325 thoughts on “Popular and Wrong”

    1. And the military?

      The second loudest cheer at senior night for high school band last night was for the guy going up the road to U. Mich. By far the loudest cheer was for the guy going to the Air Force Academy.Report

      1. Agreed, although I think the hero worship of the police is far more damaging. Soldiers & sailors may be well regarded, but they rarely get a pass when they break the law or hurt someone – with one exception being that actions on the battlefield are viewed in that context (but even then, the military is not shy about putting soldiers & officers through a court martial if it thinks they over-stepped).

        Police, on the other hand, rarely face the consequences many of us would, since to hear them tell it, everyday, everywhere is the battlefield, and they can’t be held to account when they step over the line while on duty.

        It’s a sad state of affairs when police at home have loser ROEs and oversight than troops in a war zone.Report

      2. That’s the first one that popped into my head. Vegetarianism and Veganism may not be popular, but our culture and the marketplace (see what this damn website is doing to me?) make accommodations for it. Don’t support the military? Eh, best keep that one to yourself, or limit it to cool, pragmatic concern over the ballooning Defense budget (“I mean, the DoD didn’t even want more of those tanks…”).

        Even as outright contempt continues to grow for just about any other government employee, the public sanctity for military service keeps a symmetrical pace. It’s not so much that the vast majority are “America, F*** Yeah!” types (although that’s certainly a chunk of it), it’s more that military service is now regarded as the last honorable form of public service, and we collectively double down on the honorifics for soldiers in lieu of any other institution a majority would find acceptable to honor. To say this is problematic would be putting it mildly.Report

    1. There are more than one failures in the automotive culture. The whole idea that you “need” a car for independent living is wretchedly stupid.Report

      1. One limitation of the model is that it appears to presume that all states of affairs are the products of conscious design, either by the Virtuous or the Reprobate.

        Bryan has a sufficient appreciation of spontaneous order that he must know that this is a problem. And sometimes spontaneous orders are indeed suboptimal.

        In fairness, this might apply to my meat-eating example too. Although I think it’s more plausible that someone consciously decided to start eating meat, rather than anyone consciously deciding that the suburban commute was a good idea.Report

        2. Rating meat is entirely rational when food is scarce in general, as is eating sweets. They’re both concentrated sources of nutrients that aren’t sufficiently available in the state if nature. The problem is that we’re now clever enough to make them over-available without being smart enough to enjoy them only as rarities (writes the man snacking on peanut M&Ms after finishing his chicken burrito.)Report

    2. Actually driving a car, with the problem of human reaction time and inattentiveness. (I’m part of the virtuous 10% cheering rabidly for driverless cars.)Report

      1. Believe it or not, so am I. I’ve been mulling over a GP on the subject given that it’s the closest thing I have to a unique claim to expertise around here (truck driver with a mechanical engineering degree plus grad work in information systems).Report

  3. Now consider that it can happen here, and it probably already is happening here in one form or another, and you are probably just going along with it. (And so, inescapably, am I.)

    Ask yourself: What currently happening thing within the United States does “it” refer to?

    Well, there’s more and more centralized ownership of the traditional media — newspapers, magazines, broadcast TV and cable. Just think of how much what’s published/broadcast is owned by Murdoch; and how much of the published material is guided from that centrally owned self-determination.

    Government is not the only censoring filter.Report

    1. I hear people complain about that all the time.

      While those complaints may be correct, making them isn’t such a clear indicator of independent thinking.Report

      1. Yes, you probably do hear people complain about that all the time, else there wouldn’t be a wkikpedia page to link to, would there?

        The independent part comes in in drawing the parallel between government censorship and corporate censorship; something the science fiction writers have wondered at for a while now, and best described for our times by William Gibson, with his multi-national corporations that functioned as their own nations.

        As a libertarian, I presume you tend to worry about the incursion into individual choice and freedom by government. As a liberal, I share that worry. But I’m equally concerned with corporations intruding — censoring the media, tracking personal consumption information and selling it, lobbying for legislative/rule-making advantage, etc..Report

        1. This is an altogether standard part of the progressive ideology in the United States.

          I’m not arguing about whether it’s right or wrong. I am simply saying I find that it’s not unconventional enough to count for purposes of the exercise.Report

          1. This doesn’t surprise me.

            But I wasn’t really pushing for a progressive view of this; I was hoping for a libertarian recognition of it, in whatever form that might take.

            But really, do you think this is any less original the ‘meat eater?’

            You’re pushing me to a higher standard then you hold yourself!

            Maybe it would be better to consider what vegetables you regularly consume; that seems to be where most Americans are lacking.Report

            1. I recognize that this is the progressive view. I am not terribly interested in discussing whether it is right or wrong, although I incline toward thinking it is wrong.

              I also think it’s not at all eccentric to hold it as an opinion. It’s quite common, and someone who articulates this opinion will never lack for people who agree.

              From the several months I spent as a vegetarian, I did not find this to be the case at all. Quite the contrary — people of every political stripe went out of their way to make things more difficult for me, to argue with me, to second-guess me, and to disparage the very thought of vegetarianism.

              Taken together, that’s perhaps one of the stronger forces impelling me to return to that lifestyle.Report

              2. Jason I feel your pain. I became a vegetarian in 1990, in Oklahoma of all places, and over the years I can not tell you how many people have argued, disparaged and mocked what I eat. I mean, why do they care?? Its not like I am a vegeterrorist trying to impose my eating habits on them it is totally just my own personal choice. I am always surprised at some of the sometimes emotional responses I get to my eating habits. Why aren’t they upset with people sucking down gallons of soda and eating junk food?

                Long way to say I’m up voting eating meatReport

    2. Actually we had a form of censorship in the US for a period during and after WWII. First it was that the media would not cover stories because it would hurt the war effort, then it was the whole communist scare. As an example Toscanni performed Verdi’s Hymn of Nations in 1944, including in addtion the Star Spangled Banner and the Internationale. After WWII the Internationale was deleted from the film because it was a hymn of the evil communists.
      Going back a bit further during WWI you had the sedition laws that made publishing on some topics illegal. (As indeed did the Alien and Sedition acts during the first Adams administration). So censorship has happened in the past. On a more local basis before the civil war, in South Carolina the postmasters threw away any abolitionist publications that came to their post office.Report

  4. Citizen’s Arrest laws – at least in Canada they are insanely popular.

    This may be a bit of a cop-out, as I’m vehemently against them (and so this might just be ego stroking), yet I haven’t yet found many/any people who agree. All three/four/five/whatever major parties are fully on board.Report

  5. Meat eating is a great example.

    To pick another Peter Singer-esque example, I’ll say failing to give money and time to charities is morally wrong and widely seen as perfectly fine (if not ideal), perhaps especially international charities. Even middle class people have some income and time they could use to help the poorest of the poor internationally. But favoring less internation aid is popular and few people chastize each other for not giving at least something. Instead, we chastize only the rich. But compared to the rest of the world, middle class Americans are very rich.

    How many of us find these adds asking us to donate a dollar a day irritating? (Me, for one. Sadly.) We have an obligation to help and instead we see helping as going way beyond our obligations.Report

    1. What if it’s private giving to charities that is wrong, because it ought to be done by government, as an expression of the people as a whole? (I’m only half tongue-in-cheek, and not trying to pick a fight–reading your comment just made that thought pop into my head.)Report

  6. * The death penalty is still pretty popular.
    * A restrictive immigration policy is still pretty popular (just a matter of who).
    * Hiding the true cost of gasoline/energy is still pretty popular.
    ** (nobody likes subsidizing the oil companies, but nobody wants to pay more for gas, either)
    * I’ll second eating meat
    * Harsher penalties for crime is still pretty popular
    * Support for the defense industry is still pretty popular

    None of those is particularly risky or independent-thinking positions to take, though.

    * I think we should probably spend at least a thousand times what we spend now on space exploration and on basic science research, but that makes me a kook, not an independent thinker.

    Oh! Here’s one: I think we should outlaw front lawns in most of the urban areas of the country.Report

      2. It’s more like the defense industry cuts weren’t quite the fail-safe poison pill that some people thought, which is not quite the same thing. Some funding has already been restored, and main cuts (this year) are being borne near exclusively by civil servants.Report

      3. I think that you can find any number of people (Americans, even) who say that we need to pull out of Germany, South Korea, and pretty much everywhere on the planet that ain’t US soil.

        They probably think that these bases make up about half the military budget, sadly, given the arguments about how much money would be saved.Report

    2. We should outlaw front lawns everywhere. Front lawns suck. They’re the work you do for other people – mostly strangers you don’t even know.

      Now BACK lawns…that’s where it’s at. Because that’s the work you do for you. Your home, where you come to play with your toys.Report

      2. They’re the work you do for other people – mostly strangers you don’t even know.

        Wouldn’t that make them the virtuous lawns to maintain? Or is your point that you could then identify the truly virtuous by their altruistic defiance of the law?Report

      3. Seconded. Not to mention that is a useless crop irrigated exclusively by potable water.

        The dog would miss the backyard lawn though.Report

        1. How much does good fakegrass cost. I didn’t know how useful grass was until we just moved to a house that lacks it.Report

  7. As I’ve said, meat eating is my first go-to for questions of this sort, in part because I eat meat myself so it’s less likely to just be moral posturing. Also, bonus “people of the future will look down on people of the past” points for technology making it progressively easier to avoid, which I think is true of a number of things that fit this in the past but no longer do so now.

    And, in animal rights, also the flip side: treating the state of nature as something desirable. That one’s probably going to take a LONG time to come around, though, for practical reasons if nothing else.

    With apologies to Dr. Russell:
    Pvephzpvfvba. Sure, there’s a vocal minority who criticize it (from whom I hope this post will be hidden by rot-13), but that’s equally true of meat-eating, and it’s widely accepted by mainstream culture. And, more deeply, the exceptional breadth of parental authority over children in general.Report

    1. Treating the state of nature as something desirable

      “You know how you keep saying that humanity is responsible for the latest mass extinction? Mother Nature has done it somewhere between five and twenty times. I’m not so sure ‘Man is terrible for nature’ means what you think it means.”Report

      1. That too.

        But I was actually thinking of the day to day stuff. Jason’s hypothesis is people, a couple hundred years from now, will look on a person killing an animal for no better reason than to eat it with distaste at best. My hypothesis is a couple thousand years from now people will do the same even if the killer is another animal.Report

  8. In spirit of the game:

    Using your cell phone while you’re with real, living people, supposedly having ‘together time.’

    In the same vein, businesses that take phone calls, and assist people on the telephone, while you’re standing there waiting for help; a variation of this would be assisting drive-thru customers before in-store customers.

    Fluorescent lights; I don’t care how much energy they save, they give me migraines. I suspect if we want to improve education in this country, getting rid of fluorescent lights in classrooms would be a good first step. And a second good step might be indoor air quality, most air-exchange systems don’t do enough air exchanging.

    Sex offender registries.Report

      1. This is something of a discussion topic in my community of late. We vote at the elementary school. There’s been a few letters-to-the-editor suggesting the voting should be moved to the town hall because there are registered sex offenders in the community.

        Of course, the biggest town expense is education. And with the threats to children these days, you can’t just drop in and visit (or volunteer) at the local school, you’ve got to be screened. The community at large grows ever more distant from the schools within the community, and for many of the tax payers in town, the only time they see our schools is when the go to vote.Report

      1. They flicker; and flickering is a common trigger of migraine. They also emit large amounts of radio-wave spectrum noise, which seems to bother some people. Interesting the failing to vent outdoor air into a building is also a culprit.

