Professor Maqsood Noorani, a leading surgeon made the headlines asking for legalisation of the sale of organs to prevent the exploitation that exists in the black market. Yet his comments show that he is uneasy with the concept of a market in organs. He believes that the sale of organs in richer nations would ‘tarnish the process’, and suggests that even in poorer countries accommodation or education should be offered in exchange instead of cash.
When two people want to freely exchange some good or service, we need good reasons in a free market to prevent the exchange. Moreover, when it comes to a market in organs, the good in question is life saving. Why then should we prevent such exchanges when there are willing buyers and sellers?
Imagine that I offered you £10,000,000 for your little finger. (I am a collector and yours is an extremely rare specimen.) There is nothing wrong with this offer, or with accepting it. Maybe you want to pay off your house, provide a better education for your children, buy a safer car, go on holiday, retire or some other way of making your life go better. It might be rational to accept the offer. Indeed, you lucky to get such an offer. After all, you can just refuse and kept that rare little finger and do whatever you so prize doing with it.
The major objection to a market in organs is that the world is not like this: a market would exploit the poor or underprivileged people. There are two ways to address this objection. The first is to make sure people start bargaining with a reasonable endowment. If I offered you a pound for your little finger, you would probably refuse because the pound is not worth as much to you as your little finger. That is, we need to bring about social justice and ensure everyone is a decent position to strike a bargain. That is not going to happen any time soon.
The second response, which we have already employed in the labour market, is to set a minimum price to prevent exploitation of the vulnerable and underprivileged. People get a minimum wage for their labour and danger money for risky activity. We could treat organs the same. One Nobel Laureate in Economics priced a kidney at about $30,000. This is higher than the going rate which is usually less than $10,000. If we were really concerned about exploitation, we could set the minimum price higher at $100 000, or more. Or we could do what Iran does, and have the Government buy the kidneys and distribute them.
Whatever method we choose, we can address the concerns about exploitation by creating an open regulated market and setting a decent, fair minimum price. This will protect the well-being and liberty of the poor sellers, and give the buyers a chance at life. These principles apply to all biological materials, organs, tissues and cells.
Further reading:
Savulescu, J. Biotechnology, Ethics and Free Markets, In Preparation. To be presented at ‘Technology and Freedom’: The Mont Pelerin Society General meeting 2008 on September 8 in Tokyo.