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July 31, 2009

Comments

Publius - Somin and McArdle are libertarians, not conservatives. (I don't know about Schwenkler, although he only says that he's open to the debate -- not that he necessariy favors organ sales of the kind proposed by Somin or McArdle.)

i actually had that first, but i wasn't exactly sure how to classify Schwenkler. So i left it as conservative. but it's probably imprecise, so i'll tweak

"Under the liberal view, everyone is “free” to take that offer or to decline it."
Do you mean "libertarian?"

So far it sounds like it boils down to "We shouldn't do fetal stem cell research because it is gross and wrong". Oh, I mean sell kidneys.

"At the end of the day, I guess I feel similarly to Kevin Drum – it’s not so much kidneys that bother me. It’s that I can easily imagine this logic spreading to things like eyes, or even children."

It isn't so much the idea of experimenting on 10 day old fetal cells that bothers me, it is that I can easily imagine this logic spreading to things like 8 month old fetuses, or full grown clones.

Actually, now that I've done this exercise--since I'm mildly nervous about fetal stem cell research, I sort of get your kidney objections more.

Funny, I just smacked myself with my own argument.

Very thoughtful.

Occurs to me that all markets are coersive by their very definition, so are you not arguing that the level of coersiveness is the problem?

We already allow people to sell blood. Of course that isn't permanent, but it does muddy the water of selling human 'parts', depending upon ones definition.

Maybe the line should be about stuff a fully functional, healthy human doesn't necessarily need - like the second kidney...
Though I don't want to be on the ethics committee when somebody who sold one kidney discovers the other one is failing and wants a transplant.

The ultimate free market in labor is slavery (excuse me, indentured servitude). This country has decided to ban that idea. Even personal assistants must have their income declared to the IRS.

A pint of blood, on the other hand, can be taken about once every two months without any apparent detriment to the donor.

My personal take is that kidney sales are closer to slavery than blood donation. It's a commodification of an essential and irreplaceable aspect of bodily integrity. I'm profoundly concerned by the possible secondary consequences that could arise from the viewpoint that these kinds of transactions are acceptable. (can you buy an option in a kidney, to be exercised at a future date? what happens if the donor changes his mind? etc.)

Yes, kidney selling can save lives and relieve poverty. So can slavery. Some societal values outweigh the life of a single individual.

"Some societal values outweigh the life of a single individual."
Uncle Joe would agree.

TDSWJS last night had an hilariously pointed segment with John Hodgman on this very issue...

I'm not a REAL philosopher, only a political one, but a couple of real philosophers have weighed in on this issue, sort of.

The father of market economics, Adam Smith, was a moral philosopher by trade (there were no economists back then as he had just invented the discipline) and he argued in Wealth of Nations that certain goods were too precious to human life to be left in the hands of the markets. Human greed could be a good thing under some circumstances according to Smith but certain vital items had to be protected from that greed. Kidney's would, I think, fall into that category for Smith.

Mill touched on the slavery issue, i.e. whether it was morally permissible for a person to willingly sell themselves into slavery. He determined that it was morally equivalent to suicide and thus it was one of the realms where society was justified in intervening and limiting personal freedom. The permanence and the potential for harm, thus limiting one's own future freedom which is what Mill was concerned with, would seem to make Kidney sales a moral equivalent to slavery or suicide for Mill.

Hope that was helpful.

CharlesWT wrote:

"Under the liberal view, everyone is “free” to take that offer or to decline it."

Do you mean "libertarian?"

No, he's referring to classical liberalism or the liberalism of John Locke and John Stewart Mill. Libertarianism is in some ways similar but it tends to be classical liberalism without the common sense, or at least that's the way it seems to me.

Libertarians, schmibertarians.

Under a libertarian regime, those requiring a kidney from a donor would be dead before they found the donor because they wouldn't receive the interim subsidized dialysis from our "Socialist" healthcare system.

Case closed.

So where do parents who have (or use) a second child in order to provide donor material for an ill child fall into this?

Occurs to me that all markets are coersive by their very definition, so are you not arguing that the level of coersiveness is the problem?

