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

In prior posts, I introduced the question, 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?, and argued that the medical risks to a professional career in football, boxing, and other violent sports are greater than the risks of donating a kidney and that the consent and screening process in professional sports is not as developed as in kidney donation.

Although the primary focus of our paper is on the medical risk associated with living kidney donation, we also briefly discuss concerns about exploitation, coercion, race, and class, again with an analogy to violent sports. Living kidney donors in the United States have above-average incomes (after adjusting for sex and age). In a new regime in which donors were paid a substantial fee, it is predictable that the influx of volunteers would have below-average incomes. The prospect of financially stressed individuals attempting to make ends meet by “selling” a kidney raises a red flag for some ethicists. A compensation regime would expand the choice set for those in comfortable circumstances, but those in desperate circumstances might feel compelled to sell a kidney; in that sense, the option of selling could be seen as “coercive.” Furthermore, a system that in part depended on the poor to supply kidneys could be seen as “exploiting” the poor.

We believe that using words like “coercion” and “exploitation” to characterize the introduction of a new option by which poor people (and others) could earn a substantial amount of money provides more heat than light on this situation. The legitimate ethical concern is that so many Americans are poor, with inequality increasing over time. But that observation does not support a ban on compensation, which in fact limits the options available to the poor and thereby makes a bad situation (their lack of marketable assets) worse. But for anyone not persuaded by this argument, we note that these social-justice concerns apply with at least equal force to compensating boxers; most American professional boxers were raised in lower-income neighborhoods, and are either black or Hispanic.

As more has become known about the dangers of the repeated head trauma, similar arguments regarding football have become more prominent. About 70% of NFL players are black, and Pacific Islanders are also overrepresented as compared to the American population. Accordingly, much attention has been paid to the concussion crisis as a race and class problem. As one observer recently noted, “What’s a little permanent brain damage when you’re facing a life of debilitating poverty?” In reality, NFL players are better educated themselves, and come from better educated homes, than is average for Americans, in part because the NFL typically recruits college students. Still, some NFL players, like some would-be kidney donors, come from poverty.

Of course, this is only a taste of our arguments and evidence, so read the full paper here. In my next post, I’ll recap and wrap up.

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

Comments

[anon]

Wow, you obviously can't get it. You put the words "exploitation" and "selling" is scare quotes because you apparently just can't bring yourself to believe that is precisely what you advocate.

You concede that the poor won't voluntarily give up their body parts, while, suggesting, risibly I believe that "A compensation regime would expand the choice set for those in comfortable circumstances ... " Has there ever been a more arrogantly privileged statement? Those who are "comfortable" without the money can donate now.

You continuously use the "whataboutitism" approach to justify this macabre proposal, but don't (and seemingly can't and won't) simply admit the obvious: two wrongs don't make a right.

Go watch the movie Deer Hunter. Then, tear up this ridiculous paper and start writing about the lack of advancement in medical science.

[anon]

From a Reuters story today, titled "Exclusive: Federal agents found fetuses in body broker's warehouse (Warning: Graphic images)":

"the discoveries ... raise questions about the practices of body brokers across America. Such brokers take cadavers donated to science, dismember them and sell them for parts ... The multimillion-dollar industry has been built largely on the poor, who donate their bodies in return for a free cremation of leftover body parts.

The buying and selling of cadavers and other body parts — with the exception of organs used in transplants — is legal and virtually unregulated in America. But trading in fetal tissue violates U.S. law."

But, if the author above had her way, one suspects, not for long. Why not promote a market for unborn babies, up to 24 weeks or even later? Wouldn't this be a great opportunity to increase "options available to the poor and thereby make[] a bad situation (their lack of marketable assets) [better]"? Raising little body part supply kits would be groovy, no? After all, they can't speak and wouldn't protest at all!

The mothers selling these fetuses could also strip off skin quite easily, give up a kidney, perhaps some eggs, and a lung, and ultimately, given that head transplants have been proved possible, leave something to their own kids by ultimately allowing a rich person to buy their bodies to host the privileged one's head (think, law professor).

This is such a great way to create wealth, isn't it? And, after working so hard all their lives, and enduring such hardships, and being so deserving as they all are, haven't law professors earned the right to buy body parts from poor people? After all, who is more important in this world?

OF course "ethicists" might claim that this is "exploitation" (the rich, of course, can buy designer babies carried by surrogates, augmented, perhaps, with spare parts acquired from the unborn fetuses sold by the poor), but this "concern" would be folly, wouldn't it? Ignorant "ethicists" can't fathom the deeper meaning of the enlightened market theory propounded above.

[Deep State Special Legal Counsel]

anon I and anon II,

We should cease producing and selling automobiles, trucks, trains, planes because somebody might get hurt or abuse one for not their intended purpose.

It is not a good legal argument: Potential for abuse. Using your analysis, our criminal justice system should allow for anticipatory incarceration...