Ideals, values and priorities

I am finally done with UChicago and it is about time to move on to a new place. I suppose today is a pretty good day, I got double departmental honors + general honors for my two majors and collected almost all the possible academic awards. ( I guessed I didnt get best undergraduate econs paper, but i wasnt disappointed). I have to say this is the first time in my academic career that I sort of managed to meet my own academic expectations. I expected to get 4 A stars and 2 A stars popped out in PSLE. I expected at least 9 A1s but popped out 7 A1s in O-Levels. I expected to get at least 4 As but 3As popped out.

But i didnt exactly feel happy except for that split second when i saw my results. I suppose this is in part due to my cocky presumption that i deserve the academic honors and will definitely get them. Admittedly, I spent most of my time this quarter slacking and watching serials so i dont feel like i deserve anything. But I think a large part of it has to do with my changing ideals, values and priorities in life. Academic results just doesnt seem that important to me now.


Anyway, I had a disturbing conversation with XY as usual. I realize that i don't really have many ideals left. In the past I have a strong conviction in truth, speaking out when i think there is a point to be made. These days I dont really know what the hell "truth" is and in anycase i cannot be bothered to pop the little bubble of happiness people create for themselves.

I think for a short while in the past, i was quite interested in power. But i think i am bit tired of it and especially bad in playing the game. I am trying to get myself interested in money, but i never really have a craving for money to satisfy my material needs. I think it is absolutely stupid for brand-conscious people to pay a large sum of money to obtain the rights to advertise and showoff some designer names for free. I am never really convinced with the quality argument of branded products, unless the quality can be demonstrated to me (Laptops, Cars). Maybe it is about "style", but i think basing one's style on external adornments is quite silly. Firstly, the fashion of the day changes and secondly, it is pathetic to let some freaking Italian designers decide what you should wear to impress yourself or people the next day. But i have come to think that branded products serve the psychological need for people to distinguish and differentiate themselves. They are signals of wealth and prosperity and make the person feel better.

Anyway, the point is that I dont think I have any ideals left or feel strongly for, except for the ideal of love. I guess that is why i refuse to "debase" it by having a few girlfriends and "testing" to see which one works. And I am quite amused and flattered by some of my friends' antics to matchmake me. And there is no point in figuring out what kind of girl i like, because my ideal of love is all exclusive except for me and HER (for thosewho think i am gay). I have been quite consistent in telling people all sorts of strange and weird qualities that i find attractive in girls (e.g. a girl that drinks tea is pretty). No one will find out the type of girl i like until it is fait accompli :)

>.< so many words... time for some visual stimulation

Reply to GCS.

Yeah Deborah! Your contribution is important! I need to know whether I am as ridiculous as GCS says :P

And cheap, baseless attack? Hahaha the first part is, but the second part isn't what. Aren't you not supposed to run away? My basis is your scholarship deed :D

Alright, there is definitely a difference in perspective. Things that we are concerned about are essentially quite different. I don't know anything about economics theory obviously, but I still want to urge you to not think that economics is all powerful. Neither is science, nor medicine, nor anything that is always viewed as sources of authority.

You always sound like you are very very sure that what you have learnt and what you have read is right. Well I am not wrong to say that you are like Singapore governement officials in this case? Yeah these things can predict things to some level of certainty, and we depend on them to guide us, but they almost always never work as theory says. Precedents do not always apply in all situations either. The reasons for people to go to black markets are different in different cases, before and after the existence of a regulated market, and even the groups of people who patronize the black market will be different. How can you be so sure that your alcohol prohibition example works in the organ market situation too?

I won't expect you to understand why I feel that advertisements and harassment constitutes infringement of liberty, but if you pull back a little, take more things into cosideration, it might become less ridiculous to you.

To you it is ridiculous, but sadly, to me, it isn't. Yeah and to the doctor, it is also ridiculous, irrational, and stupid for the patient to not listen to his advice. That is never the case. You will never be a good doctor, scientist, policy maker etc. if anything besides what you believe in are 'wild claims', 'irrational', or whatever terms you might use.

