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Flynn v. Holder, Markets for Bone Marrow, and Abigal Alliance

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3 Responses

  1. Doesn’t the “crowding out” reasoning prove way, way too much? I mean, allowing doctors to be paid presumably crowds out the unpaid provision of medical services. Allowing pharmaceutical manufacturers to be paid presumably crowds out unpaid manufacture of drugs. Allowing people to be paid for ANYTHING ‘crowds out’ the uncompensated provision of that good.

    But we allow people to be paid for the provision of goods and services anyway, because we realize that essentially every good and service would be radically undersupplied if nobody could be paid for providing it. Organ and tissue donation are no exception to this. And because it’s perfectly reasonable and just for people to expect payment for providing goods and services. Again, organ and tissue donation are no exception.

    I can’t see a rational reason why a tissue donor shouldn’t be compensated, while the doctor should be…

  2. tf says:

    Sorry but I see any restrictions on the sale, exxchange or other of a persons own organs (or in the case of a dying person- the one making health care decisions) as morally wrong and almost tantamount to murder by law and society. Doesn’t anyone see the long organ donor lists and the amount of people dying each day.

  3. Glenn Cohen says:

    Thanks for the comments

    Brett — actually the “Crowding Out” argument (and I should signal here that I am a skeptic) claims that in some markets currently characterized by altruistic giving, a move to a market norm would *reduce* supply, since the alteration in the social meaning alienates some current individuals who give without compensation and that diminution is not offset by the the increased number of those who give because of the compensation. Again, it is an empirical claim, one that has received *some* support in blood markets. With the sale of medical services, I think a proponent of the theory would either say (i) this is not a theory of all goods at all times, so she can concede your point as to medical services and maintain her point as to bone marrow; and/or (ii) It is too late with medicine, we already have a system of exchange conceived in market terms, and it may be very hard to reclaim an altruistic social meaning.

    TF- Again I should be upfront and signal (as you can gather from the old paper of mine I linked to in the body of the text) that my priors tend to be closer to yours on the issue. That said, (i) if you thought that the crowding-out theory was empirically well-supported as to this market (again I am skeptical), then in fact it is permitting these sales not preventing them that reduces supply and therefore causes more deaths by those on the waiting list; (ii) At least under certain circumstances the exploitation/coercion arguments may prove worrisome enough in the organ context to count as countervailing considerations. Here the Anthropologist Nancy-Scheper Hughes’ work is instructive. Again, as I said in the main post, the fact that bone marrow is renewing may somewhat blunt this concern more than in the organ sale context.