Here’s a short inverview/profile thing I did recently for the “Good Question” series that the Kenan Institute for Ethics has been doing. There was a high-concept photo-shoot and everything, so if you’ve ever wanted to see me hanging around in a junkyard warehouse surrounded by various spare parts (I’m sure you see the connection here), then now’s your chance.
{ 8 comments }
Substance McGravitas 08.09.11 at 12:50 am
I clicked to enlarge but you weren’t that much bigger. Maybe you can pick up some larger organs somewhere.
tomslee 08.09.11 at 3:14 am
If I read that right, it’s the suggestion I have seen that there is a problem on the demand side (“you can’t get a transplant unless you have the insurance to pay for it, despite others’ willingness to donate their organs”). Is that so? If yes, it hits Becker’s case (paying people to produce supply) over the head very effectively.
Kieran 08.09.11 at 5:31 am
Not quite I think—looks like there might have been some truncation in editing. The part about insurance—you need it, except in the case of kidneys—is true, but the second clause gives the wrong impression. The constraint is on the supply side, in that there are more insured patients (who get waitlisted) than there are organs available to transplant into them.
Tim Worstall 08.09.11 at 8:54 am
Or to take the UK case: the NHS will do the transplant if there’s an organ available. One recent number (I don’t know whether it’s correct or not) is that 1,000 people a year die waiting for a kidney.
A transplant is much cheaper for the NHS than dialysis (£17 k for the transplant, £5k a year for the drugs every year thereafter as opposed to £30k per year on dialysis).
As far as I’m aware, there’s only one country that doesn’t have a waitlist of any length. Iran, which is also the only country where the government pays a couple of years’ minimum wages to donors (with the ability for the recipient to top that up).
None of the other possible systems, opt in, opt out, presumed consent, produce sufficient organs simply because not enough people die healthy enough to provide the needed number of organs of the right type.
If the UK govt paid £24-£30 k to a live donor, roughly that Iranian number scaled up, it would still be vastly cheaper over the roughly decade that transplants last on average.
This was recently floated in the BMJ by a Scottish academic who had sat on (does sit on?) something like the transplant ethics board. Boy oh boy did she get some stick for it.
roac 08.09.11 at 2:39 pm
If you think paying somebody to donate a kidney is OK, what do you think about a heart? (Check made payable to the donor’s heirs, of course.)
“If the rich could pay other people to die for them, a poor man could make a good living.”
hartal 08.09.11 at 5:54 pm
Interesting interview. I am trying to work through Boltanski’s very dense sociological work on standardization, equivalence, tests (tests of strength and legitimate tests). Kieran, what do you make of this often dazzling work?
Tim Worstall 08.10.11 at 4:48 am
“If you think paying somebody to donate a kidney is OK, what do you think about a heart? ”
We allow people to donate a kidney, as we do part of their liver or even part of their lung, as live donors. We don’t allow people to donate their hearts for the obvious immediate death exception (although there was, if I remember correctly, actually a live heart donation case. One receiving cadaver heart and lungs combined was able to be a live donor of their heart that went to another).
Given that the gifting of a kidney is just fine why not offer that douceur to stop people dying on dialysis?
roac 08.12.11 at 2:56 pm
Yes, I know we don’t allow it. The question for a libertarian is, Why not? If somebody, for whatever reason, values their life at a lower figure than the financial benefit to their family, why — from a utilitarian or libertarian point of view — should something like the Hippocratic Oath be allowed to interfere with economic rationality?
As for the kidney-selling part, I myself wouldn’t have a problem with it if (1) payment is on a flat-rate basis and (2) the harvested organs continue to be allocated by an impartial body according to published criteria. I don’t care much for the idea of competitive bidding.
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