Maybe get people to sign up to the Organ Donor register instead?

[oursin]

Should we sell our kidneys?

My feeling, on finding somebody who is apparently a reader in political theory at a well-respected institution of Teh Highah Learninz positing this, is that he may have read a lot of political theory, poor lamb, but maybe he should spend some time with dystopian science fiction if he's going to contemplate these sort of questions.

I suppose, with the Organ Donation register, there is an issue that a) it is Opt-In and b) presumably by the time many people reach that state when their organs come up for donation, those organs are probably past their Best Before date.

(I just now, in connection with an entirely unrelated transaction with a government body, was solicited to sign up with the Organ Donation Register. Already have, thanks, if anyone will want my tired old organs when the time comes.)

And on the intrusion of Commerce into this matter, has this person considered the sorts of things that have been happening - only, one admits, affecting the bodies of wymmynz? - over selling their eggs, or being surrogates, and the stories one hears are Not Pretty.

He might also consider Richard Titmuss' famous 1970 work The Gift Relationship: From Human Blood to Social Policy on blood donation:

[T]he author compares blood donation in the US and UK, contrasting the British system of reliance on voluntary donors to the American one in which the blood supply is in the hands of for-profit enterprises, concluding that a system based on altruism is both safer and more economically efficient.

(Also I am not sure about his understanding of the dynamics at play here:

In the 18th century, for example, some viewed being paid to sing as akin to prostitution, and professional opera singers, particularly women, could be deemed morally suspect. At that time, therefore, it might have seemed appropriate to subject professional singing to legal strictures, just like prostitution.

I really think this was - dependent upon local legal systems of course, but, really, don't get me started on that - much more about social stigma. Which adhered to publicly performing women for a lot longer, mate.)

(I'm also thinking - has this one cropped up on agonyaunt or have I seen it elsewhere - of that scenario in which member of a family - even an estranged member of family - is being heavyed into being a donor for a relative because they are A Match. Was it even child adopted but later traced?)

Comments

[redbird]

Massachusetts now asks people to sign up as donors when they get or renew drivers licenses or state ID cards, which means that most adults are asked every few years. But it's a box on the form, which I think is relatively low pressure. "I think" because it's hard to be sure there's no pressure for something I actively wanted to do.

[redbird]

Also, that "undoubtedly" in his first sentence is doing a lot of heavy lifting: it assumes that the person who sells a kidney now won't later have a problem with the remaining kidney, assumes they can afford to take the time off from work and other responsibilities to recover, and pretends that the risk of surgery is zero. That's just off the top of my head, and before we get into situations like the "liver donor boss" letter to Ask a Manager, in which people were threatened with being fired if they weren't willing to donate part of their livers to the boss's brother.

[oursin]

Yeah, I was thinking all sorts of scenarios which could arise. Plus, two kidneys for a reason, built-in redundancy in case one goes phut.

[ethelmay]

The US policy has mostly changed since then. Plasma is still paid for, but whole blood is not (though they offer incentives such as gift cards and raffle entries these days). I tried selling plasma at one point as it seemed an ideal part time gig for a healthy stay-at-home mother with kids in school. The place was crowded with people who (a) clearly needed the money a lot more and (b) were (a few of them, but they loomed large) not very pleasant to be around. Also they were showing slasher movies in the donation room.

[pameladean]

I myself would instantly flee the slasher movies, but I have to admit that I'd be laughing too. Though surely if you want to go this route, vampire ones would be better.

P.

[ethelmay]

I lasted through several sessions but eventually got tired of it. I was hoping to get to a point where I could also get a bit of proofreading done while sitting around (I was a very part-time freelancer at the time), but that was clearly not going to happen.

[msilverstar]

I stopped reading when I saw $5,000, which seems like "let the poor people die". Also authoritarian regimes would face a lot less pushback from the public

[nineveh_uk]

Yeah, I was deeply unconvinced by the lack of examination of the suggestion that somehow everyone in Iran who needed a kidney had $5000 available to buy one. I suppose there could be a system whereby the state would be the purchaser and patients receive for free, but that isn't happening in the RL exzmple.

[conuly]

Opt out organ donor policies work better than opt in ones, if you want to get more organ donations.

[arkessian]

UK Donor register is Opt in now by default, but you can explicitly opt in (or opt out) and potential donor families are still consulted and can make a different decision!

I am of course still signed up as a donor although very little of me will be acceptable (corneas only, IIRC).

[heleninwales]

I thought it had changed to Opt Out, but perhaps that was just Wales? Ah, yes. Having now done a quick search, it is Opt Out here in Wales. I don't know why England hasn't followed suit.

I opted in years ago, though I'm already so old that any useful organs would probably not be wanted. I know there's also a box to tick when you renew your driving licence, so that might encourage a few more to opt in to the scheme.

[arkessian]

I meant that in England you are opted-in by default, and have to explicitly opt out. Obviously I didn't put it clearly.

[heleninwales]

Sorry, I should have read more carefully, but in oursin's post, it says, "with the Organ Donation register, there is an issue that a) it is Opt-In", which confused me because I read that as meaning that one has to take the deliberate step of opting in whereas, as you say, I thought we were opted in automatically and you had to opt-out if you didn't want to be included.

[oursin]

Since the Passport Office automatic reponse emails are exhorting me to sign up to the Organ Donor Register (which to the best of memory I'm already on), my inference is that it remains opt-in.

[arkessian]

It isn't, but the best way of ensuring your wishes are followed is to opt-in explicitly (belt and braces).

[nineveh_uk]

It's Opt In automatically, but with the big caveat that they ask your family anyway. So if you join the register, then they have evidence of your wishes that can be presented to your family.

So family still get to override wishes, unfortunately.

[lilysea]

(I'm also thinking - has this one cropped up on [community profile] agonyaunt or have I seen it elsewhere - of that scenario in which member of a family - even an estranged member of family - is being heavyed into being a donor for a relative because they are A Match. Was it even child adopted but later traced?)

There was a letter on Agony Aunt where a man abandoned his daughter from his first marriage with little or no contact and no child support

and then popped up years and years later because his daughter from his SECOND marriage needed bone marrow and he was hoping daughter #1 would help out, despite the fact that he'd never paid child support or even done letters/phone calls...

[oursin]

That could be it.

[silveradept]

One notes that the things that he pooh-poohs as being merely poor arguments are much stronger and more real than he believes them to be, like the prospect of the people selling kidneys falling disproportionately on the poor, especially if the payout is sufficient. He's so close to the right idea that making sure the poor don't have that incentive means making sure there aren't poor people, but instead he seems to think that the right idea is to have a regulated market for the poor to sell themselves in, rather than something more humane.