        Also totally amazing to me how few people rely on actual natural sunlight for light during the day and actual open windows for air exchange. And architects, those designers of schools, office buildings and hotels, are amongst the worst offenders.Report

      2. Murali – anecdata I know, but that article also mentions that fluourescents (particularly older ones) tend to emit more blue light, which has also been identified as a trigger.

        When I worked from an office w/fluourescents I was getting about 1-2 migraines per month – now I work from my home (doing the same work, same hours, still indoors, with A/C, but with no fluorescents) and I get 2-4 per year, and generally they are of lesser severity.Report

  9. Prisons.

    If that answer is too crazy, prison rape. It’s as much a setup as a punchline for comedians, while, at the same time, it’s a threat given by law enforcement.Report

      2. Well, then, in that spirit, I’d say that with the advent of the War On Drugs, Traffic-Light Cameras, and law enforcement’s emphasis on crimes and “crimes” that enhance revenue to the detriment of emphasis on crimes that result in harm, the police.

        “Why didn’t they return to a Sheriff system?”Report

    3. I was about to post that, so I think I will be contrary and post the opposite: Fines.

      It’s hard to think of a form of punishment that is more regressive.

      In fact I think I’d like to nominate the entire ‘justice’ system. From prisons and prison rape to fines that rich people shrug off but cripple the poor to the fact that simple being able to pay for a lawyer means you have +50% of getting off.Report

    1. They’re both popular, but there is a pretty big constituency against them both as well. I’m not sure how heroically independent it is to oppose either one of them.Report

  12. I think the widespread opposition to compulsory voting will be seen as barbaric and backwards. Does that count?Report

        1. Predictable response is predicable.

          “Because i can” as a rationale is toddler level reasoning. That doesn’t mean someone should be denied the right to do something because they have a childish rationale, just that it isn’t much of a reason.

          Because you can do something doesn’t mean its wise to do it. That doesn’t seem all that controversial.Report

              4. I thought about listing the American work ethic, a.k.a., “Living to Work”, as one, but it would fail the “clearly, undeniably popular” test above. Or a least, it would in a shallow, superficial way, as I don’t doubt there are many people, even 80-hour a week people, who would, at the very least, give lip service to a work-life balance. But work-life balance as a value is practiced about a well as Republicans practice fiscal restraint [insert equivalent Democrat dig here].

                “Vacation? Sure, go ahead, take your two weeks; you’ve earned it. Johnson will hold down the fort with us while you’re away. Johnson’s rolling his vacation days into next year. Again. Johnson’s a good team player like that, you know? But anyway, where you headed off to again? Maui, right?”Report

  14. Security cameras taking pictures (or registering an EZ-Pass) at toll booths. Saw a piece on NPR’s Newshour a while back, I think the topic was housing foreclosures, maybe college tuition. Interviewee worked typing licence plate numbers from photographs taken at the toll booths into a data base.

    Would like to know the cost vs. the cost benefit to law enforcement and whatever other branches of government/private industry use this data of every car passing through the toll on a publicly-funded roadway.

    But hey, I do like my EZ-Pass. I like it a lot.

    I’m reminded of Every Breath You Take, a stalking song.Report

    1. I’m thinking of the scene in Terry Gilliam’s “Brazil” where a worker drone is typing names into a database, and gets a single letter wrong, sending the plot careening as an innocent man is swept up into the Kafka-esque system.Report

    2. Everyone always assures me that EZ-Pass will *never* be used to enforce speed limits by calculating the time it took you to go from one point to another and mailing you a ticket if it’s less than a certain value.

      They say it’s totally impossible that the government would do that, just like all the other totally impossible things the government has done over the past few years.Report

      1. The main safeguard against this is that EZ Passes are voluntary and municipalities want people using them. Start using it for traffic enforcement, a lot of people stop using them and they have to hire more toll-booth operators.

        I suppose this is less an issue in a place where the inconvenience of not using EZPasses is so great that people will just take their lumps.

        It’s not unlike those Progressive dongles that measure your driving habits, but not your speeding. Because if they used them for speeding, people wouldn’t get them. It’s only at some point in the future, when not getting them is untenable, that they may revisit that policy.Report

        1. I suspect using EZ-Pass for speeding is small potatoes, and not worth the bother — the peevedness of the peasants taken into account.

          But when you’re tracking a high-interest subject, or trying to recreate a trail, such as Mohammad Atta’s drive through Maine on Sept. 10. . .Report

          1. Agreed.

            Added to ny other points, if they ever got too good at catching speeders, people would stop speeding and revenue would dry up.Report

            1. It’s only revenue of speeders just pay up and don’t challenge the ticket in court; courts eat money. Insurance lobby would love it, lot’s of rate increases without much increased risk of actually paying out a claim presuming driving habits remained the same.Report

              1. Most people do pay up. It’s a collective action problem of sorts. If speeders everywhere challenged tickets, cops would become much more judicious about enforcement. But it’s in the individual interest of most people to pay up.Report

              3. Challenging a speeding ticket is a PITA everyplace. I’d say, however, the leading reason people don’t challenge them is that they actually were speeding.Report

      2. If you drive through the EZPass lane without an EZPass (or if your EZPass doesn’t respond), they take a picture of your license plate and fine or bill you accordingly. In other words, this can be done with no EZPass required.Report

      3. I have a box on the windshield of my truck for “PrePass” and “EzPass” combined. The PrePass part is about those weigh stations for trucks. It allows me to bypass most of them. Part of the legal agreement when you sign up for the service is that it can’t be used to calculate your speed.

        Honestly, it wouldn’t work that well anyway. They’re too far apart in most places.Report

    1. Oh this is a good one. To that I’d had the idea of a hedonistic pursuit of pleasure is a goal in life. Pleasure is good but I do not think that life should be a pleasure crawl. Hedonism brings no more self-fulfillment than material goods.Report

    2. It was difficult for me to pick one, because virtually everything I could think of has, somewhere, a vehement opposition, thereby negating the “popular” part.

      But then I thought of David Foster Wallace’s “fish-in-water” metaphor. Consumerism is our water which we don’t even know we are in most of the time.Report

      1. There are 7 billion people in the world. This allows for something or almost anything to be both wildly popular and also vehemently denounced at the same time.Report

    3. Is that even a real thing? People buy things because they enjoy their use, or because they want to enhance their social status* and reap the benefits therefrom. But consumption for self-fulfillment? What would be an example of that? What does it mean?

      *Yes, I do agree that this is less than ideal, though I think that it’s part of a broader category of wasteful things that people do in pursuit of status.Report

        1. So people who buy big gulps are not buying them because they wish to consume a lot of soda?

          They’re just doing it because they like moving stuff and money around?

          I really tried to find an example of consumerism for its own sake, and I can’t find any. People buy and sell because they want different things from what they currently have, not because they’ve been hypnotized by money or whatever.

          Now, their motives may not be the best — me, I don’t drink sodas at all, because they’re unhealthy and not even all that tasty to me. But if I had to impute motives to soda drinkers, and if I had to choose between “they’re yummy to some people” and “watching the money bleed away,” I think I’d pick the first one.Report

          1. Brandon asked, “People buy things because they enjoy their use, or because they want to enhance their social status* and reap the benefits therefrom. But consumption for self-fulfillment? What would be an example of that?”

            And I gave Big Gulps as a response, I’d hoped a humorous response since the’ve been the topic of some discussion here, as an example of consumption for self-fulfillment.

            But I think you might have the paradigm wrong here: consuming for self-fulfillment is quite common. We eat for comfort as well as for nourishment. Some people shop to make themselves feel better when they’re sad or depressed. I’d have to think about cultural consumption; attending performances, purchasing art pieces, buying books, but there’s a definite element of ‘self-fulfillment’ there; similar to the materials we buy to pursue hobbies and recreational activities, and let’s not forget about collecting.Report

            1. Some people shop to make themselves feel better when they’re sad or depressed.

              Certainly. It’s a form of OCD, as I understand it.

              I’m not sure I feel comfortable diagnosing a mental illness in anyone who has ever bought something because it gave them a good feeling. Particularly not when it was a cultural product, like concert tickets or a painting. That might be extravagant, and an individual act of that type might of course be performed by someone with a compulsive shopping habit. But to liken shopping in general to this seems a bit much.Report

              1. Jason, maybe you need to spend more time with women. I would not call a new dress for the summer OCD or mental illness; I’d call it a new dress because it’s pretty; it makes you feel good. Not much different then, say, a new bourbon to drink, either.

                I was giving a snarky answer to Brandon, and for some reason unbeknownst to me, you think I’m saying shopping (originally consumption for self-fulfillment, as suggested by LWA,) fits popular but wrong model? I might suggest most fast fashion does; but I design slow fashion, so my incentives are aligned that way, and it would be suspect for me to suggest that. So I didn’t.

                When it comes to real heavy-duty shopping as a recreational activity to achieve fulfillment, I’m not the lady to speak with, lack first-hand knowledge due to migraines triggered by the lighting and lack of ventilation in most public places. My biggest take on it is that economist tell me consumption is the biggest driver of the economy and President Bush told us it would help heal our nation after the 9/11 attacks.

                But here’s the more pressing debate between on what’s moral, what’s popular, and what’s wrong in the marketplace of ideas freely exchanged: how does one discern between writing meant to tell truth to others and writing meant to reveal truth to the writer?Report

            2. “Panda” is even shorter and has other advantages.

              “What were you doing so late on the computer?”

              “Reading about pandas.”

              “Oh, OK. They are pretty cute.”

              “I’ll say!”Report

              1. Unfortunately, through association, you may start to become uncomfortably aroused whenever the topic of class struggle comes up, which could make for some awkward moments at your local coffee collective.Report

              5. Well, Psych Science is one of those new breeds of journals that is peer reviewed, but that publishes short articles quickly, often on sexy topics. It’s a good thing, because it allows people to put methods and results out there that might otherwise have taken years to get into more traditional journals (the trend in psych, since the late 70s, was papers with more and more studies, so that, for example, the first conference precedings(!) paper I ever wrote had 4 experiments in it… a friggin’ poster at a conference with 4 experiments… it needed 6 before we could think about submitting it to journals). But it means you have to take the findings with a grain of salt.

                That said, I see nothing wrong with their data analysis, as a sort of first pass. I just have no idea what the hell it would mean, and as they make clear in their discussion of the results, neither do they.Report

              6. I just have no idea what the hell it would mean, and as they make clear in their discussion of the results, neither do they.

                So it amounts to what someone might do after become uncomfortably aroused.Report

  17. The problem here is how do we create clear definitions of what is wrong.

    I disagree with a lot of the things that people list as being morally wrong. I don’t think eating meat is immoral or unethical. Nor do I find the thing that everyone Rot13ing to be wrong either because it is a strong part of my ethnic and cultural identity.

    The war on drugs is horrible but do we know popular it is. I seem to know no one with anything good to say about it, the tides are changing in terms of marijuana legalization. How many policies are kept around because of a determined number of supporters despite majority will wanting something else or reform?Report

    1. “The problem here is how do we create clear definitions of what is wrong.”

      Excellent question, in and of itself, which posters here have touched on many times in different forms.

      Is there such a thing, that can be universally applied?Report

    2. Nor do I find the thing that everyone Rot13ing to be wrong either because it is a strong part of my ethnic and cultural identity.

      This is a curious turn of phrase.Report

  18. When all the data about brain damage is in, football.

    Big-money college sports in general.

    Professional sports with salary caps and other ways to prevent players from being paid market wages.Report

    1. I like Big-money college sports as an answer. We here about scandal after scandal and abuse after abuse but the NCAA seems to be an unkillable beast and lots of people get excited about college sports every year.Report

    2. I predict both football and boxing are going to have to drop their ‘safety’ equipment in less than a decade. The outside of the body is designed to be injured, the inside wasn’t.

