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Fearless Philosophy For Free Minds: January 2008

Friday, January 25, 2008

Free Market Organs

Last week, Doug linked a post about British Prime Minister Gordon Brown’s support for a policy that would allow hospitals to harvest organs without prior consent of the decedent or his/ her family. In essence, the organs of all deceased British citizens would belong to the government’s healthcare system except for those individuals who “opted out” prior to death.

The policy in the U.S. is an “opt in” approach rather than “opt out.” Why is this distinction important? Answer: the presumption of ownership. If citizens have an option of opting in, this shows that individuals own their bodies; to suggest that an individual has to opt out shows that citizens’ bodies are property of the government (unless s/he makes an affirmative claim on his/her body).
The reason for Brown’s support for this policy is quite obvious: like just about everywhere else in the world, Britain is having an organ shortage.

So if presumed consent is not the answer to solving the organ shortage, what is? Randolph Beard, John D. Jackson, and David L. Kaserman of Auburn University published a study in the Winter 2008 issue of Cato’s Regulation Magazine. The team studied the effectiveness of current policies aimed at maximizing donor participation and organ matching. Among the policies they analyzed were: increased government funding for organ donor education, organ donor cards (such as having the words “organ donor” on driver’s licenses), required request, kidney exchange programs, and donor reimbursement. None of the policies have come close to solving the shortage. The researchers estimate that roughly half of the potentially viable cadaver organs are ever harvested. With the exception of the inefficient kidney exchange program, one feature that all of these programs have in common is that they each rely on altruism on the part of individuals to donate organs without any sort of compensation.

The one solution which the researchers believe would be effective, monetary compensation to organ donors or their families, is illegal almost everywhere. In 1984, the National Organ Transplant Act was passed making it a crime in the U.S. for a surviving family to receive payment for their loved one’s organs. The law was passed mostly on ethical grounds without any consideration for what would happen to the supply of available organs. The researchers estimate that some 80,000 lives from 1984 to present have been lost because of the bill’s passage and other subsequent policies in the current “altruistic” system. The researchers further project that another 196,310 lives will be lost between 2005- 2015 (and this is what they consider a “conservative” estimate!).

As controversial as compensating families organs of deceased family members is, the thought of an individual driving to a hospital, removing an organ (such as a kidney), and selling that organ to someone in need of the organ for a profit is a complete non-starter. This shouldn’t come as a shock given that in today’s lexicon; the word “profit” is a dirty word. The people who scream bloody murder whenever people decide to “scalp” tickets to sporting events or tickets for Hanna Montana concerts (what’s the big deal with Hanna Montana anyway?) will not likely be in favor of selling vital organs. Anti-capitalist objections aside, free market buying and selling of organs appears to be the most practical solution.

Cato Institute’s Director of Bioethics Studies Sigrid Fry-Revere found that Iran is the only country that does not have an organ shortage and has not had a shortage in ten years. Why? Because Iran (of all places!) is one of the only countries where it is legal for individuals to buy and sell organs from live, voluntary, donations. Revere’s findings also revealed that even if all the viable organs were taken by force by the government from cadavers, there would still not be enough organs to provide an organ to everyone who needs one (Cato Daily Podcast dated January 15, 2008). Maybe the Iranians are on to something here?

David Holcberg, writing for Capitalism Magazine agrees arguing in favor of a free market system for organs on both practical and moral grounds:

If you were sick and needed a kidney transplant, you would soon find out that there is a waiting line--and that there are 70,000 people ahead of you, 4,000 of whom will die within a year. If you couldn't find a willing and compatible donor among your friends and family, you could try to find a stranger willing to give you his kidney--but you would not be allowed to pay him. In fact, the law would not permit you to give him any value in exchange for his kidney. As far as the law is concerned, no one can profit from donating an organ--even if that policy costs you your life.

