If you need a kidney, you find someone who has an extra, and you buy theirs. Also, you can opt to sell your organs when you die, instead of just donating them.
This scenario provides several strong incentives for unscrupulous agents to harvest people’s organs without asking for permission (in addition to any existing incentives that may exist in our current society). Thus, I believe that the total utility of legalizing the organ market (as I currently understand it) would be highly negative.
If that becomes a problem, have the government check to make sure that the people who are listed as selling kidneys both gave permission (preventing people from just harvesting without telling you) and is actually missing the organ (preventing people from claiming they gave an organ that was harvested from someone else). The only other option is for the entire operation to be off the books. This would be prevented the same way it is now, along with the fact that people are less likely to buy organs on the black market if there’s a legal option.
Also, even if that was the only way the organ market worked, for every organ stolen there’d be a life saved. It seems like it would still be positive unless they actually killed the people they were taking organs from, and even then only if they only took one organ each. How could it be highly negative?
If that becomes a problem, have the government check to make sure that the people who are listed as selling kidneys both gave permission...
How would the government achieve this in practice ? For example, let’s say there’s a demand for livers this month. How would the government know whether the liver A for patient B came from a legitimate donor, some unfortunate homeless person within our country who was robbed of his liver against his will, or from some foreign national who lives in one of those totalitarian and/or lawless countries where human life isn’t worth much ?
Furthermore, let’s say that people could sell their organs after they die—by proxy, presumably—as per your scenario above. Doesn’t this create a powerful incentive for unscrupulous agents to speed their demise ?
Also, even if that was the only way the organ market worked, for every organ stolen there’d be a life saved.
I don’t think this is true. Firstly, organ transplant procedures do not have a 100% success rate, due to rejection issues, surgery complications, etc. Secondly, what do you mean by “a life saved” ? All lives will end eventually. Would it be worthwhile to shorten someone’s life by, say, 10 years (due to their loss of a kidney), in order to grant someone else 5 extra years of life (by using that kidney) ?
How would the government know whether the liver A for patient B came from a legitimate donor, some unfortunate homeless person within our country who was robbed of his liver against his will, or from some foreign national who lives in one of those totalitarian and/or lawless countries where human life isn’t worth much ?
If it didn’t come from a legitimate donor, either the doctor has to explain why he didn’t say who the donor was, why the donor doesn’t know about it, or why the “donor” still has a whole liver.
As for the foreign country, just don’t accept organs shipped across national lines if the other nation doesn’t check the stuff. I suspect it’s a bad idea to ship organs across national lines anyway, as opposed to just shipping the donor, but I don’t really know all that much about how organ donation works.
Would it be worthwhile to shorten someone’s life by, say, 10 years (due to their loss of a kidney), in order to grant someone else 5 extra years of life (by using that kidney) ?
No, but I’m willing to bet that’s not what the ratio will be. If losing an organ hurt you more than it helped the person getting it, nobody would ever consider donating them.
Edit:
Furthermore, let’s say that people could sell their organs after they die—by proxy, presumably—as per your scenario above. Doesn’t this create a powerful incentive for unscrupulous agents to speed their demise ?
You mean their next of kin? I don’t see how it’s much more of an incentive than it would be to kill them just for the inheritance. Also, I suspect that the health insurance company would normally take the money, since most people aren’t going to be in a position to donate their organs and people tend to be loss-averse.
Organ transplantation costs tens to hundreds of thousands of dollars, including the costs of doctors, hospital time for recovery, drugs, etc. Paying less than $5,000 for a legal kidney (at prices in Iran), or even $25,000 in rich countries with more expensive surgical staff, makes for a trivial portion of the overall cost of the operation. Why make the whole operation illegal (making it hard to advertise, recruit employees and customers, avoid imprisonment, etc) by not using voluntary donors to reduce costs by a few percent?
Consider that the surgeons make up a much larger portion of the cost. Should we fear that legalizing organ transplantation will drive a criminal industry kidnapping and enslaving surgeons to perform organ transplants? We don’t see such an industry for coronary bypass operations, so we shouldn’t expect it for organs.
If you need a kidney, you find someone who has an extra, and you buy theirs. Also, you can opt to sell your organs when you die, instead of just donating them.
This scenario provides several strong incentives for unscrupulous agents to harvest people’s organs without asking for permission (in addition to any existing incentives that may exist in our current society). Thus, I believe that the total utility of legalizing the organ market (as I currently understand it) would be highly negative.
If that becomes a problem, have the government check to make sure that the people who are listed as selling kidneys both gave permission (preventing people from just harvesting without telling you) and is actually missing the organ (preventing people from claiming they gave an organ that was harvested from someone else). The only other option is for the entire operation to be off the books. This would be prevented the same way it is now, along with the fact that people are less likely to buy organs on the black market if there’s a legal option.
Also, even if that was the only way the organ market worked, for every organ stolen there’d be a life saved. It seems like it would still be positive unless they actually killed the people they were taking organs from, and even then only if they only took one organ each. How could it be highly negative?
How would the government achieve this in practice ? For example, let’s say there’s a demand for livers this month. How would the government know whether the liver A for patient B came from a legitimate donor, some unfortunate homeless person within our country who was robbed of his liver against his will, or from some foreign national who lives in one of those totalitarian and/or lawless countries where human life isn’t worth much ?
Furthermore, let’s say that people could sell their organs after they die—by proxy, presumably—as per your scenario above. Doesn’t this create a powerful incentive for unscrupulous agents to speed their demise ?
I don’t think this is true. Firstly, organ transplant procedures do not have a 100% success rate, due to rejection issues, surgery complications, etc. Secondly, what do you mean by “a life saved” ? All lives will end eventually. Would it be worthwhile to shorten someone’s life by, say, 10 years (due to their loss of a kidney), in order to grant someone else 5 extra years of life (by using that kidney) ?
If it didn’t come from a legitimate donor, either the doctor has to explain why he didn’t say who the donor was, why the donor doesn’t know about it, or why the “donor” still has a whole liver.
As for the foreign country, just don’t accept organs shipped across national lines if the other nation doesn’t check the stuff. I suspect it’s a bad idea to ship organs across national lines anyway, as opposed to just shipping the donor, but I don’t really know all that much about how organ donation works.
No, but I’m willing to bet that’s not what the ratio will be. If losing an organ hurt you more than it helped the person getting it, nobody would ever consider donating them.
Edit:
You mean their next of kin? I don’t see how it’s much more of an incentive than it would be to kill them just for the inheritance. Also, I suspect that the health insurance company would normally take the money, since most people aren’t going to be in a position to donate their organs and people tend to be loss-averse.
Organ transplantation costs tens to hundreds of thousands of dollars, including the costs of doctors, hospital time for recovery, drugs, etc. Paying less than $5,000 for a legal kidney (at prices in Iran), or even $25,000 in rich countries with more expensive surgical staff, makes for a trivial portion of the overall cost of the operation. Why make the whole operation illegal (making it hard to advertise, recruit employees and customers, avoid imprisonment, etc) by not using voluntary donors to reduce costs by a few percent?
Consider that the surgeons make up a much larger portion of the cost. Should we fear that legalizing organ transplantation will drive a criminal industry kidnapping and enslaving surgeons to perform organ transplants? We don’t see such an industry for coronary bypass operations, so we shouldn’t expect it for organs.