      You are correct, there will be massive opposition to this.Report

    3. “Professional sports with salary caps and other ways to prevent players from being paid market wages.”

      Can’t help but wonder if you’d hold this opinion if were a Pirates or Royals fan.Report

      1. There have been some very successful low-salary baseball teams. The problem with those franchises is long-term incompetence. Also, I have no problem with revenue-sharing to help provide competitive balance, say splitting TV revenue with the visiting team.Report

  19. Like I said the last time we played this game, laws preventing someone with two good kidneys from selling one to someone who has none. A lot of anti-market policies make us poorer, but this is the only one I can think of that clearly, directly, and undeniably kills people. It’s murder, full stop.Report

      1. That way you don’t have only really rich people getting kidneys from really poor people, but everyone who needs a kidney gets one.

        Old people who need kidneys and people who ruined their kidneys of their own doing could be exempted from benefitting from the lottery.

        Actually, getting the kidneys from lifer and death row prisoners might be an idea, too.Report

      2. Seriously? You’d rather force people to donate kidneys than allow people who could actually benefit from selling them to have that option?

        Also, the kidneys wouldn’t only go to really rich people. Insurance would cover it. It’s likely that the market price would be less than the cost of a transplant anyway.Report

        1. Only the poorest people would sell. There would be exploitation. (And not everyone has insurance.)

          Under your plan, people who face horrible poverty would be forced to sell by their kidney by poverty. (Sell or your family starves.)

          Under my plan, people would be forced to sell their kidney (they could be reimbursed) if they lost a lottery. (Sell or you go to jail.)

          Under my plan, you are perfectly free to not enter the lottery if you leave the country and never come back. Under your plan, poor people are perfectly free to not sell your kidney if you are willing to let your family live in poverty and they are perfectly free to escape from poverty. Same diff.Report

          1. My plan is like having a draft to see who will risk their lives to protect us and save lives during war time,

            Your plan is like only sending poor people to war against kidney loss, to risk their lives to protect and save the lives of the kidney-deprived.

            The draft sure seems more fair to me. Especially given that many rich people were born into wealth and we have stunningly low levels of intergenerational movement between classes.Report

              1. Ha! I actually do think that we’re likely to solve the problem technologically before humanity sees the light on this issue. The left probably only has another 10-15 years of getting poorly filtered blood on its hands.Report

              1. This was pretty much my thought. It’s ok to take your kidney against your will, but not ok to voluntarily give one up in exchange for compensation.

                I get the “only poor people” aspect, but to me that’s just another way of saying we won’t let poor people make use of the assets they have to better their lot. When we were poor, I once sold blood to buy my wife a necklace for her birthday–was that wrong? Would I have been better off if The law had forbade me from doing so?Report

              2. Giving blood isn’t as serious as giving a kidney. The latter doesn’t grow back. The former doesn’t require major surgery.

                For worries about consent and coercion see my carve and trade policy below. Under that policy, if rich person X doesn’t want to sell his kidney, he can always pay more to win the bidding war. And if X doesn’t have the money, he should’ve worked harder to not be in the position where he has to sell his kidney to avoid what he perceives to be dire consequences.Report

              3. I’ve read and responded to your views. I find them not simply wrong, but reprehensible. For once you’ve managed to get me to make a moral claim, and my claim is that your moral stance is wicked.Report

          2. Only the poorest people would sell. There would be exploitation. (And not everyone has insurance.)

            Most people have insurance. It’s certainly not limited to “really rich people.” And people living in “horrible poverty” might not even be eligible to donate, due to organ quality issues. I suspect that most would be from middle-income countries, where they’re healthy enough to have good kidneys to donate, and

            Under your plan, people who face horrible poverty would be forced to sell by their kidney by poverty. (Sell or your family starves.)

            So your plan is to take that option away and let their family starve? You probably want to increase welfare spending (even to other countries?) enough so that nobody faces the risk of starvation (which is pretty much already the case in the US). These issues are entirely orthogonal, though. If we keep welfare spending at current levels, they should be allowed to sell their kidneys because the alternative is much worse. If we increase it, they should be allowed to sell their kidneys because it’s no longer under “duress.” There’s no scenario under which it makes sense to ban kidney sales, unless you’re arguing on paternalistic grounds—that they just can’t be trusted to decide what’s best for themselves.

            Besides, most kidney donations are made under duress today. If someone you love needs a kidney and you’re a match, there’s a good chance that he’ll die if you don’t donate a kidney. How is “Donate your kidney or your brother will have to stay on dialysis for years, and may die” any better?Report

            1. The rest of my first paragraph should read, ” have low enough incomes and cost of living to realize a significant material benefit from donating a kidney.”Report

              1. Is your plan to legalize buying kidneys locally or from other (especially poor) countries?

                Also. are you infavorof legalizi “sleep with me or your fired” policies at work.Report

              2. Both.

                Yes, as should anyone who supports legalized prostitution. But only with the express permission of the owners of the business. And I’m not having that argument again.Report

          3. Under my plan, you are perfectly free to not enter the lottery if you leave the country and never come back. Under your plan, poor people are perfectly free to not sell your kidney if you are willing to let your family live in poverty and they are perfectly free to escape from poverty. Same diff.

            Employing similar sentence structure doesn’t guarantee a valid analogy, by the way.Report

    2. Oh you are a fucking moron.

      Can you think of a time when someone would not sell their kidneys or other organs but for being in an extreme situation of financial duress.

      The law is not murder. The law is to prevent people from being exploited. The best situation is to make sure that kind of duress never happens. Not to allow people to sell their kidneys.Report

      2. Can you think of a time when someone would not sell their kidneys or other organs but for being in an extreme situation of financial duress.

        So how better to help that someone than to remove an option for relieving that financial duress!Report

          1. As Brandon said — taking steps to eliminate that doesn’t depend on outlawing organ sales. And until you accomplish that goal, outlawing organ sales simply hurts the people you’re purporting to defend.

            I understand the negative reaction to this concept, but you should really step back and consider it a bit more. And perhaps try not to call people fucking morons when they say something you disagree with, especially when your own opinion is just a gut reaction rather than a carefully-considered position.Report

      3. Though I wouldn’t call it murder (any more than a failure to confiscate guns is murder, as some would argue), but I am pretty solidly with Brandon on this.

        Can you think of a time when someone would not sell their kidneys or other organs but for being in an extreme situation of financial duress.

        And people should die because of this concern?Report

        1. I don’t quite understand this. Who is dying because there isn’t an open market to sell kidneys? Is it that because there isn’t a market people who are desperately poor and have two good kidneys can’t , essentially, put a kidney on e-bay? That seems to be the gist of BB’s argument when he isn’t being a jerk.Report

          1. “That seems to be the gist of BB’s argument when he isn’t being a jerk.”

            When is this mythic time?

            This is one of those libertarian arguments that makes me very unsympathetic to libertarianism especially with the snide calls of the “left” having murder on their hands. Never mind that there are probably plenty of Republicans that are also opposed to the idea of kidneys being freely sellable. BB is showing why ideology is the enemy. He can’t resist making attacks against the “left” even if it discredits the cause he is advocating for.

            And yes he does seem to think that allowing people to sell their kidneys on the open market would be a win win situation. The poor would get some cash and someone would have a new liver or kidney. This is the same kind of horrible argument that Tod highlighted in his post from yesterday.Report

            1. You envision the donor as someone poor, desperate, one step away from starving to death and donating something akin to a lung out of sheer desperation.

              I envision a college student who could use some extra money for doing a good thing.Report

              1. College students would do major surgery that can have complications for how much?

                People who are tempted to prostitution and begging on the street would do it for how much?Report

              3. Not every desperate person is a druggie with poor health.

                Some awful nice lookin kidneys amongst the destitute.

                Also, pet’s let the poor sell themselves into more dangerous medical tests. Remove all regulations except researchers must tell their subjects what they believe the risks to he to the best of their abilities.

                The benefits of being able to do more research on human subjects, more dangerous research, would be so amazingly beneficial to humanity, it puts kidney transpoants to shame.

                Any reason to legalize the organ trade is, mutatidis mutandis, a reason to legalize a market for using yourself as a medical research subject. And any argument against the latter (the possible exploitation of the poor and momentarily unwise in decisions) is, mutadis mutandis, an argiment against the former.Report

              5. I agree with Shazbot that this is really not a good idea.

                The better solution is still:

                1. Make it possible for people to attend college and not need to consider kidney donation or egg donation (this one happens) for the extra money.

                2. Spend money on scientific research and development to create artificial organs or the ability to grow replacement organs without the need for replacement.Report

              6. There is nothing mutually exclusive about #1 and kidney donation. I’m not suggesting people be made poor in order to induce them to buy kidneys.

                Nor is there anything particularly mutually exclusive about #2. In the meantime, you can save lives.Report

              7. Spend money on scientific research and development to create artificial organs or the ability to grow replacement organs without the need for replacement.

                Yes, obviously the ability to make kidneys from scratch is preferable. That’s still 10-15 years out. In the meantime, the government is standing between willing kidney sellers and buyers, and the latter are dying as a result.Report

              9. Yeah, when I picture someone who’s going to have good judgment about whether to take a permanent risk for an immediate reward, I think “college student”.Report

          2. The argument is that people die for a lack of kidney donations. If people could get paid to donate kidneys, they wouldn’t die.

            (I should add that donating a kidney is not like donating a lung. It’s actually something I would like to do – with or without pay – someday, if I am an eligible donor.)Report

            1. Okay. I’ll say that one, good and accurate, criticism libertarians and conservatives make about liberals is that we don’t account for unintended consequence or see how our programs might not work the way we think. Reading the pro-kidney selling argument leads me to believe that it is not just liberals that have that blind spot. Is it really not hard to see potential problems with turning internal organs into financial transactions.
              While certainly some people would get kidneys who need them there would also certainly some donors who would die in surgery or suffer a later kidney problem that hurt their one remaining kidney. As a society is there any downside to pricing organs? Doesn’t making poor people walking organ farms raise at least a little bit of sci fi dystopian future alarm?Report

              1. “Reading the pro-kidney selling argument leads me to believe that it is not just liberals that have that blind spot. Is it really not hard to see potential problems with turning internal organs into financial transactions.”

                Everyone has this blind spot for their preferred policies. This is what my neuroscience friends called cognitive bias. We are all very good at pointing out the shortcomings in our foes and what we hate. Not so much about our own preferred plans.Report

              3. I would not expect hospitals to buy kidneys from vagrants, for the most part. Even with the shortage they have, they have a screening process. With more available, why would they suddenly turn to vagrants? My guess is that they wouldn’t have to. With the possibility of making money, a lot of people would look into it and they’d have enough healthy, legitimate donors.

                It is extremely unlikely that more people would die from surgery than for lack of a kidney at present.

                I can easily imagine scenarios in which I would very much be against organs being allowed to be sold. Kidney donation isn’t one of them.Report

              4. Vagrants, probably not much. Desperate young people teens or in their early 20’s. Yes very much so. Lots of young people have little or no family support and get in bad situations or have little going for them. Getting a pile of money and not being able to judge potential long term consequence sounds a lot like something young people would do.

                I’m directly thinking of many kids i worked with when i worked in a shelter for runaway and homeless teens. Lots of those kids his age 18 without any family, often no HS and no skills. They had nothing to fall back on and little hope. There adult years were starting very hard and with little hope of getting better anytime soon. I think many kids would have seen a quick payoff and that is about it.Report

              5. There is already a screening process in place. There is very little reason to believe that they’d suddenly stop because the donors are being paid for it.

