Selling organs for transplant....

Great Debates
21

Thanks for clarification, but you left something out: an indentured servant is the property of the master. Historically, indentured servants couldn’t marry or have children; they couldn’t hold money for personal use without the master’s position; they were subject to physical abuse and were not allowed to leave the property of the master without permission. In short, they were slaves by agreement, for a contractually specified period of time.

There’s a reason slavery and indentured servitude are unconstitutional - they violate basic human rights that may not be contractually suspended. Another precept of common law is that contracts are inferior to the law of the land; you can’t sign a contract that allows someone to kill you, for instance[sup]1[/sup]. ARL, do you support eliminating the thirteenth amendment?

Slavery and indentured servitude aren’t off-topic, since they’re the reason that the sale of body parts is illegal in the first place.

[I must admit, my legal analysis is not the result of a degree, but of conversations with friends from law school. I’d appreciate correction by anyone more qualified.]

[sup]1[/sup] A case my roommate studied in law school involved a man and women undertaking a suicide pact. They took off their clothes and laid on the bed, her on top of him. They called the police and announced their intentions. He put a pistol to her chest, pointing back at him, and pulled the trigger. The bullet killed her instantly, but lacked the force to kill him; when the police arrived, they called and ambulance, and he was saved.

At his trial for premeditated murder, his defence that it was a suicide pact (and thus not murder, since he was the instrument of her suicide) was not legally acceptable because one cannot give another permission to commit a crime against oneself and make it legal.

22

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Last time I checked parents didn’t actually own their children. So far as I know there is no bill of sale or contract providing ownership of a child. A child is in the care of his or her parents.

**

Why should that be a criteria?

**

I’m an organ doner and I don’t consider it a grand or noble gesture. I simply feel that if I don’t need the parts why let them go to waste?

On the flip side if I’ve got something terminal maybe I could sell some of my organs to the benefit of my family.

Human life always has a price tag. Do people who need transplants receive free medical care across the board?

Marc

23

[QUOTE]
*Originally posted by MGibson *
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A sense of justice, perhaps?

24

A sense of justice, perhaps? **
[/QUOTE]

In what way is it justice?

Marc

25

Currently, one receives organs on a combination of availability, suitability, and timeliness. Effectively, it’s a lottery wherein someone needing a transplant hopes that a type-match becomes available before they no longer need it. This makes the distribution of this scarce resource fairly evenhanded, and not generally dependent on the financial status of the recipient.

Allowing the sale of organs would create a marketplace for organs where the cost of the organ itself is added to the already high expense of the surgical team, the operation,etc. The organ donation system would effectively halt (why give when you can sell?), and organs for transplant would be a luxury good, denied to all but the top [ half | third | quarter | … ] of society. Of course, the quality of medical care in the U.S. is already largely determined by one’s socio-economic status, so perhaps this argument doesn’t count much here.

If you had your choice, then, you would live in a society with the worst poverty and the maximum of personal liberty?

26

A quick aside, hansel: As I self-identify as a libertarian, can you please extend to me the favor of not telling me what I think, and I will return that favor? Thanks.

27

That you think these are necessarily the same thing deeply troubles me. This implies a paradox that I am not prepared t espouse here as a hijack.

28

[QUOTE]
*Originally posted by pldennison *
**

I apologise if I’ve put words in your mouth; I wrote what I did because I’ve seen that argument several times, and it’s usually come from Libertarians or those nearby. Am I wrong that Libertarians generally view any matter that can be stated in terms of a contract (including slavery, indentured servitude, and the sale of one’s organs) as permissible?

29

They’re obviously not the same thing, but outside of utopian schemes, I don’t see how one can maximise personal liberty without tossing the sort of protections for the lower classes that you seem to view as infringements upon your self-determination.

30

Agreed, Hansel, but we’re not talking about redistributing welath or something. We’re talking about organs. MY organs. If you can control the organs you control the man, wouldn’t you say? It is an unfortunate two-way street as my “argument against myself” shows, but I prefer self-determination to partial bondage when there is an option.

I thought, as well, we were discussing live organ transplants not organ donation after death. The latter is obviously up to you…just don’t do ti if you don’t want to. The former is illegal flat-out.

31

Well, yes and no. By preventing you from selling your organs, you are being subjected to the control of the state; however, no more so than you are bound by its other laws. The prohibition against selling your own organs while alive is a specific prohibition drawn from a general principle in law.

If you want to argue utopian schemes, then I’ll agree that the right to sell one’s own organs is probably harmless to others and beneficial to oneself. We can stipulate that in our objectivist paradise, non-utopian considerations (like the effect on the poor) are non-starters because they are voided in other ways.

However, we don’t live in utopia, and we can’t really argue the point if we’re not willing to argue it in present-day circumstances. In practical terms, you’re arguing for dropping a prohibition today that would have (in my view) radically unjust consequences, in addition to violating an established principle.