I don't get this comment on any level. Markets are not "coercive by their very definition." By definition, a market is an exchange in which a willing buyer and a willing seller mutually agree upon a transaction. Where is the coercion? That you are not free to steal eggs instead of paying for them?

Debra Satz, a political philosopher at Stanford, has done a lot of work on "toxic markets"--see, e.g., her recent "Voluntary Slavery and the Limits of Markets."

(Sorry for no links, but the Stanford server is being slow, so I can't get to her home page. In any event, some of her papers can easily be found by googling her name.)

My personal take is that kidney sales are closer to slavery than blood donation. It's a commodification of an essential and irreplaceable aspect of bodily integrity.

Just like forcing a woman through pregnancy and childbirth against her will. Yeah.

I didn't know that John Stuart Mills had made that analogy about slavery and suicide, but I'd go with it. Something to do with your own body ought to be your own free choice. (For this reason, I also oppose making it legal to hire a woman for surrogate pregnancy: same deal.)

So where do parents who have (or use) a second child in order to provide donor material for an ill child fall into this?

I tend to think bone marrow donation is a bit different - like blood donation, it's doesn't do any long-term damage. I would absolutely oppose parents making the decision that a minor child ought to "donate" an irreplacable organ to a sibling. (If we can leave out special cases like conjoined twins with only one set of organs between them - and even then: I think in sheer humanity the decisions about separation and survival ought to be made on a purely medical basis.)

"Occurs to me that all markets are coersive by their very definition, so are you not arguing that the level of coersiveness is the problem?"

If you are going to take this level of abstraction, all human actions that effect other people end up being coercive. Family interactions? Definitely coercive. Charitable giving with strings? Definitely coercive. Charitable giving with implied expectations? Coercive.

You've essentially emptied the word 'coercive' of its meaning.

(I would argue that the system of family obligations seen even in many 1st world families and definitely in all other families is far more coercive than most markets.)

We already allow people to sell blood.

Not whole blood for transfusion, we don't. Only plasma donors can be paid.

Sebastian: I would argue that the system of family obligations seen even in many 1st world families and definitely in all other families is far more coercive than most markets.

Can be, in abusive families, certainly. Or in families which assume economic dependence well after the age of majority.

But I feared losing my job because I came out a lot more than I feared losing my family because I came out. If I'd lost my job I could have lost my home: if I lost my family, well... as a friend once drily noted, coming out after you're economically independent of your parents means they need you more than you need them. (Coming out while still economically dependent on parents can still be a complete horror, though.)

I don't get this comment on any level. Markets are not "coercive by their very definition." By definition, a market is an exchange in which a willing buyer and a willing seller mutually agree upon a transaction. Where is the coercion? That you are not free to steal eggs instead of paying for them?

The problem with unrestricted markets is that they ultimately reward the people who can get away with stealing the eggs. Publius' point was that buyers and sellers are often limited by their material circumstances and positions within the market - people with less content knowledge, less know-how, less social capital and less financial capital can be more easily exploited and cheated by those with more; as a result, they are. Repeatedly. Coercion is a feature of the market, not a bug. The reason for this is that (ultimately) markets do not place value on people, they value things / widgets / artefacts of material utility.

However, many of us following in the moral tradition of Kant believe that it is rational to want a society that places value on people rather than on widgets, and to protect that value from a social system which does not share it - which is the entire point of regulating markets.

I'm actually going to put on a libertarian hat for at least a portion of this thread, and point out that, in fact, as a practical matter, despite much striving to convince people to do otherwise, including campaigns at the level of such that in many states, when you obtain your driver's license, you are asked whether or not you wish to be an organ donor or not, still only a minority of people, whether for reasons of religion, squick factor, simple inertia, or otherwise, volunteer to be organ donors after death, let alone offering up spare parts while living (which obviously involves a far greater sacrifice, though the degree also depends upon which organ; you can spare a kidney more easily than an eye).

