"Can we have your kidney, then?"

[Pangloss]

Over 70,000 patients in the US now need kidney transplants, but less than 16,000 donations are found each year. The waiting list has grown to five years, and each year 5,000 waiting list patients die.

 

An American doctor has proposed a solution -- allowing people to sell their kidneys for money. The plan involves psychological screening and government regulation, and the recipient receives a large cash payment (maybe $60,000) and free medical care for life (probably some sort of insurance plan).

 

The article below sketches things out a little differently from the TV story, but it's from the same source. (I've seen odd discrepencies between their TV stories and their online stories before, and I'm not sure why that happens. In this case it doesn't say "free medical care for life" in the online story, for example.)

 

http://abcnews.go.com/WNT/Health/story?id=2977619&page=1

 

To me it sounds like a pretty good idea, but I'm not sure. I think they'd have to be pretty careful to make sure that this doesn't get abused by desperate poor people, for example. I'm not sure I want to live in a country where the rich get the organs of the poor. But if it's people who are healthy and well adapted and have good prospects on life in general (and I'm not sure what I mean by that), then it feels like it might work.

 

What do you all think?

[ecoli]

sounds like an ok plan... better than taking organs without permission anyway.

 

I don't see why government would have the right to block such a plan, at any rate, should it be done privately.

[Glider]

As soon as you put monitary value on a thing, it gets abused. Unfortunately, kidneys already have a monitary value in many areas, and so the system is already being abused.

 

Another idea being considered is to put people on the donor list by default. At the moment, people have to 'opt in' to the donor list. The new system would put people on the donor list automatically, with the freedom to opt out.

 

This still provides freedom of choice, it just reverses the direction. I like this idea better than heating up the market for a trade in human organs.

[Dak]

you could combine the ideas: offer people a smaller cash insentive to become once-i'm-dead donours. maybe even something simple like $20 off of your medical insurance if you sign a donor agreement (would no doubt be cheaper in the long run for the insurance companies to promote organ donation).

 

all of the down-sides of buying organs dissapear if you're willing to wait untill they're dead.

 

lol, or maybe a quid-pro-quo arrangement? if someone recieves a lung transplant, yoink a kidney in payment whilst you have them open?

[swansont]

To me it sounds like a pretty good idea, but I'm not sure. I think they'd have to be pretty careful to make sure that this doesn't get abused by desperate poor people, for example. I'm not sure I want to live in a country where the rich get the organs of the poor. But if it's people who are healthy and well adapted and have good prospects on life in general (and I'm not sure what I mean by that), then it feels like it might work.

 

What do you all think?

 

It would be interesting to assess the prospects of a poor person's life expectancy and quality of life with one kidney, the cash and free health care vs "life as usual," which is generally adversely affected by the lack of money and access to health care.

[gcol]

The question, and the opinions so far, indicates that every moral and ethical principle has a price at which it can be bought and sold.

 

What is the value of the kidney futures market today. There isn't one? An opportunity for a genuine carpet-bagging entrepreneur then.

 

"Buy your moral principles for a dollar, mister?"......sod off. "How about a million, then?".......Er, can I have that in writing?

[CDarwin]

Another idea being considered is to put people on the donor list by default. At the moment, people have to 'opt in' to the donor list. The new system would put people on the donor list automatically, with the freedom to opt out.

 

That's what I support. I thought the UK was doing that? I read that somewhere. The New Scientist I think.

 

you could combine the ideas: offer people a smaller cash insentive to become once-i'm-dead donours. maybe even something simple like $20 off of your medical insurance if you sign a donor agreement (would no doubt be cheaper in the long run for the insurance companies to promote organ donation).

 

That would be like selling your body to science. I just worry about people taking the money and deciding "Hmm, I don't really want to give you my kidney after all" and unchecking the box.

 

I'm also afraid of the effect that might have on donorship. I think the points people bring up about the poor are vaild, especially once the stigma of "selling your organs" attaches. This plan could definately reduce donorship. The middle and upper classes would start to think that donating organs is something poor people do because they have to. Poor souls.

[john5746]

Never really thought about it before, but I would think you would really need to at least offer health care to the donor. Unless you have an emotional bond to the patient, why would someone donate their kidney?

[ParanoiA]

lol, or maybe a quid-pro-quo arrangement? if someone recieves a lung transplant, yoink a kidney in payment whilst you have them open?