I take it you subscribe to the (generally) Libertarian line that behaviour should be contractually and not legally regulated - in other words, behaviour is regulated only insofar as someone voluntarily enters into a contract to do so (pldennison, please correct me if this is a mis-statement). Assuming this is so, let me ask for a clarification: under what circumstances, if any, is someone unable or less than able to enter into a contract? Do considerations of duress come into it at all?

32

When I donate blood, it is used for whoever needs it.

Right away.

It doesn’t sit there waiting for me. My idea about the organs was that you donated one, and then it went to the first person on the list. I would imagine the way organs got doled out would be similiar to the way they are prioritized now. The only difference would be that if you ever needed a transplant, you would jump to the top of the list since you donated one earlier.

Example…

Guy is healthy and decides to donate a kidney. He figures, what the hell, all those poor people out there on dyalisis with no kidneys at all and there he is with two perfectly good ones. He can live just fine with one. So he drives down to the organ bank, they do tests, match up a recipient and schedule the surgery. The guy gets $5000 and is on his way. The rest of his life he is healthy and happy, comfortable with helping to ease the pain and suffering of other humans.
Or…

Many years later the guy’s one kidney fails. The guy jumps right to the top of the recipient list. Or maybe it is his liver.(it doesn’t matter) Since he donated out of his own free will when there was no need to, he gets priority on any organ out there if he needs a transplant.

33

The more I think about it, the better this idea sounds. I doubt that many people would donate out of a sense of charity, but I’m really curious about how many people would do so as insurance - give up a piece of your liver so that you get preferential treatment when you need that heart transplant, Mr. Smoker.

34

If we are not arguing utopian ideals but practical, real-world compromise, why is it that need is paramount? This, after all, is the primary deterrent in organ sales (so far as it has been presented here): that need would be traded for money.
Well, you might again note a paradox…that is, we’ve placed a utopian ideal as “common sense” or “real-world.”

What bothers me is the topic of need in re to organ transplants at all. This is, you might consider, a luxury of modern medicine. This is as absurd as making “cars” a need or “steak on fridays” a need…

I hate to think that the time may come for me to require such a service and find my wallet empty…this does make freedom’s idea very appetizing to both of us. I wonder if you objected to the $5000 he mentioned?

At any rate, this would be along the same lines as selling organs…that is, more along investment than direct returns but in principle the same.

35

I’ve reread this several times, and I don’t understand your use of the word “need”, so your question is lost on me. Please rephrase, making clear what you mean by need, and why it is or isn’t relevant to the question of organ transplants (I think you mean “need for an organ transplant”, so it makes no sense to me why it shouldn’t be a consideration).

36

Larry Hagman got a new liver after only 36 days on the waiting list, even though his cirrhosis was caused by his alcohol abuse (which is supposed to put you at a lower priority). And then there was Mickey Mantle being put at the top of the list after it was made public that he would die without a new liver…the officials claim that they are not biased, but celebrities and rich people certainly seem to get preferential treatment.

37

OK, what Lissa and hansel don’t seem to understand is that a market for organs would not decrease the number of free organs. It would increase the number of available free organs because some people that would have taken one of the currently available free organs are now getting a market organ instead.

This is like arguing that we shouldn’t have toy stores because poor parents couldn’t afford to buy toys.

And, we need to distinguish between selling the organs from a dead person and selling your organs when you are alive. Let’s look at dead people selling their organs. Well, what good does this do the dead person? The answer is that you buy the organs BEFORE the person dies. You offer them a modest sum in return for their organs in the event of death. This provides an incentive for organ donation. If you got $100 from the hospital in return for signing over your organs after death, most people would take the money. It’s not going to be much money, because lots of people are going to die with unusable organs.

Now, live organ transplants. I don’t understand why people are so worried about this. “Poor people won’t get transplants while rich people will!” Um, the poor people aren’t getting the transplants NOW. They are dying right now. All that a ban does is kill the rich people too. An organ transplant costs hundreds of thousands of dollars. It doesn’t matter whether I charge $5.00 or $1,000,000 for a kidney, poor people can’t afford the operation, period.

Now, how much do I think organs would cost? It is usually imagined that they will cost millions. I doubt it. How many millionaire transplant candidates are there? Maybe a few hundred or so. Most people who are transplant candidates cannot pay that much. Sure, you can demand a million for your kidney, but who will pay? Can’t they find someone else willing to donate for much less? Can’t they find a donated kidney?

Making money from transplants. EVERYONE makes money from a transplant…the doctors, the nurses, the hospitals, the ethicists, the lawyers, the orderlies, the airline pilots, Fed Ex, the anesthesiologist, everyone, except the donor. Why is the DONOR the only one ethically prohibited from making money from the deal?

Add in the fact that most people would STILL be donating to family members. What, you’re gonna charge your sister for your kidney? If your sister needs a kidney, money isn’t what you consider, especially since your sister almost always is going to be bankrupt after the medical bills from a transplant, unless insurance pays for it. And why SHOULDN’T the donor get some compensation from the insurance company? Will this be an auction? No, the insurance company says, “We pay X. Take it or leave it.” Actually, they would hope you DON’T take the money, since they save money if your sister dies.