                In all likelihood, most people worried about who would sell out of desperation probably wouldn’t even have the opportunity.Report

              6. I should add that I am really not immune to the coercion argument here. I would oppose, for example, allowing prisoners to reduce their sentence by offering to be an organ donor. My concern there is that the existence of that option – or the perceived existence of that option – would actively move them towards a situation of greater desperation. Juries and judges handing down harsher sentences because they factor in the ability to get out early by giving a kidney. Which most wouldn’t be able to do anyway.

                I just don’t see that applying at large. At all.Report

              8. The key difference is that society would be actively making the prisoners more desperate (We’re going to make prison sentences harsher because we know if we don’t they will just get out earlier by donating a kidney). That dynamic is missing from society at large.

                Whether the desperate are first in line to sell their kidneys or not, they’re also the most likely to be screened out anyway. But mostly, I do not envision social services being cut because “they can always sell a kidney” the same way I can see sentences ratcheted up for prisoners.Report

              9. My 12:23 comment was aimed at the second para of your12:09 comment. I agree about the prisoners thing.

                I can envision kidney sales coming up often in bankruptcy or foreclosure negations. Given some of the things some conservatives say about the poor and people on aid, there would definitely be people saying they should just sell a kidney and stop being a no good layabout.Report

              10. Given some of the things some conservatives say about the poor and people on aid, there would definitely be people saying they should just sell a kidney and stop being a no good layabout.

                I’m fine with organs being judgment-proof.Report

              11. We all have responsibilities to each other. If you’ve got an extra kidney and someone else needs one, why do you think you have the right to keep yours? Because it’s “yours”? How much of your kidney was made possible by this society?Report

              12. ahhh i see the problem Jay. You’ve never got the concept that everything doesn’t exist in absolutes. We do have responsibilities to each other, but that doesn’t imply we have to give everything we every have to everybody else. It’s really a pretty simple conceptReport

              13. Greg, how many people in this thread *SERIOUSLY* suggested a program whereby random people have to either donate a kidney or be jailed or exiled?

                I’ll give you a hint:

                The answer is not zero.Report

              16. I was just responding to your trolling. Was anybody suggesting that because we have some responsibilities to each other we have to cough up ( so to speak) ours.Report

              18. With regard to the second paragraph of my 12:09 comment, it’s not because I don’t think the poor would be willing to. It’s that, generally speaking, they’re more likely to fail the screening process.

                One more thing or two before I bow out of this, because this is one of the few subjects on which I really, really don’t understand the opposing point of view. (I understand “This could be abused, we would need to be careful; I do not understand “This could/would be abused, we should let people die.”)

                This actually isn’t a “yay, markets” thing for me at all. I suspect Brandon and myself part ways on this after the initial agreement. Rather, it’s about:

                1) We don’t have enough kidneys.

                2) People are dying and/or living attached to a machine due to our lack of kidneys.

                3) Kidney donation is comparatively low-risk for the donor, high-reward for the recipient.

                4) How can we get more kidneys?

                5) We offer compensation, that’s how.

                In a case where we don’t have a shortage, or one of these things doesn’t apply, then maybe re-evaluate. This just strikes me as a no-brainer. The question is primarily “How?”Report

              20. Will:
                It’s really not primarily a “Yay, markets!” thing for me, either. It’s mainly that, for essentially the same reasons you gave, legalizing kidney sales is so obviously the right thing to do and the costs of not doing so are so high that this really is something that all reasonable people across the political spectrum should be able to agree upon, even if only with some caveats like the ones Rod expressed.

                That’s why I answered Jason’s question with this specific issue out of all the controversial libertarian positions I could have picked: This is the one on which I’m most confident that we’re right and the rest of the world is horribly, horribly wrong.Report

              21. Brandon,

                Sorry, didn’t mean to misrepresent your permission. I just got the sense that you really want an open market on this whereas I am perfectly fine having a highly, highly regulated one as long as it produces the kidneys.

                Anyway, my greatest compliments on thinking of this one. It’s a really, really good answer to the question posed in the OP.Report

    3. The idea gives me the heeby-jeebies but I see the logic. But I think I would insist on certain safeguards.

      1. Having only one remaining kidney puts you at increased risk. So if you’ve donated/sold one you should be automatically at the top of the list for a transplant. And it’s free.

      2. Donation isn’t a risk-free event in itself. You can die on the table or from later complications. A substantial life insurance policy that would pay out to your family in such a circumstance seems in order to me.

      3. Insurance plans should be required to cover the cost. Otherwise, its just another damn thing that rich people get that poor people don’t.Report

      1. Rod- 3- If kidneys are for sale then rich folk , or at least really rich, people will be able to afford them. Even if insurance covers it, the rich will still have a huge leg up to harvest what they want. Also if someone gives up a kidney their own insurance company won’t like it. You are choosing an elective surgery that is essentially giving you a pre-exsisiting condition. It will, ironically, require the kind of regulations the ACA puts in place where everybody can get insurance ( mandates, guaranteed coverage, gov subsidies) that would make giving up a kidney possible. I wonder how the pro-sales feel about that.Report

        1. If rich people are buying kidneys, that frees up kidneys for non-rich people.

          I am not sure why we would be under the obligation to offer people who sell their kidneys more than we offer people who donate them now.

          If it helps, I wouldn’t actually support kidneys on eBay. It’d be pretty heavily regulated. Like it is now.Report

          1. Well it could also raise market prices if there is bidding on kidneys. There is likely to be only so many people willing to sell a kidney so rich folk could still suck up a significant amount of the supply.Report

              1. If there is a market then prices will fluctuate based on demand. If you need a kidney, you REALLY need a kidney. The rich, or even upper middle class, will be able to outbid other people. That will raise prices. If you have enough money you will always be able to pay more than someones insurance company. What happens to house in a neighbourhood that is gentrifying. The prices go up and the original residents are priced out.Report

              2. Errr, no, I don’t see housing as a good analog for kidneys. There are a whole lot of differences there.

                Yes, the rich may well be able to outbid insurance companies. But they’d be bidding on something that is not currently on the market. Those currently on the market, either do-gooders or loved ones, would still be on the market.

                If I really thought this would be a problem, I’d be open to allowing kidney sales and forbid an “open market” (regulate the buying and selling at a fixed price). I don’t think it’d be an issue, but if I did, I think it could be something remedied by something other than the current arrangement.Report

              3. Actually i didn’t think housing was that great an analogy either but it was all i could come up with. But thanks for pointing that out (insert smiley face here).Report

              4. There’s a very limited market for kidneys. If you need one, you really need one, but if you don’t, it’s useless to you.

                On the other hand, the supply has no relevant upper bound. The vast majority of humans have two good kidneys, and I’m fairly confident that the number who would be willing to sell one for $50,000 dramatically exceeds the shortfall.Report

            2. I would sell one of my kidneys for, oh, the remainder of the price of my mortgage.

              For those of you out there who really need a kidney? I’d be willing to do it off the books. Send me an email!Report

              1. Even if you think kidney markets are a good thing, is there any part of it that just makes you go “squeeee!!!” I’m not asking if that should be enough to make a law on or “should” or whatever. Just is there something about this that raises the hairs on the back of your head?Report

              3. Q: Who would voluntarily put themself in a position where, at any moment, they might get splashed by oil so hot it explodes water into steam on contact?

                A: Anyone who works at McDonald’s.Report

              5. Sure, kind of. I mean, it makes me kind of sad to think of someone being willing to sell a vital organ. But you know what else makes me sad? People dying because the government won’t allow kidney sales.

                Oh, and people dying because the government won’t even allow compensation for postmortem donations. That’s a whole new level of fished up.Report

              6. So i’m sure we can at least agree that its sad and wrong for people to die for lack of health care in general. I wonder how we can make sure everybody has health care. In fact poor people, who you have immense concern for, have much higher infant mortality rates and much worse access to health care leading to poor health. I’m glad you’ve at least come on board with providing uni HC. Can i get a solid terrorist fist bump.Report

              8. and people dying because the government won’t even allow compensation for postmortem donations

                “Mr. Smith, you’re dying.”

                “Oh, well, I guess I kind of knew that.”

                “But you have many organs that could be used to better the lives of others.”

                “Oh, that’s great. I’d like to do some last good things for others as I leave the world.”

                “You’re a good man, Mr. Smith. Just sign here for the organ donation.”

                “Will there be some compensation? I’d like to do one last good thing for my dear Mrs. Smith, too.”

                “What are you, some kind of monster?!”Report

              10. It’s a good thing there are no possible ill consequences from the current system.

                I’m not playing nirvana fallacy here. There are no perfect systems. But I do think less harm results from the proposal than the harm we currently suffer.Report

          2. If rich people are buying kidneys, that frees up kidneys for non-rich people.

            I’ve been thinking about this today, Will, and I don’t know how much we could expect out of this effect. A lot depends on where you believe the going price would end up. Personally, I think the market price would likely be fairly high, in the lower to mid five figures.

            I have some personal experience with this since my wife had a kidney transplant from her (living) brother. Kidney donation is decidedly NOT a same-day walk-in sort of affair. They open you up from a couple inches shy of your mid-line front to about four inches shy of your mid-line back. The really hack your whole side open. Apparently, they need to get at both front and back to safely extract the thing. My BIL’s scar from donating is actually bigger and uglier than my wife’s scar from receiving the transplant. You’re in the hospital for a few days and, depending on the kind and physicality of work you do, you’re going to be sitting around the house munching percocets for probably around a month. This is a major deal.

            Personally, I wouldn’t do it for a stranger for much less than $50K.

            Then you have to consider that people on the receiving end have already most likely been sick for quite a while piling up medical bills and missing work. I would be purely guessing to throw out numbers but I imagine most of them are just barely hanging on financially as it is. I think the number that could pony up an additional however much to buy an organ and jump the line is pretty small. Small enough not to have much effect on the overall supply. I could well be wrong but in any case it’s a purely empirical question.

            I just have to wonder if this whole discussion isn’t predicated on a false premise: That opening this up for organ sales would automatically make supply rise to meet demand. That may be some market-magical thinking.Report

            1. How difficult the surgery is depends on a number of factors. But yeah, it’s not a same-day thing. It took Virginia Postrel about three weeks to recover.

              I wouldn’t do it just for the five-figures, but the five-figures could be enough to put me over. Would definitely have, when I was younger.

              $50k is not out of the question. You can apparently actually pay quite a bit ($100k, according to one figure) before it costs the system more money than it saves from dialysis machines. I wouldn’t expect the patient to pay for it. It should be covered by insurance or more likely the government (which pays for dialysis).

              Even if there aren’t enough donors, how is none better than some? A few thousand a year, nationwide, would be huge. Hundreds would be good. Especially if you’re among the lucky recipients.Report

              1. I wouldn’t do it just for the five-figures, but the five-figures could be enough to put me over.

                One of us isn’t understanding the concept here. I thought the whole “create a market” thing was so that some people would do it for money rather than just for altruistic reasons (like my BIL).

                Anyway, I think we’re talking past each other a bit here. I don’t think our positions are actually that far apart. I’m actually confident that if we set up a system of standard donor payments, so $50K or so, paid for by government or insurance (which is almost the same thing under PPACA), then I firmly believe the payout could be calibrated with a bit of experience to close the demand/supply gap. This isn’t really a “socialist calculation” problem since we’re dealing with exactly one commodity and one price. We’re not trying to solve a bazillion simultaneous equations in fuzzy variables.

                The talking-past-each-other is my fault since I was really reacting to the more-or-less bog-standard libertarian solution of having the recipients offer cash to donors. I’m both morally opposed to that kind of set-up and I don’t think it would work for the reasons I outlined above.