 

I like that idea. You want your tummy tucked? Gimme a kidney.

[Pangloss]

Just to clarify, it's possible NOW to donate your kidney to, say, a loved one, or just because you want to, am I right? You just can't receive money for it, unless I'm mistaken.

[ecoli]

Just to clarify, it's possible NOW to donate your kidney to, say, a loved one, or just because you want to, am I right? You just can't receive money for it, unless I'm mistaken.

 

They do it on TV, so it must be true.

[mooeypoo]

As soon as you put monitary value on a thing, it gets abused. Unfortunately, kidneys already have a monitary value in many areas, and so the system is already being abused.

 

 

Allow me to be the whistle blower of logicl fallacies again here, but what you're saying is "Slippery Slope" argument. I do agree that it's a VERY problematic situation to control, but that doesn't mean you *can't* find ways to control it.

 

Better legislation and probably a strong committee may be able to solve this. But claiming that if we do it we'll fall to an endless extreme is the slippery slope, and i'm not sure it should be valid as an argument by itself.

 

BTW - maybe this can be equated to medical committees on other countries? I should research this but I heard there are some things like that in Europe (not with organ donation but pregnancies I think) but the point is the same, and if there's proof it works properly on other places, it may worth checking the methods here too.

 

Another idea being considered is to put people on the donor list by default. At the moment, people have to 'opt in' to the donor list. The new system would put people on the donor list automatically, with the freedom to opt out.

 

This still provides freedom of choice, it just reverses the direction. I like this idea better than heating up the market for a trade in human organs.

I must tell you, THIS i trust less than a committee... I see how 'opting out' of mailing lists, telemarketing and 'special lists' here is like, and I am not sure it's a good idea to have 'organ donation telemarketers' picketing on people on the phone to urge them to donate their body parts. There are many ignorant people - and MANY ignorant *poor* people - that can be taken advantage of. At least the other idea has a committee that if operates well, can make sure the person donating *knows* what he is getting into.

 

I guess what I'm saying has a flavor of 'slippery slope' too, but I still put more faith in a regulated committee (at least in a potential of one) than just opening it up for advertisement junkies pushing donations on you.

 

Anyways, my two cents.

 

~moo

[john5746]

How about this?

 

We have a national lottery. A portion of tax revenue plus monies from contestants goes into this lottery. Only people who agree to donate an organ can be a contestant. Every week you have a drawing and the drawing is only on those donors that match a patient in need. There would be multiple winners based on how many patients need an organ and how much money is in reserve. You win a sizeable amount of money, donate a kidney and no blackmarket crap.

 

Damn, I'm a genius - and humble too.

[ecoli]

Better legislation and probably a strong committee may be able to solve this. But claiming that if we do it we'll fall to an endless extreme is the slippery slope, and i'm not sure it should be valid as an argument by itself.

I hesitate in saying let the government have more power over it... I would say let the market deal with it, but that does have it's own problems too.

It would probably open more ignorant people up to scams... and people have a right not to get cheated out of their body parts.

 

There probably is no easy answer.

 

How about this?

 

We have a national lottery. A portion of tax revenue plus

boo... more taxes

monies from contestants goes into this lottery.

I'm ok with that one.

 

Only people who agree to donate an organ can be a contestant. Every week you have a drawing and the drawing is only on those donors that match a patient in need. There would be multiple winners based on how many patients need an organ and how much money is in reserve. You win a sizeable amount of money, donate a kidney and no blackmarket crap.

 

Damn, I'm a genius - and humble too.

 

That's not a terrible idea, though I expect it wouldn't completely get rid of the blackmarket, it would decrease the incentives.

[Pangloss]

How about this?

 

We have a national lottery. A portion of tax revenue plus monies from contestants goes into this lottery. Only people who agree to donate an organ can be a contestant. Every week you have a drawing and the drawing is only on those donors that match a patient in need. There would be multiple winners based on how many patients need an organ and how much money is in reserve. You win a sizeable amount of money, donate a kidney and no blackmarket crap.

 

Damn, I'm a genius - and humble too.

 

Yeah, not bad. Not perfect, perhaps, but the best middle ground I've heard so far.

[Glider]

That's what I support. I thought the UK was doing that? I read that somewhere. The New Scientist I think.

It's been suggested as a way to address the chronic shortage of donor organs, but I haven't heard anything about it for a while.

