If You Oppose Paying Kidney Donors, You Should Oppose Paying Football Players And Boxers Too: Wrap-Up

In this series of posts, I’ve discussed a new draft that Phil Cook and I are circulating, If We Allow Football Players and Boxers to Be Paid for Entertaining the Public, Why Don't We Allow Kidney Donors to Be Paid for Saving Lives?. Our claim, which I laid out in my first post, is that there is a stronger case for compensating kidney donors than for compensating participants in violent sports. If this proposition is accepted, one implication is that there are only three logically consistent positions: allow compensation for both kidney donation and for violent sports; allow compensation for kidney donation but not for violent sports; or allow compensation for neither. Our current law and practice is perverse in endorsing a fourth regime, allowing compensation for violent sports but not kidney donation.

A common argument in support of the ban on kidney donation is that if people were offered the temptation of substantial compensation, some would volunteer to donate against their own “true” best interests. This argument is often coupled with a social justice concern, namely that if kidney donors were paid, a large percentage of volunteers would be poor and financially stressed, and for them the offer of a substantial financial inducement would be coercive. In sum, a system of compensated donation would provide an undue temptation, and end up exploiting the poor.

To these arguments we offer both a direct response, and a response by analogy with violent sport. My posts have touched on a few key points. First, the medical risks to a professional career in football, boxing, and other violent sports are much greater both in the near and long term than the risks of donating a kidney. On the other hand, the consent and screening process in professional sports is not as developed as in kidney donation. The social justice concerns stem from the fact that most players are black and some come from impoverished backgrounds.

Note that these arguments focus on the donors’ welfare, and ignore the welfare of people in need of a kidney. A comprehensive evaluation of amending NOTA to allow compensation requires that both groups be considered. Such an evaluation, conducted by Philip Held and colleagues, reached the following conclusion about a regime in which living donors were offered enough compensation ($45,000) to end the kidney shortage: “From the viewpoint of society, the net benefit from saving thousands of lives each year and reducing the suffering of 100,000 more receiving dialysis would be about $46 billion per year, with the benefits exceeding the costs by a factor of 3. In addition, it would save taxpayers about $12 billion each year.”

As stated by Held et. al., “dialysis is not only an inferior therapy for end-stage renal disease (ESRD), it is also almost 4 times as expensive per quality-adjusted life-year (QALY) gained as a transplant.” This means that the Medicare (which pays for the bulk of ESRD treatments) dollars currently spent on dialysis could be reallocated to compensating kidney donors, saving lives and tax dollars in the process. 

As I said, even a series of posts gives only an introduction to our arguments and evidence, so download the full paper here.

Prior related posts:

If You Oppose Paying Kidney Donors, You Should Oppose Paying Football Players And Boxers Too

Paying Kidney Donors, Football Players, And Boxers: Medical Risks

Paying Kidney Donors, Football Players, And Boxers: Informed Consent And It’s Limits

Paying Kidney Donors, Football Players, And Boxers: Exploitation, Race, Class

Comments

[Anonny Prof]

I don't mean to be rude as this sounds interesting, but how many posts do you plan to do on this one topic? Could you at least spread them out a bit?

[Anon]

A world in which the poor might be able to scrape by if they allow their organs to be harvested for the benefit of the wealthy? Pretty dystopian. Not at all far fetched.

[Deep State Special Legal Counsel]

Anon at 11:29,

We already live in dystopia. We have major disaster weather events and fires due to a "hoax", a massive redistribution of wealth away from education, roads, research, law enforcement, disease prevention to mutli-national corporations (Mercedes Benz is earn almost $2 Billion more next year) and a school mass shooting (Sandy Hook) characterized as fake news. Oh yes, we allow a deranged, White, reclose, weirdo video slot gambler to purchase multiple combat weapons. And somehow White Nazis are "good people." And you want to criticize a few schleppers for selling their Kidneys?

[Deep State Special Legal Counsel]

How is this any different than a young law student entering into a "Sugar Daddy" relationship to finance an education? Not ideal, but oh well...kinda roll your eyes...but it happens. Our first lady found Donald John Trump. I guess he's a hunk!

[anon]

Thankfully, the only defense of this awful proposal, at least in these pages, is offered by a wackadoodle.

[Deep State Special Legal Counsel]

anon at 4:11,
"Awful proposal" you say? You must be live in a cloistered word of pampered wealth and have fully functioning organs. Good for you. Who are you Solyndra? You and the government get to pick the winners and the losers? Let the market decide. If I want to trade a K-Car for a kidney, that should be my choice.

[anon]

Wackadoodle.

[Deep State Special Legal Counsel]

anon^^^

If your organs were offered for sale, they would be in the scratch and dent table at Dollar General.

[Anymouse]

Wackadoodle indeed. And she/he ceased being funny long ago.

[Deep State Special Legal Counsel]

Anymouse, thanks for following me. Your organs would be found at a garage sale next to the Beanie Babies and unopened Richard Simmons video tapes. Two for a quarter. See you in the next post....

[anon]

Wackadoodle doesn't know when to stop. That's a whackadoodle.

His goal appears to be to destroy the commenting section on every post, and, he appears to be succeeding.

SO, maybe a pretender wackadoodle? But, that would make him a wackadoodle, for pretending to be a wackadoodle.

I would think the latter, but, whatever.

Wackadoodle.