Some statistics:

# Almost 100,000 men, women and children currently need life-saving organ transplants.

# Every 12 minutes another name is added to the national organ transplant waiting list.

# An average of 18 people die each day from the lack of available organs for transplant.

# In 2005, there were 7,593 deceased organ donors and 6,895 living organ donors resulting in 28,108 organ transplants.

# In 2005, 44,000 grafts were made available for transplant by eye banks within the United States.

# Approximately 1,000,000 tissue transplants are performed annually.

# According to research, 98% of all adults have heard about organ donation and 86% have heard of tissue donation.

# 90% of Americans say they support donation, but only 30% know the essential steps to take to be a donor.

Usual caveat: I don't take these numbers as gospels, other stats can be found. But they generally agree in principal, if not every last detail.

The most up to date and reliable data comes, I think from UNOS, and particularly here. There are vast shortages and long waiting lists for organs.

So the argument also goes, practically, that for every organ donation that is prevented by banning sale of an organ, a given number of people end up dying for lack of the necessary organ, as well.

So that has to be figured into the moral equation, as well, until such time as we've, at the very least, achieved a vastly higher rate of people simply being willing to be voluntary organ donors at death.

Personally, the idea that this doesn't happen in so many cases simply because of inertia, or lack of caring, offends me tremendously.

This doesn't mean I want the poor to start seeing large opportunities in selling off limbs and organs, but it does mean, IMO, that there are indeed two sides to the debate over whether allowing monetary transactions in organs from the living should be allowed.

I'd like to think that in the not very distant future, we'll be able to solve this problem with cloning. (And, no, not via horror movie ideas, a la Michael Bay vehicle, where whole humans are raised only for their parts.)

But we're not there yet, and won't be for another couple of decades, or so, I tend to think.

And, naturally, prior to a cloning organs by themselves, option, I also agree we should try to outlaw organlegging, which is to say, enacting a practice of getting most of your parts from criminals sentenced to death, and therefore continously lowering the death penalty to be applicable to ever-more minor crimes.

The problem with unrestricted markets is that they ultimately reward the people who can get away with stealing the eggs.

There is no such thing as an "unrestricted" market. I don't even know what this means: that everything is for sale?

In fact, all markets have restrictions, which are implied by the very definition of a market that I offered: "a market is an exchange in which a willing buyer and a willing seller mutually agree upon a transaction." You can't have a mutual agreement without rules prohibiting a range of sharp dealings.

Publius' point was that buyers and sellers are often limited by their material circumstances and positions within the market - people with less content knowledge, less know-how, less social capital and less financial capital can be more easily exploited and cheated by those with more; as a result, they are. Repeatedly.

In some circumstances, this can be a problem which can be addressed by the rules governing the market.

"Under a libertarian regime, those requiring a kidney from a donor would be dead before they found the donor because they wouldn't receive the interim subsidized dialysis from our 'Socialist' healthcare system."

Under our present regime, the current waiting list in the U.S. for a kidney is 85,458 people.

Bluntly, what we are worried about is not a society where nice, happy middle-class people voluntarily choose to sell a kidney to help with college costs for their kids, but a society where extremely poor & desperate people have to sell their kidneys without considering the long-term consequences so they can pay their rent arrears.

In other words, a society headed towards one where very poor people are harvested for their organs by very rich people.

I don't feel like I need to defend my opposition to that. Gross inequality causes a lot of other problems, some nearly as grotesque, but that doesn't mean I should accept another one.

Yes, we should reduce inequality, but the way to do that is not to legalize ever more extreme manifestations of that inequality.

Just like forcing a woman through pregnancy and childbirth against her will.

I've been thinking about this lately and have come to the conclusion* that forcing a woman through pregnancy and childbirth against her will is a form of torture and, as such, since we don't torture people to save other people's lives,** we shouldn't do so in order to save an unborn fetus.***

*based mostly on observing my wife during her recent pregnancy, which by all accounts was pretty easy on her

**or at least the US used to hold such a view

***obviously there a certain differences between the two situations but I'm not sure they're material.

It would be interesting to see a bankruptcy judge list a kidney and cornea as assets to be distributed.

