In a recent post, Alex suggests that we should use market incentives to encourage organ donations from cadavers. I am all for this. But I also read Alex as suggesting that cadaver organs will form the bulk of the organ sales market, if such a market is allowed to develop. He is trying to present a relatively attractive picture of a market in organs, no fear of the desperate poor selling their organs for a pittance, and then squandering the windfall.
What about outsourcing, so to speak? If we had a truly free market in organs, I suspect that most organs would come from the living, and mostly from poor countries. The going rate for a kidney, for instance, runs between $1000 and $2000, which is probably cheaper than the incentives needed to garner many more kidneys from the dead in America. So if we wish to defend a trade in organs, we still need to face up to its less savory aspects, gains from trade or not, most people blanch at the idea of cutting live people open to pull out their kidneys. We can avoid this scenario if Alex is an organ protectionist, though I doubt that he is.
One more palatable option would involve harvesting kidneys from the poor dead, in poor countries. This is the best case scenario, as it would combine both free trade and harvesting from the dead rather than from the living. Needy patients get the kidneys, many lives are saved, but without cutting open desperate kidney sellers. But how easy is it to evaluate the quality of a kidney from abroad, much less ship the kidney from somewhere like India? Most likely, the cheapest way to ship kidneys is to put a living body, the kidney owner, on a plane. I could be wrong, indeed I hope I am wrong. But if I am right, perhaps there is at least some argument for organ protectionism. (Imagine the political rhetoric, “no more cheap kidneys from abroad!”. etc., Gephardt could mention this to kidney-selling states in the debates and get all the heads nodding.) If you, like I, believe that most poor organ sellers benefit little from their trades, it could be better to harvest organs from the American dead, than buying them from the living poor abroad.