A market in kidneys?

[formica]

a few nights ago I went to a hypoethical in the city, chaired by Ben Richards and including a bunch of interesting people- Julian Burnside, a lawyer who wrote one of my favourite books on refugees in Australia; Sally Cockburn, a GP and 'media personality' who's big on Australian talk shows; the CEO of the Royal Alfred Hospital; my biomedical ethics lecturer; some PR guys, some ethicists, some people working for human rights organisations. And they all got together to talk about fun pharmaceutical and medical stuff, including some stuff on legalising a market in kidneys. So let's recreate that, but with metanet people.

Having two kidneys isn't exactly necessary. A bunch of research on kidney donations in the developed world has revealed that only having one kidney doesn't really shorten your life expectancy at all- the health risks are so minor that insurers don't take kidney donation into account.

Live kidney transplants are much more useful, medically, than kidneys from cadavers. I think you get an average of 5-7 years of kidney from a cadaver and around 20 from a live transplant.

There aren't enough kidneys going around in the current system, where selling kidneys is illegal but donations are allowed, and where all other kidneys have to come from deceased organ donors. There are a bunch of deaths on dialysis, and the whole situation is fairly sucky.

Kidneys currently cost a huge amount on the black market- hundreds of thousands of dollars- due to the expenses of bribing relevant officials, flying transplant teams to hospitals willing to do the transfer (with the best, least- regulated countries changing regularly) and the difficulty of finding the right donor. The people who actually donate their organs tend to get around $1000.

Kidney donors are screwed over in other ways, too, including a lack of follow- up care, people reneging on payment, etc. Plus, the health risks are much worse for kidney donors in developing countries, because the risk factors for diseases that might damage the remaining kidney are much higher.

So.

Legalising a market in kidneys, either nationally or internationally, would hopefully cut out a large proportion of the black market in kidneys. Those donating kidneys would get better care and better money, and costs for those needing kidneys would go down. People who own an extra kidney become empowered, because from now on the choice of selling it is always available to them. There's a net benefit (assuming the donors live in healthy conditions and have good access to medical care), because those receiving the organs get 20 extra years of life while the donors barely have anything shaved off their life expectancy. Plus, if distribution is arranged by the government on a needs basis (using the existing waiting list as a template), the rich won't be the only people benefiting from all this.

Sound good?

If not, what exactly feels off with the concept?

Are there other problems? Are people's bodies special, and therefore shouldn't be commodified? Or is there something wrong with the way that all the burdens of providing kidneys will fall on people in economically desperate situations? Are there better solutions? Say, conscripting everybody as an organ donor for when they die?

Go! Discuss!

[otters~1]

I think it's really sweet that there's a legit black market of human organs, so I don't support legalization.

[Luminaflare]

But what if one of my Kidney's breaks? normally I'd be fine but if I only had one left due to selling it I'd be needing that kidney, and would people really be happy to give me a kidney when they just paid me for one (UK health care is free).

[Aldaric]

Some people kill people for their organs. That is bad. It is actually a problem in China. I think you should be able to sell your own kidney though. The other organs cost a lot more for obvious reasons.

[t̷s͢uk̕a͡t͜ư]

Some people kill people for their organs. That is bad. It is actually a problem in China. I think you should be able to sell your own kidney though. The other organs cost a lot more for obvious reasons.

Some people kill for money. That is bad. It is actually a problem everywhere. I think you should be able to sell your own money though. Other people's money costs a lot more for obvious reasons.

[otters~1]

Some people kill people for their organs. That is bad. It is actually a problem in China. I think you should be able to sell your own kidney though. The other organs cost a lot more for obvious reasons.

Some people kill for money. That is bad. It is actually a problem everywhere. I think you should be able to sell your own money though. Other people's money costs a lot more for obvious reasons.

Yeah, I think the subset of people who kill for organs is significantly less than that of people who kill for sex or drugs, etc.

[formica]

Some people kill people for their organs. That is bad. It is actually a problem in China. I think you should be able to sell your own kidney though. The other organs cost a lot more for obvious reasons.

No they don't. At least, I've never read anything about it in the handful of articles I've read about the organ trade in China. The state just takes the organs of executed prisoners and sells them off for government funds.

There *are* large- scale rumours in the developing world about organ theft, though. It doesn't look like many (any?) people have been taking off the street and dumped in a bathtub full of ice blocks, but a bunch of people have gone into hospitals for appendix removal operations and then been told it was medically necessary to take a kidney, too.

Some people kill people for their organs. That is bad. It is actually a problem in China. I think you should be able to sell your own kidney though. The other organs cost a lot more for obvious reasons.

Some people kill for money. That is bad. It is actually a problem everywhere. I think you should be able to sell your own money though. Other people's money costs a lot more for obvious reasons.

Which only works if you look at organs as commodities and individuals as the property- owners of said commodities. If you wanted to argue that "no, an organ is a person or essential to being a person or something, it's a bit different. And bodily parts as commodities hasn't really gained that much widespread acceptance out of America and maybe India. There are even huge problems with it in Iran, where there is a regulated market, because people view it as akin to prostitution- selling a part of yourself that shouldn't be sold.

But what if one of my Kidney's breaks? normally I'd be fine but if I only had one left due to selling it I'd be needing that kidney, and would people really be happy to give me a kidney when they just paid me for one (UK health care is free).

Not actually that big a problem for anybody who knows how to look after the remaining kidney. Life expectancy of kidney donors is roughly the same as 'whole' people in the U.S, and insurance companies don't even charge higher premiums for donors. Of course, people who sell their kidneys would be lower- class, and lower- class people have the highest instances of substance abuse, diabetes (I think) and screwing up their kidneys, so it could happen.

I think it's more quality of life type stuff. Things to do with long- term pain at the operation site, lowered physical ability if they have to resect any of your ribs, and depression and that kind of thing about having sold a part of your body (a really big deal in Iran, and possibly India. The studies in India talk a lot about lowered levels of general health, but the Indian working class don't often talk about feelings of depression, instead putting depression in terms of general aches and pains and sickness that kind of thing.) Plus there's the issue of follow- up care. If you've sold a kidney to pay off debts or if you're generally slack or something, you might not have any money left over for follow- up care.