I think this law [making sales of kidneys illegal] is basically a form of mass murder. The government is not merely allowing 5000 deaths a year, or failing to save 5000 people; it is killing 5,000 people a year. Since the killing is unjustified (it is not, e.g., done in self-defense, or defense of an innocent third party, or as just punishment for a heinous crime, or as a form of euthanasia), it is murder.
This is from Michael Huemer, “Why Not Sell a Kidney?,” April 6, 2019. Huemer is co-blogger Bryan Caplan’s favorite philosopher. The title does not quite fit the content, by the way. The post is really about why kidney sales should be allowed. So don’t worry that Huemer is trying to persuade you to sell your kidney.
In case you think the quote above is an overstatement, first go and read Huemer’s whole post, which is not long.
I wrote a memo justifying kidney sales in 1983, around the time Representative Al Gore’s bill was introduced in Congress.
READER COMMENTS
Warren Platts
Apr 7 2019 at 2:58pm
Kidneys are already for sale: China offers a brisk market in Uighur, Falun Gong, and Han kidneys for sale to the highest bidder….
john hare
Apr 7 2019 at 3:21pm
I attended a talk by Don Boudeaux at Webber and he says 30,000 to 50,000 deaths a year because it’s illegal to buy a kidney.
Scott Sumner
Apr 7 2019 at 4:38pm
I agree with John; recent estimates are much higher than 5000 per year.
Matthias Görgens
Apr 7 2019 at 9:31pm
Huemer is a great bullet biter: someone ask in the comments “wouldn’t poor people be pressured into selling a kidney to support themselves?” (I assume the implication is that they wouldn’t get welfare otherwise or so?) And Huemer just answers that he’s OK with pressuring people into saving someone’s llife.
David Henderson
Apr 8 2019 at 9:08am
Yes, I noticed that too.
Donald Boudreaux
Apr 7 2019 at 9:34pm
State prohibition of the voluntary exchange of kidneys and other transplantable body organs by adults at mutually agreeable prices above $0 is as murderous as would be state prohibition of the voluntary exchange of food and water at mutually agreeable prices above $0 – which is to say, it is indeed murderous.
Matthias Görgens
Apr 8 2019 at 11:38am
Price gouging eg after natural disasters usually meets with strong social resistance. I am not sure, some jurisdictions might even have legal barriers to it.
Sounds murderous by your definition.
Jon Murphy
Apr 9 2019 at 7:58am
In the article, Heumer does call price gouging legislation murderous
Todd Kreider
Apr 7 2019 at 11:16pm
By the time kidneys are allowed to be sold, synthetic kidneys will be perfected. It looks like 2025 to 2030.
John P Palmer
Apr 8 2019 at 9:18am
Two comments:
It is easy to recommend a market for organs (and indeed I do support having one) but in Canada we socialize the risks of everything. People who sell a kidney are at slightly increased risk of needing a kidney or dialysis themselves in the future, and the costs of this would be borne in part by taxpayers. I’d like to see an amendment to the policy requiring sellers (here in Canada) to have supplemental health insurance.
A simple transition to allowing a market in human organs might be a futures market in organs. People could sell options for their organs and body parts, possibly to intermediaries like insurance companies, who would then be able to assign the usable organs and parts to whomever they would choose. See this.
Matthias Görgens
Apr 8 2019 at 11:46am
If healthcare is socialised, then the reductions in medical bills for the recipients will probably outweigh the increase for the donors?
In any case, compare your suggestion with David Henderson’s observation that the market clearing price for kidneys would likely be below what living people would accept and the market would be dominated by kidneys from the recentlied departed.
That suggests that you could probably get eg lower health insurance premiums in return for an organ donor card. Either as a completely private transaction: whoever is financing the reduction in premiums gets the right to your organs; or perhaps even as an alternative palatable to the general public right now, if financed via eg the government (or some association of people in need of organ donation or their insurance companies.)
Kurt Schuler
Apr 8 2019 at 8:43pm
Here is my site on the subject, which has links to some others:
https://www.organreform.org
David Seltzer
Apr 8 2019 at 9:48pm
There is a market for total body sales The NFL compensates players for their talent, risk of injury, disability or death. Players know the risks of CTE, ALS, dementia and suicide, yet still sign contracts to play. The public has little problem with this as NFL revenues are at record levels. Finally! I boxed for many years. My point. I have total dominion, authority and jurisdiction over my person. What I do with my corpus or what I put into it is no ones business so long as there is no third party harm.