Actually, I am not convinced of why we should accept a regulated market when an intermediate system is proven to be workable. Well, you may tell me some theory that says that the whole thing will end up in an open market in the end, but we definitely are not ready to accept it. Please consider how different people will react to even a regulated market. Hmms to you all of them are irrational because they all chose to turn a blind eye to all the obvious benefits right?

I am just starting to decipher intricate relationships between scientists, doctors, patients and policy makers. I guess in order for me to formulate a full opinion I need to continue to read and take classes until end of junior year. Though now I know that economics is simply one of the many factors affecting this relationship. Organ donation is an issue right in the middle of this mess... that's why I'm interested.

Anyway, I would love to take economics classes... but I will need to put in too much effort because I have zero background. I realised I might need to do human anatomy and physiology also other than those molecular stuff in order for me to be reasonably well prepared for PhD in any branch of medicine, and I am taking on history of science and medicine definitely.

So no time for economics... tell me more will you? :P

Short Reply to XY

Ok, there are too many problems with what you saying and I am honestly too lazy to respond to all of them. I will like to engage the powerful Deborah Koh into the debate. I suggest that you take some Economics classes and I will just reply to some of the wild claims you made.

“By making you annoyed, or influencing you into serving their interests, they are infringing into individual liberty. A person under influence is not making decisions out of his own mind.”

I don’t think advertisements are powerful enough to convince people to sell their organs. It is quite ridiculous to suggest that advertisements and phone calls infringe one’s individual liberty. They may influence people, but they are hardly coercive. You can choose not to accept the message of the advertisement and your individual liberty is not threatened. You paint an image of organ sellers as simpletons blindly accepting whatever information is conveyed to them. I have more faith in organ sellers. In any case, even if advertisements are as pernicious as you made them out to be, this is a small problem. Advertisements on organs dealing can simply be banned just like advertisements on cigarettes in Singapore.

Anyway, in Singapore there is a heavy penalty for smuggling cigarettes from Malaysia, selling them and buying them, and Singapore has an efficient law enforcement system. Thousands of people still buy these cigarettes... because they are much cheaper. GCS thinks that a heavy penalty and poorer quality will deter people from buying marijuana from unauthorised dealers.

What GCS thinks is useless, what Milton Friedman and other Nobel Prize Winners say about marijuana legalization are more useful.

http://economics.about.com/gi/dynamic/offsite.htm?zi=1/XJ&sdn=economics&zu=http%3A%2F%2Fwww.prohibitioncosts.org%2F

Your argument is really problematic. I have never said that regulation will totally eliminate black markets. A black market for organs already exists and the question is how to significantly reduce it. A regulated, open market for organs will significantly reduce the size and harm of the black market. Please read the history of the Alcohol Prohibition in the United States.

Your evidence that “thousands of people still buy these cigarettes” from the black market doesn’t prove that the regulated open market for cigarettes has failed. Without a regulated, open market for cigarettes, I predict that there will be tens of thousands of existing smokers buying cigarettes from the black market. I understand that the black market for cigarettes consists of smugglers importing packs of tobacco leaves. People will buy these cheaper packs of tobacco leaves, divide them, and roll the tobacco leaves using paper before smoking them. The lack of warning labels with pictures of rotting lungs on cigarettes pack and cigarettes filters will probably lead to more smoking-related deaths.

This thinking shows that he lives in an ivory tower extremely typical of Singaporean government officials. Hahaha the civil service is for you man; don't try to run away :D :D :D

This is a cheap potshot la. Can’t believe you make this kind of unwarranted and baseless attack. Ok, going to watch my BLEACH now.

Reply to GCS.

