Should the poor be allowed to sell their kidneys?

opinion guy

Chuck Stone wrote: »

I'm only going to address this part of your post because the rest of it is merely a reason to regulate the market.



Apart from being a different issue those are livers are from dead people so I don't think he could buy one even if he wanted to. I don't think the families of dead people are allowed to put their organs on Ebay.

a) you can do a live liver transplant. You take away part of the liver from a person and it regrows and the part should grow in the recipient (liver being the only human organ to regenerate).

b) why couldn't he buy one ? its already happening

c) since there is a shortage each liver the alco burns through represents the death of someone else waiting on a liver.

For someone proposing this idea you don't seem to know an awful lot about it.

As to the rest of my post which you all seem to think is fair game to ignore - these are the extremes of the market. The same issues of donors being pressued to donate by finanical or other reaons, donor's ending up worse off due to health complications etc, apply, if not in so extreme circumstances.



You and seachmail have ignored my suggestion - make organ donaiton opt out instead of opt in. Its the obvious and moral thing to do

karma_

Seachmall wrote: »

No, but WHY WOULD THIS MARKET INHERENTLY ALLOW FOR THE MASS EXPLOITATION OF SELLERS?

Would it be impossible to regulate and impossible protect the sellers? If "yes", why?

We already exploit the third world, how would an international - for profit organ donation market be any different?

Chuck Stone

OldmanMondeo wrote: »

Come off it, this is after hours, nothing is ever serious. Cop on.

I don't see what the problem is. The discussion seems to have been quite amicable until you joined it throwing around slurs.

If you have a problem with anything report it.

LeBash

I hope no self respecting surgeon would cut into a perfectly healthy body.

opinion guy

Seachmall wrote: »

No, but WHY WOULD THIS MARKET INHERENTLY ALLOW FOR THE MASS EXPLOITATION OF SELLERS?

Would it be impossible to regulate and impossible protect the sellers? If "yes", why?

Because ALL markets allow for the mass exploitation of the 'motivated' seller. Its one of the fundamental characteristics of a market

Chuck Stone

LeBash wrote: »

I hope no self respecting surgeon would cut into a perfectly healthy body.

What about cosmetic surgery?

Seachmall

opinion guy wrote: »

You and seachmail have ignored my suggestion - make organ donaiton opt out instead of opt in. Its the obvious and moral thing to do

If you read back a bit I said it was by-far the best option when Karma mentioned it, but it's not what is being discussed.

Because ALL markets allow for the mass exploitation of the 'motivated' seller. Its one of the fundamental characteristics of a market

So should we shut down all markets?

There is a balance to be met in all markets. Some here are suggesting the balance cannot be met in this specific market but have yet to actually present a reason as to why that is the case.

LeBash

Chuck Stone wrote: »

LeBash wrote: »

I hope no self respecting surgeon would cut into a perfectly healthy body.

What about cosmetic surgery?

I did say self respecting.

Scanlas The 2nd

Chuck Stone wrote: »

karma_ wrote: »

I'm certainly not ignoring it Chuck, I'm just wondering who would sell a poverty stricken African a kidney on the cheap, when his good remaining kidney fails and he's on dialysis. It just wouldn't be profitable to do so when you could earn much more selling it to a rich man.

You're pointing to an extreme to make a case against something (it's probably a logical fallacy)

That's a bit like saying 'nobody should be working down mines because someone might die'.

There are risks and rewards. The risks of living with one kidney seem inconsequential.

+1

Risk and reward is hugely important in maximising people's happiness. There is the risk of dying when you get in your car. But clearly feel the benefits are worth the risk.

OldmanMondeo

Chuck Stone wrote: »

I don't see what the problem is. The discussion seems to have been quite amicable until you joined it throwing around slurs.

If you have a problem with anything report it.

Take your blinkers off and think about people who are effected about what your talking about. You have pointed out about this being about people with kidney disease, which is usually not because off drink drugs or other abuse.

I am sure most people with any organ disease would not like other people to suffer to help them live. I have no problem with organ donation once you die, I would try and encourage it if possible, but to give the poor and needy the option to be cut open and sell organs is stupid. Any money they might make would be used up in after care anyway.

And I stand by this being a vile and disgusting thread.

Chuck Stone

opinion guy wrote: »

a) you can do a live liver transplant. You take away part of the liver from a person and it regrows and the part should grow in the recipient (liver being the only human organ to regenerate).

I wasn't aware of this.

b) why couldn't he buy one ? its already happening

Again you're pointing to an extreme to try to discredit any transaction involving organs from people who choose to voluntarily.