                It’s really the same reservations I have about free-market healthcare in general. The laws of supply and demand I was taught in Econ 101 guarantee that some people who need treatment will be left wanting for lack of ability to meet the equilibrium price. That’s how the equilibrium price is determined after all. That’s my moral deal breaker.Report

              2. Okay, good. I read your first comment from the other day and it resonated with me. I think there were nips and tucks to be negotiated, but I was comfortable with your concerns and that they could be addressed one way or another, and that you were open to it if those concerns could be addressed.

                And some of the fogginess was caused on my end. I’ve been very non-specific (perhaps even shifty) about the particulars most I don’t really care about the particulars, all that much. By which I mean, I am not wedded to “the eBay model.” We might disagree as to whether or not that would constitute something better than the status quo (I think it would), but I do agree that there are better models.Report

        2. You have a population skew problem.

          If kidneys are for sale, then certainly rich folk will be able to avoid selling their kidneys, but they will benefit from the sale of kidneys.

          However, there are a lot more poor and middle class people who need kidneys than there are rich people who need kidneys.

          I have to say, if I was on dialysis, I would very much like it if there was a market for kidneys. Because it’s much, much more likely that I’ll find a donor if people can profit off of selling one… whereas now, very few people volunteer themselves up to be checked for donor compatibility.

          18 people die every day from a lack of a donor organ (http://donatelife.net/understanding-donation/statistics/). Granted, they’re not all kidney failures, but it’s certainly a reasonable guess that a bunch of people every year die from the lack of a match on a kidney, just in the U.S.Report

          1. As far as I know I have two healthy kidneys right now.

            What I don’t know is whether I will have two healthy kidneys in the future. This is what most people don’t know.

            So someone might sell a kidney today but develop a disease down the road that shuts down their remaining kidney. This would seem to be a wash. We only need one kidney but I imagine we have two for a reason.

            Is someone immoral for thinking like the above and not giving a kidney to someone who needs one? This is not an easy question.

            I don’t think it is wrong for medicine or law to ban the sale of kidneys for the above reasons either.Report

      2. Insurance plans should be required to cover the cost. Otherwise, its just another damn thing that rich people get that poor people don’t.

        Those sound reasonable. I wouldn’t insist on them (the seller can buy insurance if he wants it), but I have no strong objections, either. I wouldn’t mind an age requirement, either, if that were a sticking point. 21 or 25 or whatever.

        I can’t imagine that #3 would be an issue, though. The payment to the donor would likely be a fairly small proportion of the overall cost of the procedure. And it’s not like insurance companies arbitrarily refuse to cover certain classes of treatment just to be jerks. A kidney transplant might even save money relative to dialysis.Report

        1. Another caveat I would like to add. Before we (American society, whatever) go down this route there are other, simpler, less controversial steps that can be taken.

          The main one is “presumed consent.” I have a notation on my driver’s license that says I’m an organ donor. So if I were to die in a highway accident, which given my profession is one of the more likely near-term mortality scenarios, and I’m pronounced dead, the hospital doesn’t have to wait for an OK from my wife to start harvesting my organs. (And her answer would undoubtedly be “yes” since she is a kidney transplant recipient herself.)

          Currently, this is something that you have to “opt-in” for when you get your DL issued or renewed. Other countries have successfully turned this around so that you have to positively opt-out instead.Report

          1. I don’t like that approach. I believe all things (or almost all) should be opt-in notepad of opt-out. Personally, I don’t think the body is sacred in any way, so not only am I happy to be an organ doner, but I really don’t care what’s done with my body after I die. Use my cadaver for an anatomy class, plasticize me for a museum exhibit, or grind me up for dog food–I’m pretty sure I’m not going to mind.

            But I’m hesitant to impose my views on others, and hesitant to assume that their failure to opt out wasn’t just accidental.

            It’s a regime I’d want some strict rules on, anyway, to minimize that problem.Report

            1. I find it baffling that _anyone_ is talking about paying for organ _donation_ when we could _probably_ just solve the problem by paying for people signing up to become organ donors.

              I.e., they sign up _now_ to donate upon death, and we pay them _now_. Make it $500 or something that isn’t huge, but isn’t nothing. If saying ‘Yes, I will be an organ donor’ is worth $500, what 18 year old _wouldn’t_ do it? (Might instead want to structure it as a yearly thing, I dunno.)

              Also, we need to fix the laws, because right now organ donation is still legally dependent on the family instead of the actual donor. Which is nonsense….you own your own body, and after death your estate owns it, and if you’ve given clear directions to the government what you want to happen with your body, other people should not be able to override that.

              Fix that and have 99% of people sign up, and we’ve solved this ‘organ donation’ problem _without_ the obvious dangers of paying for the _organs_.Report

              2. Something like this is close to my preferred policy as well. I saw an idea like this broached recently at the ELPAT conference in Rotterdam.

                Also, we need to fix the laws, because right now organ donation is still legally dependent on the family instead of the actual donor

                Its slightly more complicated. In theory, where people have opted in the hospital has the right to take organs. However, as far as I understand it preping the body for extraction requires slightly different EOL care from those whose organs are not extracted. This often requires familial consent. Even when it doesn’t no hospital is willing to go to court over one organ in order to over-ride familial objections.

                Another problem is that in practice, extraction of organs after circulatory death in the US takes place even when circulatory death can in principle be reversed, but no one is willing to reverse it. Of course the law requires the cessation of unaided circulation to be permanent which makes all donations after cardiac death technically illegal.Report

              3. Yeah, I’m not exactly sure what the laws are about any of that.

                I just hear stories about family members refusing to proceed with donation, which in my mind is roughly akin to family members asserting that they aren’t going to read the will and instead will divide up the deceased’s property how they want…it’s complete nonsense. That’s not how that works. A dead person’s estate _owns_ their body.

                I guess there’s a point where prepping the body still counts a ‘medical decision’, and not ‘property laws’, but that just demonstrates that organ donation agreement needs to include an aspect of living wills.

                But I don’t actually know if this needs to change anyway. If we actually pay people for this, if something like 95% of all people are signed up, then just 5% of them is more than enough for all needed organ donations. And presumably the percentage agreeing would grow as organ donation became the default assumption for everyone.Report

  20. I see a few more problems here:

    1. People seem to filer their answers through their own ideological biases and filters. See Kidney Donation.

    2. These are more maleable categories. All people are a combination of righteous, conformity, or reprobate depending on the issue.Report

  22. Why can there be only those two equilibria in a a population (either the true&right prevails or else the false&wicked prevails)? Why mightn’t a stable equilibrium develop in which what is popular (and enacted) is a set of policies that, in sum, amount to a morally ambiguous situation?Report

  24. For everyone in favor of legalizing kidney sales.

    A while ago there was a debate here about whether libertarians are in favor of legalizing “sleep with me or I won’t keep employing you” commands at work. People said libertarians weren’t in favor of that. That I and others were being too harsh to say libertarians would be in favor of legalizing that. “We are moderate libertarians” I heard

    Here’s an analogy: Should I be able to say to my employees “Give me your kidney or you lose your job?”

    How about “Give me your wife’s kidney or you lose your job?”

    How is that any different than “Give me your kidney and I’ll give you a job?” or “If you want to work here, you have to be willing to a.) have sex with the boss, and b.) give up your kidney.”

    I tell you, libertarians don’t get that a world without regulation is a world filled with exploitation of labor and the poor. Sorry to generalize, but I don’t see any difference between the exploitative potential of sexual harrasment and kidney sales. If anything, the latter could be worse.

    And other organ selling would be even worse.Report

  25. And just to be clear, the reason that people don’t like my policy of a kidney lottery is that taking someone’s kidney and writing them a check for, say, 15,000 is a huge injury to that person, which the person would only consent to if they were desperate.

    I think we would be okay with a lottery that if lost people would have to give up some of their time, say, sitting on a jury. That time is a small loss, even though it belongs to the person as much as their kidney. But we are okay forcing all people (rich and poor) into giving up that time for jury duty.

    So by legalizing kidney sales. you are legalizing a tremendous harm done to poor people who will so need the money that they will consent to that harm. If you prefer that to distributing the harm randomly through a lottery, you must think the poor deserve that harm more than a randomly selected group.Report

    1. No the reason I don’t like it is that you’re advocating stealing people’s internal organs! Try to make your policy proposals look less like an episode of Invader Zim. What ever happened to “my body, my choice”?Report

      1. My point is that there are some sales of your body that are too damaging, too fraught with the potential for exploitation, to be legalized.

        Aother good example would be allowing people to sell themselves imto very dangerous medical tests.

        I’m not engaging in a slippery slope argument here.Report

      2. A military draft is stealing lives. Jury duty is stealing time. Taxes are stealing property, which is a mixing of your body with the earth.

        Actually, under my policy proposal none of these things are stealing. By living in a society with a draft, or random jury selection, or random organ donation, you have consented to give up your organs if youhave been called upon to do so.

        How about this modification: All poor people will be exempted from the lottery. Only the wealthy (those making 7 or figures a year and/or with more than 8 figures in assets) will be eligible for the kidney draft. (The IRS will enter their names.) Once a rich person is selected, he or she will be able to enter a bidding war to see who can pay the most not to have to donate a kidney. (If it isn’t such a big deal, some will be willing to donate the kidney instead of giving up 30,00o, say.) All proceeds will go to saving lives in countries where there is starvation and the worst kinds of poverty, saving as many lives as the kidney program itself.

        That way the poor aren’t exploited. And the rich get to make choices about how much they’re willing to sell their kidneys for. And no one individual is forced to sell their kidney, because every individual has the choice to take money or their kidney.

        Instead of cap and trade, we’ll call it carve and trade.Report

            1. That’s a mere assertion. Bt the logic that government can force me to face death, and kill others against my will, just because somebody declares it’s my duty, what can’t government legitimately require of me? Is China’s regime of forced abortions, sterilization, and destruction of your house for having an extra baby ok? What about my example of forced redistribution of babies? Under your logic that doesn’t seem to be theft.

              You have done a great job of highlighting how dangerous the logic of duty to society is when not tightly constrained. You haven’t moved me off “monstrous.Report

        2. By living in a society with a draft, or random jury selection, or random organ donation, you have consented to give up your organs if youhave been called upon to do so.

          Some women can’t have babies, some women have multiple babies. By living in a society where second babies are taken and given to infertile women, you have consented to give up your second (third, etc) babies if you are called upon to do so. It’s not theft.

          There’s a monster in this room, and it’s not libertarianism. I’m pretty sure it’s not standard liberalism, either.Report

          1. Are you contrasting the gov’t redistributing children with poor people being able to sell their children. Both are pretty monstrous. (I am in favor of neither.)

            And what you think is monstrous is counts argumentatively, the fact that most people think selling organs (as they doIin Iran) should count against Brandon’s position. Your intuitions about what is monstrous are no more valid and quite different from what others intuit about what is monstrous.

            Also, are you saying that donating a kidney is as bad as losing (or having taken away) a child? I thought one of the premises of this argument is that the loss of a kidney is not that great a harm. If it is a great harm, why not allow people to sell themselves into other great harms, like dangerous medical testing (which would save countless lives over time.)?

            Finally, when I suggested and others suggested long ago that libertarians would be in favor of “sleep with me or your fired or sleep with me or I won’t hire you” rules despite the possibility for exploitation, I was ridiculed for saying libertarians aren’t that extreme. But now, you’re in favor of “Give me your kidney or you aren’t hired.”

            BTW, selling kidneys for jobs and not cash is pretty common in Iran.Report

            1. Dude, it’s not the loss of the kidney that’s the great harm. It’s the forced invasion and violation of individual autonomy.