I think I would prefer mandatory organ harvesting of the dead before legalizing the sale from the poor.

"It's a commodification of an essential and irreplaceable aspect of bodily integrity."

Jes brings up: "For this reason, I also oppose making it legal to hire a woman for surrogate pregnancy: same deal."

It's almost as equally interesting a debate. U.S. states vary considerably on where they stand on the issue.

[...] Much has changed in surrogacy in the two decades since the high-profile Baby M case, in which the surrogate was the baby’s biological mother and unsuccessfully sought custody after the birth.

The legal proceedings in that case markedly changed the conversation about the validity of surrogacy contracts. Some states have laws that protect the commissioning parents in surrogate pregnancies. And in a vast majority of surrogate pregnancies today, the surrogate has no genetic link to the baby.

Still, surrogate pregnancy is illegal in some states, including New York, and it remains fraught with controversy despite the fact that thousands of American couples — most of them not celebrities or especially wealthy — are happily bringing up children they could not produce on their own.

[...]

Surrogate pregnancies don’t always blossom into lasting friendships, of course, and many people consider the process repugnant. It has been called a violation of natural law, a form of prostitution or baby selling, an exploitation of poor women, and a privilege of the rich and famous who may not want to disrupt their careers or their figures by giving birth to their own children.

Reputable agencies and lawyers who specialize in surrogacy guard against the exploitation of women who serve as surrogates and against spurious reasons for seeking a surrogate pregnancy. In virtually every case they process, the intended parents, like the Tamens, cannot produce their own children, yet want children biologically related to them or choose not to wait the years it can take to adopt.

People may choose to have a gestational carrier bear their children if the woman lacks a uterus or has a malformed uterus; must take medication incompatible with pregnancy; or has had repeated miscarriages or failures at in vitro pregnancies. Or, in the case of a male couple or single male, if there is no woman involved.

As for charges of exploitation and baby selling, Pamela MacPhee, who was a surrogate for her cousin and his wife, says most surrogates do it for altruistic reasons. In her new book about her experience with surrogacy, “Delivering Hope” (HeartSet Inc.), she says the payment most women receive — typically $15,000 to $20,000 — “is for the services, time and sacrifice of the surrogate, not for the child directly.” And the amount paid is well below minimum wage when factored over nine months of pregnancy and the hormonal preparations that usually precede implantation of viable embryos.

[...]

But the two families were anything but casual about the matter. A psychologist evaluated the women and their husbands to make sure everyone was emotionally healthy, realistic and in agreement with the arrangement. A lawyer drew up a contract that guaranteed the baby would belong to the intended parents. Mrs. MacPhee said that Hope, now an 8-year-old with her parents’ genes, is thrilled about the special circumstances of her birth.

A Cautionary Tale

Arrangements for surrogate pregnancies don’t always go smoothly or have happy endings, especially if they are undertaken without psychological screening and legal guidance. Care must be taken to protect both the surrogate and the intended parents and to ensure that the parents’ names — and not the surrogate’s — will appear on the child’s birth certificate.

Melissa B. Brisman, a lawyer in Park Ridge, N.J., whose three children were birthed by surrogates, specializes in such arrangements, helping to secure about 300 surrogates a year for people who cannot conceive or carry a child. The intended parents may provide their own eggs and sperm or those of a donor. In addition to heterosexual couples, her clients include gay male couples, single men and single women.

Surrogate qualifications differ slightly by agency, but Ms. Brisman’s criteria are typical: The carrier must be between the ages of 21 and 44, must be a nonsmoker, must live in the United States and must have given birth to at least one child. She said that laws prohibit acceptance of surrogates from Michigan, New Hampshire, New Jersey, New York, Washington and the District of Columbia.

Ohio, where the Parker-Broderick twins were born, is “a very popular state for gestational carriers,” Ms. Brisman said in an interview. “In Ohio, you can get the commissioning couple on the birth certificate even if a donor egg was used.

“People don’t become gestational carriers as a way of making money,” she continued. “Rather, their motives are altruistic.”

