Donors of bone marrow can now be paid(reuters.com)
reuters.com
Donors of bone marrow can now be paid
http://www.reuters.com/article/2011/12/02/us-donors-bone-marrow-idUSTRE7B11FR20111202
7 comments
If people own their organs, then why can't they sell them? In any case, this seems to be a step in the right direction.
And in some countries people are constantly being kidnapped and held for ransom. We don't have that problem in the US and we probably wouldn't have a big organ gang problem either.
The difference is that currently the amount a kidnapper could extract from an average person is not very high. If selling organs is allowed, suddenly the body of every person walking in the street is a worth a lot of money. It will drastically increase the probability of getting kidnapped for one's organs.
But the whole purpose of having a government at all is to prevent people from murdering, defrauding, kidnapping (all of which involve force initiated against another).
Some might say that if someone buys an expensive life insurance policy, the probability that they will be murdered by the next of kin goes up. Or that if you buy a nice car, the probability that it will be stolen goes up. But that doesn't mean that anyone should be prevented from buying a nice car or a life insurance policy.
Issues of rights and justice need to be handled on an objective basis, and that requires an impartial arbiter to protect the rights of its citizen masters. That ideal arbiter and protector of rights (to life, liberty, and property) is the ideal government. Given the existence of even an imperfect government such as our own, the right solution to kidnapping is twofold: first, encourage the government do its job, which is to provide the conditions necessary to live your life without worrying about others initiating force against you; second, live your life as you see fit, without violating the rights of any other (because to do so would go deeply against your long-term self-interest - in the long run, lying/stealing/cheating/kidnapping etc. are all forms of cutting your own throat).
Some might say that if someone buys an expensive life insurance policy, the probability that they will be murdered by the next of kin goes up. Or that if you buy a nice car, the probability that it will be stolen goes up. But that doesn't mean that anyone should be prevented from buying a nice car or a life insurance policy.
Issues of rights and justice need to be handled on an objective basis, and that requires an impartial arbiter to protect the rights of its citizen masters. That ideal arbiter and protector of rights (to life, liberty, and property) is the ideal government. Given the existence of even an imperfect government such as our own, the right solution to kidnapping is twofold: first, encourage the government do its job, which is to provide the conditions necessary to live your life without worrying about others initiating force against you; second, live your life as you see fit, without violating the rights of any other (because to do so would go deeply against your long-term self-interest - in the long run, lying/stealing/cheating/kidnapping etc. are all forms of cutting your own throat).
That is the purpose of the government but you do agree that certain policies can make accomplishing that purpose much much harder, maybe even impossible?
A nice car is not a good analogy since 1) buying one is a matter of choice and 2) kidnapping someone for a nice car is not likely to get someone seriously injured or killed (as long as one agrees to the kidnapper's demands) whereas kidnapping for organ donation is completely different.
A nice car is not a good analogy since 1) buying one is a matter of choice and 2) kidnapping someone for a nice car is not likely to get someone seriously injured or killed (as long as one agrees to the kidnapper's demands) whereas kidnapping for organ donation is completely different.
You know, you only live so long. It's not as if you have an indefinite amount of time and money over the course of your life.
If you work for years and save to buy that nice car, and someone steals it from you, someone has taken part of your life away. Even if the blow is distributed across a lot of people via an insurance policy, this is still true.
If you work for years and save to buy that nice car, and someone steals it from you, someone has taken part of your life away. Even if the blow is distributed across a lot of people via an insurance policy, this is still true.
You own yourself, but cannot sell yourself into slavery, for very good reasons.
No, but you can sell your posessions, your labor, your ideas, your likeness, and numerous other rights and privileges. Why the arbitrary comparison between organs and slavery?
Because of the pressures it would put on the people most likely to 'take advantage' of it.
Do I sell my kidney or tell my kid he can't go to college?
Do I sell my liver or live in credit card debt for the rest of my life?
Plus, the illegal gaining and trading of organs would spike.
Do I sell my kidney or tell my kid he can't go to college?
Do I sell my liver or live in credit card debt for the rest of my life?
Plus, the illegal gaining and trading of organs would spike.
