The idea for this post came from my Economics of Healthcare class. We have an exam this week, so it's mostly for my own benefit.
Despite years of awareness campaigns and promotions, demand for organs continues to greatly outstrip supply. Economists have argued that allowing a market for organs would bring supply closer to the level of demand. Not surprisingly, this is met with quite a few objections. But how valid are they? And do they cancel out the benefits of increasing organ supply?
1. Buying and selling organs is morally and ethically repugnant. Abortion, gender reassignment, and cosmetic surgery might also transgress moral and ethical codes.
2. Only wealthy people will be able to afford organs. Poor people won't get needed transplants. This one is a little trickier. First, opening up a market for organs will increase supply - increased supply usually results in lowered prices. Second, the estimated price for a kidney on its own is in the $15-20 thousand range. The surgery to get the organ where it needs to be costs at least $110 thousand. Even if the organ were free, only wealthy people would be able to afford the operation. Third - and this is sticky - with the current system, rich and poor people die on the waiting list. With a market system, rich people wouldn't die. I'm REALLY not entirely comfortable with that last point, but in a strict economics sense, it works.
3. Thinking about bodies as commodities leads to abuse. This is even stickier. We commodify bodies anyway: bodies sell products, lifestyles, ideas. Second, you could argue that stringent enforcement of property rights laws would prevent this. However, that doesn't take into account the logistical difficulties of locating and prosecuting offenders.
Being an anthropologist, it's difficult for me to strip this issue down to the basic economic facts of it. In essence, an organ market would move goods to a higher-valued use. But bodies aren't conceptualized the same way as most consumer products. Nancy Scheper-Hughes and Margaret Lock have written on the "anthropology of the body," looking at the way bodies are integral parts of human existence. In addition, there are already alarming abuses in many regions, and class and gender can affect who sells and who buys.
This exam is going to be a doozy.