Monday, 14 June 2010

The Economist can't think of any good arguments against trading organs

People have probably already seen the new posters for The Economist, frankly, I don't think any of the three issues they've picked are particularly interesting debates (should drugs be legalised, should prisoners be allowed to vote and should we allow trade in human organs). As far as I can see, all three are pretty much a slam dunk for the yes side. Anyway, it appears that, at least for the organ trading argument that the Economist agrees with me. Let's have a look at their 'against' arguments (you can see the poster here).
1. The British Medical Association says that allowing organs to be traded would put pressure on poorer people to sell.
Well.. yes, and allowing cars to be traded probably puts pressure on poorer people to sell. I have no idea why this is supposed to be a bad thing. Does the BMA have some reason to believe that poorer people would prefer having two functioning kidneys to money? That they should prefer this? Is there any particular reason we should believe the BMA is likely to have anything interesting to say about the question (they're medics, not economists or ethicists)
2. There are alternatives to a trade in organs. Countries in which people's consent to donating their organs is assumed unless they opt out have shorter waiting lists. 
Again, I have no idea why anyone would think this was an argument against allowing a trade in organs. Countries in which a trade in organs is allowed (ie, Iran) have even shorter waiting lists (ie, they don't have any).

There are alternatives to most things, the question is which alternative is best. (I would think presumed consent is even more of a slam-dunk than allowing trade in organs, except there's remarkably little evidence that it actually increases donations).
3. Legalising the trade in organs would turn the human body into a commodity. That is taking free markets too far.
To paraphrase "If we legalised trade in organs, then trade in organs would be legal. This is bad. Ner ner ner ner". This just doesn't even begin to be an argument against anything.

I'm not very surprised that the Economist agrees with me about legalising trade in organs, but surely they could have tried a bit harder to come up with some argument against? Or is it just that there aren't any?


Adrianna said...

the 'remarkably little evidence' link says something about expired cookies. What are you referring to?

John Faben said...

Ok, I officially hate Wiley. The paper I was referring to is entitled Opting-out systems: no guarantee for higher donation rates.

I've always been surprised that there's any doubt at all - it seems pretty obvious that presumed consent should increase donation rates, and I think most of the evidence suggests it does, but not as much as you might expect.

I think most studies find a small positive effect for presumed consent, when you control for other factors (there was a decent systematic review in the BMJ recently which says something to this effect)

I'm still all for presumed consent - it certainly doesn't *decrease* donation rates - if for some reason introducing organ trading is "politically infeasible" (whatever that means)

I guess the reason I said 'remarkably little' is because you would expect the evidence to be overwhelming, whereas actually it's merely strongly suggestive.