That Which Can Be Given...

EDITOR’S NOTE: Originally published at The Roots of Liberty August 2019. A recent throwaway comment and a couple responses suggested I revisit the matter of selling organs.

A recent conversation about organ donations reminded me of another, decades-old, conversation I had with a co-worker during a company blood drive. Apparently, he had donated regularly for many years. Then, if I recall correctly, a family member was soon to undergo a significant surgery, and was going to need blood transfusions. He wanted to donate blood for that purpose, to avoid some expense, but was denied the opportunity to do so. That they profited off his donations but didn’t take them into account when his family needed blood really rankled him.

The details are lost to the haze of history, but the general essence of that story bubbled up as I read comments about people’s opposition to the selling of organs for transplant. That opposition was typically couched in “protection against the exploitation of the weak and vulnerable.”

This is very often the defense put forth by people who avow “I believe in liberty, but…”

That sort of statement is a pretty clear demarcator between democrats, liberals, republicans, conservatives, etc., and libertarians. It’s also often used to perpetuate the harms caused by the prohibitions they justify with “but.”

I have a rare and highly desirable blood type (O-negative, CMV negative), and am perpetually beseeched by the organizations that collect donated blood. I donate, but not as often as I could. This is probably true for most who donate, and many who could donate simply don’t. According to the blood centers, there’s almost always a shortage of blood. Whether that’s true or simply marketing puffery is its own matter, but if true, it could absolutely be remediated simply by paying donors. I bet it wouldn’t even need to be a big payment.

Technically, it’s not illegal to pay for blood donations, at least in many jurisdictions. Hospitals and governments offer reasons for their refusals that are couched in “protection of the blood supply,” but, frankly, something doesn’t add up in their reasoning. Perhaps there really isn’t a blood shortage after all, and they have found that they can get away with the free model. After all, why pay for something that you can convince people to give away, especially if you can get enough via the latter route?

Organ donations are another matter. By one source, twenty people die every day waiting for a donated organ.

I repeat.

Twenty people die every day waiting for a donated organ.

There is a severe donated organ shortage, one that has not been addressed by public awareness campaigns, driver’s license check boxes, or other efforts to encourage volunteerism. And, yet, we still hear the objections to permitting sale: concerns about the exploitation of the weak, alteration of end-of-life decisions, and the like. This is presumably people declaring their ethics, but these ethics are killing people. They’re as selective as the “ethics” of people who oppose GMO crops, regardless of the hundreds of thousands of lives that opposition to GMOs cost the human race each year.

One aphorism of libertarianism reads:

If you can give something away, you should be able to sell it.

It’s a pretty simple idea, and it connects with another libertarian tenet, “I don’t know what’s best for other people.” This is where we deviate from people of other political/philosophical leanings. Most will say (and believe) this to some degree, but inevitably, the “white knight” emerges past a certain point, and people want to legislate prohibitions to protect a subset of the populace. From exploitation, from bad choices, from their own ignorance, and so forth.

Oftentimes (not always, but oftentimes) this is a veneer laid over a feeling of unease, as in “it’s unseemly to sell organs (or blood, or one’s body for sexual acts, or certain recreational chemicals, etc).”

In other words, “It’s icky, so I want it banned.”

Fact of the matter is – the law already makes provisions for protecting against various exploitations. Society, via legislation, prohibits fraud, theft, blackmail and other coercions, and if we want to help those who are in vulnerable positions, we have many, many options to do so other than blanket prohibitions.

Those options are more complex, and they may not always work, but prohibitions don’t work either. We all know that drug use and prostitution continue virtually unabated despite prohibitions. Black markets also exist for organ transplantation. “Transplant tourism” is a thing.

Want to talk about exploitation? Transplant tourism screams exploitation. But, because it’s happening elsewhere, and involves exploitation of people who are far away and “different” from us, it’s easier to ignore, and to ignore the fact that opposition to paid organ donation is the driver.

To repeat, if you can give something away for free, you should be able to sell it. Legalizing payment for organs will save thousands of lives every year, and it’s past time we got over whatever collective squeamishness our society has about it.