trying to make fun?

Are organs going the way of bicycles?

Check Megan McArdle's blog again

http://meganmcardle.theatlantic.com/archives/2009/07/moral_quandaries_that_arent.php

Um, arguing with an intentional misrepresentation of somebody else's position -- that an organ market should be legal -- really demonstrates the weakness of your own case. If you had a strong point to make, you would argue it against what McArdle has actually said, not some cartoonish caricature of it that you dreamed up.

Not that McArdle has addressed a single argument against donation, including those of the director of the bioethics center at her own university. McArdle said that the poor should sell their organs to the rich because the remaining kidney will compensate, insurance companies will pay the donor for the organ, lots of new organs will come on the market, and the donor will not be negatively affected--indeed, he will benefit greatly. She has not proven any of these assumptions, but evidence never has been McArdle's strong suit.

In addition, I don't understand why McArdle does not have the courage of her convictions. She needs to donate a kidney at once to prove that donors do not suffer any ill effects. Indeed, it's her duty to do so.

As for the chap in Brooklyn: he broke the law. I'm against that, even if the law is stupid, which is why I dutifully sign for my sudafed, instead of breaking into the pharmacy after hours. On the other hand, the law seems grotesque to me, possibly near the level where one has a duty to break it.

Tear down that law, Megan McArdle! If you are afraid to go to jail for your convictions, just donate one or more organs. That selfless act will do more to open the markets to organ selling than any mere blog post. Then you can sell more of your organs when the law allows.

You have two eyes--how can you sit there selfishly denying others your eyeball, when some people are blind? If the poor can do it, so can you, and maybe get rid of those pesky student loans or buy a house.

Megan's post under the link left by Digital Cabinet is absurd, but unfortunately the typical level of "quality" we've come to expect from her writing.

"Explain why we should prevent people from voluntarily donating a kidney..."

We don't. We prevent people from selling kidneys. Big difference. HUGE, actually. How does this idiot get paid for her writing?

@Susan of Texas, your obtuseness, I hope, is willful. Given your extremely weak and presumptuous arguments against legalizing an organ market, I assume you are also pro-life? I mean, obviously you think that the government should have a say over what people do to their own bodies. I also assume you are against legalizing marijuana, for the same reasons?

Besides all that, your inability to separate "personal convictions" from what is essentially an empirical debate over a quantifiable set of pros and cons marks you as a somewhat unsophisticated thinker. I think that, for the most part, nonviolent drug use should not be criminal. That doesn't mean I have a moral responsibility to go out and use a bunch of drugs. How insipid.

I have given no arguments against selling kidneys. You obviously have a problem with reading comprehension. I'd suggest you buy McArdle's reading comprehension, but sadly she doesn't have any either.

Susan - I don't anybody's arguing that people should be required to sell their organs, so I don't know what kind of rebuttal that is.

I would read the bioethicist's argument you're referring to, but I agree with Megan that as a general rule, people should be free to do things, and the burden of proof falls on someone wanting to prohibit an action. (That's not a statement of whether or not the burden is met with regards to selling organs, just a general principle).

As for the assumptions you mention:

- Clearly the other kidney with compensate somewhat; that's why kidney donors survive. The question of whether the other kidney compensates 100% is beyond my knowledge, but Megan did refer to a study indicating there was not an increased risk of kidney issues for donors. I'm always suspicious of people linking to "authoritative science" that happens to agree with their opinions, and I'm not going to pretend I can evaluate that study, but she did provide evidence for this statement.

- I don't see why it matters much WHO pays for organs. And if nobody is willing to pay for organs, why does it matter whether its legal? In the same way, if there's not a lot of new organs because people don't choose to sell them, why do we need to make it illegal?

- I don't see where someone's saying a person selling an organ benefits greatly (except for the $). As for the argument that the seller isn't negatively impacted, she did refer to that study, and I tend to think that modern science has evolved to the point where the impact isn't huge.

But my opinion is that a donor likely is somewhat negatively affected when donating an organ. Thus, a potential donor would have to weigh cost that against the benefit of the $ received. But I don't see why that shouldn't be a personal decision, and I do think the burden of proof is on those who want the government to dictate the decision.