Aye someone else other than GCS and me say something leh, everyone should have finished finals already right :P

Hmms Part 1 is enough already la. And obviously I don't know what Lockean liberalism is (I am a bio major! Bad idea to take on an econs + public policy major). Anyway, the irony is that absolute liberty almost always produces the opposite effect. In order to ensure freedom of choice a certain limit is somehow necessary, whether or not it is set by the government or anything else.

Freedom is good for people who know who they are and what they want. I absolutely love the freedom that I have here. However, for those who don't, they are bound to be influenced, and in fact, they might even need influence (I concede that I absolutely need guidance in certain aspects of my life too). If that is not the case your friend won't be so troubled over choosing courses for her next quarter and she won't need to ask you for advice. Your advice serves to limit the freedom she has so she won't be so lost; sometimes, I realised, in order to solve the problem you will even need to instruct her what to do. I have tried to merely give an advice or opinion by stressing to the other person that she will have to decide for herself what to do because I cannot make the decision for her, but eventually to end her trouble I am compelled to tell her what to do.

This is positive liberalism. You think it doesn't work? Yeah, of course you and me don't need anyone else to tell us what is good for us. Though somehow even you don't have a choice. That is the irony; even though you believe that you have no right to tell her what to do, and she has the absolute right to not listen to you, you still have to tell her what to do.

No one should tell us what to do because we know what is good for us. Though what about those who don't, and for their whole life can't figure that out? If we follow your argument, is society supposed to just leave them alone and let them sort themselves out? The US has groups of completely screwed up citizens who are marginalized by society. To them liberty and freedom is basically absolute hyprocrisy...

Anyway, yeah, I am a positive liberal. So? :D

When I answer your points below, I argue from the standpoint of an individual who knows who he is and what he wants. In case you wonder. Hmms, no one should tell me what is good for me, unless I really don't know.

In your rebuttal regarding coercion, you do not recognise 'harassment' as a kind of 'coercion'. Well, literally coercion requires force and threat, but isn't harassment and to a lesser extent advertisements a rather strong positive force as well?

It is not whether I am nice or not. When dealers carry out the act of advertising and harassing, almost always they have a specific target. By making you annoyed, or influencing you into serving their interests, they are infringing into individual liberty. A person under influence is not making decisions out of his own mind. Of course the law can ban anything and protect anyone it wants, but people still get 'harassed' to enter into those time-share schemes, in the end losing huge sums of money. From what I understand, the law cannot do anything for these people.

Generally government/NGO run organ donation programs do not have as strong a driving force to infringe the liberty of individual donors/recipients because they are not profit driven. To the donors and recipients it is a more free system compared to an organ market: the donor can decide whether to donate without any pressure from commercial acts.

GCS says that a regulated market is definitely safer than a black market. I am much more skeptical. That is not to say that a black market must be safer than a regulated one: but that doesn't mean that a regulated market is necessarily as safe as he argues it to be. Medics in the SAF all know that the spotchecks don't mean anything. People take chances all the time, especially in the biomedical field. Do you think we adhere to the SOPs absolutely when we work in the labs? If we really 'keep all surfaces wet all the time' to minimize contamination while doing mouse work, we will take twice the time. It's entirely up to the dealers' and the doctors' discretion even in the presence of regulations: we skip some steps because we calculated the risk and think that it doesn't matter, with the stake being our experiments, and our driving force is time. Well, with a much stronger driving force (i.e. profits, time, etc.) in an organ market, and people who are willing to take bigger risks because of these driving forces, who can guarantee that a regulated market is definitely as safe as you argue it to be?

And remember, once the patient enters the operating theatre, he has no choice but to trust the dealers, the doctors, and everyone involved in the deal. He won't even know when there is something wrong, let alone doing anything about it.

Anyway, in Singapore there is a heavy penalty for smuggling cigarettes from Malaysia, selling them and buying them, and Singapore has an efficient law enforcement system. Thousands of people still buy these cigarettes... because they are much cheaper. GCS thinks that a heavy penalty and poorer quality will deter people from buying marijuana from unauthorised dealers. This thinking shows that he lives in an ivory tower extremely typical of Singaporean government officials. Hahaha the civil service is for you man; don't try to run away :D :D :D

(And you don't you download stuff over the net too? Are you aware that if you are caught (and there are indeed people who police the net) you can be fined heavily under federal law?)