It's related to the issues in selling organs, but with significant differences, as well. And there are reasonable arguments on both sides, as well, I think.

Ultimately, I think, this is yet another in the endless series of issues that simply ultimately come down to where you wish to draw the line, if you do, on where capitalism should or should not be the reigning modality, and if it shouldn't be, are you proposing any active alternatives for the gap left, or not?

For instance, if we decided firmly to make illegal all surrogate motherhood payment arrangements, and all selling of organs, I'm guessing most people don't think laws mandating forced organ donation for criminals, or other classes of people, would be a more moral solution.

Yet while we continue to just try educational campaigns to increase voluntary organ donation from the dead, well as occasional living donations of parts where you can live without your spare, such as one of your kidney, lots of people die on waiting lists.

So it doesn't remain a simple issue, in my view so far, not being a trained philosopher (oh, if only we knew someone who was expert on bioethics who could help us out here).

"I think I would prefer mandatory organ harvesting of the dead before legalizing the sale from the poor."

This gets into violating freedom of religion as guaranteed in the First Amendment, to name one obvious problem.

Taking the pro kidney selling argument to the extreme, if a spare kidney is a valuable commodity, should/could its monetary value be considered an asset in a bankruptcy proceeding?

"a market is an exchange in which a willing buyer and a willing seller mutually agree upon a transaction."

I'd just like to point out that a lot is loaded into the word "willing" here. Suppose A sells B a kidney because otherwise B will shoot him. There's certainly a sense in which A sold his kidney willingly: he decided that he'd rather be down one kidney and up some money rather than dead. This contrasts to a case where B drugs A, cuts out the kidney while A is unconscious, and leaves some money on the table. A loses his kidney and gains the money, but there's no decision on his part.

Of course, most people would object that A hasn't willingly sold his kidney in any *relevant* sense of "willing"--his choice is forced in a way that's unacceptable.

So consider the case where A sells his kidney, not under fear of being shot, but under fear of starvation. Does he sell the kidney willingly, in the relevant sense of "willing"? How we answer this question, I think, depends on our intuitions about whether or not A's choice is unacceptably forced--that is, whether or not A is subject to a pernicious form of coercion.

So, von, I don't think that your definition of a market does as much work as you'd like it to. Instead of arguing over whether or not a particular transaction was coerced, we'll just argue over whether or not it was entered willingly, in the relevant sense of "willing."

I am not sure that the First Amendment applies to dead people.

See, I don't agree at all -- I consider myself a liberal (fan of the welfare state, etc.), but I don't see the idea of markets being by their nature coercive as holding water*; I don't see the Walmart example as exerting force on the poor**; I'm not particularly bothered by people selling kidneys***.

Same support for suicide and surrogacy, FTR.

*von gets it right at 12:35

**Really, inflation aside, there's no reason offering somebody $5000 for a finger forces somebody who could use the money to take it; if the offer doesn't exist, he still needs that money.

***As long as it's the spare.

What about permitting the sale of organs by the executor of a decedent's estate to the benefit of the estate & his or her heirs?

I don't get this comment on any level. Markets are not "coercive by their very definition." By definition, a market is an exchange in which a willing buyer and a willing seller mutually agree upon a transaction. Where is the coercion? That you are not free to steal eggs instead of paying for them?
In fact, all markets have restrictions, which are implied by the very definition of a market that I offered: "a market is an exchange in which a willing buyer and a willing seller mutually agree upon a transaction." You can't have a mutual agreement without rules prohibiting a range of sharp dealings.

von, this is starting to sound very much like a 'no true Scotsman' fallacy. All markets have restrictions, yes, but these are restrictions, rules and boundary conditions which have to be imposed externally either by custom or by government. These boundary conditions (for example: salary caps, minimum wage, collective bargaining, environmental laws) are not intrinsic to markets, they are not implied in the definition of a market, and it would be insanity to pretend that they are.

As it stands, I agree with publius that creating a legal space within which sale of organs is permitted would be a moral monstrosity which would victimise people who are poor, who have little content knowledge and little financial, intellectual or social capital.