 

Allow me to be the whistle blower of logicl fallacies again here, but what you're saying is "Slippery Slope" argument. I do agree that it's a VERY problematic situation to control, but that doesn't mean you *can't* find ways to control it.

It's not really a slippery slope fallacy because (as I said) the system already exists and is already being abused.

 

Better legislation and probably a strong committee may be able to solve this. But claiming that if we do it we'll fall to an endless extreme is the slippery slope, and i'm not sure it should be valid as an argument by itself.

Inthe same way as strong committes have solved the problems of the illegal drugs trade and the illegal trade in Eastern European women as sex slaves and so-on?

 

The problem of illegal trade in human organs already exists, so there is no slope. All the idea does is to widen (and so heat up) a market that already exists. To suppose that it will be any different in the USA is just naive.

[mooeypoo]

Glider, that's a good point. I'll need to think about it.

 

But I don't know .. the fact that what we do today doesn't work doesn't mean that it *can't* work.. I need to research this further, I think (again) I read somewhere about committees like these actually WORKING in some places in Europe.

 

I'm not in 'the system' though, so I am not sure what goes on other than what I hear and read, and there's not much to read in the newspapers about illegal trading of body parts...

 

Still, those are good points.. I'll do some digging and get back (try to, at least) with some more concrete ideas.

 

I hope

 

~moo

[Severian]

What about other bits of the body? If you get a good price for your kidney, could you also get a good price for your retina? How about selling portions of your scalp for hair replacemnet surgery? Or your teeth?

 

Can we transplant limbs or appendages from one person to another yet? Maybe in a few years, these spam emails offering larger penises will have a different angle...

[gcol]

From a letter to the editor of the Organ Transplant Market Review, June 2020:

 

"Dear Sir, as chairman of the American Eunuchs society, may I say how encouraged we are by the phenomenal recent increase in our membership. We also note growing number of enquiries regarding the possibility of trading-in small appendages for larger ones. We have to point out the cost differential, larger ones being in short supply at the moment. Market forces will work themselves out, no doubt. We also note a similar increase in the number of proffessional athletes seeking heart and lung upgrades. Amusingly, some students are pressing for brain upgrades to be made compulsory for certain members of university faculties."

[Dak]

How about this?

 

We have a national lottery. A portion of tax revenue plus monies from contestants goes into this lottery. Only people who agree to donate an organ can be a contestant. Every week you have a drawing and the drawing is only on those donors that match a patient in need. There would be multiple winners based on how many patients need an organ and how much money is in reserve. You win a sizeable amount of money, donate a kidney and no blackmarket crap.

 

Damn, I'm a genius - and humble too.

 

if you want to combine chance and rewarding donours without resorting to buying organs, then maybe you could let the donours cue-jump?

 

I mean, i'm a donour (as in, carry the card that says people can salvage my body when i'm dead), i don't see why, if all else is equal, someone who isn't willing to contribute to the system should get an organ before me.

 

If donours can cue-jump, and non-donours thus have a higher chance of dying if they ever need an organ, i assume more people would donate?

[Royston]

Hmm, is the rise in diabetes in the U.S due to obesity, we have the same problem in the UK. I realize it's a genetic disorder, but it's also genetic to become obese, not to be obese. I think there should be restrictions on who receives a transplant if the patient doesn't take steps to make a concerted effort to change their diet, exercise regime.

 

If that's way off, someone say...but I don't believe somebody has the right to an organ transplant if they have the opportunity to reduce organ damage by changing their lifestyle. Obviously if there's nothing the patient can do, then that's a different story. I personally think it's a waste of money that could go into diabetes research and educating people on preventing the onset of diabetes...i.e put money into the cause of the problem, not rely on organ donations. It could be quite an attractive offer for somebody who needs $ 60,000, and perhaps more information on the primary cause of the rise in diabetes is needed here, before people start giving up their kidneys for cash.

[ParanoiA]

If that's way off, someone say...but I don't believe somebody has the right to an organ transplant if they have the opportunity to reduce organ damage by changing their lifestyle.

 

Well then every aspect of your lifestyle can be judged. That is so wrong. Denying someone an organ because you don't agree with how they treated their original one? I'll do anything to avoid that kind of "collective" centralized morality rule. Good bye individuality and self determination.

