The current system for motivating the supply of human organs has failed to end the shortage. Thousands of people die every year while they wait helplessly for an organ transplant and thousands more will die in the next few years.Read more at location 1440
Today, roughly 60,000 people are waiting for organ transplants, although less than 10,000 will become donors.Read more at location 1443
For many years, a number of economists and economics-minded lawyers have offered their solution to the crisis: remove the legal restrictions on the purchase and sale of human organs (Becker 1997; Epstein 1993, 1997; Cohen 1989; Pindyck and Rubinfeld 1998; Barnett, Blair & Kaserman (1996, this volume).' The economic argument is familiar. Just as rent controls create a shortage of rental apartments, government rules that outlaw the buying or selling of organs on the open market hold the price of organs at zero and make an organ shortage inevitable.Read more at location 1444
Discomfort with organ sales is so strong that even some people who are desperately waiting for an organ are against allowing monetary compensation for donation. Many people feel that organ sales violate a moral intuition about the inalienability of the bodyRead more at location 1450
Others believe that opening a market for human organs would lead to an unfair distribution of organs.Read more at location 1452
Allocating organs, at least in part, by ability to pay is often perceived as unfair.Read more at location 1455
Monetary compensation to the donor could be arranged without the necessity of payment from the recipient, thereby avoiding this issue. But the counterargument of those who think that markets are unfair is that monetary compensation is the "thin edge of the wedge" that would eventually usher in monetary purchase. Read more at location 1456
Organs are treated like fish in a lake owned in common. Anyone is allowed to fish in the lake, but the decision to restock is private and voluntary.Read more at location 1463
The same thing has occurred with the supply of organs. Anyone is allowed access to the supply, but contributing imposes private costs on signers of the organ donor card.' Read more at location 1465
The costs of signing an organ donor card are in part psychological-perhaps the potential donor does not want to think about his own mortality or suspects that donation will interfere with proper enjoyment of the afterlife.' More concretely, some potential donors fear that if they sign their cards and are involved in a life-threatening accident, they are less likely to be revived than nondonors.6Read more at location 1467
The traditional solution to a tragedy of the commons problem is to enclose or "privatize" the commons. In the case of transplantable human organs, this can be done by restricting organ transplants to those who previously agreed to be organ donors; in short, a "no-give, no-take" rule.Read more at location 1471
At present, nonsigners face no costs to not signing their donor cards. The no-give, no-take rule raises the costs of not signing or, equivalently, increases the benefits of signing, and thus it will increase the number of organ donors.Read more at location 1476
Children would be automatically eligible to receive organs until the age of sixteen, when they would have the option to sign their cards.Read more at location 1479
To prevent people from signing after learning they were in need, there would be a mandatory waiting period of at least one year after the age of, say, 18 before the right to receive an organ took effect. Read more at location 1480
The no-give, no-take rule may result in the deaths of some people who would have lived under the current rules. Thousands of people are dying today, however. If the no-give, no-take rule increases the number of potential donors, then fewer people will die on net. If enough people sign their donor cards, this plan could even produce a surplus of organs. Read more at location 1481
Any remaining organs could then be allocated on the same basis to nonsigners.'Read more at location 1486
A more modest version of the no-give, no-take rule could be implemented by stating that, henceforth, points should also be awarded for previously having signed one's organ donor card.' It would then be allowable, for example, to give an organ to a nonsigner before giving it to a signer if the nonsigner had been on the waiting list for a long time. Read more at location 1486
A considerable advantage of the no-give, no-take rule over organ markets is that far fewer moral qualms are raised.Read more at location 1488
Although it is understandable that some people may have misgivings about becoming donors for personal or religious reasons, why should someone who was not willing to give an organ be allowed to take an organ?Read more at location 1490