              You know, people do sell babies. Surrogate motherhood is a real thing. And you can bet your ass they are disproportionately poorer women, not wealthy ones. So, yes, I am contrasting selling ones baby* with government redistributing babies.

              Would you ban surrogate motherhood because poorer women are more likely to do it than wealthier women?

              Your intuitions about what is monstrous are no more valid and quite different from what others intuit about what is monstrous.

              True, but the same applies to you. And it’s so common for liberals here to treat libertarians as monsters that I think you all have quite forgotten that your positions are sometimes seen as not just wrong, but truly monstrous. You’re the good well-meaning guys who care about humanity, so you couldn’t possibly be monsters, right? But, dude, your arguments in that moment are. In fact they’re so monstrous that I made the specific effort (not that you ever make a corresponding such effort) to distinguish them from liberalism in general. Because I don’t think you’ll find many liberals supporting them, and if I was to present them as a liberal position, I’d get shouted down (and rightfully so).

              But now, you’re in favor of “Give me your kidney or you aren’t hired.”

              Go back and re-read. I did not say that. Bitch at the guy who did if you want, but don’t accuse me of something I didn’t say.
              ____________
              *you changed the language from baby to children–don’t do that, because selling an older child is a very different thing from selling a baby.Report

              1. 1. You bet I would ban surrogate motherhood in a wide variety of cases. Commercial surrogacy is banned in many countries for exactly this reason.

                2. Organ donation, surrogacy, and adoption can be done with compensation. But the goal should always be to eliminate exploitation of the poorest and most desparate.

                3. How is legalizing “have sex with me or you’re not rehired” not analogous to “give me your kidney or you’re not rehired.”

                4. The slippery slope with surrogacy runs both ways. You say that if I ban kidney sales, why not ban surrogacy. I say if you legalize kidney donation, why not heart, lung, eye, etc. donation. There are people (with kids who need help, especially) who would die for the right amount of cash and there are people willing to spend through the nose for a heart. Why not legalize heart sales?

                Presumably, you and I agree that we have to draw the line somewhere. We only disagree about where it is to be drawn.Report

              2. 1. So I’m a teen girl who gets pregnant, doesn’t believe in absorption, so i’m going to bear the baby and give it up for adoption, and someone offers to care for my medical care and provide me some compensation. And your going to ban this in the name of protecting me? I think your theory is all about abstract groups of people, and doesn’t take real individuals into account.

                2. You use exploitation as a clincher, as though the very possibility of it settles the question. You also seem to think any thing you find distasteful is exploitation if a poor person does it to try to better their situation. You demean and dehumanize the poor by substituting your judgement for theirs and trying to protect them from their own choices.

                3. I didn’t bring that and I think at this point it’s a distraction.

                4. I would legalize those things. If I die from a bullet to the brain and somebody wants to pay my wife $50,000 for my heart, who are you helping by banning it? Not the guy who needs a heart, not the guy just below him on the transplant list, and not my wife. You’re just protecting some hypothetical person who might decide they want to give up their life and benefit others in the process. And you’ve done that on the basis that you can make better decisions for their life, you, more than they, can tell if they’re being exploited.

                Your whole philosophy rests on the arrogant assumption of knowing better than others what is best for them. That’s why, despite it’s pretense of caring for humanity, it’s really a dehumanizing philosophy.Report

              4. I’ll point you to the commenting policy and ask that – if you’re going to respond to James – you respond to the content of his comment, instead of pulling out the extremism sticker and plunking it on his forehead (especially as you’ve been hanging around here long enough to know that there is more than a little daylight between James and Rothbard).

                He specifically asked you a question, and your response passed over it. I think it’s fair to ask that you answer it:

                If I die from a bullet to the brain and somebody wants to pay my wife $50,000 for my heart, who are you helping by banning it?

                Who *are* you helping by banning it?Report

              5. The problem with tagging James as extreme is that when he divulges what others see as libertarian orthodoxy, it becomes about how he is not qualified to comment as libertarian because he doesn’t agree with what is seen as libertarian orthodoxy. People have been going round and round on that with James since forever.

                To me, the difference between live heart sales and live kidney sales is that nobody consents to the donation the former, as far as I’m aware, and hospitals wouldn’t let you if you could. People do consent to kidney donation, and hospitals go with it. That’s a pretty big brick wall, in my view.

                I’d have to think more on it before I would figure out how I feel about the selling of hearts (I’m not sure I am personally in favor), but I do see a lot of daylight between that and kidney sales.Report

              6. Shazbot,
                I suspect nobody’s ever really challenged the morality of your position before, so it’s a bit shocking. I’m not offended by the extremist comment–it’s just kind of sad–but I am bothered that you chose to skip over any of the actual questions I’ve posed. Both the one Patrick repeats, and my question about redistribution of babies. Answer that one and I’ll tackle the one about a kidney for a job (which I’ll admit I find troubling, and difficult to answer).Report

              7. I was talking about heart donations of people still using them.

                Selling organs (depending on how you do it) that will be sold upon brain-death is a different kettle of fish. The only harm there (which could be an awful harm if you constructed the heart market without regulation) is that it creates a perverse incentive (big money) to pull the plug early even on people who could’ve survived and maybe even to kill in rare cases. (This what life-insurance has to avoid too.)

                So selling organs could harm ill individuals with family members who need cash.Report

              8. Is it an insult to call someone extreme like Nozick?

                Extremism is good, if you are an extremist for justice or an extremist for love, a la MLK.

                I would say allowing people to sell their hearts or allowing employers to tell their employees to blow them or be fired is pretty extreme.Report

              9. I answered the surrogacy claim. I am against a market for surrogacy, and it is illegal in many places to have such a market.

                I am okay with a highly regulated surrogacy market, but the devil is in the details, of course. So too with a kidney market or a heart(or eyes or lungs or liver or whatever)-from-people-still-using-it market. The market must be regulated to prevent the poorest and most desperate from making such a sale.

                If kidney sales for 100,000 are not a big harm like jury duty is not a big harm, then we should have a lottery to determine who has to sacrifice a kidney just like we have a lottery to determine who has to donates.

                How about this lottery. Anyone who has over a half a million dollars is entered into a lottery. If they lose, they have to give up half of their money (at least a quarter of a million) or their kidney, but not both. It is up to them. That way rich people will be born into a society where they have to chose between material wealth and a kidney, not just the poor. Feel free to nitpick the policy and resolve the nitpickings at your own speed.

                I have been challenged over this argument before. As much as the claim extremist is an insult, James’ implication that I am naïve is an insult. But I will not take it that way.Report

              10. What about government redistribution of babies?

                And you know you meant extremist as an insult, so even though it didn’t particularly bother me, I’d prefer you not try to weasel out of it, but stand up for your claim. As my old religion prof used to say, “sin bravely!”

                As for your claim that the person you’re protecting someone is someone whose relatives might want money, I’ll insist you’re still talking about hypotheticals–possibilities–in contrast to the specific cases I’ve mentioned. Could it happen? Sure. Do you know that it will happen, and lead to worse consequences, on net, than the current system? No, there’s no chance on earth that you know that, because none of us do. That includes me, which is why I dealt with that as my true rejection.

                You haven’t yet stated your true rejection. I’m curious about what yours is.Report

              11. I know some people who refuse to be (dead) organ donors for fear that doctors won’t go as far as they could in saving their lives, if their death means life for five other people. Should post-mortem donations be banned? I think there is even a financial incentive in there, somewhere?

                Anyway, I am a bit concerned about the “pull the plug and cash in” but it seems to me there is a straightforward solution: The deceased has to sign a document stating that their heart can be sold. That way, if James trusts his wife not to pull the plug for a payout, he can sign. If someone else doesn’t trust his wife, he won’t sign it.

                I suppose you can say “But he’ll be pressured!”… but I’m not sure that’s my determination to make.Report

              12. Will- you can bet a few of those cases would end up in court and on courttv ( or whatever they call it) Think Terri Schiavo. Not saying it proves anything one way or the other, just noting.Report

              13. If kidney sales for 100,000 are not a big harm like jury duty is not a big harm, then we should have a lottery to determine who has to sacrifice a kidney just like we have a lottery to determine who has to donates.

                Shaz, out of all of your arguments, this one is the one that quite frankly doesn’t make any sense to me at all.

                I know people who would sell a kidney for $100,000, and not consider that a harm. I know people who would give up a kidney for free, and not consider that a harm. I know people who wouldn’t sell a kidney unless you upped the price quite a bit. The amount of potential harm means different things to different people, which is why they affix different prices on the thing.

                I don’t know anybody who would pay $100,000 to get out of jury duty, nor do I think anybody would consider volunteer jury duty at all okay if it involved a statistically non-negligible chance of death.

                I mean, there are people who are totally okay with mandatory jury duty who find the draft completely unacceptable, right?

                This analogy is just terrible.Report

              14. Depends on how the law is written. If written well, it would at mist be an aggravator of current issues. There needn’t be ambiguity around the sale of the heart itself.Report

              15. I need to respond to Patrick, Will, James H

                James,

                I decide what I meant. I am not afraid of anything here. I did not mean “extremist” as an insult. I just want you to note that if you are for “sleep with me or your give me your kidney or your fired” you are an extremist. And you are in favor of that, entailing all the exploitation it would allow.

                Extreme libertarians do nothing to prevent exploitation of those who have been born with less (less inheritance in terms of wealth and connections, less natural talent, etc.).

                I am for not allowing people to commit suicide to sell their organs to give money to their kids. I am okay with people getting a standard amount of cash for signing an organ donor card or even a standard DNR when chances of being saved are negligible. The former has much greater possibility for exploitation. The latter could result in some exploitation as we see in places where organ donation occurs legally (Iran) or illegally-but-tolerated (rural India).

                Patrick,

                You seem to be laboring under the assumption that if X agrees to outcome Y, Y can’t be a harm to X. If so, then when a women sleeps with her boss because he says “sleep with me or you’re fired” is not a harm to her.

                But it is a harm to her even though she chose the sex over losing the job.Report

              16. The analogy is perfectly apt.

                The only difference is degree of harm. Jury duty is a small harm. Selling your kidney is a larger harm. The draft is a larger harm than the loss of a kidney, Selling your heart (while alive) is a monstrous harm. (Selling your signing of an organ donation card or a DNR and organ donation will is almost no harm at all, though a market for such things could create moral hazzards if done incorrectly, just as legalized euthanasia could do if done incorrectly.)

                There is a difference between didn’t harm and consented to.Report

              17. Will,

                First off, thank you for being so kind and fun to argue with. There is no bullying or BS from you and I appreciate it so much. I have never met someone so able to argue politely, effectively, and excitingly. Kudos.

                Second, I agree that how you structure the law matters. I am okay with creatong rewards for people who give up kidneys. A good samaritan bonus. But I am worried about the moral hazzards, if you will, and the effect on the worst off. The laws should be structured so as to get the well off to give up their kidneys.

                If the poor need and can benefit from the money from selling a kidney, they should get access to that money and the resources they need it to buy (socialized healthcare, decent welfare, free public education, etc,) without having to sell their kidney.

                I take that as a pretty basic Rawlsian liberal protection of the worst off.Report

              18. Shaz,

                I don’t view the two as being hitched to one another. Which is to say, if the better welfare net is there, then it should be legal. If the welfare net is not there… I don’t see how keeping it illegal helps them. Nor do I see the existence of organ donation as being an impediment to the creation of welfare nets.

                Personally, I think the law should be structured primarily as a way to allow those who want to donate their kidneys, the ability to do so. That, first and foremost. Compensate people for their trouble.

                After that, and here is where we are going to disagree, I simply don’t see the value in gearing it away from allowing those who could use the money the ability to get the money. Which is to say, I don’t see the value in preventing 25 year old Trumwill from going forward with it. I don’t think he’s being coerced. I think the assumption that he must be coerced to agree to do it is flawed.

