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The Tragedy of the Government’s Ban on Human Organ Sales

In late September surgeons successfully attached a kidney from a genetically modified pig to a human body, establishing a “proof of concept.” This is a large step in alleviating a massive shortage of cadaver or donated human body parts for those often desperate people in need of a transplant.

Given the functionality of these pig parts and the existing genetic modifications created for those with meat allergies, this breakthrough could open the door to a normal life for hundreds of thousands of Americans suffering and dying from their damaged organs.

What we should know is that all the money, research time, and technology sacrificed in this effort might not have been necessary in the first place. However, transplant surgeons and scientists will hail this as a great step forward. It is, and many unintended benefits may come forth. Professional ethicists and other people with an unwarranted or overestimated belief in the importance of their own values will likely whine and complain that this development is immoral. However, some “bioethicists” have already condoned the practice, even in this early stage of development.

The economist has a different agenda. They must ask if this is the most efficient and logical course of action. Are we doing the most to improve the human condition and its future? Are there better paths to take? Are we unfairly enriching some to the determent of others? This is the maxim of French economist and proto-Austrian/libertarian Frédéric Bastiat.

First of all, everyone considers this situation a shortage. There are simply not enough human organs available to make the required number of transplants, and this is complicated by the fact that it is difficult to match donors and recipients by biological markers to prevent organ rejection by the recipient. Second, there is really little disagreement concerning the cause of the shortage. In reviewing Professors David Kaserman and A.H. Barnett’s The U.S. Organ Procurement System: A Prescription for Reform, I describe the cause of the shortage as:

The National Organ Transplant Act of 1984, sponsored by Senator Al Gore and signed into law by President Ronald Reagan, set up this bureaucratic killing machine that imposes a five-year sentence and a fine of $50,000 for anyone willing to invade its turf by offering “valuable consideration” to a family that would donate the organs of a deceased family member to save someone else’s life.

The Health Resources and Services Administration, reports that more than one hundred thousand people are currently on a waiting list for a transplant, most of whom are in need of a kidney. Many more cannot get on a list or have grown too sick or old to stay on the list. Only about twenty thousand kidney transplants were performed in 2020. Thousands of Americans died each year for want of a transplant.

[See also “Back Alley Organ Transplants,” by Mark Thornton]

So, the pig transplants could be a lifesaving and health enhancement for tens of thousands of Americans per year. This also means lower after-surgery medical costs, less lost work time, and longer, more fulfilling lives.

However, such transplants and their development costs could have been avoided if the shortage had not been created in the first place. NOTA-84 bans any economic motivation for donating human organs, setting a price ceiling of $0.00 per organ. Selling organs is therefore illegal. At a price of zero, even potential cadaveric donations, where the donor or their family bequeaths the dead person’s organs to recipients has been squashed, causing the giant shortage.

Economists Kaserman and Barnett described and diagnosed this largely unnoticed tragedy in their book, and they lay the blame for this tragic situation at the feet of government policy. Market prices, and more importantly market forces, would alleviate the shortage and have widespread health and economic benefits.

It is easy to imagine horrible images of, for example, Indian boys selling their bodily organs for food, but the solution is actually easy, direct, and low cost. Tens of thousands of otherwise healthy people unfortunately die each year with viable organs. The current system of getting those organs donated is inefficient and ineffective due to policy that makes market forces illegal and makes unapproved entrepreneurship subject to very heavy penalties.

For example, if enough young adults signed organ donation cards the shortage could be cured. Potential market methods could be employed by charities and insurance companies offering inducements to sign the card. In their book, Kaserman and Barnett estimate that sufficient organs could be had for less than $200 each. Nobody knows how the market would proceed, but we can be reasonably confident that it would succeed and that this brand-new pig transplantation technology would be unnecessary.

We can also be quite certain that some of the resources “wasted” on the new technology could have been better spent on even better transplant and organ-saving technologies, such as mechanical organ replacements. Such forever organs might, for example, eliminate the problems of rejection and have other enhanced health benefits. Or maybe it would be nanorobots that could repair existing organs.

We can celebrate this new transplant technology and wish it a speedy journal to implementation, but we should never forget that, as we look behind its cloak, as a country, we have doomed millions of people to agonizing life situations and early deaths for the last half century because of the government-imposed prohibition on human organ exchanges. Now that is unethical.