For someone proposing this idea you don't seem to know an awful lot about it.

I'm not proposing it I'm playing with it as an idea and throwing it out for discussion. My view on the matter is not static. I know very little about the organ transplant market.

You and seachmail have ignored my suggestion - make organ donaiton opt out instead of opt in. Its the obvious and moral thing to do

Again this is a separate issue. You could opt out and still choose to sell, or donate, a kidney if you chose to.

texidub

LeBash wrote: »

I hope no self respecting surgeon would cut into a perfectly healthy body.

They do it all the time for aesthetic surgeries. And I think we can all agree that the rich are far more aesthetically pleasing than the poor.

/devil's advocate

Chuck Stone

OldmanMondeo wrote: »

Take your blinkers off and think about people who are effected about what your talking about.

Yeah people are dying waiting for transplants - perhaps this is a solution?

You have pointed out about this being about people with kidney disease, which is usually not because off drink drugs or other abuse.

Yep.

I am sure most people with any organ disease would not like other people to suffer to help them live.

Who said anything about suffering?

to give the poor and needy the option to be cut open and sell organs is stupid.

Why?

Any money they might make would be used up in after care anyway.

Source?

And I stand by this being a vile and disgusting thread.

I don't understand why you do at all tbh. Looks like you're seizing upon a perceived opportunity to get annoyed about something that you shouldn't be.

Seachmall

OldmanMondeo wrote: »

And I stand by this being a vile and disgusting thread.

These comments really irritate me. It's a valid, and interesting, hypothetical discussion. It doesn't intend to insult, dehumanise or in anyway offend anyone but rather question the practicality and ethical issues in such a market.

How can it be disgusting?

PhlegmyMoses

Seachmall wrote: »

These comments really irritate me. It's a valid, and interesting, hypothetical discussion. It doesn't intend to insult, dehumanise or in anyway offend anyone but rather question the practicality and ethical issues in such a market.

How can it be disgusting?

You also devalue your own points by explicitly demonstrating a bias.

Agreed on this. Although I disagree with some of the points made, it's an interesting discussion.

Chuck Stone

A better title for this thread would have been 'should people be prevented from selling their organs' rather than 'should the poor be allowed...'.

Suryavarman

Chuck Stone wrote: »

I'm not proposing it I'm playing with it as an idea and throwing it out for discussion. My view on the matter is not static. I know very little about the organ transplant market.

In that case I have some recommended reading on Iran's kidney market:

http://www.economist.com/node/8173039

http://www.aakp.org/aakp-library/Compensated-Donations/

http://cjasn.asnjournals.org/content/1/6/1136.full.pdf

andrew

I think they shouldn't be allowed to do it.

It changes the incentive structure of donation. With no remuneration, then you're almost guaranteed that a person is donating a Kidney for altruistic reasons. If you introduce money into the equation, then you change the reasons for which kidneys could be donated. In particular, you open up the possibility that individuals could be forced by circumstances, or others, into selling a kidney in order to, (for example) pay a debt. Given selling a Kidney is potentially very unhealthy, then this is a definite harm which accrues from opening up the kidney market. Imagine a bank telling someone with no material assets to sell a kidney in order to pay off a loan; economically efficient perhaps but socially harmful.

Of course, the above is an extreme case in which a person is effectively coerced into selling a Kidney. But it's possible to imagine a less extreme case in which a student is looking to finance, say, a year in college. To do this, she needs €10,000, which she could obtain by either selling a kidney, or getting a 1 year loan @ 10% interest. At the end of the year, she would be either 1 kidney down, or €10,100 down, and so you'd think that if she personally values her kidney at less than €10,100, she should sell it, right?

But what if the student is (as I think she would be) valuing her kidney incorrectly? If her remaining kidney were to fail, then the value of having that backup kidney would suddenly shoot up; in retrospect she'd have to be offered perhaps an infinite amount of money to have sold that kidney. It'd be almost priceless. That's a lot more than the €10,100 she sold it for. But she's young and healthy and doesn't really take into account the value of having two kidneys, and undervalues the fact that she currently has two healthy kidneys, and so sells one. I don't think people value their kidney enough to be able to make the rational decision to sell them. People are too systematically biased toward the present to be able to make that decision. Certainly, almost any payment they received would be too low. As it currently stands, the 'payment' they receive is that someone else is alive; it's hard to put money on a life, but being able to voluntarily save the life of someone in need is probably the equivalent of a very large payment. Receiving money for 'saving' someone's life, however, is likely to reduce, in people who are forced to sell a kidney, the value they place on having saved someone's life (so I don't agree that the fact that they're still saving a life means that the payout is merely enhanced).

