Why not have a system that works?

We may have mentioned this before – just pay people for their kidneys, organs, already. Yes, sure, it’s just fine that we’ve a system which digs usable bits out of the dead to keep the living going. But that doesn’t produce enough organs for transplant, we need more. So too altruistic donations – hey, why not? Someone wants to do something nice for a stranger good on ’em. But this also doesn’t produce enough bits for transplant. We need more.

This isn’t though what is happening. Instead we’re getting praise – nice enough but not all that effective – for the altruists:

Almost 5,000 people are on the waiting list for a kidney transplant, but the number of living kidney donors in the UK fell to an eight-year low in 2017.

Carl Pinder is one member of a reasonably exclusive club after he decided to donate a kidney altruistically to a stranger.

It is indeed nice that Carl gave a kidney. But note the other little two facts there. The number of people doing so is falling. And there’re all those people on the waiting list too. Some to many of whom will die without receiving one. That is, not that they will die if they don’t get one, but that they will die because they don’t get one.

We can and should do better than this. For there is, as we’ve mentioned before, one country where people are paid for a live donation. There is also one country where people don’t die waiting. It is not a coincidence that they’re both the same place, Iran. And do note that transplants are cheaper than dialysis, that’s why the Mullahs started the paid program. They couldn’t afford dialysis back in the early 80s so they forced themselves to become efficient.

The reason we don’t follow suit is because of morals. Some people think it’s icky to pay money for an organ for transplant. So, we’ve made it illegal. That means that people die because of some peoples’ intuitions about ickiness. Most moral we all agree, right?

The correct answer is a government backed market for live organ donations, with people being paid. Those whose morals don’t allow this can, of course, just decide to die instead.

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    • It may be that the government’s insistence on taking organs is causing the drop in donations. Things like donations are very hard to price properly and incentives may result in unexpected behaviour. It may be that offering money causes the altruists to drop out – in fact it is highly likely that it will do so. I would not be surprised if the government insisting on their right to take our organs causes some people to decline to donate them.

  1. Dr. Walter E. Williams, in his Socratic style, takes his readers through many public policy questions by making us start at this first principle: “You own your own body, don’t you?” On this topic (which he has addressed), if you give the right answer, you hardly have to go further.

  2. There’s also the Known Space option of making capital punishment victims automatic donors, and then increasing and increasing the range of capital offences. Speeding? We’ll have that kidney. Dropping litter? We’ll have those lungs as well. Slightly annoying voice? That’s a full harvest, thank you.