Sigrid Fry-Revere
Apr 10 2019 at 4:01pm
Sales are not necessary — look at the Netherlands. Sales are also misleading because we are not honest about the risks. How much should a living organ donor get for giving up his / her reserve when it comes to illness or pregnancy. Yes, every pregnancy for a living organ donor should be treated as a high risk pregnancy where both the mother’s and the fetus’ health are at above average risk because the mother has only one kidney. Look at the complications page at http://www.kidunot.org/complications. That is the real question? How much should a donor be paid to make up for that risk. Or, the risk that should s/he ever get cancer, some of the most effective forms of chemotherapy cannot be used on someone with just one kidney. I’ve looked into purchasing health insurance for donors to deal with such complications and I haven’t found a single insurance company that thinks such a policy can be written with reasonable premiums. The risk is too high. Yes, people are allowed to take risks for whatever pay they are willing to accept, but if society is not honest about the risks, then there can’t be a fair market. So why have one, when places like the Netherlands have solved their kidney shortage by just being fair to donors and making sure they get the medical and financial assistance they need. In the Netherlands, most 72% are friends and relatives for whom the main benefit is saving someone they care about. You can’t put a price on that — but having the necessary medical and financial assistance in place to make donations safe for donors, these types of donors can donate with much less risk to themselves than in a market situation like in Iran, which by the way, now has a lower rate of living organ donation than the Netherlands. See my TEDx https://www.youtube.com/watch?v=W1IgNZyrNWQ
David Henderson
Apr 11 2019 at 12:01pm
Thanks. I’ll take a look at your talk in the next day or two.
But just to clarify, I’m not clear that there’s a huge amount of dishonesty. There may be misinformation and people like you will be helpful in giving people information. Fortunately, the number of adults who are in the stage when they are contemplating pregnancy is well under half of adults, and indeed, just doing the numbers in my head, well under one quarter of adults. So they obviously would not be the people most willing to price a kidney.
And that’s alright because no one would make them sell their kidney.
I suspect that if people were allowed to sell their kidneys, over 80% of the supply would come from dead donors. So I think the problems with live donors that you’re referring to above will turn out to be a small problem.
Dalton Lee Gossett
Apr 16 2019 at 9:59am
In this article posted by David Henderson, I was able to take a look at two additional posts advocating for the sales of kidneys to be legal. After double checking the statistics mentioned in both, I found that when it comes to those who suffer from kidney failure, they are extremely accurate. The arguments stated in both seem to be relevant and well stated, however in the article titled “Why Not Sell a Kidney?’, I don’t believe the examples mentioned really exemplified the situation accurately.
In “Why Not Sell a Kidney?’ by Michael Huemer, I agreed with certain aspects mentioned as a part of his argument. Such as the ratio to how many healthy donors they’re are to those with kidney failure, the legal notion preventing kidney sales takes away initiative for those to donate, and how saving a person’s life should be a top priority in society. And even though I do agree that kidney sales should be legal, I also understand that like other plans to help, they can be corrupted. Because when thinking of sales, marketing, and authenticity today, all of the following can be falsified. What I mean by this is the kidney would then become a product, meaning that it would be open to the opportunity of someone committing fraud and being held liable upon transplant failure. There is always a level of risk when entering into a transaction with another party.
That is why I believe the government has made the act of kidney sales illegal. Huemer lists some interesting examples to try and explain how this justification is technically murder, however they do not exactly relate to the situation at hand. I say this because in the examples it mentions a person threatening another person not to help another specifically through violence. That is not what the government is doing at all, they have just made the act illegal.
In conclusion, I do agree after reading both articles that kidney sales should be legal, but only if they have a checks and balances system to be able to prevent corruption. If that can be done, I believe that it would give donors a great incentive to help save another’s life. Also, as mentioned in the archive article “My 1983 Piece on Market for Kidneys”, it provides some information about the risks associated with donating are extremely low. I found this article, even though older, to be more relevant than the other because the facts and argument seemed to be stated so much better.
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