Also, I havn't read this entire thread, so sorry if I'm repeating anyone's arguments.

drkpower

andrew wrote: »

But it's possible to imagine a less extreme case in which a student is looking to finance, say, a year in college. To do this, she needs €10,000, which she could obtain by either selling a kidney, or getting a 1 year loan @ 10% interest. At the end of the year, she would be either 1 kidney down, or €10,100 down, and so you'd think that if she personally values her kidney at less than €10,100, she should sell it, right?

But what if the student is (as I think she would be) valuing her kidney incorrectly? If her remaining kidney were to fail, then the value of having that backup kidney would suddenly shoot up; in retrospect she'd have to be offered perhaps an infinite amount of money to have sold that kidney. It'd be almost priceless. That's a lot more than the €10,100 she sold it for. But she's young and healthy and doesn't really take into account the value of having two kidneys, and undervalues the fact that she currently has two healthy kidneys, and so sells one. I don't think people value their kidney enough to be able to make the rational decision to sell them. People are too systematically biased toward the present to be able to make that decision. Certainly, almost any payment they received would be too low. As it currently stands, the 'payment' they receive is that someone else is alive; it's hard to put money on a life, but being able to voluntarily save the life of someone in need is probably the equivalent of a very large payment. Receiving money for 'saving' someone's life, however, is likely to reduce, in people who are forced to sell a kidney, the value they place on having saved someone's life (so I don't agree that the fact that they're still saving a life means that the payout is merely enhanced).

If you change the subject matter of the 'student dilemma' to the student becoming a high-class escort rather than selling a kidney, what would your view be?

andrew

drkpower wrote: »

If you change the subject matter of the 'student dilemma' to the student becoming a high-class escort rather than selling a kidney, what would your view be?

Then you're getting into a comparison between prostitution and selling your kidney. Given prostitution is less likely to lead to death than having surgery and no backup kidney (and has less long term implications), my view would be that becoming a high class escort would be less worse than selling a kidney, to the extent that I would probably be OK with the student becoming an escort.

Stereomaniac

I agree with what you said. But I also think that people should be allowed to make their own decisions, even if I don't agree with them.

Suryavarman

andrew wrote: »

Then you're getting into a comparison between prostitution and selling your kidney. Given prostitution is less likely to lead to death than having surgery and no backup kidney (and has less long term implications), my view would be that becoming a high class escort would be less worse than selling a kidney, to the extent that I would probably be OK with the student becoming an escort.

Are you against students being able to donate their kidneys or just against them being able to donate them for money?

drkpower

andrew wrote: »

Then you're getting into a comparison between prostitution and selling your kidney. Given prostitution is less likely to lead to death than having surgery and no backup kidney (and has less long term implications), my view would be that becoming a high class escort would be less worse than selling a kidney, to the extent that I would probably be OK with the student becoming an escort.

Why should it be you (or society) that makes and accepts/rejects the risk assessment inherent in certain activities?

Just to mix it up a bit: Lets say the student escort caters to the HIV positive market, which attracts a premium, which brings the risk assessment for her choice of activity above the person who donates an organ, would you legislatively prevent her from becoming an escort?

Stereomaniac

Neither.

andrew

Suryavarman wrote: »

Are you against students being able to donate their kidneys or just against them being able to donate them for money?

To clarify, this isn't about *students*, i just used a student as an example. And I'm against them/anyone being able to donate them for money specifically. Donation in which a person chooses to donate is fine, since there is less scope for coercion by a third party, and less of a chance that they'll receive a payout which doesn't take into account the real cost of the kidney to the seller.

drkpower wrote: »

Why should it be you (or society) that makes and accepts/rejects the risk assessment inherent in certain activities?

Just to mix it up a bit: Lets say the student escort caters to the HIV positive market, which attracts a premium, which brings the risk assessment for her choice of activity above the person who donates an organ, would you legislatively prevent her from becoming an escort?

Because individuals tend to be quite poor at making risk assessments. For example, many people probably wouldn't wear a seat-belt, but do because it's illegal not to. People engage in a multitude of activities which in the long run are extremely harmful to themselves. If the state can easily legislate to prevent people from making bad choices without restricting their daily activities too much, then I think it should do so.

