Monday, October 24, 2011

Ethics of an Organ Market

I am pleased to post this guest article by Elaine Hirsch.

Healthy organs are in short supply. For topics taught in phd programs in economics, the price for healthy organs would be dictated by the amount of demand compared to supply. Given the lack of supply, the amount people are willing to pay for healthy organs should skyrocket.

In reality, however, markets for organs are highly inelastic. Government regulations and social pressures prevent organs from being efficiently allocated. Willing patients are held on long transplant lists, while people willing to sell their organs are prohibited by law to do so. With political and social barriers to organ markets being the status-quo, revisiting the ethics behind the ideas of such markets will surely provide insight into a much-needed topic.

The idea of organ markets have been pioneered by academics and economists interested in improving efficiencies within the health care sector. For example, Steven Levitt and Stephen Dubner, authors of the book series Freakonomics, have been vocal about increasing discussion about legalizing organ markets. Noting the ineffective methodology for organ transplants in the United States, the authors believe that “a free market in human organs would save thousands of lives a year”. Interestingly enough, a market for human organs does not necessarily involve the exchange of money; donors can be attracted with incentives such as being fast tracked to the front of the line if they are ever in dire need, increasing the circulation.

Gary Becker, a prominent behavioral psychologist, conducted a study which found that monetary incentives for healthy organs would decrease the long wait times of organ transplant lists without increasing the total costs of surgeries by more than 12%. In the study, Becker notes that greater incentives are needed for individuals to take the risks involved in donating organs.

Proponents of organ markets typically cite utilitarian results behind their reasoning. Incentives would increase the supply of organs, which would lower overall prices of organs, which would therefore save more lives in the long run.

Pessimists, on the other hand, argue that allowing markets dictate the supply of organs will lead to many inequities in the availability of organ transplants. Instead of being merit-based, organs will instead be given to people who can afford transplants and the surgeries that accompany them. For example, a 60 Minutes report highlighted an affluent Japanese businessman who obtained a liver transplant despite being lower on the transplant list than several patients who passed away.

There are obvious inefficiencies with today's transplant system. Many patients wait years for a healthy organs, which are only supplied when a perfect storm of accidents occurs at the expense of another's life or due to the good will of a perfect stranger. A market for transplants, however, allows incentives to skew where organs end up. With advantages and disadvantages that come with both extremes of organ transplants, what you do think is the best way to efficiently manage the market for organs?

About the author:
Elaine Hirsch is kind of a jack-of-all-interests, from education and history to medicine and videogames. This makes it difficult to choose just one life path, so she is currently working as a writer for various education-related sites, including and writing about all these things instead.

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1 comment:

Katrina Bramstedt, PhD said...

Rather than move to a system that commodifies human organs, another approach would be to more widely accept the practice of Good Samaritan organ donation-- living donation from strangers to needy patients. Many hospitals do not allow this. Some countries ban the practice. Proper screening of these donor candidates can select for those who are healthy and have altruistic motivations. You can read more about this in detail in my book, THE ORGAN DONOR EXPERIENCE: GOOD SAMARITANS AND THE MEANING OF ALTRUISM.

Living donation can help bridge the gap in the area of liver, kidney, pancreas, lung and intestine transplant.