 

Obviously if there's nothing the patient can do, then that's a different story. I personally think it's a waste of money that could go into diabetes research and educating people on preventing the onset of diabetes...i.e put money into the cause of the problem, not rely on organ donations. It could be quite an attractive offer for somebody who needs $ 60,000, and perhaps more information on the primary cause of the rise in diabetes is needed here, before people start giving up their kidneys for cash.

 

See, I appreciate the sentiment. But what is "money" going to do? What kind of education do you think people aren't getting? I believe everyone already knows eating sugar and fat will make you obese and unhealthy. We don't need any more education - we need discipline. Money isn't any good for that either, as I'm not going to pay anyone to be healthy, but discipline is dying concept in america, anyway.

[Royston]

Well then every aspect of your lifestyle can be judged. That is so wrong. Denying someone an organ because you don't agree with how they treated their original one? I'll do anything to avoid that kind of "collective" centralized morality rule. Good bye individuality and self determination.

 

Well like I said, I might be way off, there needs to be more info on the primary cause. I don't understand what individuality has to do with it, I'm stupid enough to smoke, and drink quite heavily...if my liver packs up, it's my own stupid fault, I deserve to kick the bucket.

 

See, I appreciate the sentiment. But what is "money" going to do? What kind of education do you think people aren't getting? I believe everyone already knows eating sugar and fat will make you obese and unhealthy. We don't need any more education - we need discipline. Money isn't any good for that either, as I'm not going to pay anyone to be healthy, but discipline is dying concept in america, anyway.

 

Education probably wasn't the best example, but money into research rather than into organ donations seems appropriate. I've never understood the money into a quick fix, as opposed to a long term solution approach, especially where this is concerned...giving up an organ is certainly not to be taken likely. As for discipline, and if that really is the reason for a rise in diabetes in the west, then my sentiments are tough sh*t. But again, I might be barking up the wrong tree.

[ParanoiA]

Well like I said, I might be way off, there needs to be more info on the primary cause. I don't understand what individuality has to do with it, I'm stupid enough to smoke, and drink quite heavily...if my liver packs up, it's my own stupid fault, I deserve to kick the bucket.

 

You deserve to kick the bucket if you can't find a donor that will give you their organ as a replacement. You don't, however, deserve to kick the bucket because we have decided you don't treat your organs very nicely, and block you from getting one - that's called murder.

 

I am operating on the presumption you're talking about a law of some kind - that circumvents personal choice, freedom and ultimately individuality - since anyone who "behaves" differently will be denied privileges - like organs.

 

Education probably wasn't the best example, but money into research rather than into organ donations seems appropriate. I've never understood the money into a quick fix, as opposed to a long term solution approach, especially where this is concerned...giving up an organ is certainly not to be taken likely. As for discipline, and if that really is the reason for a rise in diabetes in the west, then my sentiments are tough sh*t. But again, I might be barking up the wrong tree.

 

I completely agree with solving the problem as opposed to treating symptoms. And I truly believe my spoiled countrymen are in dire need of reckoning. Discipline is a word associated with a bygone era over here. Our lives revolve around instant gratification. Eating healthy takes more time, interest - and it's not fun the whole time. Can't do anything that isn't fun you know...

[Royston]

Firstly apologies to Pangloss is this is going slightly off topic.

 

You deserve to kick the bucket if you can't find a donor that will give you their organ as a replacement. You don't, however, deserve to kick the bucket because we have decided you don't treat your organs very nicely, and block you from getting one - that's called murder.

 

I'm not sure I agree, I know perfectly well that smoking and my weekend / midweek drinking is detrimental to my health. Why should I get treatment when that time could be used on somebody who has had no choice in their condition. I'm not sure if it's possible, but if I could get figures on the amount of man hours, resources and money that's gone into treating smokers, the obese and heavy drinkers, and imagine if that was put into treating / researching cancer, progressive multiple sclerosis, coronary heart disease et.c et.c If you choose a certain lifestyle, then you should deal with the possible consequences of that lifestyle, you shouldn't be a hindrance to people who have had no choice in their condition.

 

I am operating on the presumption you're talking about a law of some kind - that circumvents personal choice, freedom and ultimately individuality - since anyone who "behaves" differently will be denied privileges - like organs.

 

Somebody correct me if I'm wrong, but I remember the NHS proposing that treatment for smokers is not preferential i.e they're stuck on the bottom of the list for treatment, which I personally agree with.

 

And I truly believe my spoiled countrymen are in dire need of reckoning.

 

Quite right