No idea why you're being downvoted. This is some interesting context on paying for organs:
In Pakistan, 40 percent to 50 percent of the residents of some villages have only one kidney because they have sold the other for a transplant into a wealthy person, probably from another country, said Dr. Farhat Moazam of Pakistan, at a World Health Organization conference. Pakistani donors are offered $2,500 for a kidney but receive only about half of that because middlemen take so much.[33] In Chennai, southern India, poor fishermen and their families sold kidneys after their livelihoods were destroyed by the Indian Ocean tsunami on December 26, 2004. About 100 people, mostly women, sold their kidneys for 40,000–60,000 rupees ($900–$1,350).[34] Thilakavathy Agatheesh, 30, who sold a kidney in May 2005 for 40,000 rupees said, "I used to earn some money selling fish but now the post-surgery stomach cramps prevent me from going to work." Most kidney sellers say that selling their kidney was a mistake.[35]
http://en.wikipedia.org/wiki/Organ_transplant#Compensated_do...
In Pakistan, 40 percent to 50 percent of the residents of some villages have only one kidney because they have sold the other for a transplant into a wealthy person, probably from another country, said Dr. Farhat Moazam of Pakistan, at a World Health Organization conference. Pakistani donors are offered $2,500 for a kidney but receive only about half of that because middlemen take so much.[33] In Chennai, southern India, poor fishermen and their families sold kidneys after their livelihoods were destroyed by the Indian Ocean tsunami on December 26, 2004. About 100 people, mostly women, sold their kidneys for 40,000–60,000 rupees ($900–$1,350).[34] Thilakavathy Agatheesh, 30, who sold a kidney in May 2005 for 40,000 rupees said, "I used to earn some money selling fish but now the post-surgery stomach cramps prevent me from going to work." Most kidney sellers say that selling their kidney was a mistake.[35]
http://en.wikipedia.org/wiki/Organ_transplant#Compensated_do...
As has been demonstrated time and time again, the way to get rid of a black market is to repeal whatever prohibition is creating it.
You missed the point of my post. The point is that the poor are disproportionately pressured by this kind of market, black or otherwise. A non-black market will just make it easier for the poor to sell their organs, and the rich to obtain them. Re-read what I posted.
I've read your other post on the subject and it frankly makes me sick. You've clearly never been poor and exploited by people with money, felt the range and depth of their manipulation to obtain what you have, without them giving a shit about you as a person.
I've read your other post on the subject and it frankly makes me sick. You've clearly never been poor and exploited by people with money, felt the range and depth of their manipulation to obtain what you have, without them giving a shit about you as a person.
The poor are disproportionately pressured by every market, obviously. In my experience being poor, all the pressure pretty much stems from one issue: needing money and not having any. The only way to relieve that pressure is to either make people not poor or make money less important. Taking away options without providing alternatives does not help, it just backs people into a corner, making them more desperate and more vulnerable to exploitation.
I don't see how my proposal could be much more compassionate. Everybody gets free and equal access to organs, and the trade is exclusively between donors and the government, subject to whatever concessions and protections the public at large has it in their heart to offer the donors.
The alternative is what you described, and what we have now: we either get lucky, die waiting for a transplant, or buy our life saving organs from criminals who rip off the poor for their body parts. Does that really make you less sick? If not, what is your solution?
I don't see how my proposal could be much more compassionate. Everybody gets free and equal access to organs, and the trade is exclusively between donors and the government, subject to whatever concessions and protections the public at large has it in their heart to offer the donors.
The alternative is what you described, and what we have now: we either get lucky, die waiting for a transplant, or buy our life saving organs from criminals who rip off the poor for their body parts. Does that really make you less sick? If not, what is your solution?
> Taking away options without providing alternatives does not help, it just backs people into a corner, making them more desperate and more vulnerable to exploitation.
Selling your organs out of desperation is pretty much as low as you can go for money. Maybe selling yourself for sex is lower, but you can argue that you're still physically all there after that. So the argument of preventing them sinking even lower is a non-issue. Selling your organs is right down there with the lowest.
> what is your solution?
The solution is for people to start supporting sciences to regrow organs from stem cells. That fixes 99% of the issues. Which brings up another point, say you legalize organ sales, and businesses become established, who do you think is going to be opposing regrowing organs? The businesses brokering the sale of organs. They're not going to want kill off their whole industry so everyone can get the organs they need directly.
In the long term, selling organs will create more problems and suffering than they'll solve. Let's face it, this is only an issue to rich people who are dying with 5-6 disposable figures. You don't see poor people begging legislators to let them sell their own organs, because deep down, they know that they never want it to come to that.
Selling your organs out of desperation is pretty much as low as you can go for money. Maybe selling yourself for sex is lower, but you can argue that you're still physically all there after that. So the argument of preventing them sinking even lower is a non-issue. Selling your organs is right down there with the lowest.
> what is your solution?