Just to let you know, I am rather wary of any research done with a commercial motive. They are essentially not false but they tend to draw too many conclusions from too little data. As far as I am concerned those research cannot be trusted unless it is cross-examined by someone neutral. I hope you understand why it is hard for me to trust a profit-driven organ market.

There is no risk associated with sperm donation. Egg donation is a little more tricky; it is still a controversial issue and please don't make it sound as if everyone in the US approves of dealers paying $600 for eggs from pretty young college students.

And what kinds of regulation do you have in mind? Ban advertising? How do you accredit dealers/surgeons/hospitals? What will be the relationship between the surgeon, healthcare workers, the dealers, the donor and the recipient? Will the surgeons be allowed to be directly involved in dealing, or should they just be workers/employees of the trade? Should the price of organs be regulated, and if so, how and why? How do you grant licenses, and what are the conditions the dealers are supposed to meet before their license can be maintained? Answer these questions? :P

Reply to XY, Part 1

I think that “liberalism” is a very loaded word with many different meanings. You can a political liberal in the Lockean sense, and disagree with economic liberalism. I have charged that you are a positive liberal and I think rightly so. In your arguments, it seems that negative freedom- the government’s main job is to ensure that one man’s freedom is not infringed by another’s- is not enough. For you, the government has to step in and intervene in people’s life and make sure that they don’t screw up their own lives.

I agree with you that the first step to a completely liberated model of organ market is the “fudged-over” intermediate model of Iran. You used the word “intermediate” and seem to have tacitly conceded the point that there should a natural progression to the end stage of a fully-fledged regulated organ market J

I will respond to your rebuttals point by point.

Coercion. XY has fell flat on his rhetorical question by asking how I would feel if organ dealers try to bug me like insurance and property agents. I would feel dulan and just throw away the brochures and not pick up the call. And I dare say that this would be the common response of most people. XY, you are too nice la.

In any case, I think XY has a very strange conception of coercion and how the regulated organ market is to work. By coercion, I mean that an individual is forced to do something against his free will. The organ dealer pointing a gun to my head and asking me to dig out my kidney is coercion, listening to his irritating phone call is not. In any case, the harassed individual can appeal to existing laws to protect him from nuisance calls. I reiterate that the regulated organ market is merely a mechanism for interested buyer and seller of organ to engage in VOLUNTARY transactions. XY, you have not demonstrated to me as to why an individual is “coerced” to sell his organ. I don’t remember reading any article on individuals being coerced to give up their sperm or eggs. It would especially be hard for guys to be coerced to give up their sperm J

Safety. A regulated market is definitely safer than a black market. That is one of the most important reasons as to why the Dutch government legalized prostitution. Logically it makes common sense. In a regulated market, you have regular spot checks and operators are subjected to license renewals only after they comply with certain standards. Even if they are ineffective, they are better than no standards.

Yes, you may have black markets coexisting with legal ones but they are likely to be very small. The whole point of having open legal market is that it reduces incentives for both sellers and buyers in the black market. Take for instance marijuana. If marijuana is legalized, buyers of marijuana would have very little incentive to buy from the black market because they run the risks of paying heavy penalties by buying from an unauthorized seller and they cannot be certain of its quality. More importantly, marijuana sellers have little incentives to continue operations in the black market. The whole point of operating in a black market is to earn supernormal profits, which will be eroded in the event that marijuana is legalized. Together with the heavy penalties of getting caught, marijuana sellers would withdraw from the black market. I see the same happening for the organ market.

