Dying for a piece of you

Dying for a piece of you

Saturday, July 31, 2010 - Stimulus That! by Jim Picht

Natchitoches, LA (7/31/2010) - A friend died intestate this year, so her possessions will all go to her deceased husband's children. Her family (mother and siblings) gets nothing, not the house that she paid for, not family heirlooms that had been entrusted to her, nothing at all. That prompted me to make revising my own will a top priority this week, and while I was at it I made provisions for the disposition of my organs in the event that I end up a vegetable and my wife decides to pull the plug.

My organs will be made available for transplant; I'd prefer that they be made available for sale. They'll be donated, but only if the transplant surgeons donate their services. I don't think that surgeons should have to work for free, but neither do I think my estate should get nothing for my pristine and healthy liver. I don't smoke or drink and I never have. My doctor tells me my heart and lungs are in excellent shape and I have the liver function of a man half my age. The rest of me may be falling apart, but I'm carrying around some prime organs, probably worth hundreds of thousands of dollars on the open market, if there were one, but there's not. Why not?

We have laws against it, that's why not. When I ask people why they think we should have such laws, they tell me that they protect the poor from exploitation by the rich. I didn't know that Bill Gates was out to collect poor people's kidneys, but I guess rich people are different from the rest of us. Still, why do poor people need someone to tell them they can't sell their kidneys? Are they stupid? Would $20,000 for a kidney be blown on liquor and cigarettes? Who'd pay good money for the kidney of a smoking booze-hound? It seems to me that the ability to raise that kind of money on short order would be pretty valuable to poor people, especially to people who take care of their organs. It would be a godsend for their heirs.

Perhaps the laws stop people from acting too quickly to pull loved ones off life support. Do the children of the rich yank their grandmas off life support so they can inherit? Perhaps they do, but that only means that a change in the law would put poor old people on the same footing as rich old people - they'd have greedy heirs yanking them off life support to get their estates. Or perhaps we think that the children of poor people are more likely to succumb to greed than the children of rich people? How odd, and how classist.

Perhaps by prohibiting organ sale we hope to prevent organ theft and black markets, but if organs were for sale, they'd probably be much less valuable to thieves than they are now. Who wants to run the risks of buying stolen organs (and paying the black-market costs) when they can be had on eBay? By the way, those stories of people waking up in New Orleans hotel bathtubs full of ice with notes saying their kidneys have been taken are ridiculous. If I were kidnapping people to steal their organs, I'd take all of them and leave no witnesses. Why would anyone want to pay me the very high price I'd have to charge for that kind of wet work when they could get the goods easily through legal channels? Making the sale of something legal doesn’t create black markets for it, it destroys them. There will be no serious black market for milk until we ban the sale of milk.

The laws against organ sales don't protect organ donors or their families. They don't protect poor people or make transplants more affordable to them (the concept of "affordable transplant" is up there with "cheap nuclear power" and "budget space travel"). They don't reduce the likelihood of organ theft or keep human turnips on life-support. What they do is produce a shortage of organs, keep kidney patients on dialysis for years, make young people wait for hearts until they're too sick to survive a transplant, and doom a lot of people to slow death when organ sales would let them live. Our laws against organ sales enrich doctors, hospitals, dialysis centers and organ banks. Because patients and insurers don't have to pay for kidneys, they have more money to pay for surgeons and hospital rooms. If people could sell their organs, hospitals and physicians would make less profit. Hospitals would sell fewer services to people chronically ill with organ failure, dialysis centers would have fewer customers, more physicians would be providing more transplant surgeries at lower cost. Organ banks would have to stop paying their directors six-figure salaries. It's no wonder that medical organizations lobby so hard against legalized organ sales.

Anyone who's had ECON 101 knows that allowing organ sales would increase the availability of organs. The ban is a price-ceiling, and price-ceilings create shortages. Get rid of the ban and the shortage goes away. This can only be a benefit to patients, and there's no persuasive argument that it would be bad for organ donors and their families. Giving their organs market value would in general be to their good. It might make you feel good to give your kidneys away, but then it should also make hospitals, doctors and nurses feel good to give away their services. It would be a disaster to decide therefore that we should cap their prices at zero. We shouldn’t require organ donors to be the only ones in this business to “feel good” about their generosity. Let them feel bad and compensated.

James Picht teaches economics at the Louisiana Scholars' College in Natchitoches, Louisiana. From the age of six he always knew what he wanted to be. Economist wasn't it. But after accidentally falling in to it he found that he liked it. Now he also likes raising his two children, being a husband to Lisa, and taking pictures of trees in the middle of the night. He eats right and takes mostly good care of himself, and if a tree doesn't fall on him his reward will be living long enough to go back to diapers. It's enough to drive a man to drink.

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