Bodies for Sale

Thursday, August 12, 2010 -- 5:00 PM
Ken Taylor

Our topic this week is Bodies for Sale.The buying and selling of vital organs is illegal in most developed countries.  But there is a thriving, global black market in body parts.  Should the buying and selling of organs be legalized and brought into the above ground economy?  Or is something inherently wrong about treating the human body and its parts as mere commodities?

One thing for sure.  There is huge pent-up demand for body parts.  In the US alone, according to the National Kidney Foundation, over ninety-five thousand people are currently waiting for an organ transplant, with another four thousand added to the wait list every month.  In 2006, more than six thousand people died awaiting life-saving organ transplants.  And of the twelve thousand dying people who could donate organs, only about half actually do.  The numbers are just staggering – utterly staggering.   In 2002, the World Health Organization pegged the number of people suffering from diabetes around the world at a hundred seventy one million.  By 2030 the number will climb to nearly four hundred million.  Those folks are prime candidates for kidney transplants.

So… we’ve got a huge global demand for bodily organs and an inadequate supply of donations.  Is it any wonder there's a thriving black market?  Legend has it that a healthy kidney can fetch up to a hundred fifty thousand dollars.  That’s a mighty tempting number.  Doesn’t that suggest that if there were open, legal, well-regulated markets in bodily organs the supply problem would just disappear?  And we might do a lot to alleviate third world poverty while we’re at it. 

But legend and reality don’t always match.  Take that hundred fifty thousand price tag for a kidney, for example.  Numbers like that are sometimes thrown around on internet chat rooms, but the reality is quite different.  In places like the Philippines or Iran -- where the buying and selling of organs is not against the law -- the price for a kidney is pretty low -- a few thousand dollars at most.  It’s true that black market brokers will sometimes charge as much as ninety thousand dollars to their rich Western clients for third-world kidneys.  But hardly any of that money reaches the person who offers up the kidney for sale.

You might think that the  problem is the black market itself, but it also could be that even an  open global market in kidneys might do more to enrich those who exploit the poor than it would do to help the poor themselves.    Even open global organ markets have great potential to exploit the poor and desperate around the world by turning their bodies into repositories of spare parts for the well-off, without really doing much to improve their own lot.  After all, not many middle or upper class Westerners are going to sell a kidney for a few thousand bucks -- even on a legal open market.   And not many of the world’s desperately poor are going to be able to afford to buy kidneys on ANY market.   So even in an open market the burden would fall disproportionately on the poor, while the benefit would fall disproportionately on the rich.   

So the situation is deeply morally fraught.  It seems pretty nearly completely upside down to the egalitarian liberal in me.  And then there’s the intrinsic yuckiness of  thinking about your own body parts as mere commodities.   I tend to be a Kantian and the Kantian in me tends to recoil at the very idea of treating my own body as a mere thing, a mere tool to be bought and sold like any other commodity.  Kant would probably say the buying and selling of organs is inherently wrong.  When you sell an organ, you're treating yourself as a mere means, rather than as an end in itself.  And Kant thought you should always treat yourself and others as ends in themselves.  And my gut instincts almost always go with Kant on these matters. 

But, of course, it turns out to be more complicated than Kant realized.  When I sell my labor, for example, I allow my employer to treat me as a mere means.  If it’s morally okay to sell your bodily labor, why isn’t it morally okay to sell your bodily organs?  I'm not sure the Kantian has a satisfactory answer to that question. 

We’ll put that question and much more to our guest,  Debra Satz,  author of the very fine book, Why Some Things Should Not Be For Sale: On The Limits of Markets.  Tune in to see what she has to say. 

Comments (9)


Guest's picture

Guest

Thursday, August 12, 2010 -- 5:00 PM

Take a look at Al Roth's blog: http://marketdesig

Take a look at Al Roth's blog:
http://marketdesigner.blogspot.com/
He is an economist who designs transactions for repugnant exchanges.

Guest's picture

Guest

Thursday, August 12, 2010 -- 5:00 PM

As the death toll from the organ shortage mounts,

As the death toll from the organ shortage mounts, public opinion will eventually support paying for human organs. 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 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.
David J. Undis
Executive Director
LifeSharers
www.lifesharers.org

Guest's picture

Guest

Saturday, August 14, 2010 -- 5:00 PM

There needs to be some way to compensate donors fo

There needs to be some way to compensate donors for their time, risk, and kindness. My brother recently received a kidney from a co-worker. It would have been nice to pay for some of the donor's lost work hours, childcare so his wife could spend time with him, maybe a hotel nearby so she didn't have to travel so far, dinner for her. But no gifts at all are allowed.
Cadaver donors should have their funeral paid for, up to a set amount. Living donors should have all expenses related to the donation paid for, up to a set amount. This provides for their family to be able to support them; recovery time (giving a kidney HURTS, btw); travel expenses; childcare...
As it is, the donor had to use his own vacation/sick time to donate, and while the actual medical costs were paid for out of my brother's insurance, all the surrounding costs were his. And that isn't fair.
I think expenses up to, let's say, $10,000 should be allowed, or funeral costs up to the same. It isn't payment for the organ, it's an allowance to absorb the costs of donating...