Sure, I think there should be a lot of disclosure and information provided before someone should be allowed to sell an organ, but I don't want the government to be so paternalistic that it tells me I absolutely can't do something. I may not want to sell any of my organs, but there are other things I do want to do, and I hate the idea of a government constantly telling me I can't do things "for my own good".

Pseudonym - I'd agree that her phrasing was odd, but why is there such a huge difference between someone donating a kidney gratuitously and someone donating a kidney for money?

I don't anybody's arguing that people should be required to sell their organs, so I don't know what kind of rebuttal that is.

Since nobody stated that people should be forced to sell kidneys and nobody argued against the forced selling of kidneys, I'm not surprised you're at sea.

Reading comprehension, folks. Try it some time. I see no reason to take anyone seriously if they can't understand what they read. The fact that Dave refuses to even read a rebuttal tells me it wouldn't be a serious argument anyway.

you're right, Susan OT. Reading comprehension is awesome. and it's not that hard. For example, when Megan says that people shouldn't be prohibited from selling their organs, we can understand her as saying as much. But that's different from your characterization, where you claimed "McArdle said that the poor should sell their organs." "should be able to" is not the same as "should." I think that everyone should be allowed to eat nothing but ice cream if they want, but I don't think they should. I also think people should be free to be paid to eat ice cream.

Now, of course the poor will be the first ones to sell their kidneys if it were legalized. That's because they need money more. There's a lot of stuff that I do for money that Bill Gates never would. There's a lot of stuff that a lot of people do for money that others with more money wouldn't.

and @Clever Pseudonym, what exactly makes selling something an involuntary act? If I offered you $20k for a strand of your pubic hair, would it be an involuntary act on your part to oblige me? Or would you take me for a total dupe, as you should? What about when you go to work in the morning, all for money? is it really involuntary? are people really just automatic money acceptors in your model of how the world works?

First David,
When did I say there was? I didn't offer my opinion on the subject either way, at least not here.

Second David,
Where did I write that selling kidneys would be involuntary? All I did was point out Megan's completely wrong choice of phrasing. Again, I have so far given NO opinion here whatsoever.

"Should" doesn't mean "should be forced to" either.

Since you appear to want to make organ selling legal, why not look at nations that already make it legal? You can look at China, where all 8,000 kidneys transplanted in 2006 came from executed prisoners. No chance for exploitation there! Perhaps you would prefer Pakistan, "where two-thirds of the operations are performed on foreigners. The survey showed that almost 70 percent of donors were slaves or bonded laborers; 90 percent were illiterate; 88 percent had no improvement in economic status from the donation; and 98 percent reported a subsequent decline in health, including chronic pain from large incisions."

How about the Philippines? It's not legal there but it is common. You can sell a kidney for $900 there, a far cry from the $160,00+ that McArdle's commenters are fantasizing about. Egyptians might do a bit better selling their organs to rich Gulf Arabs--$2500 for example. How is an American to compete with low fees like that? Pretty scenarios of perfectly healthy and willing Americans getting rich selling useless kidneys are fun to imagine, but not very likely. Ignoring every negative aspect of the issue is dishonest.

MEgan sez:

Roy Edroso unctuously asks for someone to defend the Brooklyn chap who was just arrested for selling organs.

Can't she just say "snarkily" like everyone else? Or maybe she thinks Roy is an unguent.

Megan's a master of thesaurus abuse. She seems to be under the very mistaken impression that using words like that make her look smart instead of just absurdly pretentious. Not that it isn't ironic to see her calling someone else out for supposedly being affected and smug. That's her entire schtick.

The uncompensated kidney donation system has failed miserably, and people are dying as a result. You have two honorable options:

1. Get the hell out of the way and let voluntary, life-saving kidney sales go through.

2. Volunteer to be first in line to go under the knife and do your part to make the current system work.

Anything else is murder.

And it doesn't even occur to you to find a solution that doesn't entail exploiting the poor and cutting our their organs.

There will always be an easy, profitable way to solve a problem or make money by exploiting someone. That's why people do it. But demanding that it be done out of morality--that takes a very special sort of persson.

Susan:
If we assume rational actors, it's clear that someone is made no worse off, and in some circumstances better off, by being given the option to sell a kidney. With the option, you can either have the money or the kidney. Without the option, you don't get a choice--taking the money simply isn't an option.