Regarding the prostitute example, there's no exact fine line at which being a prostitute becomes just as dangerous as donating a kidney. Suffice to say where being a prostitute is clearly less dangerous, I would allow prostitution. Where it's clearly more dangerous, I wouldn't. In between (as in your example), there's a grey area we could spend forever discussing but which I don't think adds much to the argument in general.

drkpower

andrew wrote: »

Regarding the prostitute example, there's no exact fine line at which being a prostitute becomes just as dangerous as donating a kidney. Suffice to say where being a prostitute is clearly less dangerous, I would allow prostitution. Where it's clearly more dangerous, I wouldn't. In between (as in your example), there's a grey area we could spend forever discussing but which I don't think adds much to the argument in general.

So is the dangerousness of the activity the defining factor?

If I were to show you an example of something that people do for profit which is demonstrably more dangerous than selling a kidney, would you argue for it being made illegal?

andrew

drkpower wrote: »

So is the dangerousness of the activity the defining factor?

If I were to show you an example of something that people do for profit which is demonstrably more dangerous than selling a kidney, would you argue for it being made illegal?

Not exactly.

First of all there's my point about the social harms which could potentially accrue when people are forced to sell a kidney and put their health at significant risk in order to feed their family, settle a debt etc. Being forced to have your body abused like that, just to settle a debt, would be a horrible experience. I can't think of anything more invasive than someone forcing me to sell a part of my body and physically harming me for profit. And even if it didn't happen to me, I wouldn't like the idea that others might have to.

Second of all, even after the debt had been settled, say, they'd still have to live with the potential health consequences of having paid that debt. The health implications of having sold a kidney exist for the rest of that person's life. Being forced to do a for profit BASE jump would be less bad than selling a kidney, for example, because even though it's more immediately dangerous, at least after the BASE jump the person can rest assured that they're safe. So it's both the danger itself, and the uncertainty too.

I assume you've an example in mind though? What is it?

cynder

OldmanMondeo wrote: »

As a husband of someone with Kidney disease can I just say how disgusting and vile this thread is. Some ****** want to have a laugh at both the poor and the sick.

Scumbag.

It's a discussion, my dad died 2 and a half years ago, he was in kidney failure. He Had dialysis every other day, 4 months after diagnosis he died.


I don't find this thread disgusting. It's life, good, bad and ugly.

drkpower

andrew wrote: »

Not exactly.

So if it isnt the 'dangerousness', what is the critical factor in your view? You are not really explaining yourself.

andrew wrote: »

Second of all, even after the debt had been settled, say, they'd still have to live with the potential health consequences of having paid that debt. The health implications of having sold a kidney exist for the rest of that person's life. Being forced to do a for profit BASE jump would be less bad than selling a kidney, for example, because even though it's more immediately dangerous, at least after the BASE jump the person can rest assured that they're safe. So it's both the danger itself, and the uncertainty too.

Are you really making that distinction? That a health risk that is a one-time only high risk is less morally repugnant than one that poses a long-lasting minor threat?!!

andrew wrote: »

I assume you've an example in mind though? What is it?

Almost any high risk endeavour. The long term risks of kidney donation (once recovered from the operation) are negligible.

andrew

drkpower wrote: »

Are you really making that distinction? That a health risk that is a one-time only high risk is less morally repugnant than one that poses a long-lasting minor threat?!!



Almost any high risk endeavour. The long term risks of kidney donation (once recovered from the operation) are negligible.

I think you're underestimating the harm a small amount of uncertainty can have on people. If you remove someone's kidney, you now make them hyper aware that if they harm their remaining kidney, they're fucked. Not only that, but it's entirely their fault too. Even if the threat is objectively minor probabilistically, it's still a threat to their life, and so people will still give it a very large weighting. For example, see the fear people have regarding radiation exposure. They freak out, because the long term effects are so uncertain and yet potentially deadly; the risk of actually dying from radiation exposure is tiny.

Havermeyer

Brussels Sprout wrote: »

In before all the libertarian lunatics claiming that it may not be a good idea but it should be up to the individual concerned.

Obviously there are arguments and counter-arguments about such a practise, like exploitation for example, but why should it not be up to the individual concerned?

drkpower

andrew wrote: »

I think you're underestimating the harm a small amount of uncertainty can have on people. If you remove someone's kidney, you now make them hyper aware that if they harm their remaining kidney, they're fucked. Not only that, but it's entirely their fault too. Even if the threat is objectively minor probabilistically, it's still a threat to their life, and so people will still give it a very large weighting. For example, see the fear people have regarding radiation exposure. They freak out, because the long term effects are so uncertain and yet potentially deadly; the risk of actually dying from radiation exposure is tiny.

Is that what your argument boils down to? That exposing oneself to a long term threat to health - regardless of the gravity - should be against the law, while exposing oneself to a short term threat to health should be permitted? Because, it is all you have really said so far.

