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 ban against paying kidney donors cannot rest on the basis of medical risk when we pay professional athletes to incur far greater risks. Today, I will talk about the consent process and the extent to which we might expect the system to protect participants – whether organ donors or professional athletes – from making bad choices against their own interests in exchange for the lure of money.
We believe that if NOTA were amended to allow payments to donors, potential kidney donors could be protected against being unduly tempted through the existing structure of screening, counseling, and delay, perhaps with some additional protections to prevent hasty decisions. On the other hand, it is not clear that NFL recruits have such protections in place.
Whether and when sane, sober, well-informed, adults should be banned by government authority from choosing to engage in an activity that risks their own life and limb is an ancient point of contention. There are a variety of hazardous activities that are permitted with no legal bar to receiving compensation. Included on this list are such occupations as logging, roofing, commercial fishing, and military service. Also included are violent sports such as football, boxing, and mixed martial arts (MMA). These examples illustrate a broad endorsement of the principle that consenting adults should be allowed to exchange (in a probabilistic sense) their physical health and safety for financial compensation, even in some instances where the ultimate product is simply providing a public entertainment.
One potentially distinguishing feature of kidney donation is that the harm is not the result of an accident, but rather of the deliberate action (of the surgeon and medical team). But this is also the case with fighting sports and with egg donors, who are compensated.
It is helpful to deconstruct the decision to donate a kidney under both the current regime (no compensation) and a hypothetical regime (in which the donor would be financially compensated). A well-developed organ procurement process in the American system seeks to ensure that potential donors are fully capable of making a good decision. Potential kidney donors are not only provided with full information, but also screened for mental and physical disability. While there is the possibility of “mistakes” (a decision to donate against the true best interests of the individual) under both a compensated and uncompensated system, the screening, consent process, and delays should minimize the chance for the kind of errors that behavioral economics has demonstrated are common. There is nothing intrinsically irrational about a willingness to assume medical risk in exchange for a substantial amount of money. But the quality of the choice may be influenced by a variety of factors, and we recommend some “nudges” designed to overcome the most common causes of faulty decision-making under such circumstances.
The same concerns that apply to the quality of kidney donor decisions also apply, and more obviously, to the decision to sign a contract to play in the NFL. Yet the consent and screening process in professional sports is not as developed as in kidney donation. Players are provided with little information about the risks, and indeed, the longer-term risks (including the risk of CTE in middle age) have not been well quantified, but appear to be far higher than for kidney donation. The payoff in both financial terms and status is also very high, and in part conveyed immediately. Any counseling or screening that might occur is up to the player to pursue.
In short, to the extent that the ban on compensated kidney donation is grounded in a concern that the lure of money may cause donors to disregard the risks of the procedure and subsequent long-term effects, that concern applies with even more force to participation in violent sport.
This, of course, is just a taste of our analysis and evidence, so read the full paper for more.
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
Once again, you are simply arguing that professional sports that injure the players should be regulated (to some extent, they are) and banned if the harm is substantially certain to occur (boxing is fading).
You still haven't addressed the core issue:
The rich can afford to buy organs, the poor cannot;
The poor need to sell organs, the rich do not.
These truths logically destroy your rationalizations by way of "whataboutism" ...
In your Orwellian world, organ slavery is freedom; or, perhaps you prefer a Marxist ideal (after all, Big Brother's party was English Socialism), but this is obviously not your notion of a fair society, or will you tax the populace and then pay poor people to sacrifice their organs (again, the rich have no need to sell organs)?
In any real world, you are talking about capitalism at its most naked, disgusting iteration. You say, quite paternalistically/maternalistically, that you will provide "safeguards" to the victims of this devilish system.
Really? Do you honestly believe that ANYONE would allow a vital organ to be removed from his or her body if not for the money? You concede that this is rare, or you wouldn't be proposing this awful idea.
I'm not sure if you believe what you say. I recall a post wherein, if I am not mistaken, you thought woman sell their eggs for altruistic reasons, and therefore should be paid more. Sort of like blood, right? Eyes (after all, most people have two)? Testicles? Skin?
Wouldn't it be easier, in this utopia, just to raise the donors in camps, where you can "educate" them to accept their role as supply kits for the idle rich, who sit around dreaming up new ways to exploit them? Wouldn't that save the time of the "protections" against "mistakes" you sort of risibly describe?
Posted by: anon | December 24, 2017 at 03:04 PM
anon^^,
I think the "poor" would pay for organs through insurance, Medicare or Go Fund Me as well. It would not be limited to the idle rich, a stereotype you resort to in your post.
Where I donate blood, I get a T-Shirt and two Target gift cards worth twenty dollars. As a society, we collectively believed that mixed race and same sex marriages were verboten. And aren't we hypocrites when we allow weirdo, recluse, white rich gamblers access to unlimited quantities of AR-15s?
Posted by: Deep State Special Legal Counsel | December 24, 2017 at 06:27 PM