The comment posted by: Jacob Davies | July 31, 2009 at 12:39 PM settles it for me.

I think that Jesurgislac has the right of it. The coercive power of a market on the poor is a symptom of . . . well, of the circumstances that cause poverty. As a symptom it's legitimate to look at it when evaluating a narrow policy decision---should we legalize selling kidneys right now, in our current social milieu---but it's not going to be the foundation for a solid and general moral framework. You're allowed to say, "I can see an immediate harm this would cause, because right now, many many people are desperate, and this would exploit them," but I don't think you'll be able to follow that back to a principle re: free markets or kidneys, I think you'll just be able to trace it to some form of due diligence or Hippocratic "don't screw people over in reality while trying to do good in theory." On the other hand, I think Jesurgislac's suggestion that we not commodify elements of bodily integrity probably points towards something reasonably sound. There are other moral issues there, but one big issue is that the model of money, labor, and exchange falls apart when you commodify elements of the people doing the labor, making the exchanges, and holding the money. There's substantial power in wealth to distort the markets in which it works already, and there's already very limited freedom to leave a degenerate/broken market and take your labor/wealth elsewhere, but when you start listing economic actors on the exchange it seems like both those problems become unsolvable.

This gets into violating freedom of religion as guaranteed in the First Amendment, to name one obvious problem.

As jrudkis says above, dead bodies don't have any rights, First Amendment or otherwise, to exercise. And I'd be interested in how the free exercise interpretation would play out in terms of the survivors' interest in disposing of remains in a certain manner.

von, this is starting to sound very much like a 'no true Scotsman' fallacy. All markets have restrictions, yes, but these are restrictions, rules and boundary conditions which have to be imposed externally either by custom or by government.

No, it's not. It is plausible to argue that defining a market by its rules is somewhat circular, because a market presupposes certain rules defining its boundaries. But my points have nothing to do with the "no true Scotsman" fallacy.

Now, if you're saying that we can modify the rules the govern markets: indeed we can. (But that's also not the "no true Scotsman" fallacy.)

I'd just like to point out that a lot is loaded into the word "willing" here.

I'm applying the standard definition, JDKBrown. http://www.google.com/search?q=define%3Awilling&rls=com.microsoft:en-us&ie=UTF-8&oe=UTF-8&startIndex=&startPage=1

Under y'alls thinking, there would be complete market failures at every level for every good. But that doesn't happen.

"I am not sure that the First Amendment applies to dead people."

The handling of dead people is, by law, the provision of the heirs; it's their First Amendment rights that would be at issues, unless someone dies without heirs or will. Similarly, if someone express a desire in a will to be dealth with in a way forbidding organ donation, the law would need to be changed to forbid that, and if the desire was for religious reasons, again the First Amendment would come into play.

"As jrudkis says above, dead bodies don't have any rights, First Amendment or otherwise, to exercise."

Phil, that's just not true: that's what a legal will is. The law requires the fulfilling of legal provisions of a will. Even after you're dead.

IANAL, but this is my understanding. Actual lawyers are welcome and encouraged to correct any misunderstanding I might have.

I think that Jesurgislac has the right of it. The coercive power of a market on the poor is a symptom of . . . well, of the circumstances that cause poverty.

Just for clarity: It is not the coercive power of the market on the poor, but the incentives created by poverty itself.

15 people died yesterday for want of a kidney, 15 more will die today.

I take it you didn't know any of them.

Kidney excision doesn't lower life expectancy and has negligible side effects. How on earth is *anyone* "victimized" by undergoing a procedure with basically no harmful effects?

Explain that to me. Are we somehow doing violence to the psychic integrity of the seller? Is that worth killing 15 people a day?

Are we scared that poor folks will try to sell both of their kidneys? That the lure of quick kidney-cash will outweigh the prospect of certain death for these poor benighted souls?

I think most of your libertarians could meet you halfway: lets keep it illegal to donate *both* kidneys. Satisfied?

This whole argument is an example of normal thought crippled by the Knobe Effect and too much schlocky science-fiction.