Anyway, the point of all this rambling is to show that the nightmare dystopia of rich people as organ-vampires if we allow organ selling is just a fantasy. No one’s going to pay much for organs, only a few thousand, so no one is going to get rich selling organs. Therefore, the “rich” won’t have to pay millions for organs. Therefore, “regular” people will have the same access to organs as the rich. After all, we have to bid against the rich for every other commodity on earth. Why haven’t they bid the price up to where the poor/regular people can’t afford it? Because they don’t need to. They get what they want at cheap prices. Why would organs be any different?

38

Ummm, wouldn’t that be less power to you?

How about a little twist on this topic of organ donation? (If this appears to be a hijack, I’m sorry)

How about organ rentals – surrogate motherhood, for instance. Should this be legal? I suppose an arguement could be made either way; if the surrogate mother did not supply the egg, or eggs, than the practise is ok, fine and dandy; but what if the egg is hers? Is what appears to be a simple contract – allowing a person or persons a child they could not otherwise have – actually slavery?

(Take this a little further – take it to the sperm bank, which could not exist without a lot of men donating, at least, the time of their organs.)

Oh, facetiousness, where would we be without it?

Anyway, the question remains as the question has always been, two-sided: how much power should society have in an individual’s life? how much do we, as individuals, owe society for enforcing the terms of the contracts which allow us to pursue life, liberty and happiness without too much trouble?

An ethic is a personal ideal. A moral is societal ideal (of the two, I worry more about ethics). Both types of ideals are unattainable. This is probably why we keep reaching for them; we want what we can’t have. And there is something in the struggle, something in the measuring of ourselves against our past selves and against others – it may be that we find peace too much like death. (I did commit a hijack. Oh well.)

39

[QUOTE]
*Originally posted by hansel *
**

Libertarians believe in the philosophical foundation of libertarianism, the non-coercion ethic. That is, that all people should be free from initiated force and should be free to make decisions in that context. All else is window dressing.

I believe that a contract entered into willingly and with full knowledge and understanding of all terms by all parties is permissible.

40

I don’t agree with you on this point. If a family could get cold hard cash for their loved one’s organs, I sincerely doubt that altruism would outweigh greed. Most organs would come with a price tag because people would figure, “Why give them away for free?” That said, a lot of (live) people wouldn’t give up their organs, even if they can get money for them. Some out of religious reasons, some out of fear that “Hey, I may need this someday,” and some out of fear of the idea of major surgery. The number of organs available, free, or with a price tag, would remain relatively static. Organs from dead donors might increase, but that would be out of the family’s wish to defray burial and other final expenses. That brings up the relatively icky notion of profiting from a loved one’s death. Hell, there might even be an incident or two of killing someone so that you could sell off what was usable. We’ve all heard the urban legend of the guy who wakes up in a bathtub full of ice, sans a kidney. If organs are profitable, this might actually become a reality. You never know.

Sigh. A toy does not mean life or death. You can’t even compare the two.

This I don’t have a problem with. Sounds like a pretty good idea, actually. $100 isn’t a lot of money, as you said, and the primary benefit would be that more people would donate, and it has the added benefit of not necessarily raising costs of transplants. Sounds like a good idea. Everyone would benefit. There would be more organs out there to help anyone who needed them.

You’re right in some respects. The very poor are not getting more than basic medical care, and a transplant is far beyond their means. But what about people like me? Mrs. Middle Class. My medical insurance would cover the surgery, should I or Hubby need a transplant, but I seriously doubt it would cover the cost of purchasing the organ on the open market. (Hell, it won’t even cover my birth control.) The money for purchasing the organ would have to come out of our pockets. It would be almost impossible for me to find $50,000 for a new liver. I also doubt that a bank would give me a loan for one.

Not if there’s money to be made. As I said, we’re not a culture famed for our altruism, and I doubt many people will be giving away what they can get paid for. All in all, I would estimate that the costs of an organ would be around $10,000 to $15,000. Why? Because when you’re desperate not to die, you’re willing to pay, and where there’s a buyer, there’s a seller. People would realize the value of the organs very quickly, and desperate people would pay a pretty penny, especially when it’s their child lying on that hospital bed. People are going to want to get every cent they can out of the organs, and the old addage of supply and demand will be demonstrated as the costs of organs go up, and up, and up.

And this is a GOOD thing?

Bullshit. I’m not saying that people will be fabulously wealthy off of organ sales, but greed and demand will naturally raise prices. For that matter, so will inflation. I’ll say it again, how much can you afford to pay to save your life? What if it’s not enough? It’s not a car lot, where you can decide that the price on that Ford Focus is a bit high, and go to the next dealership. What if it’s the only kidney/heart/liver that matches you? You can’t just pick any old kidney and stick it in there and watch it work. Even close family members are often not matches. And what if you’ve just slapped down your last ten grand on a liver and your body rejects it? I doubt if their return policy will be as generous as WalMart’s. So what do you do next? Save up to buy a new one? Wait until someone dies and hope that their relatives will be one of the few who decide to donate the organs for free?