In any case, as the long term effect of kidney donation is negligible, by your argument, it should be permissable, right?

andrew

drkpower wrote: »

Is that what your argument boils down to? That exposing oneself to a long term threat to health should be against the law, while exposing oneself to a short term threat to health should be permitted? Because, it is all you have really said so far.

As i've said, that's not just what it boils down to. I've already said that people being forced to sell a kidney is a harm in and of itself; I wouldn't like it if others had to do that.

But it's not so much that exposing oneself to a long term health threat should be against the law. It's that legalising selling kidneys means that someone might be unwillingly exposed to this long term threat for a myriad of reasons. It'd be impossible to prevent someone selling their kidney to pay off their mortgage. It should be illegal because if it were legal, then someone might be forced into a situation where they have to donate a kidney, and I think such forced donation would be very harmful to the person involved (and as i mentioned in my previous point, it'd also be harmful to society in general). In short, I think legislation should prevent where possible situations in which a person might be forced to do something which is harmful to them, eg. donate a kidney.

In any case, as the long term effect of kidney donation is negligible, by your argument, it should be permissable, right?

If the long term effect of kidney donation was actually negligible, then yeah I'd think it should be permissible. But until people develop the ability to regrow kidneys, then long term effect will always potentially be either death, or a kidney transplant and immunosuppresants, which is bad.

Basically, there are two elements to the 'harm' as I see it. The probability that the risk will obtain, and the damage that accrues if the risk does obtain. If either component is high, that harm is high. So even if the probability of the risk obtaining is low, if the damage from that risk is high, then the overall harm is still high.

drkpower

andrew wrote: »

In short, I think legislation should prevent where possible situations in which a person might be forced to do something which is harmful to them, eg. donate a kidney.

But not other dangerous activities (like prostitution or base jumping). You stilll haven't explained how you justify the distinction.

andrew wrote: »

If the long term effect of kidney donation was actually negligible, then yeah I'd think it should be permissible. But until people develop the ability to regrow kidneys, then long term effect will always potentially be either death, or a kidney transplant and immunosuppresants, which is bad.

You probably didnt read the thread. Have a read back on it.
http://www.scientificamerican.com/article.cfm?id=kidney-donor-mortality

The study, published March 10 in JAMA The Journal of the American Medical Association—60 years after the first kidney transplant in the U.S.—found no increase in mortality in donors once they recover from the operation. "With this study we're able to say that whatever happens to people physiologically after kidney donation—it doesn't cause a premature death," Segev says. "After donating a kidney a person can live exactly the way they lived before donating—a long, healthy, active life with virtually no restrictions at all."

Suryavarman

andrew wrote: »

To clarify, this isn't about *students*, i just used a student as an example. And I'm against them/anyone being able to donate them for money specifically. Donation in which a person chooses to donate is fine, since there is less scope for coercion by a third party, and less of a chance that they'll receive a payout which doesn't take into account the real cost of the kidney to the seller.

How on earth is it coercion? Since when did voluntary exchange become coercion? Effectively what you are arguing here is that if an act that could have minor long term negative health effects it should be illegal to receive monetary compensation for it.

Feisar

Definitely not. It opens the door to a slippery slope where people will be obliged to sell kidneys to pay back loans etc. Maybe I'm metal but it's the first thing I thought of when I seen this thread. A persons body should not be seen as collateral in any make shape or form.

andrew

drkpower wrote: »

But not other dangerous activities (like prostitution or base jumping). You stilll haven't explained how you justify the distinction.

Prostitution while wearing a condom isn't life threatening, so I think that example can be ignored.

The BASE jumping thing comes from the distinction between long and short term harms. Replace kidneys with BASE jumping. Now, someone might be forced to BASE jump to pay off a debt. Why is this different? Because once the jump has been completed, the threat to the person's life is 0. It has no effect. Debt paid off, jump done. If you donate a kidney, you potentially suffer from the consequences of that donation from the rest of your life. Which brings me on to the link you posted.

You probably didnt read the thread. Have a read back on it.
http://www.scientificamerican.com/article.cfm?id=kidney-donor-mortality

[Indeed, I didn't read the thread.]

Firstly, I accept that this does weaken my argument somewhat (though I'd be interested to know how people with kidneys removed fared when they subsequently got kidney disease). But the fact is that even if the risk is small, it's still non zero, and more importantly, people will still perceive the risk to be high. This is crucial. People who have been forced to give up a kidney (and I still think that that harm in and of itself is enough to warrant kidney selling being illegal), will still perceive their actions as constituting a real and constant threat to their health, and will be harmed by the knowledge that they now have only one kidney.