                I’ve been around a couple times with ND on this, too. He wants to create a society where people don’t need to sell their kidneys to get by. That again rests on the assumption that it must be predicated on desperation. No matter how much the welfare net takes care of, it would take nothing short of communism to take care of so many of my needs that $10-50k wouldn’t be desirable.

                It would be very alarming if it turned out that only the poor and hard-up were doing this. But I also wouldn’t want to bar them from doing it. And I have some very, very serious objections to a lottery or a draft.Report

              19. I am okay with some compensation for adoptive mothers, but (as there are in many places now) with very strict limits to prevent baby sales.

                I could imagine organ selling that didn’t exploit the worst off. I have given two options of how that might work. The lottery that the rich could buy their way out of was thought by you to immoral coercion, which is odd, because the lottery that the poor buy into as a result of being born into poverty in a world where kidney sales are allowed is not viewed by you as immoral coercion. The price fixing of kidneys at a very high level was another.Report

        3. A military draft is stealing lives. Jury duty is stealing time. Taxes are stealing property, which is a mixing of your body with the earth.

          Note that I am utterly against conscription, precisely because it is slavery combined with a substantial risk of death. I’m less sold on jury service, simply because I’m not sure juries are good for much, but since the alternative to taxation is anarchy (literally, since you can’t run a government without some kind of taxation) the loss of liquid assets to allow a function government is an acceptable trade-off.Report

    2. Having the opportunity to sell if expected benefit exceeds expected cost is now defined as “taking?”

      A voluntary individual choice is now defined as “huge injury?”

      Replacing choice with mandatory police enforced obligation is the elimination of “exploitation?”

      I could quip that we are using different dictionaries, but I suspect it would probably be more accurate to say that you are painting a veneer of rationality over your senses of moral purity/bodily sanctity, and injustice.

      If the poor were, hypothetically speaking, overwhelmingly empirically advantaged via the freedom to sell organs, would you then support it? I suspect you would still answer no. It violates your moral senses.Report

      1. Sometimes the choices that the poor make have consequences that are huge injuries for them, e.g. choosing to work in an unsafe building that are sure will collapse someday because you can’t get a better job.

        My carve and trade policy simply pushes these choices onto the rich instead of the poor.

        No rich person is harmed, according to your reasoning, because each rich person can always choose to pay more to be exempted from having to give up their kidney. If some rich person doesn’t have the money, well, under that rich person is in the same tough spot as every poor person under Brandon’s proposal.

        The rich are also better able to make these decisions about the value of their kidney vs. selling it. They have better access to medical care and financial planning. They are under less duress in determining how much money they need to survive, etc.Report

        1. No rich person is harmed, according to your reasoning, because each rich person can always choose to pay more to be exempted from having to give up their kidney.

          I’m pretty sure Rogers’s reasoning was not the logic of protection rackets.Report

        2. Shazbot,

          Actually I solute your attempt at coming up with an alternative solution. I disagree for lots of reasons, but like the creativity.

          Would you support allowing a free market in the sale of kidneys if it, completely hypothetically, clearly and consistently improved the lives of the poor?

          Would you support sweatshops if , completely hypothetically, they completely and consistently improved the lives of the poor?

          I seriously suspect you would answer no to both questions*. Thus we are not arguing on facts, but completely on values.

          To answer the inverse questions, I would NOT support organ sales, drugs or sweatshops if they, hypothetically, consistently harmed the poor. Thus proving that I am not a “real” libertarian.Report

          1. Kudos, Roger, for being open and measured in your response to an idea offered earnestly and in good faith about a topic under discussion with which you strongly (or maybe it’s not all that strongly for you, can’t quite tell) disagree.Report

            1. Btw, how would you answer the questions? My guess is you would answer in a fairly utilitarian manner and our disagreements are indeed primarily around the facts.

              I think Jonathan Haidt would get a kick out of this subthread.Report

              1. 1. I’d support kidney sales in that case, though I think the category “improves the life of” is undefinable, so I think it would never apply.

                2. As to the sweatshop debate, I’ve decided I don’t know what a sweatshop is, and that I therefore have no position on the question – also the issue with the category I mention above.Report

              3. Hmmm, I think “improving the life of ” may be unmeasurable more so than undefinable. Granted we can never be omniscient and our theories and explanations are never proven.Report

              4. I think it’s too many possible things and trade-offs to be abstracted into a “thing” of its own, and to me that means it would be undefinable. It’s also going to be immeasurable – from the outside, as you say. Even subjectively, while it’s often perceptible, in my experience quite often it’s too ambiguous ambiguous a question to know whether something has “improved one’s life” overall. To me, that indicates that, when push comes to shove, it may be undefinable. In any case, I don’t know how to define it.Report

              6. Btw, those answers were in no way a statement that I don’t presently support legalizing a market in kidneys. I don’t have a solid position on the question. In fact, I’m even going to retract the conditional statement of support and simply say that I don’t have a solid position on the question one way or the other, and I don’t know if that would change under the condition you give (which, in any case, I view to be essentially meaningless for the reasons given).Report

          2. Roger,

            Good question.

            I am against the poor and the worst off being harmed, but there is a question about who constitutes the worst off or the poor.

            It is true that many beneficiaries of the sales will be poor themselves. Maybe the result is improved well-being of the poor over all. But suppose those that sold are poorer than the average poor person, especially at the time of sale.

            There is, as you surely know, a general problem with utilitarianism too. (Often stated in terms of an organ taking example.) Suppose a mental patient comes into the hospital and an administrator decides to kill him and use his organs to save multiple lives: a heart transplant, two kidney transplants, etc. This clearly benefits a group (lets say the group is all somewhat poor). But it isn’t moral because of how this one individual was treated.

            I am more worried about a few poor individuals being abused unfairly than the poor as a class being made worse off overall.Report

            1. I appreciate your answer. As a side note, I am not a utilitarian either. I do think when it comes to choosing rules or conventions that rule utilitarianism is a reasonably good, though imperfect, way to choose rules.Report

  26. you’re not allowed to condemn something that’s already widely condemned, like income inequality, or the drug laws, or illegal immigration. Those may be wrong, but they are all disliked enough that you gain no points here from piling on. You have to condemn something that’s clearly, undeniably popular.

    Popular or unpopular in what social nexus? How many employees of academic institutions are willing to critique or lampoon the ‘diversity’ humbug? Would this inhibition apply in most other social circumstances?Report

      1. Those people don’t want to be part of that culture. They don’t show up in the first place. I don’t know why people are troubled by there not being as many of them around as some idealized number.Report

  27. I will give the same answer that I gave when Tod asked a similar question.

    I condemn exploitation, defined as harming someone against their will to help yourself or someone else. I view social progress, where it has occurred, as a long series of institutional and moral advances of eliminating various types of exploitation or harm.

    There are countless examples today of how most people (well over 90%) justify, excuse or rationalize certain types of exploitation or harm. I call most people out. Modern western society is still full of exploitation, and I believe we need to own up to this fact and begin to rise above it.

    I suppose some people will dismiss this as trivial. Who could be for exploitation?

    My answer is who could be for killing animals? Who could be for censorship? When it comes to food and China, we’ve already answered this (above). Modern society is infested with accepted forms of exploitation, where people use coercion to harm one person to benefit themselves or another. We need to first recognize it, and then condemn it and then look for solutions to the problem.

    Honestly, I see the solutions as the least hard part of the situation. The real problem is establishing and spreading the moral and intellectual paradigm. It is not OK to harm or restrict others against their will to benefit yourself or your favorites. Yes, I am talking to us!Report

  28. Okay, last attempt at a policy.

    Kidneys can be sold. Insurance companies (and or medicaid and medicare) have to cover kidney purchases.

    No Kidney can be sold for less than 2,000,000. No person under 30 can sell a kidney. Anyone selling a kidney must undergo strict psychological scrutiny (as with euthanasia proposals) to ensure they are cognitively aware of the risks and not deciding impulsively. No kidney will be sold except through a government agency.

    If we need 6000 more kidney transplants a year, that is 12 billion added to thecost of insurance and medicaid, which, if spread over 300 million people, is about 30 bucks a person, per year. Of course, the costs aren’t quite distributed that evenly through insurance premiums, but you get the point.

    I am surprised (though not really) that the libertarians here suggested a market where poor people mke a few grand for selling a kidney, often out of desperation, than a scheme where kidneys have to be sold for big money.Report

    1. I am surprised (though not really) that the libertarians here suggested a market where poor people mke a few grand for selling a kidney, often out of desperation, than a scheme where kidneys have to be sold for big money.

      Which s evidence that you still don’t know jack about libertarianism. And, no, it’s not the desperation we’re striving for. It’s the letting people make their own choices, so long as they’re not harming others, without interference by others who would presume to substitute their own judgement.

      I think your scheme is an improvement. I find it over-regulated myself, but at least it’s not morally monstrous, and it would make more kidneys available while compensating donors and the imposition of costs on others, while non-ideal, is not egregious (and in a world where I’m forced to pay for things I don’t want to pay for, paying for someone to receive a kidney is incomparably preferable to paying for drone strikes on wedding parties).

      But while I’d accept this as an improvement over the status quo, the only rule here I really agree with is the psych screen.Report

          1. I, personally, would be hard-pressed not to sell a kidney for a reasonable sum.

            First of all, because by donating a kidney, I’d be possibly saving somebody’s life. Unless that somebody is an utter anus, well, hell… that’s doing good, right there. It does, however, come with some risk. I have a family to think of, after all.

            If society chose to compensate me for that risk, I’d be much more inclined to take the risk, because if I croke off because of a random medical mishap, at least my kids get to go to college.Report

            1. This. It’s weird to me to read about how this policy would be predatory on the poor when, I wish this were legal and I had done it back when I was 25. Having $10,000 (I’m curious how much people would get, but that’s my WAG) would have been immensely helpful, I would have been able to help save someone’s life (or keep them off a machine), and it might have even motivated me to quit smoking! Further, I plan to look more into it once the kids are in school. Money isn’t required, in that case, though I would confess I’d be more likely to do it if it meant having some money for the kids’ college fund, even if money wouldn’t be the primary motivator. Likewise, back when I was 25, knowing that I would be getting paid for it would have alleviated financial concern as significant barrier.Report

              1. But you’d have been preyed upon. Don’t you see? Someone else knows what’s best for you.

                Oh wait, that only applies to lower-class people. You were poor, but it was a genteel poverty, so you get to keep your dignity. Not so the others…Report

              2. If it made the difference between it becoming legal or not becoming legal, I’d support preventing lower-class people from doing it. I don’t like the idea, because it seems kind of unfair to lower-class people.Report

          2. At that amount, if you wanted to sell, you would have to enter a lottery to have the right to sell your kidney to someone who needed it. So maybe 20,000 people, say, would want to sell, but only 5000 would be selected to be sellers.

            At that amount of money, you might be able to guarantee that you could buy yourself a lifestyle (live in safer neighborhood, better health insurance over your life, etc.) that would increase your lifespan and health more than the loss of the kidney harmed you.

            That would make the kidney sale less of a harm.Report

            1. At that amount, if you wanted to sell, you would have to enter a lottery to have the right to sell your kidney to someone who needed it. So maybe 20,000 people, say, would want to sell, but only 5000 would be selected to be sellers.