I tend to share the concerns expressed above regarding the sale of kidneys (or other organs that can be removed in relative safety to a live donor.) Given the current shortage of kidneys, my sense is that having a market to sell kidneys would be a pretty good thing; a lot of the concerns regarding oppression can be cured by tightly regulating the market and requiring that the exchange go through a health care provider.

I am a little concerned, however, about the slippery slope. Today, a market for kidneys would probably fill a need. But I am very cautious about creating a world in which the poor exist to provide useful body parts to the rich.

"Just for clarity: It is not the coercive power of the market on the poor, but the incentives created by poverty itself."

Which is why I believe it's the moral duty of a rich society to provide a negative income tax, to prevent the existence of poverty beneath a certain minimal level.

Which, as I've pointed out many times, makes me as socialist as Milton Friedman.

"Is that worth killing 15 people a day?"

There's actually a distinction between letting people die for lack of a positive act, and killing people via a positive act.

"...and too much schlocky science-fiction."

Who ya calling schlocky?

Knobe Effect: this explanation is not a model of clarity as to its conclusions.

[...] 'This asymmetry in responses between the ‘harm’ and ‘help’ scenarios, now known as the Knobe effect, provides a direct challenge to the idea of a one-way flow of judgements from the factual or non-moral domain to the moral sphere. ‘These data show that the process is actually much more complex,’ argues Knobe. Instead, the moral character of an action’s consequences also seems to influence how non-moral aspects of the action – in this case, whether someone did something intentionally or not – are judged.
And therefore....?

This argues that the issues are "complex" -- no disagreement there -- and that "consequences... influence... how... action[s]... are judged."

Which isn't anything I disagree with, but doesn't seem to provide much of a helpful answer to any questions.

Perhaps you have a pointer to a better explanation of what you have in mind than simply dropping the name?

Gary,

Those are legislatively created standards: it is not Constitutionally driven. I can see the argument that disposing of a loved ones remains has a religious component, but I am not sure that your wish to dispose of someone else's body in the way you regard appropriate is unfettered: there are not a lot of people sending bodies down rivers or funeral pyres happening in the US any more, while I suspect some would like to do that (a big bon fire with a keg party when I go might be a good sendoff).

Plus, it might be a good way to help finance healthcare: if you are getting government insurance, the government gets a lien on your organs for when you pass away.

It would be interesting to see a bankruptcy judge list a kidney and cornea as assets to be distributed.

Seems to be an implausible slippery slope, no? The law allows us to sell our gametes to fertility clinics, but I don't think that any bankruptcy judge has yet been tempted to list eggs/sperm as assets to be distributed.

In fact, the legislative tendency seems to point the other way: perfectly ordinary assets like primary homes are often protected during bankruptcy proceedings. I have few worries that a kidney would become a seizable asset, or that options/futures markets in kidneys would spring up -- I'd hope that fairly straightforward regulations could prevent this parade of horribles...

"Kidney excision doesn't lower life expectancy and has negligible side effects."

Until or unless you develop a problem with your back-up kidney. Which certainly isn't unheard of.

Mind, I'm all for voluntary organ donation after death: I'd urge every human being on the planet to sign up for it, and I think people should be free to decide to make voluntary organ donations while living.

von: "But I am very cautious about creating a world in which the poor exist to provide useful body parts to the rich."

You mean like this?

Radley Balko contributes.

"Seems to be an implausible slippery slope, no? "

Sure. But without slippery slopes, what would we have to talk about?

Does the law allow any other "irreversible" sales?

-Slavery... no
-Allodial title... not anymore
-Paying someone to be sterilized... maybe?

I really can't think of any that are definitely allowed.

"I can see the argument that disposing of a loved ones remains has a religious component, but I am not sure that your wish to dispose of someone else's body in the way you regard appropriate is unfettered: there are not a lot of people sending bodies down rivers or funeral pyres happening in the US any more, while I suspect some would like to do that (a big bon fire with a keg party when I go might be a good sendoff)."

Jewish and Muslim law have mandates on how bodies must be disposed of; both, within Orthodox or strict interpretation, forbid autopsies under most circumstances, for instance. A Jewish take. A Muslim take.

