Tuesday, October 16, 2012

Why do we find trade in organs repugnant?

"We" is intended to be very vague here. I didn't think I found it repugnant. And then after thinking about it I decided there were some aspects of it I found vaguely repugnant (and these issues are more prominent for organs than other issues, which is why they come to mind in this case), and some I was fine with. But what do we find repugnant about it?

1. Commodifying organs?
2. The idea that the destitute would have to sell their own bodies to help make ends meet?
3. The idea that organs are well allocated when those with higher ability to pay get them (certainly willingness to pay plays a role, but the real constraint is inevitably going to be ability to pay)?

I think peoples' real problem is with #2 and #3.

I think economists that get really worked up about organ markets (I am pro- but I don't get very excited by the idea) like to focus on #1 (which is the least problematic), consider #2 a feature, not a bug - and don't really worry about the dehumanization of it all (possibly because the more libertarian among them have written off other solutions), and wave their hands at #3 and accept the established definition of "efficiency" and try to pretend that we shouldn't worry about the fact that demand schedules are determined by both willingness and ability to pay.

If you do hesitate a little at #2 and #3, then the fact that you are not bothered at all by #1 isn't much comfort.

9 comments:

  1. A big question for #3 would be to consider how insurance companies would deal with organ markets. That could change a lot of the calculus on this.

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  2. There's another problem that I saw come up during a lecture of Roth's. Let's say that organ markets are legal, and there's some general price for, say, your kidneys. If you go into bankruptcy, does the lender have a claim to make you sell your organs? Are unsold organs considered an asset?

    I'm not convinced that this is something that will actually happen, but it's certainly an unaddressed moral problem with legalized organ markets.

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  3. 4. Some believe that a large portion of organ transplants is obtained in the acts of murder of the poor third-world inhabitants. That said, I, myself, don't know if this is true or not, but I've heard this idea often enough from different sources.

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  4. "3. The idea that organs are well allocated when those with higher ability to pay get them (certainly willingness to pay plays a role, but the real constraint is inevitably going to be ability to pay)?"

    There is a problem with allowing MORE people to get life-saving kidneys, because all of those additional people will be higher up the demand schedule? It would be okay to save more poor people's lives, but because we can only save more people if these additional people have money, no deal?

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    1. There may or may not be more organs available - probably there will be more, I agree. But if you start pricing them its very likely that less organs will be available for people who can't pay for them. Previously they wouldn't have had to pay for them. Don't talk about more kidneys available to those who can pay without recognizing that it'll represent a loss for those who can't.

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    2. This is an empirical argument basef on absolutely zero evidence. People primarily donate kidneys for intrinsic reasons. They want to help someone.
      This is also ignoring the other side of the substitution effect: people who can pay for a kidney will do so to avoid the uncertainty and delay. Thus leaving a smaller pool of people needing a kidney to be allocated to them as is done now. This will increase the likelihood of the poor getting a kidney.
      The effect on the poor is at worst ambiguous, at best a strict improvement. You are going to need a much better argument if you wish to advocate forcing thousands of people to die every year.

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  5. What is interesting is that you - like a good liberal - talk about the fairness aspect of the issue, whereas a conservative would be as much as likely to talk about the sacred nature of the body.

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    1. 1. I'm not really all that much of a liberal in the sense that you are meaning it.

      2. Wasn't the sacredness of the body more or less my #2?

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  6. No, you're only talking about fairness and equality there. You haven't really mentioned issues like sanctity or authority (I don't know how loyalty would fit into this).


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