How on earth is it coercion? Since when did voluntary exchange become coercion? Effectively what you are arguing here is that if an act that could have minor long term negative health effects it should be illegal to receive monetary compensation for it.

My point is that allowing the exchange of kidneys for money opens up the possibility of coercion, which is harmful. Obviously voluntary exchange isn't coercion.

To summarise (for easier quotation) the problems I have with it:

Regarding the possibility of coerced or forced donation:

• Harm accruing to me, from the knowledge that someone was forced to sell a kidney
• Harm to the person from having their body invaded against their will
• Long term (albeit negigable) physical harm from only having 1 kidney
• The psychological harm from knowing that,even if the chance that you'll actually be harmed small, there might be a physical harm, and you still might die as a result of your actions (since people tend to weight existential risks very very highly)

Regarding the idea of paid donation in general

• The inability of the price mechanism to deal with a good which someone might value at €2,000 one day, and infinity euro the next.

drkpower

andrew wrote: »

But the fact is that even if the risk is small, it's still non zero, and more importantly, people will still perceive the risk to be high.

I know of a way to resolve that..... inform them. So all of your arguments re: harm/dangerousness are effectively nil.

andrew wrote: »

My point is that allowing the exchange of kidneys for money opens up the possibility of coercion, which is harmful.

Then any activity for reward could be considered coercion.

Seachmall

andrew wrote: »

In short, I think legislation should prevent where possible situations in which a person might be forced to do something which is harmful to them, eg. donate a kidney.

Would a sport such as boxing not fall into this category? I'm sure there have been boxers who fought in the ring out of pressure from others even when they didn't feel fit to do so. Even without a concrete example the possibility is there, and it could be fatal.

In this instance it's the coercion that should be addressed, not the sport. Even if such coercion is prevalent among boxers that is a failing of the regulatory bodies, not the sport itself.

I.e. The possible ethical concerns of selling kidneys are not a result of the act selling the kidney but an issue of how the system is regulated. The practicality of regulating a paid donor system are addressed in one of the page 8 links on Iran's system.

If the long term effect of kidney donation was actually negligible, then yeah I'd think it should be permissible. But until people develop the ability to regrow kidneys, then long term effect will always potentially be either death, or a kidney transplant and immunosuppresants, which is bad.

The long term effects of kidney donation are negligible. Of course the chance of needing that spare kidney is there but it's the same decision someone makes currently without financial compensation.

Basically, there are two elements to the 'harm' as I see it. The probability that the risk will obtain, and the damage that accrues if the risk does obtain. If either component is high, that harm is high. So even if the probability of the risk obtaining is low, if the damage from that risk is high, then the overall harm is still high.

The risk of death should they develop a kidney disease can be high but there are some factors that need to be considered. If donors undergo routine follow up checks in the years after the donation, as they currently do, any issues can be caught early and dealt with before they permanently damage the donor. If, however, the disease (or whatever) spreads fast and does damage the donor's only kidney the market would provide a much great supply of kidneys than there currently is if a transplant is necessary (Self-solving problem).

andrew

drkpower wrote: »

I know of a way to resolve that..... inform them. So all of your arguments re: harm/dangerousness are effectively nil.

Well, no. It's quite hard to inform people that something isn't dangerous. Why do you think there is so much opposition to nuclear power?

Then any activity for reward could be considered coercion.

How? I'm taking about the possibility that a person has no other choice but to raise money by selling a kidney, and is forced to do so by a bank, for example.

Seachmall wrote: »

Would a sport such as boxing not fall into this category? I'm sure there have been boxers who fought in the ring out of pressure from others even when they didn't feel fit to do so. Even without a concrete example the possibility is there, and it could be fatal.

In this instance it's the coercion that should be addressed, not the sport. Even if such coercion is prevalent among boxers that is a failing of the regulatory bodies, not the sport itself.

I.e. The possible ethical concerns of selling kidneys are not a result of the act selling the kidney but an issue of how the system is regulated. The practicality of regulating a paid donor system are addressed in one of the page 8 links on Iran's system.
The long term effects of kidney donation are negligible. Of course the chance of needing that spare kidney is there but it's the same decision someone makes currently without financial compensation.

I agree that it's a problem of regulation, but it's impossible to regulate such that people aren't forced into donating their kidney. It's not the idea of donating that I've a problem with, it's the incentives which paid donation creates (and which fall under the 'harms from forced donaton') heading.

drkpower

andrew wrote: »

Well, no. It's quite hard to inform people that something isn't dangerous. Why do you think there is so much opposition to nuclear power?