The solution is for people to start supporting sciences to regrow organs from stem cells. That fixes 99% of the issues. Which brings up another point, say you legalize organ sales, and businesses become established, who do you think is going to be opposing regrowing organs? The businesses brokering the sale of organs. They're not going to want kill off their whole industry so everyone can get the organs they need directly.
In the long term, selling organs will create more problems and suffering than they'll solve. Let's face it, this is only an issue to rich people who are dying with 5-6 disposable figures. You don't see poor people begging legislators to let them sell their own organs, because deep down, they know that they never want it to come to that.
Myself and numerous other people here have signed up to give our bone marrow to a total stranger for free. I suppose we've all hit rock bottom then?
For the sake of poor people, transplant patients, and sex workers everywhere, please don't impose your own backwards morals on everyone else.
For the sake of poor people, transplant patients, and sex workers everywhere, please don't impose your own backwards morals on everyone else.
> total stranger for free. I suppose we've all hit rock bottom then?
First, you haven't actually had your marrow sucked out for 6 hours after 5 days of medication. Second, there's a distinct difference between the people who donate their organs for free and those who sell them. Go back and read the statistics I posted.
> For the sake of poor people, transplant patients, and sex workers everywhere, please don't impose your own backwards morals on everyone else.
I'm really not, I'm just expressing my opinion. I'm sorry you're so offended as to feel imposed upon, but it really is just a block of text on the internet. No need to get catty.
Find me people begging to sell their organs and I'll concede that it's a good idea.
First, you haven't actually had your marrow sucked out for 6 hours after 5 days of medication. Second, there's a distinct difference between the people who donate their organs for free and those who sell them. Go back and read the statistics I posted.
> For the sake of poor people, transplant patients, and sex workers everywhere, please don't impose your own backwards morals on everyone else.
I'm really not, I'm just expressing my opinion. I'm sorry you're so offended as to feel imposed upon, but it really is just a block of text on the internet. No need to get catty.
Find me people begging to sell their organs and I'll concede that it's a good idea.
Well, you found one. Even though I'm willing to give my marrow away, if the government or an insurance company wanted to pay me for doing so, I would take the money without hesitation. Why the hell not? I might even sell a kidney if the fee was enough to change the course of my life. I don't see what misguided principle would compel me to turn down the offer. If anything, my principles would compel me to accept it, knowing that someone's life depends on it.
Doctors, police officers, and firefighters accept enormous personal sacrifices and risks in order to save lives, yet we have no qualms about paying them and they have no qualms about getting paid. And even though most of them aren't in it for the money, if we didn't pay them then we wouldn't have them.
Doctors, police officers, and firefighters accept enormous personal sacrifices and risks in order to save lives, yet we have no qualms about paying them and they have no qualms about getting paid. And even though most of them aren't in it for the money, if we didn't pay them then we wouldn't have them.
So you would rather force them to not send their kid to college and be in credit card debt for the rest of their life? If you are concerned about people being poor, help prevent them from being poor. Don't deprive them of whatever options they have left because you find it distasteful. They have to do something. If selling their organs is the best option, and they're not allowed to do it, they will just do something worse.
Besides, I don't understand why anyone finds it so horrifying. We indiscriminately implore people to donate their bone marrow for free, and we applaud those who do. But if they get paid for it, suddenly they are being exploited? And it would have been better if the leukemia patient died?
It's not the selling of organs that I find distasteful, it's the buying of organs. Or more specifically, patients not getting an organ because they can't afford one. That, and middlemen profiting from the organ trade without adding any life-saving value. But both of these things can be prevented by publicly regulating and funding the commercial organ drive.
Besides, I don't understand why anyone finds it so horrifying. We indiscriminately implore people to donate their bone marrow for free, and we applaud those who do. But if they get paid for it, suddenly they are being exploited? And it would have been better if the leukemia patient died?
It's not the selling of organs that I find distasteful, it's the buying of organs. Or more specifically, patients not getting an organ because they can't afford one. That, and middlemen profiting from the organ trade without adding any life-saving value. But both of these things can be prevented by publicly regulating and funding the commercial organ drive.
[deleted]
This is interesting timing because of the Amit Gupta social media attempt to get a donor. Now, Amit is allowed to offer money for the bone marrow.
It's too late now, unfortunately.
http://amitguptaneedsyou.com/
http://amitguptaneedsyou.com/
I'm not sure it is. To the best of my knowledge, Amit hasn't found a donor yet - they've just found several possible matches.