I think there is something wrong with the reasoning you used in the construction industry. The occasional safety lapses are not strong evidence against regulated markets. In fact, more often than not, the problem is not with regulation, but rather the lack of regulation. You used the construction industry to illustrate your point; I will use the coal industry, a similarly heavy industry where safety standards are important to illustrate my point. Why is it that so many people die in China’s coal mines rather than those in France or the United States? It is because the regulatory authority is messed up in China and cannot be bothered to enforce safety standards. All the coal mines operators in China, France and the United States are concerned with maximizing profits. The crux of the problem is the lack of regulation rather than the profit motive per se. I will change my opinion if you can demonstrate to me that a black market is safer than a regulated market.

Happiness. I concede to you that happiness is very subjective and no one (including me especially) acting under limited information can be certain that a chosen path will lead to happiness. Yet, there is at least a 17% success rate, which is better than no hope of success right? Out of 100 people, 17 people have the chance to happy… the other 83 are already unhappy anyway, it seems pretty good to me.

Moreover, you highlighted the problem of unhappy children, tensions between surrogate and biological parents etc. I think these are information on uncertainty known before the willing parties take part in the transaction. I don’t think we have the right to judge them being worse off simply because some problems surface from time to time. I have watched the Winter Sonata show, lovers turn out to be brother/sister, forbidden love and all sorts of other human relations shit. I feel sorry for them la, but hey, these stuff are too rare to cloud my rational decision making J

The good thing about organ trading is that there are fewer externalities. Organ trading primarily involves the buyer and the seller. Organ trading does not pop out children of angst. The negative externality of a child confused about his parentage will not pop out from organ trading.

I have conceded that happiness is subjective and that even if we debate to the death, we cannot tell whether an organ transplant will make the recipient happier. So XY, as true political liberal, why not let the recipient be his own judge and bear both the good fruits and negative consequences of his freedom of action?

Yes please blog more.

I believe in individual autonomy, freedom of choice, justice, equality, and universal human rights. This makes me politically a liberal, and GCS has accused me of practicing positive liberalism before. Now it is on these grounds that I have to point out certain problems in his arguments for organ trading.

(That's why I say I won't do anything to anyone who breaks my heart or dirty dances with whoever with consent, because I respect individual autonomy and freedom of choice. Everyone can choose how to live his/her life; I have no say in it no matter what I think and how I feel. Of course, I have the right to tell you how I feel and what I think, but you also have the right to not listen to me.)

Just a sidenote: if you wonder why I know his work so well, well, his article comes from a paper that I have written. What do you think.

I have ceased to oppose to linking monetary exchange to organ donation. I acknowledge that the merits to these systems outweighs the problems. In fact, it can be morally unjustifiable for governments to insist on using the current system when it has been proven to be ineffective.

I tend to support a fudged-over intermediate 'compensatory' model similar to Iran's. Anyway, GCS's argument has 3 problems:

1. Coercion. GCS says that a regulated market allows people to decide freely whether to donate or not. Hmms, imagine organ dealers keep sending you brouchures and giving you calls like the insurance and property agents (both markets are regulated). How will you feel?

My proposal would be a government/NGO-managed donation system which comes with benefits such as monetary compensation, moral recognition, life-long medical insurance, etc. similar to Iran's. This system protects individual autonomy better than an organ market: since when do you see the Red Cross persuading you to donate blood like a property agent persuading you to sell your house?

2. Safety. A regulated market doesn't mean a safer market. As long as something becomes profit driven, there will bound to be more safety lapses. I can't even say for sure a regulated market will definitely be safer than a black market and a black market will definitely be eliminated by a reulated market. There are black markets for almost everything: from medication to rice, you name it. The construction industry is always regulated, but you always see safety lapses even in Singapore despite that being against the law. China and Malaysia always see contractors using unsafe building material or even insufficient building material for construction in order to cut costs.