So, we should legally prevent someone from engaging in an activity because of their mistaken belief that it is dangerous, even when it is not dangerous, and we have advised them clearly of this.....?

When might you see that your position in this regard has become untenable?

andrew wrote: »

How? I'm taking about the possibility that a person has no other choice but to raise money by selling a kidney, and is forced to do so by a bank, for example.

So; if someone is not so forced, should they be entitled to sell their kidney?
In other words, if someone makes a lifestlyle choice to sell their kidney in orde, lets say, to pay for their kids private schooling, should they be alllowed to?

andrew

drkpower wrote: »

So, we should legally prevent someone from engaging in an activity because of their mistaken belief that it is dangerous, even when it is not dangerous, and we have advised them clearly of this.....?

When might you see that your position in this regard has become untenable?

So; if someone is not so forced, should they be entitled to sell their kidney?
In other words, if someone makes a lifestlyle choice to sell their kidney in orde, lets say, to pay for their kids private schooling, should they be alllowed to?

I think I've laid my objections out pretty clearly in a previous post. Clearly, if someone wasn't forced into selling their kidney, my only objection is that the price mechanism would be ineffective when it comes to allocating kidneys.

But you can't allow people to sell their kidneys and at the same time prevent people from being coerced into selling their kidneys. So no, I'm not saying we should legally prevent someone from engaging in an activity because of their mistaken belief that it is dangerous, even when it is not dangerous, and we have advised them clearly of this. I'm saying we should prevent someone from being forced into doing an act which they believe is dangerous, and which constitutes a massive violation of their bodily integrity etc. (where etc. includes the harms from forced donation I've already outlined).

In short, my points: forced donation is very bad. You can't have a system of paying for kidneys without forced donation of some sort existing. Even without forced donation, pricing is very difficult.

Also, I don't see how my arguments are untenable, given you havn't even dealt with most of them.

Seachmall

Suryavarman wrote: »

I agree that it's a problem of regulation, but it's impossible to regulate such that people aren't forced into donating their kidney. It's not the idea of donating that I've a problem with, it's the incentives which paid donation creates (and which fall under the 'harms from forced donaton') heading.

I'm not entirely sure what falls under "forced donation" so I'll address two things I think you could be referring to.


Coerced Donation

People in need of a kidney coercing someone to donating one wouldn't/shouldn't be an issue. Using Iran as an example they haven't had a donor waiting list for 8 years.

There would be no need to force someone to sell a kidney because there would be a surplus of them. Simply put, the amount of people willing to sell their kidneys would far outweigh the number of people who need them.


Donation out of desperation

People selling their kidneys to pay off gambling debts, for example, is a different matter all together and has two issues as far as I can see.


A) People should have full control over their own body regardless of their motives.

The benefits of someone, in desperation, selling their kidney and saving a life outweigh the negatives of someone living with one kidney.


If you disagree with (A) I think we'll just have to agree to disagree. It's not really an argument I want to get into.

Given the difference in life expectancy and living standards between someone with both kidneys and someone with only one is negligible I think (B) is objectively and absolutely true. You may disagree and I'd like to hear your arguments if you do.

woodoo

The banks would be after a kidney if you over borrow on your house.

I can't believe so many people favour selling a kidney.

Solair

There are possible long term health consequences to losing a kidney. The costs of these would fall on the state.

It's one thing where it's an unusual circumstance involving a family member etc, it's another when it's a sale !

Seachmall

woodoo wrote: »

The banks would be after a kidney if you over borrow on your house.

I don't think anyone is suggesting corporations should be able to claim your organs as collateral.

There are possible long term health consequences to losing a kidney. The costs of these would fall on the state.

Nope.

drkpower

andrew wrote: »

In short, my points: forced donation is very bad. You can't have a system of paying for kidneys without forced donation of some sort existing. Even without forced donation, pricing is very difficult.

First, you havent explained why donation is bad at all. I have shown how medically it has negligible effects (following operative recovery).

Second, why cant you have a system of paying for kidneys without forced donation of some sort existing? You can & do have financial & other recompense for medical and other research without forced medical & other research. Why do you think such a situation can occur?

Third, why would pricing problems justify it being illegal (assuming issues 1 & 2 being resolved...?

andrew wrote: »

Also, I don't see how my arguments are untenable, given you havn't even dealt with most of them.

:pac:

andrew

Seachmall wrote: »

I'm not entirely sure what falls under "forced donation" so I'll address two things I think you could be referring to.


Coerced Donation

This wouldn't/shouldn't be an issue. Using Iran as an example they haven't had a donor waiting list for 8 years.

