Saturday, January 27, 2007

Virginia Postrel on Kieran Healy on Organ Transplants

Organ transplants are at once the most amazing and frustrating of medical miracles. A new kidney or heart can cure someone who would otherwise die or, even in less than ideal circumstances, extend life and improve well-being. The surgical skill and pharmaceutical innovation required to make transplantation work are wonders of human ingenuity.

But there is still no such thing as a truly new organ. Unlike insulin or artificial hips, organs so far cannot be successfully manufactured. They come only pre-owned, usually from young, healthy people who have died suddenly in traumatic accidents that destroyed their brains. Rainy weekends increase the organ supply. Helmet laws reduce it. The more than 94,000 Americans on the waiting list for organs are, in effect, waiting for someone else to die so that they can live.

This grisly calculus posed enormous cultural problems for early transplant advocates, as Kieran Healy, a sociologist at the University of Arizona and a contributor to the blog Crooked Timber, notes in “Last Best Gifts.” “Public ambivalence about transplantation was overcome, in part, by arguing that donation was the ‘gift of life,’ ” he writes. “The success of this idea now makes it more difficult to garner support for a market for organs.” By emphasizing altruism, transplant advocates gave comfort to the bereaved, conferring meaning on a tragic event and justifying what might otherwise seem like desecration. This early success helps explain why, even in the face of a critical shortage of organs, many leaders in the transplant field oppose any financial incentives for organ donors, including tax credits or payment toward funeral expenses.

The “gift of life” story is useful but, according to Healy, oversimplified. Shaped by a strongly anticommercial ideology, it places too much emphasis on the division between giving and selling. It doesn’t acknowledge the diverse ways in which people define the social meanings of exchange, regardless of whether money is involved. The fable of heroic altruists also misleadingly emphasizes the motives of the donor (or the donor’s family) over the system in which the decision to give or not takes place. “The voluntary donation of human goods is an organizational accomplishment,” Healy argues...

1 comment:

Ponzi Q. Globalization said...

Some random thoughts.

1. There will be more organs available to those who need them.

2. Plugs will be pulled earlier on average.

3.Family members who profit from the sale will feel guilty.

4. Financial institutions will develop new products based on the sale of organs. For example, you can sell claims to your potential post-brain death organs while alive. A secondary market will form making some very rich (usually not the people donating the organs).

5. The financial gains that will be available prior to brain-death such as the one mentioned in the example in (4) will factor into the decision to have a child.

6. Human beings will be viewed as commodities even more than they are today.

7. There will be instances where healthy people will have comas induced so that others can profit. Robin Cook will say I warned you.

8. Libertarians will be bolstered in their argument that living people should be allowed to sell their organs even when they are healthy. After all, there is no such thing as exploitation when freedom of choice can be asserted.

9. Neo-liberals will be bolstered in their argument that the export of human organs from poor nations to wealthy nations is mutually beneficial. After all, these poor people need our capital and this sort of resource extraction is the only path to take to bring these people out of poverty!

Of course, ignorance, desperation, and corruption, will allow connected middle men to keep most of the profit from these sales. Also, murders for organs will increase. This maximizes profit.