Up@dawn 2.0

Thursday, May 2, 2013

Organ donation, an economic step forward.

My final blog post part the Deux
After pondering on the presentation in class about the current state of organ donations I recalled a proposal that I agree with, that we should allow for the sale of organs.

The proposal, or at least acknowledgement of the possibility for such a market, is from the writers of the book Freakonomics and an article about the topic can be found here (http://www.freakonomics.com/2008/04/29/human-organs-for-sale-legally-in-which-country/)

There is currently a constantly overburdened waiting list, and many people die each year because they did not receive a donation in time.
Because: There is a constant of shortage of organs and certain organ donations can be made without causing significant harm (in this proposal, specifically kidneys.)

Iran allows the sale of organs, and does not have a transplant waiting list. I agree with

    In everything there’s good and bad, the same is said for the trade of organs.  So let’s look at some of the supposed ethical problems with it.

The first argument is the argument of “Self Autonomy,” the argument that we have the right to do with our bodies as we wish. Unlike in some of the other presentations involving this problem, this doesn't seem to be a strong argument against the sale of organs, because we can already donate organs as well as other parts of our bodies (blood, skin, sperm, etc.) If we can give them away for free, why should we be unable to be compensated for them? While eggs and sperm present your own unique problems (even though both can be sold,) blood and kidneys do not. As long as we can construct a sufficient system for their sale, there should be no qualms in selling.

Many tend to believe that there is an ethical problem in sale of one’s organs, due to the possibility that the donor is agreeing when they would not otherwise (a form of coercion.) I read in a plan proposed by a Stanford professor an argument against this. He explained that every single day we do things for payment, things we wouldn’t normally do. For example, many go to jobs that they do not find joy in simply because of the money they receive for doing so (a topic covered at length in a presentation.) Implying the invalidation of the notion that money being involved drastically changes the issue.

Erin and Harris In their paper at the bottom of the post provide a set of policies that should remove a few more major concerns with a market for human organs and they are
  1. It is limited to a particular geopolitical area, such as a state or the European Union, with only citizens or residents of that area being allowed to sell or to receive organs.
  2. There is a central public body responsible for making (and funding) all purchases and for allocating organs fairly in accordance with clinical criteria. Direct sales are banned.
  3. Prices are set at a reasonably generous level to attract people voluntarily into the market.
The idea behind the rules would be to eliminate the fear that we would start buying organs from other countries to implant, to prevent exploitation. They also proposed banning direct sales.  They did this to try and prevent complete economic takeover of the system where the most willing and able to pay would get the organs, instead of who needed them most.

Another idea they prepose is limited healthcare coverage for those providing the organ, so far as covering risks because of the surgery and loss of organ itself.   This with the encouragement of money itself provides coverage for the risk, time, and effort involved with giving an organ. Opposed to the current system where you must care enough to give, and risk penalties to yourself including complications of the surgery and supposedly some insurance companies will raise your costs because of the possible complications down the road.  These papers and proposals are all written by economists with the acknowledgement that people need some kind of incentive to partake in the risks involved with giving an organ, and since some of the other ideas to reduce the shortage of organs are far more ethically complicated, propose that money is always good incentive.


Erin, C. and J. Harris, 1994, “A Monopsonistic Market” in Robinson, I. (ed.) The Social Consequences of Life & Death Under High Technology Medicine, Manchester: Manchester University Press, 134–157.


  1. One other issue here, if organs are for sale to the highest bidders: the rich get richer, the rich live longer. Better plan to extend health care to the coverage of organ purchase too.

  2. Oh i did miss that, forgive me it was late (or rather early depending on how you look at it)
    One of the economists suggested that an organization be formed just for handling the organ collection and dispensing. This organization would handle the income of government and charitable funds to dispense to the donor, provide the limited healthcare and followups to the donors, and combined with rules 1 and 2 they proposed with the ban of direct sales hoped the institution would be able to make sure that they are not sold to the highest bidder and hopefully facilitate making sure they go out by order of NEEDs.
    But the whole thing might require a change in the way we do health care...Which i'd argue we need a good reboot of anyway.

  3. I agree with the possibility of being able to sell organs even though it is a form of coercion because I agree that people do already do things they do not want to because of the money they receive. But in contrast would there be a set price and would it stop with the selling of kidneys. Because when other organs are called into question, most of the time the donor is dead (ie. heart). Who would receive the money at that point? Would the organ donor have to have it in a last will and testament. Also would the loved ones of the deceased have the ultimate say and possibly go against the deceased's wishes and donate their organs just for a payday. Also would there be a price cap on the purchase of these organs and what about the people receiving these organs are they the ones purchasing them? I mean if we had a set up where it was the hospital purchasing these organs so there's not a financial burden on the patient then that would be good. Sorry if I'm rambling.