There would be no need to force someone to sell a kidney because there would be a surplus of them. Simply put, the amount of people willing to sell their kidneys would far outweigh the number of people who need them.

To clarify I don't mean coerced donation in terms of people being forced to donate because there isn't enough Kidneys, I meant in terms of people having to donate out of desperation.

Donation out of desperation

People selling their kidneys to pay off gambling debts, for example, is a different matter all together and has two issues as far as I can see.


A) People should have full control over their own body regardless of their motives.

The benefits of someone, in desperation, selling their kidney and saving a life outweigh the negatives of someone living with one kidney.


If you disagree with (A) I think we'll just have to agree to disagree. It's not really an argument I want to get into.

Given the difference in life expectancy and living standards between someone with both kidneys and someone with only one is negligible I think (B) is objectively and absolutely true. You may disagree and I'd like to hear your arguments if you do.

Regarding A, I agree that people should have full control over their own body. But if someone is forcing you to sell your kidney, you don't have full control over your own body. That's my point; it gives people power (explicit or implicit) over someone else's body

I think the negatives of someone perhaps being forced to give up a kidney, outweigh the benefits; it's all about your point A. Would you agree with legislation which allowed the government to forcibly remove someone's kidney? If not, then why agree with legislation which allows the private sector to forcibly remove that kidney. The only difference is that the force involved wouldn't be physical, it'd be an implicit and explicit power play which leads to the same outcome. Someone goes to a food bank looking for a handout? Well, sell your kidney first then we'll give you food if you still need it. That kind of power play.

andrew

drkpower wrote: »

First, you havent explained why donation is bad at all. I have shown how medically it has negligible effects (following operative recovery).

Second, why cant you have a system of paying for kidneys without forced donation of some sort existing? You can & do have financial & other recompense for medical and other research without forced medical & other research. Why do you think such a situation can occur?

Third, why would pricing problems justify it being illegal (assuming issues 1 & 2 being resolved...?
:pac:

Because my point isn't that donation is bad. IT's that paying someone to donate is bad. I'm not trying to show that donation in and of itself, as a concept, is bad.

Because it's literally impossible to ensure that someone is doing something for the right reasons. And I think someone donating a kidney for the wrong reasons is incredibly harmful, harms you havn't addressed. Do you agree that being forced to donate a kidney by a bank would be really terrible, or do you think it'd be fine?

The pricing problems are contingent on donating a kidney being at least somewhat risky. If it's really as risk less as it appears, then it's not so much of an issue. If it is risky then it'd be a bigger issue.

Seachmall

andrew wrote: »

Regarding A, I agree that people should have full control over their own body. But if someone is forcing you to sell your kidney, you don't have full control over your own body. That's my point; it gives people power (explicit or implicit) over someone else's body

I think the negatives of someone perhaps being forced to give up a kidney, outweigh the benefits; it's all about your point A. Would you agree with legislation which allowed the government to forcibly remove someone's kidney? If not, then why agree with legislation which allows the private sector to forcibly remove that kidney. The only difference is that the force involved wouldn't be physical, it'd be an implicit and explicit power play which leads to the same outcome. Someone goes to a food bank looking for a handout? Well, sell your kidney first then we'll give you food if you still need it. That kind of power play.

Well I'm going to assume that legislation is in place that prevents explicit coercion, so from here on in all coercion is implicit (minor difference but I can see it causing issues down the line).

I'm also going to assume legislation that organs are not legally considered commodities or assets, or at least not until removed or while they're being used. This will prevent the number of kidneys you have popping up on a means test or when filing for bankruptcy :pac:. I think this is a fair enough assumption, it wouldn't be too difficult to word and I can't see it having any issues being passed into legislation.


Taking those two factors the only other issue I can see is the implicit coercion you're describing. But I don't see it as an issue.

If a bank, for example, puts pressure on you to pay your €10,000 debt you can opt to sell your kidney to pay off the debt but because of the legislation in assumption two there is no requirement for you to do so. You could choose to sell off property to raise the money or even file for personal bankruptcy. As your organs are not considered assets they have no legal recourse in demanding you sell them to pay off the debt.


Added onto that the fact that the negligible difference in living standards it is perfectly reasonable, in my opinion, for you to consider your kidney simply as an asset from day 1 and simply use it as a rainy-day piggybank.


In essence, one of your kidneys would, at your whim, turn into an asset but up until that point it is treated as it is now. Just an organ with no value.


Edit - Rereading it I think my second assumption addressed your point, that it's not an asset until removed (or until the relevant papers have been signed, etc.) and the rest of the post just expands on it. I hope it addressed your issues anyway and I'm not misunderstanding you.