Last week, baseball hall of famer Mickey Mantle, waiting just one day, moving ahead of others on the waiting list, received a liver transplant. As a result ethical hand wringing began as to whether celebrity status played a role and whether he really deserved a liver after destroying his own through alcohol abuse. Should these be issues? Since organs are scarce, not all who want one can be served. But is there a better way of deciding who gets them? Or shall we leave the decision up to the arbitrary capriciousness of the medical profession? I say no! How about deciding the same way we decide who gets what house, car, food or clothing - the market. The ought to be a market for buying and selling of organs. Let's look at it.
Let's answer the basic question: to whom does my liver and kidneys belong? If they're mine, I have the right to sell, or bequeath them to my heirs as part of my estate. That being settled, let's look at the benefits of an organ market.
When one's loved one is in the last throes of life many of us reject requests for an organ donation out of an emotional desire not to see our loved one "cannibalized." There would be a lot of reconsideration if we knew there was $100,000 or more for some of his parts. That's the first benefit of an organ market - an increased supply of organs.
Another benefit can be appreciated if we ask questions about the optimal way to die. In financial matters, it's with a zero bank balance. But people usually die with larger balances? The reason is easy; they can bequeath it to heirs. The same principle applies to organs. The optimal way to die is go out in a big bang with all organs at failure. After all if you can't bequeath your organs, it doesn't make any more sense putting perfectly functioning organs in the ground than it makes to leave a fortune. Therefore, organs could become part of one's estate, there'd be greater incentive to take better care of them during one's life.
"Okay, Williams, you say, "so far so good, but with a market only rich people would get organs." That makes as much sense as saying with the market only rich people will get cars, houses and food which we all know is nonsense. I'd much rather compete with the likes of Mickey Mantle or Pennsylvania's ex-governor, Bob Casey, who got a heart and a lung just waiting one day, in the market than through favoritism and the medical profession's who-needs-it-the-most method.
Non-rich people have money raising alternatives like mortgaging a home, family members and friends could do the same if necessary. They might purchase lower quality, lower price organs, those with fewer years of service. Plus, there would still be the option of charitable donations. These and other options available through a market exceed those available now. If a doctor says you're 230 on the waiting list, the only option you have is hope.
The medical profession wouldn't take kindly to the idea of organ markets; they'd lose their God-like power to control to say who lives and who dies. Then there are people who think selling body parts is evil. To them I say: don't sell yours, but mine is mine so don't interfere. By the way, the most reliable test of whether a person owns something or not is whether he can sell it. If I don't own my organs, please tell me who does.
Walter E. Williams
June 12, 1995
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