I consider the chance to explore an array of new fields one of the many positive sides of following an MBA course. We are now invited to elaborate on the question whether there should be a market for human organs. A close look is needed, as there are many sides to this subject. To formulate the scope of my paper I need to break down the question. “Should” there be some form of trade, implicates the ethical weight expected on our paper.
A suggested “market”, given the subject, provides the controversial setting in this story. Plus, the question itself asks for my personal opinion, which I intend to convey through this paper. ‘Should there be a market for human organs?’ Yes, I believe there should, provided ethical regulations are in place. And I must admit, that was not my first thought when I started this assignment. I want to elaborate on how my opinion was formed and how I define this market situation. Further, I want to make a contribution to this ‘free market’ concept analyzing some of it’s constraints.
My internet research on the topic soon revealed the issues at stake. I base my opinion upon these findings. There is a tremendous shortage on donor organs. This leads to long waiting lists and consequently to a high fatality rate. In the US only, the number of casualties reaches over fifteen per day and the numbers are only growing. The public opinion is divided into two camps. Regulations are still driven by some form of government paternalism. Law makers still believe in an altruistic-based allocation system instead of a market-based mechanism. Recent laws prohibit donors to sell their organs engaging in a common market situation. Efforts to increase donation through educational campaigns have failed miserably. There is a well documented illegal circuit in human organs.
Unlawful practices take often place in closed governments such as China or in poor and underdeveloped countries such as India. Illegal activities are driven by desperation on both sides; supply and demand. Here we see ethical, religious and cultural believes collapse under pressure of human needs. This proofs once again that the forces of demand and supply are strong and not to be ignored. Both sides will always meet; the question is how and under what circumstances. In a far distance, we can compare this to the Dutch policy on soft drugs. Trade and consumption is out of the illegal circuit and therefore partly controllable. I believe we are better of if we can regulate this. The number of experts endorsing the free market concept is growing, renowned doctor and high ranked politicians among them. They see this as the only solution to the growing pain left by the negative current statistics.
Where am I in favor of? A market is a place, either virtual or located, in which demand and supply meet. These forces within a market regulate the price. Rules of the game are agreed among participants, including governments. I intend to use the concept of a market in the broadest possible way. I believe the current situation on organ transplant calls for a mechanism of exchange that brings supply and demand together. As in any market, it needs a mechanism that regulates underlying issues such as fair play and ethical questions such as acquisition and distribution of organs.
On the internet we find different market models and proposals supporting a free market. Some practical, ingenious while others plain ludicrous. All of them are dealing with scarcity, distribution and regulations. They all use economic rules and principles to support their models. I read again all eight basic principles of economics (Libermann-Hall, p.13) and I think they all apply. As a sponsor of the idea I would like to make a contribution. I will look at possible constraints of this free market model, things I have not come across yet.
Will such a model survive on the long run? Suggested market models all trust on self regulation and mutual agreements between all participants, including government. The call for a free market is triggered by the unnecessary suffering of its patients. All patients, regardless of their race, wealth, status or age. It is important to regulate some parts of the market to ensure proper and fair distribution of organs. I consider the problem not to be the liberation of the organ market, but how to ensure ethical rules are lived up to. The commercial spin off is merely the driver, but certainty not the end goal. I wonder if such ethical free market is not something close to socialism. A good idea, but not sustainable at the end. How do we secure this?
Will a market mechanism eliminate important thresholds when deciding about donor-ship? The theory believes the compensation factor to be enough to unleash the organ reserves needed to cope with demand. As an individual, I have the right to dispose of my own organs. In a market situation, I have the chance to cash on my decisions. But, as much as I endorse the idea, I am personally not willing to sell. The money factor does not apply to me. I still base my decision on other factors. Contradiction? Yes and no. As an actor in the market, I consider myself (if ever necessary, God forbid it) on the demand side. I expect supply to be regulated by the market, as in any other good. The same goes for the large bit of the western world I presume. I have my doubts whether market mechanism will trigger a firm supply of organs as expected.
So, where do we harvest our organs and how good is ‘our supply’? Our supply is located there where human need is strong enough to abandon all other possibilities when making a decision. Third world countries are to become our biggest suppliers of human organs. Some type of specialization one could say. What is to say about our ‘organ reserves’? The biggest accumulation of possible donors is facing the most of the constraints. Infrastructure, facilities and skills needed to subtract and secure organs are scarce in underdeveloped countries. The growing HIV, AIDS and other epidemics makes a large population unsuitable for donation. Questions rise about the true size and quality of the supply.
Will market equilibrium still provide enough trigger for supply on the long run? If the mechanism works, supply will increase. I expect actual demand to remain constant. If we elaborate on this theory, we can predict a price fall. The logical question follows; up to what price are suppliers willing to deliver? Will this mechanism eventually collapse and rise again? Or do we need some type of price intervention to keep prices at an acceptable level, with all the consequences of high artificial prices.
I am in favor of creating a well regulated market for human organs. It would profit form the regulation forces of demand and supply. We expect so to put an end to scarcity in donor organs, increasing the chances of survival for any patient. I formed my opinion weighting ethical issues such as; organs as a commodity vs unnecessary suffering and thousands of dead every year. It would be ideally if this market survives the many practical and ethical constraints. If we analyze, treat and above all protect this concept as a regular market I think it’s feasible. Further, together with a free market concept I predict a new type of service industry to arise. I see a number of active player; government, finance, insurers, medicals and agents among them. Maybe something for further elaboration in class.