If so, then the next challenge will be getting one of those matches to donate. Per article on HN yesterday, "more than 50 percent of South Asians in the registry refuse to go through with the donation process if selected" (Source: http://www.good.is/post/amit-gupta-and-the-south-asian-bone-... )
If payment improves that ratio, then I would think this could still potentially help Amit.
If so, then the next challenge will be getting one of those matches to donate. Per article on HN yesterday, "more than 50 percent of South Asians in the registry refuse to go through with the donation process if selected" (Source: http://www.good.is/post/amit-gupta-and-the-south-asian-bone-... )
If payment improves that ratio, then I would think this could still potentially help Amit.
What was the clock counting down to?
Artificial deadline to instill a sense of urgency leveraged by the call to action.
[deleted]
There is a massive profit made along the chain from selling donated blood in the USA to hospitals and patients - we're talking billion of dollars (the Red Cross is very guilty, so is Baxter and other corporations).
The plasma payment model works just fine, I say try it for other things that are renewable.
The plasma payment model works just fine, I say try it for other things that are renewable.
In a recent thread I argued that renewable is not a sufficient criterion (and perhaps not necessary, either). Risk to the donor is much more important. Money in medicine is coercive, but if you are coercing someone into doing something nearly never harmful (blood or sperm donation), it's not a problem. If you're coercing them into doing something with high risk, even if the tissue is renewable, then I believe we have a problem (liver donation).
Modern marrow collection techniques generally put the donor at low risk, and marrow is renewable, so it appears to be a clear win.
Modern marrow collection techniques generally put the donor at low risk, and marrow is renewable, so it appears to be a clear win.
Risk matters, but the only impact is has on anything is on price. If something has a 0.1% chance of killing me, I'll expect far, far less money for it than something with a 5% chance of killing me. I might still do it, but the payoff has to be proportional to the risk I'm taking. I ride in cars knowing that I'm taking a risk, but I do it because I want the value that riding in a car gives me.
In the abstract, I agree. One could create a utility function expressing the necessary compensation (for them) in exchange for taking on a certain amount of risk. In the concrete, I'm not so comfortable with this on a population scale. People in general are not good at understanding risk, and they are not good at understanding medicine.
Procedure X has a 10% chance of killing you, a 1% chance of leading to necrotizing fasciitis that will not kill you but will require an amputation, a 3% chance of disfiguring scarring, a 4% chance of in-procedure myocardial infarction that will leave you alive but in heart failure ... etc. If we even had an exhaustive list of the actual risks of the actual procedures in the hands of the actual surgeon doing the procedure (we don't), it would still be impractical to get any particular person to understand the whole array of risks that they face, not just mortal risk.
We would need a much better way of measuring 'understanding' than I believe we have right now for me to get onboard with compensation for extremely high risk procedures for donation. And that's assuming a coldly rational populace.
Procedure X has a 10% chance of killing you, a 1% chance of leading to necrotizing fasciitis that will not kill you but will require an amputation, a 3% chance of disfiguring scarring, a 4% chance of in-procedure myocardial infarction that will leave you alive but in heart failure ... etc. If we even had an exhaustive list of the actual risks of the actual procedures in the hands of the actual surgeon doing the procedure (we don't), it would still be impractical to get any particular person to understand the whole array of risks that they face, not just mortal risk.
We would need a much better way of measuring 'understanding' than I believe we have right now for me to get onboard with compensation for extremely high risk procedures for donation. And that's assuming a coldly rational populace.
I probably just don't fully understand the situation, however this seems bad. I'm usually for capitalism and the concept of supply and demand, but not in this case.
What's my marrow worth to me? Probably not much; a bit of time and discomfort but overall not a huge deal. However, for the buyer, it's the matter of life or death. Seems like it would be easy to extort someone who needs it.
This is one of the rare cases where I hope the market is very heavily regulated -- say, "Bone marrow is worth $1k. It's illegal to ask for more."
What's my marrow worth to me? Probably not much; a bit of time and discomfort but overall not a huge deal. However, for the buyer, it's the matter of life or death. Seems like it would be easy to extort someone who needs it.
This is one of the rare cases where I hope the market is very heavily regulated -- say, "Bone marrow is worth $1k. It's illegal to ask for more."
Having price ceilings would cause shortages in supply which would possibly lead to more deaths than cost increases. By meddling in the marketplace you are bound to create a lot of unintended consequences that will be detrimental to patients.
Death is not the only measure of quality of life. ER docs are not empowered to negotiate fees with their patients in the moments before service either.
Right now the problem is supply. The problem is not people being unable to pay $x more for the treatment.
Oh no! Now there will be bone marrow thieves! </sarcasm>