The Economist has cogent things to say on setting up a market for organs including the fact that organ sales are legal in, of all places, Iran and the shortage in that country has been eliminated. Here’s another interesting point:
America already lets people buy babies from surrogate mothers, and the
risk of dying from renting out your womb is six times higher than from
selling your kidney.
Hat tip to Harold Kyriazi.
I’ve got a much better idea: increase spending on medical research and stop so many organs from failing in the first place. While being able to get a transplanted organ without a lengthy wait is good, not needing a transplant in the first place is vastly better.
Good idea Peter. And since an increase in research spending will lead to immediate results, no need to worry about everyone who needs a transplant today.
“I’ve got a much better idea: increase spending on medical research and stop so many organs from failing in the first place. While being able to get a transplanted organ without a lengthy wait is good, not needing a transplant in the first place is vastly better.”
We shall fix the problem by assuming that it does not exist.
“America already lets people buy babies from surrogate mothers, and the risk of dying from renting out your womb is six times higher than from selling your kidney.”
That is a argument against allowing people to buy babies from surrogate mothers.
Peter, who is opposed to increased medical research? Not I. And I’m certainly not implying stop all research; don’t be silly.
You, however, presented your idea as an alternative to organ transplant. Perhaps you didn’t mean to, but I’m not the only one who read it that way. When you start with “I’ve got a much better idea…” that implies the other idea should be abandoned. Furthermore, while your idea may work in the long-run (there is no guarantee we can ever prevent organ failure to the point where it is trivial), it does nothing in the short-run.
Do you remember Star Trek IV twenty-some years ago during the chase scene at the hospital when Bones asked a woman with kidney failure: “Dialysis? Here, take this!” with an apparently effective result from the pill he gave her. I say, let StarFleet deal with the kidney shortage issue.
I agree with David that we need to deal with the current organ shortage problem with the technologies available to us. A market in organs is one of those technologies. Sometime prior to Operation Iraqi Freedom the New York Times Magazine had an article about for-sale kidney transplants, contrasting the fate of an Israeli who had a quickie transplant in Istanbul which failed, probably due to lack of follow-up care after surgery, with a successful for-sale kidney transplant in Iraq of all places. I could only imagine how successful for-pay transplants would be at major U.S. or European medical centers.
Given a hypothetical question whether we should cease all funding for biomedical research and direct it towards enabling warp-drive, expecting that the benefits of exploring new worlds in space will far exceed the benefits of research here on earth, including therapy for kidney failure, I am undecided (just kidding).
But we should concentrate on research and interventions we can do, aided by free markets in organ donation.
FWIW, the shortage in for-sale donatable kidneys is a market opportunity for countries adjacent to the U.S. Imagine if Newfoundland legalized for-sale organ transplants. Canadian physicians and hospitals meet essentially the same quality standards as U.S. physicians and hospitals. Newfoundland hospitals would do a brisk transplant business, and with the appropriate tracking tools the outcomes could be compared to those of kidney recipients in the U.S. who received cadaver or non-paying donor kidneys.
Virginia Postrel call your office!
I also wasn’t aware that backing open markets in organs = not caring about preventative medicine.
So Peter, should I call up the guy who appropriates all the money to research and organ transplants and tell him to change his allocation formula or do you want to take that to-do?
Seriously Peter, do you think all this spending is managed by a committee?
Peter, you’re making the most obvious straw-man argument I’ve ever heard. If this is the best argument the anti-organ-market people have, then choosing to allow an organ market is a no-brainer.
Let me present to you another way. You’ve got two options:
1. Keep the current Organ donor program and increase research spending. No matter the funding, the research spending will not meet the most immediate needs and may or may not meet the needs in the distant future. (If you know some doctors to give money to that will cure Kidney diseases in six months, let us know.)
2. Legalize organ markets and fund research, immediately curing those with Kidney diseases and keeping the possibilities of major new cures alive.
This decision, in every sense, is a no-brainer. The only reasons we haven’t taken option 2 are people’s unwillingness to see a possible “market” for a body part and the lack of will of politicians to show the life and death consequences of not having a market.
I mean, if you knew someone that needed a Kidney transplant, which option would you support?
What exactly is the right balance between spending on current and future demand (i.e. immediate needs and research)? On what basis – i.e. What are the relative values of those expenditures (accounting for risk and payoff)? What is the current spending on each? Who is going to make the necessary corrections? How many problems besides transplantable organ failure must be accounted for in this? How do we know that those guiding the spending will get just the right balance by choosing just the right solutions to the most important problems? Why haven’t they already?
BTW – it’s “preventive”, not “preventative”. You want prevention, not preventation.
Y’all are ganging up on Peter, but he has a decent point…so in light of that great libertarian classic: “Defending the Indefensible”…I’d like to suggest ya listening more carefully to what he is saying and think more about what it means for you and your family…
1) While medical research investments are not all allocated by some giant committee (as Peter’s critic implies he might expect), Kevin Murphy and friend suggest the benefits of most medical research are terribly hard to capture. And so we get way, way, way to little of it….
http://www.milkeninstitute.org/publications/review/2000_3/mir5_22_medresearch.pdf …they
2) It’s therefor not silly to suggest that billions that should go to research might well go to transplants instead…
Of course we can persue transplants and other “preventive” measures at the same time… but Peter’s sense that we are focusing too much on transplants is not so easily dismissed. As to pharmaceuticals, Peltzman suggests we have been loosing around 60% of new drugs from “over-regulation” http://fdareview.org/harm.shtml What other high tech industry requires about half a billion dollars and a decade to get government approval for any new product?
I think Peter may be the devil’s advocate.
Prof. AT,
Iran is also making impressive headway in stem cell research.
Presumed consent seems like a good idea.
As for living donation of kidneys, if a market was allowed, transplants would take place more liberally. Currently doctors consider it to be a last resort. We would see more poor people donating and (perhaps) more rich people receiving. Should the proceeds from the sale be taxable? Where do we draw the line in terms of age? Should a starving college student be allowed to donate and cash in at 19?
What incentive does the medical provider have in continuing to provide health care to the donor after donation? Would there be a contractual relationship? Do you think Medicare should cover care for donors whose only other kidney fails?
I think that, organ transplantation is important but what do you donor in the future?
liqingchao 07年8月21日
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