              I’m not sure what this is going to solve.Report

              1. I thought someone objected that the mandated high price of kidneys would mean too many sales and wasted kidneys. I just wanted to clarify that the proposal would only allow a fraction the people who wanted to sell -if that many would sell for big money- to actually sell. Something like that.Report

  29. Dragging the “selling your kidney” bit down here, because hey, it’s been a while since we came close to a thousand comments, let’s keep it going…

    (a) The vast majority of the people in the country aren’t rich. There’s about 180,000 people waiting for organs. If we assume the distribution is close enough to the income distribution (which will do just fine for our purposes, I’d think) that gives us:

    86,418 -> less than 25k
    49,014 -> 25-50k
    23,148 -> 50k-75k
    9,522 -> 75k- 100k
    11,898 -> 100k or more

    Or, you know, 11,898 “rich” people vs. 168,102 “non-rich” people.

    Now let’s look at the reality: anybody who makes over 100k a year has a lot of options for medical care. They can afford to fly to Korea or Singapore or somewhere else for a transplant. While availability of organ matching is still a limiter, I’d guess that of those 11,898 people, more of them are going to get a donor organ match than the other 168,102 people on the list, because they can go international and cost is a barrier for everybody else. So let’s say that they have a statistically significant chance of finding a donor that’s bigger than everyone else, but not bother to clarify the number, because that would require just guessing.

    So, if allowing people to sell some organs, with some reasonable bit of regulation, increases the supply of organs to the extent that you halve the number of people who are waiting for an organ, you’re looking at assisting or saving:

    ~84,000 “non-rich” people vs. under 5,500 “rich” people.

    I’m not sure this is “screwing the poor to assist the rich”, as a public policy. You know, on outcomes alone.

    (b) The lottery system Shaz describes is not a good idea. Why? Because there is a statistically nonzero chance that any surgical operation can put you in the ground. While I’m okay with people choosing that risk (even for filthy lucre), I’m not so much okay with someone showing up at the door to my house and saying, “Your daughter is a match for a kidney recipient, so we’re taking her, buh-bye”.

    (c) New Dealer points out that there are temporal issues involved. I agree: I can sell a kidney *now*, but wind up needing to buy one later. This isn’t exactly a wash, though, even from just a strict economic public good sense… because in the meantime, both I and the gal who got my kidney kept on truckin’ on, whereas if I hadn’t donated my kidney, she might have died years ago. So the fact that I need one now might be a wash in the sense that the system now needs to provide *me* a kidney, as well, but that’s fine. It’s not like musical chairs, necessarily, where the music runs out and there’s no place for me to sit; the music runs out but there might be somebody else who can share a seat with me, and there are going to be more of those people if we allow people to sell their kidneys than if not.

    Essentially, “You can sell a kidney” does two things the existing system does not: it increases participation in the donor pool (which is a good thing) and it gives the donors (who would be admittedly more poor- than non-poor) a payday for helping somebody, which improves their economic condition.

    Could this be gamed? Sure. Any system is susceptible to coercion. But that’s true of our existing system, too (see Mantle, Mickey).Report

    1. I continue to suspect the disagreements have never been over facts — over whether the poor actually benefit. As I wrote on Kazzy’s thread, it would be pretty easy to design a system where the poor benefit more than anyone else (sales come with a lifetime guarantee of “free” kidneys to all donors and their families).

      https://ordinary-times.com/blog/2013/05/what-is-your-true-rejection-organ-trade-edition/#comment-544002

      The disagreement is probably over values, with Shazbot bringing values ala Jonathan Haidt to the table that we do not share. Christians do the same thing on the gay marriage issue.Report

      1. Shazbot’s value (expressed here) is, “I don’t want to do this because the rich will benefit immensely and the poor won’t”.

        That’s empirically wrong. Even if private insurance was the price-setter (as opposed to individuals and/or Medicare), the sheer number of poor outweigh the sheer number of rich, who require kidneys.

        Even if *all* of the rich who needed kidneys benefited from this system, and only 10% of the non-rich did, we’d still have *more non-rich people benefiting than rich people*, in absolute numbers. Even discounting the fact that right now rich people have better access to health care, better access to surgical procedures, and international access that non-rich people don’t have, that would be absolutely a win for poor people who need kidneys.

        And the people who donate them, even *IF* they needed a kidney sometime in the future… they would monetarily benefit, which would help lift them out of poverty!

        I can’t imagine how this is regarded – on outcome – as less equitable than the status quo.

        If Shazbot’s principle is *also* “I think we have a right to mandate that people ought not to engage in this sort of private exchange”, that’s a different argument. But “the poor would be made worse off” is just… well, I’ll say it’s hard to justify on the numbers.Report

        1. I agree, and thus am assuming, perhaps unfairly, that Shazbot is rationalizing moral values. That is why I attempted to sidestep the issue and ask what his call would be if he assumed hypothetically that the supreme being guaranteed that the disadvantaged would be consistently and overwhelmingly benefitted. Would he still be against it? He has yet to answer.

          I have the same question on forced union membership, eliminating sweatshops, socializing medicine worldwide and raising minimum wages. I oppose these because I think the logical long term effects in every case would harm the poor, and I can show my homework. If someone could show me that the opposite is actually true, I would change my stance on each. I welcome them to so convince me.

          I am not sure if Shazbot would change his mind. The reason is because I suspect he has other important values related to bodily purity/sanctity and egalitarianism that would be violated. It would make the world WRONG.

          By the way, I think a few libertarians here would also reject the utilitarian argument as well. They would refuse to violate the sanctity of freedom even at the expense of the poor or human welfare in total.Report

          1. I’m not sure this isn’t sort of begging the question. If we could guarantee that any particular policy would work great how can anybody be against anything. If i could give a God Approved stamp that a certain government program would both not violate freedom and improve human well being how could you possible be against it.

            I think one of the common tangles we all get in when we have these discussions is some people are trying to guess at real world implications while others are talking at a theoretically level. But those are two separate things and we end up talking past each other.Report

            1. some people are trying to guess at real world implications while others are talking at a theoretically level.

              Who’s who in this case? Because it honestly seems to me like both sides have focused on what they think the real world implications are–we just disagree about what they are, and to the extent we agree we give different valuations to those outcomes. But it seems to me that accusing either camp here of just being theoretical is inaccurate.Report

              1. Well i was making a general statement about many conversations we have here. I see that a lot. In this particular conversation i see Roger talking about freedom and liberty which is his style.Report

              2. Talking about it as being instrumental rather than some natural right.

                The point of the hypothetical wasn’t to beg the question (indeed i also asked and answered the contrary hypothetical), it was to separate issues of morality from instrumental reasons. It is the equivalent of asking:

                Assuming nobody was hurt by the action ever in any way, would you support having mutually enjoyable sex with your sister?

                Most people say no.Report

          2. If the policy didn’t harm any poor people, then I am fine with it.

            But if it doesn’t harm the poor, then how would my lottery harm the rich? The rich can always pay more to get out of the lottery, and any rich person who isn’t willing to pay more will have consented to giving away his kidney.

            There is also a problem with utilitarianism in general that might be relevant. Suppose we take one homeless guy and kill him and give his organs to poor people who need them to survive. That benefits the poor overall, but hurts the poorest of the poor even more. Not sure if that is just or moral.Report

            1. But if it doesn’t harm the poor, then how would my lottery harm the rich?

              Because they didn’t consent. I mean, not just didn’t consent in the sense that you apparently don’t believe anyone can really consent to kidney donation if there’s money involved, but I mean didn’t consent as demonstrated by their failure to flee to Canada or some other country where they don’t force you to have surgery against your will.

              My objection to your plan isn’t what it does to the rich, per se. It’s what it does to everybody, rich poor and in between. As someone that would like to donate a kidney (with or without a payout), actually forcing someone to do it by virtue of their citizenship and/or some misguided attempt at egalitarianism is utterly horrifying to me. And it has little to do with the risk of harm of the surgery, which I may willingly undertake if I am a donor.Report

        2. It depends on how you divide up the category “the poor.”

          If you mean everyone earning below 30,000, you might be right. If you mean people who are poor enough to think about selling their kidney, are the poorest of the poor, then the kidney sales benefit the poorest not so much.

          Again, the mere fact that X is consented to does not mean that X is not a great harm, nor does it mean that X should be legalized. See legalizing “sleep with me or your fired” rules in workplaces.Report

  30. I find myself in critical conversations with James H, James K, Patrick, Roger, and Brandon.

    I must bow out as it is overload. This is why I like being a commenter and not an OP’er, because I can’t have this many conversations all at once.

    Sorry. I hope that what I have said is useful and that others will pick up the thread. If I have time, I’ll try to come back to it.Report

  32. Finally,

    If a market for selling one of your kidneys should be legal, why not a market for selling both of them (along with your heart, lungs, skin, eyes, etc.)?Report

    1. For the same reason that I can (while living) donate a kidney, but not a lung or a heart. The notion of taking a kidney out of someone and putting it in someone else, but refusing to do the same with a heart, is pretty well established, isn’t it?Report

      1. Will’s answer holds for what would be the most likely outcome of a policy allowing organ sales. The selling of a heart or both lungs just wouldn’t fly; of that I have no doubt.

        But my position is not as outrageous as you think, if you can agree to the reasonableness of one thing: that suicide should be legal. If you do not think legal suicide is outrageous, then anything attendant to it is probably outrageous as well. But if you think a person should legally be allowed to kill themselves, then I would think you would agree to the following:

        1. That they ought to be able to arrange to donate their organs, including their heart, following their self-inflicted death (any non-damaged organs, let us stipulate–we don’t need to mess around with, “sure, you can have the heart I just blasted with a 12 gauge” scenarios).

        If you can agree with legalized suicide and 1, then the following becomes no more outrageous than other organ sales:

        2. Instead of arranging to donate my heart after death, I arrange for someone to give my next of kin $X in exchange for me designating that I am donating my heart to them.

        Granted, any time someone is contemplating suicide, there’s a good chance they’re not thinking straight, so of course there is concern for whether they’re making a good and rational decision here. But the decision of real concern is not the selling of their heart, but the killing of themselves. As I noted previously, I would be comfortable implementing a psych screening before an organ sale can be finalized. Although this is not a justification for the heart-selling policy, it would, strangely enough, bring at least a few people into contact with professional mental health counseling who otherwise would never have sought it out.

        The alternative, in those cases where the person has not agreed to be an organ donor, and their next of kin don’t want to donate their organs, is the heart going to waste.

        I think you may assume people killing themselves just for the money they can get (not for themselves, obviously, but for someone else) for the heart. I don’t think that’s very plausible, unless someone, and their immediate family, are in terrifyingly desperate straits. You want policies to prevent that, and I’m fine with that. The screening could–should–also look for that, and direct people to services that can help bring them out of those desperate straits.

        I see this happening only as an extremely rare case, and then only in the case of someone who’s dedicated to committing suicide anyway. And probably vanishingly few of them, since few people who are committing suicide are thinking about anything than their own unbearable misery.

        So, outrageous? No, I really don’t think so when you break it down into a step-by-step analysis.Report

        1. What people contemplating suicide think about how others see their suicide greatly impacts suicide rates. This is why -IIRC- Japan, for example, has a high suicide rate, despite having other factors that should lower the rate. The cultural tolerance of suicide makes people feel less ashamed and better about themselves for acting to commit suicide, which increases the likelihood.

          If people start to think, in more cases, that their suicide is benefitting their loved ones, they will be more likely to kill themselves. “I kill myself after selling my heart and my kidneys, etc., and so my loved ones will live in a mansion. I will be loved. I will be a good parent/brother/sister/child, etc.”

          That’s an empirical question. Maybe it won’t happen. But it is so awful, I wouldn’t risk it.Report

  33. For those who think the liberals outnumber the libertarians, I am debating like 5 on 1 here.

    🙂

    Or maybe the liberals think I crazy too.Report

Comments are closed.

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