Patients' attempt to circumvent this deplorable state of affairs has led to the emergence of "paired" kidney donations, an arrangement whereby two individuals--who can't donate their organs to their loves ones because of medical incompatibility--agree that each will donate a kidney to a friend or family member of the other. But this exchange of value for value is precisely what today's law forbids. Thus, under pressure to allow this type of exchange, in December the U.S. House and Senate passed The Living Kidney Organ Donation Clarification Act, which amends the National Organ Transplant Act to exempt "paired" donations of kidneys from prosecution.

The congress says that kidneys can be exchanged without sending anyone to jail; how thoughtful. While this is an encouraging step in the right direction, why won’t our elected officials go the rest of the way? Is it the potential risks for the donors? Holcberg points out that the risk for a healthy person dying from donating a kidney is about .03% and usually live normal lives without reducing his or her life expectancy.

No, I suspect the objection to selling organs is more rooted in the overall distain far too many people have towards capitalism. It’s simply unethical to make a profit off of something that someone else “needs” whether its gasoline, Hanna Montana tickets, or a kidney. Only the “privileged” will be able to buy organs if such a system were adopted, they would argue.

Even if this were true, denying a person the right to purchase an organ to save his or her own life should not be subject to a vote or someone else’s ethical hang-ups. If I want to remove a kidney and sell it to a willing buyer for $30,000 (or whatever the going market rate is) I ought to have that right. Why must we assume the government has the right to tell us what we can do with our bodies whether it’s selling our organs by our own choices or government taking them from us after we die without prior consent? Our individual rights of life, liberty, and property demand that we have the ability to make these choices for ourselves.
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Wednesday, January 16, 2008

When Gun Rights and Property Rights Collide

THE ATLANTA JOUNAL-CONSTITIUTION - Calling it "a core fundamental issue" for his group this year, the head of the National Rifle Association lobbied hard Monday for a bill that would allow employees to keep handguns in their cars at work.

NRA Executive President Wayne LaPierre made a rare appearance under the Gold Dome Monday, a week before the Legislature convenes, to push the bill with key lawmakers.

My first instinct was to be on the side of the NRA. “What right does an employer have to prohibit me from having a firearm in my vehicle?” and “What right does my employer have in even asking and/or searching the contents of my car?” were my first thoughts. But then it occurred to me that we are dealing with a voluntary relationship between private citizens (an employer and an employee) that can be ended at any time for any reason by either party (assuming we are operating on the principle of life, liberty, and property). An employee of a company has a choice to either honor his employer’s wishes or find another job because the employer has obligation to allow employees to park on his or her property at all.

As Ayn Rand once said:

Contradictions do not exist. Whenever you think you are facing a contradiction, check your premises. You will find that one of them is wrong.

My false initial premise was that the right to bear arms was otherwise being infringed by the government but in fact this is not the case. In fact, this proposed legislation would be a violation of private property rights. McQ at QandO blog made a couple of very good points on this issue:

If you come to the door of my house wearing a pistol on your belt, I have every right to bar your entry and tell you that isn't allowed in my home. It's my property and I have the right to control who enters it and what goes on within its boundaries. Why wouldn't that extend, as well, to the driveway?


And for the same reason I object to legislation which bans smoking on private property such as bars or restaurants. It is none of the state's business. They're welcome to ban smoking in every public venue they control, but stay away from private property. Camel's nose, slippery slope and all that. Why do you suppose they feel empowered to go from banning smoking on private property to now dictating that private property owners must allow guns on their property?

Because we let them get away with the smoking ban, that's why. While I don't smoke and prefer a smoke free environment, I don't agree that government has a role in deciding that for owners of private property, any more than I'd agree they could dictate whether anyone could smoke in my house.

There are plenty of causes the NRA is and should be leading when it comes to the Second Amendment. This is not one of them.

Also posted @ The Liberty Papers (Already over 100 comments! Join the discussion there).

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The Club for Growth's Anti-Huckabee Ad

For the life of me, I don’t understand why so many “conservatives” support Mike Huckabee*. He raises taxes, increases spending, his anti-capitalist/populist rhetoric is indistinguishable from that of John Edwards (minus the “Two Americas” b.s.), he wants a national smoking ban in all workplaces, and he once thought that AIDS patients should be quarantined! Democrats traditionally want into our boardrooms while Republicans traditionally want into our bedrooms; Mike Huckabee wants to be in both! Basically, he is the William Jennings Bryan of our time.

