Tuesday, January 22, 2008

How much for a pound of flesh -full text

Last week the state of New York moved towards its revenge on the body-snatchers - the ghoulish gang that plundered corpses of transplant material on their way to the crematorium.

Certainly they deserve severe punishment for their clinical ineptitude, which included selling bones from bone-cancer victims, but if they hadn't been so sloppy, one has to wonder if this were not, in essence, a victim-free crime.

Alistair Cooke, the famous journalist whose bones were disturbed by the ghouls would probably have been very pleased to think that he could help someone else live - but equally very displeased with the idea that others may catch cancer because of the greed of the ghouls.

Those who opt for cremation tend not to pay much heed to the idea of bodily resurrection and it raises the question of who actually owns our earthly remains. My father for example left his body to Liverpool School of Medicine, which refused to accept it because, they told me, they only took "healthy bodies". It was an intriguing concept, since most cadavers of my acquaintance have been terminally unhealthy, but it was, a term of art which presumably applies to transplants as well as dissection.

The philosopher John Harris once posed a thought experiment to solve the problem of organ shortages: a lottery would pick which person who would be sacrificed to save others, and since more people would live as a result, society as a whole would be enhanced by the exercise. But not even Ron Paul has taken up the idea.

Different countries have different strokes. Reputedly, transplant hospitals in China are close to execution grounds, ensuring a steady supply of "healthy bodies" for dismemberment. In countries with civilised healthcare systems, altruism rules. Donors and doctors give their organs and services pro bono publico. But that does not work in more robustly entrepreneurial economies.

My father's main concern was to stop the undertakers' making a profit from his corpse, and in similar vein, I must say that my only compunction about filling in the organ donation section on my driving license is that in the US, so many people, doctors, hospitals, insurance companies and others, would make a killing, if you forgive the expression, from any of the organs that my dissolute lifestyle have left fit for transplant.

In the US, the alleged bastion of property rights, religious obscurantism is robbing American citizens of their birthright. Everyone, no matter how poor, is wandering around with some quarter of a million dollars worth of transplant material: but because of the 1984 National Organ Transplantation Act, they cannot cash in their chips.

The surgeons and hospitals of America can charge an arm and a leg for hoisting out hearts and replanting them, and it seems some morticians can eke out their bottom line on the side, but the donors have no financial incentive whatsoever. Talk about a "death tax!" This no mere Republican rhetorical trope - it's the real thing. The federal government, almost unchallenged, has deprived us of the usufruct of our most personal property.

Adam Smith's invisible hand is just waiting to be transplanted into this field. Of course you may object that it is difficult for a cadaver to take profits from such a sale, but think futures. If bankers can sell stinkers like collateralised debt obligations, they should easily be able to devise an actuarially advised organ options market which would make a return for the living, and help a return to life for those in need of the spare parts.

The principle is the same as the viaticals market in which for example, HIV sufferers were able to cash in their life insurance early so they could enjoy the proceeds while still alive.

The people who would rush to sell organ futures would very likely also be those who are least likely to have a private pension scheme and who would benefit most from topping up their social security funds.

If the government really must get involved, it could help solve the alleged social security crisis by insisting that at least some, if not all, of the proceeds, would be invested in some sort of individual retirement account, but a cash handout would also help boost the recession-verging economy by putting money into the hands of people who would rush out and spend it.

Once the market is up and running, we would see that old invisible hand in operation, matching supply and demand and fixing appropriate prices for organs and tissue, going beyond the old barter economics of a cornea for a cornea. We would see the rapid development of a spot market, of derivatives, futures, hedging. Investors could go long or short on the organ of their choice. At last we would get a serious price for a pound of flesh.

Rescind the US organ transplant act now, and save America!

1 comment:

Anonymous said...

Well if anyone deserved a spot in hell it is these people..
Have you seen spotinhell.com. If you have'nt check it out.