The only way you can argue that someone is made worse off is if you posit that he's irrational--or, more bluntly, just too damned stupid to be treated like an adult capable of making his own decisions.

Is it indeed your contention that the poor are too damned stupid to be treated like adults capable of making their own decisions, and thus must be denied the right to sell a kidney if they believe that it's in their own best interests?

Think carefully before answering--you may not like the implications.

Susan:
Fair enough. There is, technically, a third honorable option: Tell the world about the workable solution you have for restoring kidney function without the need for donor kidneys.

I apologize for not recognizing sooner the extent of your scientific genius, but I must admit that you don't immediately come across as a person of such staggering genius that you'd be able to do what our best and brightest have been struggling to do for decades without success.

Berg, your understanding is limited and discussion is futile. Your attempt to persuade us that it would be condescending to refuse to exploit the poor is muddled at best and immoral at worst. You keep looking for reasons to cut up and sell the poor and evidently nothing will dissuade you because to you the human dignity of others is not even a factor.

I suggest in all seriousness that you sit down and read what Jesus said in the Bible. I am not a believer myself but I recognize the love and respect for mankind in his words.

Please remember you should put yourself in the place of Jesus' family and followers, not the Romans'.

Susan of Texas, you just got PWND. And you think you're defending the "dignity" of the poor by depriving them of the opportunity to not only save a life, but justly earn substantial compensation for it, thus making them no longer poor? You're not very bright. Getting paid to do something ≠ exploitation. Get over yourself, the so-called poor don't need your paternalistic and patronizing brand of "advocacy."

Susan, equating allowing poor people to make personal choices you don't think they should make with "exploiting" them is rather dishonest and certainly patronizing/condescending. I don't think people should drink themselves to death for a variety of reasons, but I don't feel even stronger that the government shouldn't prohibit individuals from drinking. How is your argument different?

Comparing the way the United States might deal with the freedom of individuals to sell their organs to the way that totalitarian dictatorships deal with it is simply illogical.

Let me add that it's important to look at all the negative possibilities arising from allowing individuals to make decisions about what they want to do with their own "guts." While developing ways to alleviate as many of the negative possibilities as possible, it should in no way prevent us from admitting that we, not the government, own our bodies and should be allowed to do with them whatever we want. Even poor people own their bodies.

Reason has responded as well:

http://reason.com/blog/show/135060.html

Reason has responded as well:

http://reason.com/blog/show/135060.html

If the donation process is truly voluntary, doctors should do the surgery for free too.

Susan of Texas, please note that many people who have donated kidneys, including me, believe that compensating kidney donors would be a good idea. If you are truly concerned about the poor, please consider donating a kidney yourself--most of the 80,000 people on the waiting list are, in fact, poor, either because they were to start with or because life on dialysis has made it impossible for them to work. (Only 10% of people on dialysis work even part time.)

It is easy to design a compensation program in which incentives encourage the rich to give kidneys to the poor. To take an extreme example, suppose you could get a one-year exemption from income tax for donating a kidney. The richer you were, the greater the incentive. On a more modest level, payment could take the form of a non-refundable tax credit, of use only to those with substantial tax liability.

Those are not especially attractive alternatives, since they only give rewards to the rich. But if that's your concern, it's easily addressed. For better approaches, see http://www.theatlantic.com/doc/200907u/kidney-donation

This issue is a lot of fun for people to argue about on comment threads, but it is not some kind of thought experiment. Real live human beings are suffering and dying every day under current policies. And, predictably, sleazy black marketeers are the winners.

Ms. Postrel, I've read your article before and I admire your selfless act. But it does not sanctify your cause.

I can't believe anyone would advocate harvesting the poor's organs. Arguing about the details is disgusting.

There are a lot of authoritarian people in this country and authoritarians do not recognize boundaries. Children forced to give up their own opinions, wants and needs for those of their authoritarian parents do not learn that there is a point at which "you" ends and "I" begins. You have the right to make your own choices and so do I. I do not have to be just like you, even if you have authority over me, as a parent, clergy, or president would.

Your rights and the needs of dialysis patients end at the skin of another human being. You do not have the right to create a world in which the desperate must decide whether or not to sell a body part. This is the United States of America, lady, and we don't buy and sell human beings.

What an individual decides to do within the law is his or her business. But we do not and will not pass laws to cut up the poor for our benefit.

