Economics, Exploitation
Should we sell kidneys on eBay?
Sometimes, some views are just so stupid that they need to be corrected.
In yesterday’s New York Times Katrina A. Bramstedt, a professor of medical ethics at Australia’s Bond University School of Medicine, argued that markets in human organs would lead to “an economic class war”. Given facts about how organs would be distributed in a market for them, this view is idiotic.
First, I must confess that I’m not quite sure what an “economic class war” is. If one’s economic status and one’s class are to be equated, then one of these terms seems redundant, but if they’re not, it’s not clear what is doing the warring—are economic classes fighting against social classes? Are certain economic classes and social classes fighting against other economic classes and social classes? Are they really fighting, or are they just competing for scarce resources? If the latter, how is that different to, say, people competing for professorships at Bond University School of Medicine? And is that really morally problematic?
But let’s leave to one side Prof. Bramstedt’s neo-Marxist terminology, and concentrate on her reasoning—such as it is.
She offers two reasons to oppose markets in human kidneys: That this would be to put a price on life, and that it would lead to the wealthy getting kidneys when the poor do without.
Neither of these reasons should be accepted.
First, medical goods—including life-saving medical goods—are already priced. Pharmaceuticals cost money; so do operations, medical equipment like pacemakers and dialysis machines, and even the expertise of healthcare professionals. To put a price on a kidney is no different from putting a price on dialysis. But no-body is complaining that the makers of dialysis machines should give them away free. And no-body but the crudest and most simplistic of utilitarians believes that the value of a person’s life is reducible to how much would be paid to keep her alive.
Second, Prof. Bramstedt believes that if we have a market for kidneys the wealthy would benefit at the expense of the poor. Now, I must admit that I am not familiar with how medical goods are distributed in Australia. Perhaps they really do have sell all of their healthcare on a medical version of eBay, and require the sick and injured to bid for what they need with payments being made directly from their personal savings. And perhaps this does result in hysterical, emotional bidding wars, which lead to the wealthy living and the poor dying and everyone overpaying or buying what they don’t want or need. (Prof. Bramstedt believes that in any auction emotion will take over, and decision-making will be impaired.)
But I suspect that that’s not the case. I suspect that in Australia healthcare—like that in all developed countries that I know of—is primarily paid for by insurance companies, whether privately owned or supported by the State. And that’s just how kidneys (and the associated healthcare associated with their provision) would be distributed were they allowed to be bought and sold. The wealthy would receive kidney transplants paid for by their insurance companies—and so would the poor. And since we’d have far more kidneys available for transplant were a market to be allowed, this would benefit both the rich and the poor.
A reliance on donation has failed, and has resulted in the unnecessary deaths of tens of thousands of people. It’s time we put ideology aside and started saving lives.