3. Happiness. A market for semen and eggs does not necessarily make the recipient more happy. With a 17% success rate for IVF, childless couples face a lot of disappointment, pain, and finacial costs before any hope of success. Furthermore, if the sperm or egg is bought, the child is bound to face problems regarding genetic identity (assuming that he has the right to know that he does not bear his father's or mother's chromosomes), which again can be stressful to the child, the parents, and the donor. If a surrogate mother carries the child, problems regarding biological motherhood surfaces. The United States had dealt with several court cases regarding these.

Refer to The DNA Mystique: The Gene as a Cultural Icon by Dorothy Nelkin and Susan Lindee for an excellent account on issues surrounding genetic identity.

In conclusion, in his argument GCS made quite a bit of assumptions which is limited by his economical perspective. His attempt to use bioethics to argue for organ trading is also not effective: he is basically using the age-old 'the ends will justify the means' argument (the moral good done by increasing the number of patients saved will drive an organ market because it will increase organ supply), which can hardly be persuasive unless under extremely dire circumstances.

Anyway, GCS has also just reduced our right to freedom of speech in this blog for some reason. I urge everyone who contributes to this blog to exercise caution when dealing with sensitive personal issues.

Must Blog a Bit

Market for Organ Trading

As of January 18th, 2007, there were 94,664 Americans on the Organ Procurement and Transplant Network (OPTN) waiting list. Patients waiting for kidney transplants account for roughly two-thirds of the list. Given the severe shortage of kidneys, more than 3,500 people now die each year while waiting for a kidney transplant. By most projections, the number of patients waiting for kidney transplants is likely to increase significantly in the next few decades. This presents a classical economic problem of the demand for organs far outstripping the supply. If altruism is a sufficiently powerful motive, the supply of organs would satisfy the demand and there is no need to change the existing system. However, many patients continue to die today from the acute shortage of kidneys and other organs. If the government legitimizes the purchase and sale of organs, a market for organs trading would increase the supply of organs. Individuals motivated by financial gain would come forward to donate their organs. This would alleviate the suffering of patients waiting for organ transplants and save thousands of lives. It is understandable that opponents of organ trading worry that organs would be commodified, therefore violating the sanctity of the human body, and that the poor could be exploited of their own body parts. In this paper, I first present both sides of the argument to the reader before responding to the arguments that are against organ trading.

By a “market for organ trading”, I mean a regulated market operating under certain principles and constraints.[1] The strongest argument for organ trading is that it would increase the supply of organs for those in need. It is a reality that few people are willing to give up their organs upon death, and it is even more difficult to persuade a living person to donate an organ. In a sense, people are rational in demanding monetary compensation for there is a price to be paid in discomfort, fear and lost wages in the process of donating an organ. A prototype of an organ market already exists in Iran with great success. Iran encourages living-unrelated donations by giving a “fixed monetary gift” and free lifelong medical insurance to organ donors. Within two years of the program’s inception, Iran eliminated the waiting list for kidney transplants, even though the number of patients with end-stage renal diseases remains high at 22,376 (in 2005) (1). The success of the Iranian system suggests that a market for organ trading in the United States is likely to be just as successful if not more as the latter has a more advanced and developed medical industry.

An open market in organ trading would eliminate existing black markets. Currently, patients in need for organ transplants would travel to poorer countries such as China and Turkey where enforcement against selling organs is slack. Organ transplants in those countries are often operated by less qualified surgeons in hospitals with low safety standards. This jeopardizes the lives of both the seller and the buyer of the organ. A regulated organ market in the United States under a regulatory authority could impose the safety standards and optimum conditions for organ transplants to take place.

Proponents of organ trading believe that an organ market is a mean to achieve the ultimate moral end of saving human lives. An existing market for human blood, eggs and sperms have led to increased happiness and improved quality of life for all those involved in the transactions. The same is likely to be true for the organ market. Some proponents of organ trading would further argue that organ trading is a moral mean in itself. Sellers of organs are not coerced to give up their organs. Sellers of organs should have the freedom and the choice to exchange their organs for financial gain. They should be trusted to act in their best self interests, without the paternalistic tutelage of society and government telling what is best for them.

