Re: Kidney-nappers

Anders Sandberg (asa@nada.kth.se)
08 Sep 1997 20:20:19 +0200


Arjen Kamphuis <mountain@knoware.nl> writes:

> Received this very long mailing on the internal mailingsystem. Cleaned it a
> bit for readability and because of security issues. I've not been able to
> confirm this independently, If anyone can please let me know.

[Text about people stealing kidneys from business travellers
deleted for brevity]

You have fallen for an urban legend. Actually, the posted text is extremely
typical for urban legends (friend of a friend stories, many themes which
recur in other urban legends, a horrifying but unusual theme, suggestions
that sin (drinking, girls or drugs) are involved, "realistic details"
like the 911 number etc). See any standard textbook about urban
legends.

See for example
http://www.usis.usemb.se/topics/bp-unrep.txt
http://www.urbanlegends.com/medical/organ.theft/bit_listserv_transplant_faq_organ_theft.html

See especially
http://urbanlegends.miningco.com/library/weekly/aa062997.htm
which deals with the NO rumor.

If you think about it, the story falls apart completely. Organ
transplants have rejection problems, which means you can't transplant
an organ from a random donor to a patient. Using random people you
have not tissue-typed will likely lead to rejection, not to mention
the risks of spreading disease. So while there might be unscrupulous
people who might be willing to sell others organs, there would be
few buyers who would want them.

> We really need to push the bio-tech reasearch that will allow us to use pig
> kidneys or such (I've heard of pighearts as donororgans), as
> transplantation technology becomes more advanced the shortage of organs
> will rise, and thus their black-market value.

While I think xenografts are a good thing (although I am concerned with
retroviral infections) and also would like more development of artificial
organs, this will not likely solve any black market problem.
In fact, it is uncertain if there is a black market problem for organs
right now. There is however a noticeable lack of organs.

I have been thinking about the current bans on selling organs. The
idea is that it is unfair of selling life-saving organs and that they
should be donated (and perhaps also to prevent poor from selling their
organs). Does it do more good than harm? While I'm certainly not
as market-happy as many (most?) extropians, this is one area where
I have seriously considered a free market solution.

Right now there is some international cooperation to match organs
and patients, but this is a non-profit collaboration. Since the
rules for donation and transplantation are different in different
countries, there is a constant low-key grumble about some
countries not doing their part or being "organ sinks".

Allowing organ trade would produce an incentive to provide organs (or
replacements), and would convince at least some people that it would
be a good idea to become donors. In fact, it is a bit strange that
we do not have full rights to our bodies in this respect: should
we not be allowed to do what we want with them (assuming us being of
sound mind, not coerced etc)? If I decide to sell a kidney instead
of donating it, what is wrong with that decision? One could argue
that it is somewhat selfish, but do we not have the right to
do our own valuations, even if they are selfish? We have the right
to *refuse* donating organs, which could be seen as even more selfish.

Of course, many have argued that this would lead to a situation
where the rich would buy the organs of the poor. But it would
be a fair trade (assuming the right legal supervision), and a
sellers' market: the patient would want a high-quality organ,
and the set of known tissue-compatible donors would be small.
In the long run it seems to me that the organ shortage can
be solved, partially due to technological advances spurred
by the market (organ cloning, organ freezing, xenografts and
implants), partially because there would be more organs
available.

Would this do more harm than good? Strict legal controls are
of course needed to prevent organ theft, but given the need
for other strict medical and logistic controls in organ
handling suggests that this would be possible; theft can
probably be avoided since it is in the interests of all
parts (patients, health care providers and donors) to keep
the business "clean". It would also be necessary to
avoid having go-betweens earning undue profits; a
certification scheme might work and would fit fine with
the current trends in medical quality control. The
same might go for informed consent, which already apply
to donation.

So it seems that if the trade could be kept legit, there
IMHO would be little reason to believe trade in organs
would harm more people than it helped.

[Newsflash: Anders is taking a stand in a controversial
question! Flame war expected! Pictures at 11. :-)]

-- 
-----------------------------------------------------------------------
Anders Sandberg                                      Towards Ascension!
asa@nada.kth.se                            http://www.nada.kth.se/~asa/
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