It is not from the benevolence of the butcher, the brewer or the baker that we expect our dinner, but from their regard to their own interest. … Nobody but a beggar chooses to depend chiefly upon the benevolence of his fellow-citizens. -- Adam Smith, The Wealth of Nations
Consider the economics of an organ transplant. Everyone involved gets something of value. The doctors and nurses are paid. The hospital receives money. The organ recipient gets something that will save her life. And the person donating the organ gets a nice, warm feeling inside.
We can all admire the selflessness of the donor. But if pure altruism is such a wonderful motivator, why don't we rely on it to get medical professionals to provide their services?
Simple: Because we would find that there are far more people demanding free care than people supplying it. To make sure that we can obtain the treatments we need, we elect to pay, not hope. It's too important to rely on altruism.
Our approach changes, though, when it comes to procuring kidneys and livers. In fact, since 1984, it has been illegal to pay someone to surrender a body part, even posthumously. Campaigns to browbeat Americans into signing organ donor cards, however, haven't sufficed. The transplant organ shortage has grown.
Since 1989, kidney donations have doubled. But the number of patients in need of them is five times higher than it was then. Last year, 4,456 people died while waiting for a kidney transplant. The story with livers follows the same line.
Among the losers from this guaranteed-shortage policy are victims of cancer and other lethal diseases who need bone marrow transplants. Some of them have filed a lawsuit, which goes to court in Los Angeles this week, asking to be allowed to offer compensation to donors -- which is now a felony punishable by five years in prison.
One of the people involved in the lawsuit is Doreen Flynn of Lewiston, Maine, a single mother with five kids -- including three afflicted with a rare, fatal blood disease that can be cured only with a bone marrow transplant.
The ban is particularly indefensible in this realm. Someone giving up a kidney loses an important organ for good. But bone marrow donors produce new marrow to replace what is lost. Given that it's legal under federal law to buy and sell blood and sperm, why is bone marrow treated differently?