Guest's picture

Guest

Sunday, September 5, 2010 -- 5:00 PM

One of Professor Satz's central arguments is that

One of Professor Satz's central arguments is that legalizing the sale of body parts would impose a cost on people who do NOT want to sell their body parts. I take it this is just an opportunity cost (if I sold my kidney, I'd make some money, so when I don't sell my kidney, I have that much less money).
But creating an economic opportunity doesn't result in my actually losing anything at all. It is my choice not to sell my kidney either legally or illegally, and so even while organ sales are illegal, I have less money than I would if I sold my kidney. Regardless of the legality of organ sales, I don't actually lose anything I have when I encounter an opportunity cost.
I'm not at all confident that organ sales should be legal, but I don't think this opportunity cost argument is a good reason to keep organ sales illegal. Then again, I'm not an economist.

Guest's picture

Guest

Wednesday, September 8, 2010 -- 5:00 PM

Although I do agree with your post, I have my own

Although I do agree with your post, I have my own reservations.

Guest's picture

Guest

Thursday, September 9, 2010 -- 5:00 PM

To my thinking, the social morality (and the legal

To my thinking, the social morality (and the legality) of organ selling is and should be intrinsically tied to the propensity and severity of the fraud and exploitation that it will entail.
A certain amount of fraud or exploitation is inherent in the market, as anyone whose ever bought a packet of sea monkeys, or taken a telemarketing job can testify. This is why we have wage and truth-in-advertising laws.
But in most cases, the consequences are relatively minor. If you take a job that sucks, you can quit. If you buy a bunch of brine shrimp imagining that they would form a fun-loving, utopian civilization before your eyes, you're only out a couple of bucks, which you can right off to experience. Not so with an organ transplant.
If you sell your kidney and later realize that shortening your life by ten years wasn't worth the used camarro you bought with the proceeds, it's too late. There's nothing you can do (short of buying someone else's kidney, perhaps) that will mitigate the damage that's already done.
If you sell a kidney under duress or in following self-serving medical advice from someone looking to buy your kidney, the organ is gone, your lifespan is considerably shortened and there's nothing you can do about it. You can't simply chalk it up to experience and you can't quit being a former kidney donor. You can sue the person or organization that defrauded you, but even if you win, that won't bring your kidney back. The simple truth of the matter is that when it comes to organ-selling, there's no way to adequately address the consequences of someone being swindled out of a kidney. Any legal protection that matters must happen on the front end of that transaction.
If you allow people to monetize their life-saving organs, there's a very large incentive for people to defraud and exploit them. And the consequences of being victimized in this manner are so dire, that given these facts I think a society has the moral obligation and legal right to step in and regulate or even ban organ selling in a way it doesn't with other, more benign transactions.

Guest's picture

Guest

Friday, October 8, 2010 -- 5:00 PM

It is of some interest, I think, to consider that

It is of some interest, I think, to consider that the entire enterprise of organ donation and transplantation was the stuff of science fiction, not so many decades ago. Be that as it may, there are numerous arguments, for and against this miracle of modern medical science.
Certain fundamentalists may argue against it on religious and/or moralistic grounds. Science, on the other hand, is more pragmatic and generally unfettered by religious dogmas and moral high ground: we have done it; we can do it; it extends lives (for some or many); and, some folks (or their medical insurers) can or will pay the price.
Black marketeering is only one of many ways in which humanity engages in corruptive behavior. We should not be so shocked, because it is also a part of world economy.
An ex-coworker "gave up a kidney" for his brother, about fifteen or twenty years ago. He died before I retired. I think the brother (younger and diabetic) died also. We do the best we can with what we have. Sometimes.

Harold G. Neuman's picture

Harold G. Neuman

Friday, October 8, 2010 -- 5:00 PM

The horse is out of the barnyard and the cat is o

The horse is out of the barnyard and the cat is out of the bag---assuming that said cat was ever in the bag in the first place. It is way too late for wailing and gnashing of teeth. And it is similarly late to be asking ourselves whether organ donation and transplantation are morally reprehensible or merely technologically factual. It just does not mean beans for us to ask these sorts of questions now.
Of course, it is fun for the agitators, debaters and quibblers amongst us and it provides fuel for the fires of fundamentalism. All of this too shall pass as medicine advances beyond the need for organ donations and successfully grows replacement parts for humans. As most people know, this has already begun. Those of us who are unafraid of such forms of progress would like to see it. Some of us will---probably not yours truly, however.
Let us move on to some problem which we can solve and/or ought to solve, shall we? Black markets have been with us since biblical times and before. Why would we think they are something we can eliminate? I can't imagine---can you?

Guest's picture

Guest

Saturday, October 16, 2010 -- 5:00 PM

Donating organs is very honorable. Buying them mea

Donating organs is very honorable. Buying them means some people are not on the same level playing field. Do the wealthy deserve them more? That is the question you must ask yourself.

 

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