Teaching the Ethical Foundations of Economics

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Teaching the Ethical Foundations of Economics. Lesson 7: Should We Allow a Market for Transplant Organs?. Are some markets too repulsive to consider?. ewww!!!!. prostitution. gambling. pollution permits. interest on loans. ticket scalping. horse meat. illicit drugs. uterus rental. - PowerPoint PPT Presentation

Text of Teaching the Ethical Foundations of Economics

Should We Allow a Market For Transplant Organs?

Teaching the Ethical Foundations of EconomicsLesson 7: Should We Allow a Market for Transplant Organs?

1Are some markets too repulsive to consider?ewww!!!!



pollution permits

interest on loans

ticket scalping

horse meat

illicit drugs

uterus rental


selling human organs

Should We Allow a Market For Transplant Organs?Or. . .Brother,can you spare a kidney?Kidney Transplant BackgroundFrom the first kidney transplant in 1954, both transplants and those seeking transplants have grown over time.

Transplants1990 10,0002005 13,700Most of this increase came from live donors.

Background. . .Waiting list1990 17,0002006 65,000Reasons for the increase?Technological advance.Inability of the current system to procure enough organs.Background. . .In 2004, there were 50,000 on the official waiting list, but 335,000 on dialysis.

The median waiting time for people placed on the kidney transplant waiting list is more than 3 years.

People suffer and die while waiting for a kidney transplant:1990 1,000 people died2005 4,000 people diedBackground. . .In 2004, 80% of living donors and recipients were related.

The opportunity to buy and sell kidneys has the potential to save lives and improve the quality of life for many people.

The Demand for Kidney Transplants Has Grown Faster Than the Supply

Source: Becker and Elias, 2007

Government mandated price ceiling of $0.Prohibition places a ceiling price on kidneys.

20,000 kidneys supplied (donated) at P= $0How many kidneys are donated at P=$0?

20,000 kidneys supplied (donated) at P= $080,000 kidneys demanded at P= $0How many kidneys are demanded at P=$0?

60,000 kidney shortageWhat is the shortage, and what caused it?

What would happen if the ban on kidney sales was lifted?Objections to a Market SolutionUnfair to the poorExploitationCoercionObjectificationIllegal (black) marketsFewer altruistic donors

Fair to the poor? No!Poor are priced out of the market.Poor may be coerced into selling kidneys.Poor may not understand the risks. Yes!Is it ethical to deprive the poor of the opportunity to increase their standard of living and save lives?We allow markets in: blood, hair, and the use of a uterus. Coercion and Exploitation?Coercion in the absence of monetary compensation?

Is it coercive to pay people higher wages for more dangerous employment?

It is an unethical approach to shift the tragedy from those waiting for organs to those exploited into selling them.

27First bullet, Kahn and Delmonico (2004).

Transplant surgeons avoid donors who seem to be coerced by monetary or non-monetary means.

Second bullet Ghods and Savaj (2006)

Objectification?Money can transform a good deed into a bad one.

Treating the body as a commodity?

any procedure which tends to commercialize human organs or to consider them as items of exchange or trade must be considered morally unacceptable, because to use the body as an object is to violate the dignity of the human person. Pope John Paul II, 2000Organ theft?As opposed to prohibition, a market would make kidneys more available, lowering the price, making theft less profitable.

A live donor market could virtually eliminate the possibility theft.

Under prohibition, what is the black market price of a kidney?

The Black Market price of kidneys?

Would there be fewer altruistic donors?S31Altruism is not absolute. Markets my motivate donors who are somewhat altruistic.

Public campaign to increase altruistic donations?SIf it is obvious that a market would save lives, why dont we allow it?AgentActionConsequencesEthical TheoriesOutcomes-Based: Right ConsequencesIts results that matter.

Duty-Based: Right ActionProscribed ethical principles.

Virtue-Based: Right AgentIntentions and personal virtues matter.Policy OptionsCurrent voluntary system

Free market

Regulated market

Communitarian approachFurther ReadingBecker and Elias, Introducing Incentives in the Market for Live and Cadaveric Organ Donations, Journal of Economic Perspectives 21(3), Summer 2007, p.2-24

Howard, Producing Organ Donors, Journal of Economic Perspectives 21(3), Summer 2007, p. 25-36.

Roth, Repugnance as a Constraint on Markets, Journal of Economic Perspectives 21(3), Summer 2007, p. 37-58.