Squashed is concerned about the ethics and equity of a market in human organs:
The human body is not for sale.
Let’s back up. I think capitalism, on a whole, is a good thing. But I have no faith in the mystical power of the market to solve problems that it has, demonstrably, failed to solve. Their are some things I am not willing to sacrifice on the bloody altar of extractive capitalism in order to appease the hungry gods of the market.
Even at its best, capitalism is about creation and distribution of wealth. One of the great things about kidneys is that they’re pretty optimally distributed. Almost everybody has two of them. Nobody wants three of them. There are no speculators on kidney futures. Supply is almost perfectly matched to demand. Once in a while somebody needs a new kidney. Similarly, people die and stop using their kidneys. Thankfully, we can do transplant. We have a system that works pretty smoothly. If we needed to increase our kidney supply, we could tweak a policy, say by making organ donation opt-out rather than opt-in. Or we could pray to capitalism and ask it to do its thing, recreating existing structures in its own image. And suddenly we’ve got a kidney surplus—so we can sleep comfortably at night knowing that we’ve added “kidney failure” to the list of things our money and privilege can prevent us from dying from. (As usual, we ought not inquire too closely into where that warehouse full of frozen kidneys came from.)
Of course, voluntary exchange for human kidneys would not “appease the hungry gods of the market,” who do not exist, but save some or all of the 4,500 Americans who died waiting for a kidney last year—who are unequivocally real.
Kidneys are not optimally distributed. Nor does our system of donation work smoothly. In fact, last year alone millions upon millions of surplus kidneys were wasted while thousands of needy donors died.
Last year, 85,000 people were on the waiting list for a kidney transplant in the United States. For those on the list, a donor kidney is of enormous value: every one of them needs a new organ to survive. Meanwhile, of about 2.4 million Americans who died last year, only 6,662 donated their organs after death. Unless the dead have a personal or religious reason to keep their cadaverous organs intact, their kidneys have no value at all. We ought to ask capitalism to “do its thing”—that is, to reallocate cadaverous kidneys from low-value uses like throwing them in holes in the ground and covering them up with dirt to high-value uses like transplanting them into needy donors.
I understand the ethical objections to a market in organs from live humans, though I don’t agree with them. But for the sake of argument, I’ll accept that live organs are too special to “sacrifice on the bloody altar of extractive capitalism.” Fortunately, a cadaverous organ is no longer a unique and beautiful component of a human life—it is a bit of flesh soon to decay in the body of the deceased.
Squashed suggests “making organ donation opt-out instead of opt-in” as a possible policy option. Under such a system, we might increase the supply of organs, but it’s easy to imagine organs harvested from the uninformed against their will. Under the current system, we have a shortage of organs, but at least every donor has clearly consented to give up their kidneys at death. Voluntary exchange would solve both problems: supply would increase while maintaining express consent from each donor.
In fact, I think Squashed touched on the correct solution to the kidney conundrum. “There are no speculators on kidney futures,” he writes. But there ought to be! Why not allow me to sell an options contract on my kidney, redeemable after my natural death in exchange for some sum of money paid to my heirs? Such a contract would be totally voluntary. Redeemability and payment after natural death would both prevent the poor from grinding themselves “in the gears of capitalism” in pursuit of a quick buck, and prevent foul play in pursuit of fair organs. Most important, kidney options contracts would save tens of thousands of lives each year.
Some will surely object that I am blinded by ideology, dedicated to extending cold capitalist logic to a market in human life. But which belief is really more rigid: an unswerving declaration that “the human body is not for sale,” or the idea that we should adopt any voluntary mechanism that will help more suffering humans in need?
Reblogged from squashed 4 months ago; Comments |