The strongest argument against organ trading is that it invites people to see the body and thus the self as a mere commodity. Organ trading would violate the dignity of human life. The market treats the organ as any other product and allegedly removes the human quality from it. Opponents of organ trading believe this would debase those who trade in organs as the organ is treated as a mere commodity with an explicit and impersonal price tag.

But how exactly is the commodification of organs any different from our commodification of labor service? We sell our labor service and hence a part of ourselves to the highest employer in the marketplace. Moreover, it is important to keep in mind that organ trading is a voluntary transaction rather than a coercive one. If a potential seller of the organ believes that is degrading or “morally incorrect” to sell his organ, he has the choice not to partake in the transaction. The squeamish sensibilities of the moral majority should not the dictate the organ seller’s freedom of action.

Besides the moral problem of commodifying organs, opponents believe that organ trading would lead to other ethical compromises such as the exploitation of the poor. Given that the act of organ removal is usually irreversible, opponents believe that the poor may not have the information and the knowledge to make an informed decision. The poor are therefore likely to be exploited by unscrupulous surgeons, being pressured to make a decision without understanding the risks involved. Another related fear is that the poor may make their decisions on impulse and subsequent regret their decisions. As such, society and the government have the moral obligation to protect them.

Why should the moral majority be arrogant enough to believe that it knows what is best for the poor? Under the regulated market model, the necessary information would be conveyed to potential donors to let them make informed decisions. A waiting period could be enforced between the time the seller makes his decision and the time of the transplant operation. Poverty does not equate ignorance. If society takes the unfortunate stand that the ignorant should be protected from themselves, then there no reason to stop intervention at organ trading. It could be extended to financial decisions; lifestyle decisions etc and a multitude of other decisions in life. This is the surest road to serfdom.

Some opponents of organ trading believe an open market for organs would lead to human rights abuses. People may be kidnapped for their body parts or that totalitarian governments would harvest the organs of their people. These organs obtained through questionable means may be smuggled into the legal organ market in America. A conscientious recipient of an organ may experience considerable trauma if he realizes that his health is restored at the expense of another person’s life.

Although it is possible that some authoritarian governments could harvest the organs of their people and sell them to the United States, the likelihood of that happening is small. Every organ has a specific blood type, code of protein and other labels that allow it to be tracked back to the seller. The likelihood of discovering an unaccounted shipment of bean-shaped kidneys in a reputable hospital is very small.

In conclusion, an open market for organ trading is likely to significantly increase the supply of organs and save thousands of human lives who die waiting for an organ transplant. It would further eliminate the black market for organ trading and establish optimum safety standards under a regulatory authority. However, the objection of the moral majority is likely to stifle any developments in the organ market in the foreseeable future. The society as a whole needs to thoroughly explore the concrete benefits and moral consequences of organ trading and come to a consensus on the increasingly pressing problem of organ shortage.

References

1. A. Bagheri, Kennedy Institute of Ethics Journal, 16, 269-282 (2006)
   Compensated kidney donation: an ethical review of the Iranian model.

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[1] As Dr. Benjamin Hippen argued during the June 2006 Council meeting, a properly regulated market in organs would be distinguishable from a free market by its four side constraints. First, the market must be safe for the vendor and the recipient. Safety, here, would be determined by current medical knowledge and practice. Second, the processes of donation and transplantation must be transparent, meaning that the risks of the surgeries and the potential outcomes must be clear to the vendor and the recipient. Third, there must be institutional integrity. Each institution involved in organ transplantation (hospitals, transplant centers, and even transplant physicians) must establish policies that explain the institution's moral commitments regarding organ vending, namely whether or not the institution will support it. And fourth, the organ market must operate under the rule of law. The law would provide the boundaries of the market (i.e., what can and cannot be done while buying and selling) and would provide a means to settle contractual disputes, which naturally arise in any market setting)