Medical Self-Defense, Organ Markets, and the Poor

Cite this Article
Josh Wright, Medical Self-Defense, Organ Markets, and the Poor, Truth on the Market (November 13, 2006),

Eugene Volokh has posted a series discussing his new article (forthcoming in Harvard L. Rev.) “Medical Self-Defense, Prohibited Experimental Therapies, and Payment for Organs,” which I point out because the article claims that bans on organ payments violate patients’ medical self-defense rights. As readers of TOTM know, organ markets are a topic of substantial interest around here. Eugene dedicates a separate post to refuting the oft-repeated mantra that the ban on compensation is necessary to prevent the wealthy from buying up all of the organs. I remain unconvinced by claims that organ markets will harm the poor for reasons addressed in greater detail in this post. Eugene’s article admirably contributes to a substantial literature refuting the claim that organ markets will make the poor worse off (see, e.g., Cohen, Epstein, Boudreaux, Becker links in this post).

While it is very difficult to say anything new about the benefits of organ markets — there are only so many ways of saying that supply curves slope upwards — the comments to Eugene’s posts and discussions of this issue elsewhere lead me to believe that there are a few points worthy of repetition with respect to the assertion that the wealthy will buy up all of the available organs at the expense of the poor.
The first is a simple one. The market price of kidneys would not depend only upon the willingness to pay of the rich. This is not how prices are formed. As Gary Becker put it in this post, “market forces rather than rich persons would determine the price of organs, in the same way that rich people do not presently set the price of maid services.”

The second point is a tired one, but one that bears repeating as often as necessary: the problems of organ shortages and poverty are different problems. There are a number of policies one might prefer as a method to reduce poverty.  A ban on compensation for organs is not one of them. We might also agree that some form of state subsidy of organ transplant costs for the poor is a good idea.  Again, this issue is distinct from whether the transactions should be allowed.  The relevant policy inquiry with respect to poverty is whether lifting the ban on compensation for organs will make the poor better or worse off? Even assuming arguendo that the organs will come primarily from those living below the poverty line, the argument that a ban on kidney transactions will make the poor better off when we restrict their choice set necessarily assumes that these individualsare simply unable to economize the relative costs and benefits of the choice. As I have written previously:

I fail to understand how depriving those with low incomes of a choice they currently do not have shows a greater concern for the poor than giving them an option not previously in their choice set. This objection masks, and not very effectively, an assumption that the poor either cannot or will not economize on the potential costs and benefits in the language about justice.