*Well he is likable and has a great sense of humor – I’ll give him that. He also supports the Fair Tax. I’m afraid, however; that Huckabee might do more harm to the Fair Tax movement than good because of some of the reasons I mentioned above
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Tuesday, January 08, 2008

A Fallen Soldier’s Final Words

On January 3, 2008 Major Andrew Olmsted along with two other soldiers were killed by a sniper just Northeast of Baghdad, Iraq. Olmsted contributed to a blog called Obsidian Wings using G’Kar as his handle. Olmsted wrote a post which he entrusted to another contributor to the blog in the event he would be killed while serving. Hilzoy, the person who he instructed to publish his post said that Olmsted wrote what turned out to be the final revision back in June.

"I am leaving this message for you because it appears I must leave sooner than I intended. I would have preferred to say this in person, but since I cannot, let me say it here."


This is an entry I would have preferred not to have published, but there are limits to what we can control in life, and apparently I have passed one of those limits. And so, like G'Kar, I must say here what I would much prefer to say in person. I want to thank hilzoy for putting it up for me. It's not easy asking anyone to do something for you in the event of your death, and it is a testament to her quality that she didn't hesitate to accept the charge.
Olmsted goes on to describe how he enjoyed blogging and why he thought thoughtful debate was essential to preserve America:

Believe it or not, one of the things I will miss most is not being able to blog any longer. The ability to put my thoughts on (virtual) paper and put them where people can read and respond to them has been marvelous, even if most people who have read my writings haven't agreed with them. If there is any hope for the long term success of democracy, it will be if people agree to listen to and try to understand their political opponents rather than simply seeking to crush them. While the blogosphere has its share of partisans, there are some awfully smart people making excellent arguments out there as well, and I know I have learned quite a bit since I began blogging. I flatter myself I may have made a good argument or two as well; if I didn't, please don't tell.

Olmstead also shares his concern that his death might be used to promote a political agenda:
I do ask (not that I'm in a position to enforce this) that no one try to use my death to further their political purposes. I went to Iraq and did what I did for my reasons, not yours. My life isn't a chit to be used to bludgeon people to silence on either side. If you think the U.S. should stay in Iraq, don't drag me into it by claiming that somehow my death demands us staying in Iraq. If you think the U.S. ought to get out tomorrow, don't cite my name as an example of someone's life who was wasted by our mission in Iraq. I have my own opinions about what we should do about Iraq, but since I'm not around to expound on them I'd prefer others not try and use me as some kind of moral capital to support a position I probably didn't support. Further, this is tough enough on my family without their having to see my picture being used in some rally or my name being cited for some political purpose. You can fight political battles without hurting my family, and I'd prefer that you did so.

On a similar note, while you're free to think whatever you like about my life and death, if you think I wasted my life, I'll tell you you're wrong. We're all going to die of something. I died doing a job I loved. When your time comes, I hope you are as fortunate as I was.
I want to honor Olmsted’s wishes so I ask that anyone who wishes to leave a comment here or on the original post to avoid writing comments either pro or anti war. I’m not posting this for any other purpose than to help this soldier tell his story and share what he felt was important to the world. I regret that I was unaware of him or his writing before his death. I encourage everyone to read the whole post regardless of where you stand on the war.
UPDATE from Hilzoy on how to help honor Andrew Olmsted:
A member of Andy Olmsted's family has just written me to say that if people want to do something in honor of him, they can send donations to a fund that has been set up for the four children of CPT Thomas Casey, who served under Andy and was killed while trying to help him. The address is here:

Capt. Thomas Casey Children's fund
P.O. Box 1306
Chester, CA 96020

Thanks so much.
The post also has a running list of links of all the blogs paying tribute to Andy Olmsted.
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