"I can't believe anyone would advocate harvesting the poor's organs."

i don't think anyone is. i see why you seem to think so, but that's your misreading of the general thrust / predictions about where an organ market would lead us. kidney donation isn't exactly like a payday lender or other avenue of the financial desperate; it's extremely life-altering.

"You have the right to make your own choices and so do I."

you don't actually believe this, or if you do, for whatever reason it does not apply to "the poor" or anyone else who would enter into a financial arrangement for organ donation.

perhaps limiting the donor pool to people who make over x amount per year would help?

Every year thousands of people die horrible painful deaths because people like you can't get over the "ewwwww" factor of selling organs.

Get over it. People need the organs to live, other people need money and would continue to live after donation. So, one human being gets to keep living and the other gets some money.

I, myself, am willing to save human life at the expense of feeling a little icky inside. But if your need to avoid disgust is strong enough to send thousands of people to horrible painful deaths, then I really don't know.

Susan, I was thinking of responding, but then re-read this:

You do not have the right to create a world in which the desperate must decide whether or not to sell a body part. This is the United States of America, lady, and we don't buy and sell human beings.

And I realized you can't possibly be serious. You must be pro-organ selling and you're trying to misrepresent the opposition as simple-minded authoritarians who consider the poor to be no better than children.

Well, played, madam. Well played.

It is not condescending to the poor to to acknowledge that they don't have the same sets of choices as other people. The woman who takes out a payday loan because her paycheck can't reach to the end of the week and runs up a couple thousand dollars in interest--she would have pressures on her decision making that don't exist for the trust fund baby. It's all too easy for me to foresee the day when the collection agent calls and asks, "Well, have you considered selling a kidney?" The idea that the law would require anyone to sell their guts is a straw man; but it's not a straw man to see the private sector picking up the slack and applying pressure to the desperate -- not for the sake of the kidney but for the sake of the money. Thus there will be people who will feel that they do not enjoy free and secure possession of their own bodies. The law is not the only agent that compels people by force. So let's not pretend that the poor have the same choices or the same consequences when they choose. That's a lie, and you know it is. And a lie like that is an insult to the poor. It appears that you are willing to tolerate any insult to human dignity when it's someone else who has to experience its cruelty and callousness. Everyone in society has an interest in seeing to it that the poor are not driven to such desperate straits, which is simply that no one can fall further than the place where we place the lowest of the low. If the poorest are never driven by need to sell their guts, you can be damn sure that whatever happens to you, you will never have to. The best security for you is security for them.

The woman who takes out a payday loan because her paycheck can't reach to the end of the week and runs up a couple thousand dollars in interest--she would have pressures on her decision making that don't exist for the trust fund baby.

This implies that these are the only kind of people in the country, when we both know they're in the minority. Middle class folks suffer great financial difficulties, as well, and many would consider selling a kidney and saving a life while they save their house. Like poor people, middle class folks own their bodies.

...but it's not a straw man to see the private sector picking up the slack and applying pressure to the desperate -- not for the sake of the kidney but for the sake of the money. Thus there will be people who will feel that they do not enjoy free and secure possession of their own bodies.

This is condescending. You're saying that if poor people feel pressure to sell an organ, that pressure is beyond their ability to resist based on their own, individual beliefs. Well, like rich people and middle class people, some poor people are weak willed and some are strong willed. They don't need protection from their autonomy.

The law is not the only agent that compels people by force.

This is nonsense. What other agent can remove you from your home and family and imprison you legally by simply accusing you of breaking any number of arbitrary laws?

It appears that you are willing to tolerate any insult to human dignity when it's someone else who has to experience its cruelty and callousness.

And it seems you're willing to watch hundreds, if not thousands of people needlessly die because of your own personal notions of what constitutes "human dignity." This is not one bit different than a religious fundamentalist objecting to stem cell research. Not one bit different than those who want to outlaw abortion. Again, even poor people own their bodies and deserve the freedom to make choices regarding what they do with them.

And your last sentences assume that everyone would share your horror at making money via selling what they own (they're bodies) while saving someone's life. You are treating the poor as if they all share your values. And protecting people (forbidding them) from having to make choices that you, personally, wouldn't want to have to make (the end result being needless death and fewer choices for the adult individuals you call "the poor") is the very definition of condescending.

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