against – an ongoing collapse of principle in this field. 

Though the poor would be more likely to sell their kidneys and other organs, they also suffer more than others from the current scarcity. Today, the rich often don’t wait as long as others for organs since some of them go to countries such as India, where they can arrange for transplants in the underground medical sector, and others (such as the late Steve Jobs) manage to jump the queue by having residence in several states or other means. The sale of organs would make them more available to the poor, and Medicaid could help pay for the added cost of transplant surgery.

Gaming the system like Jobs did needs to be stopped. But we should not add another wrong on those already being caused. We shouldn’t claim that exploiting some of the less well off might save others from further delays caused by queue jumping.

Our fear of suffering does not justify slouching toward the creation of a market in human organs. Indeed, our real focus should be on the immorality of the buyers and the medical professionals who make it possible.

Going overseas to buy an organ should be just as illegal as going overseas to sexually exploit a trafficked child.  The buyers should be named and shamed. Laws should be passed requiring doctors to report them to the authorities when they come in for treatment in the transplant’s aftermath.

Read my great pal Dean Koontz’s novel, Your Heart Belongs to Me, for a very good fictional account of the issues at stake. I have written more extensively here.

One of the reasons I don’t like libertar​ian thinking is that everything isn’t a market!

[Clark]

http://online.wsj.com/news/articles/SB10001424052702304632204579338492295096438

Is a Market in Kidneys the Right Answer to Shortage?
It is a tragedy when people die while waiting for a lifesaving transplant, but paying for organs isn't the answer.

In "Cash for Kidneys" (Review, Jan. 18) the economist authors recommend establishing a market for human organs to alleviate the organ shortage in the U.S. It is a tragedy when people die while waiting for a lifesaving transplant, but paying for organs isn't the answer.

In our current system, openness about the potential donor's health, high-risk activities and family history is presumed because the only compensation donors receive is the restoration of health to someone they care for. Payment can introduce health risks for the recipient because important medical information can be withheld to receive an incentive. A system of payment for kidneys often exploits poverty-stricken sellers who can be manipulated or coerced into selling their kidneys for quick money or to repay debts.

The National Kidney Foundation believes there are other ways to increase kidney donation and has advocated for the following: expanding paired exchange and donor chains; protecting job security for those who take time off to donate; covering all donation-related expenses; and ensuring the availability of health, disability and life insurance for all living donors.

Bruce Skyer

CEO

National Kidney Foundation

New York

One option not included in the essay is the policy of reciprocal donation. In some countries, a person isn't eligible to receive an organ unless he also is a designated organ donor. This seems like a better place to start.

Valerie J. Connor

Davenport, Iowa

Last Saturday's article misrepresents the Iranian system of compensated donation. I spent nearly two months in Iran interviewing paid kidney donors for a documentary film I was planning. I visited six different regions and returned with over 200 transplant stories. Sometimes money is what makes helping others possible.

I disagree with economists who say you can put value on someone giving up part of their body to save another person's life. A conscious, informed decision to risk oneself for another is an invaluable gift both to the person and to society.

Iran is the only country in the world that has solved its kidney shortage, and it has done so by legalizing and regulating compensated donation. Paid donors know the system works to protect their rights as much as the rights of recipients.

Kidney donors receive on average the equivalent of six months' salary for a registered nurse in Iran, or approximately $32,000. All receive at least one year of health insurance and an exemption from Iran's two-year mandatory military service. With other goods and services, I estimate the total average package that paid donors receive in Iran is close to $45,000 in value.

In many regions of the country there is a waiting list for people who want to donate. Maybe it's time we learn something from their experience.

Sigrid Fry-Revere

Lovettsville, Va.

Dr. Fry-Revere is a bioethicist and founder and president of the nonprofit organization Stop Organ Trafficking Now.

What advocates of living-donor kidney transplants won't mention is that kidney function declines with age, and an elderly person needs two kidneys to maintain healthy kidney function. Kidney donors shouldn't take aspirin or ibuprofen for the remainder of their lives, and they should forgo activities that risk impact to the remaining kidney. Kidney donors, who are extensively screened before donation, are healthier than the general population before donation but lose that advantage following donation. That doesn't sound like a "normal life."

Dan Hiltz

Fort Mitchell, Ky.

The arguments made in "Cash for Kidneys" fail to assuage moral concerns for the commodification of human life. Mutatis mutandis, Oscar Wilde's quote, "Nowadays people know the price of everything and the value of nothing," is quite apropos.

Rev. Michael P. Orsi

Ave Maria School of Law

Naples, Fla.