Neither absolutely forbids autopsy, but requires a very good reason.

Summary of one Jewish view:

[...] Obviously, if postmortem needle biopsies or blood samples or peritoneoscopy would suffice, autopsies should not be performed at all.

However, when an autopsy is necessary, permission to undertake this procedure should be given only if the operation is reduced to a minimum, performed as soon as possible--and in the presence of a rabbi or observant and halakhically knowledgeable physician--and undertaken with reverence. There must be absolute assurance that all parts of the body will be retained for burial.

Because, however, the frequency of autopsies has increased, the danger exists of their becoming mere routine; and because recent studies (particularly the Journal of the American Medical Associa­tion, vol.233, 1975, pp. 441-443) have shown the questionable medical value of routine performance of postmortem dissections, permission should be withheld unless a physician who is sensitive to the halakhah [Jewish law] advises its performance in terms of the criteria for saving life which have been listed above.

Naturally, in the U.S., the actual law controls, not religious laws. But religious preferences are relevant, and would become more so the more there would be a movement towards mandatory organ donation even in death.

IANAL, but as I understand it, the law needs a specific reason to violate a will, or religious preference, as to how a body should be treated after death, as in an autopsy or exhumation. IANAL, but I would think organ donation after death falls into the same category.

That's all I'm saying.

Personally, I'd like to have a loved one with a large freezer they could store me in, both to preserve me for the ever-so-fleeting chance of eventual revival, but mostly so they can remember me every time they get a popsicle or tv dinner, and thus pay their respects.

Failing that, a nice pyramid has been known to last, aside from the looting problem.

And ashes being shot into space has a certain appeal for me.

The latter after all my organs suitable for donation have been removed; I hereby state that if there's any doubt about it, I want all my organs available for donation after my death, even though I realize this is not a witnessed, legally binding, statement. But I'm making it here in case it's ever helpful. This has been my lifelong believe, and I have no reason to believe I will ever seriously change this completely serious lifelong preference, which is emphatic.

For the record.

A little research suggests that commonly burial instructions in the U.S. are done in a separate legal instrument than a will, and that every state has its own law on the matter.

Hmmm... it's true. Basically everything of interest DOES have to do with slippery slopes:

slippery slope

My will currently has my body donated to the army for explosives testing. Presumably it is useful to test real bodies using armor to see if it works.

Exactly, Gary. Maybe we've already crossed that bridge, so the appropriate question is whether we deal with it with regulation or leave it to the black market.

Does the law allow any other "irreversible" sales?

Absolutely. Many sales are irreversible (or become irreversible) after a period of time. We also allow sales of goods and services that permanently alter or change the body (e.g., plastic surgery; lasik).

Publius: "I’ve basically said 'there should be a line,' but I haven’t established whether kidney selling crosses that line. Maybe someone else can."

Some of your links make interesting points. One:

[...] States could offer [...] funeral benefits to families of posthumous donors. Donors could also be offered a tax credit or perhaps a very generous contribution to a charity of their choice.

The rewards could come from state governments or approved charities, not from individuals, and the organs would be distributed according to formulas already in place. That means organs will not be available only to the wealthy.

Also, specifically addressing the arguments made here, rather than offering a vague I-don't-know would perhaps be an interesting contribution to the discussion.

"Basically everything of interest DOES have to do with slippery slopes"

Conclusion: everyone should take up recreational skiing as an aid to logical thinking.

Wait, maybe I need more skiing to reconsider the logic there.

Re: Selling children.

Children are not things you own and can therefor sell. They are people you have (temporary) custody of.

While you are living, your body parts are not things you or anyone else owns and can therefor sell. I don't own my head or my heart. I am a wholeness that consists of my head, heart, various body parts, a spirit (if you believe in that sort of thing), etc.

The very reasonable exception to all this is donation. I think it's OK to donate a spare kidney to a family member, friend, or total stranger. By my reasoning above, it's not mine to donate. But I still think I or anyone else should have the right to do it.

It's odd. I was under the impression that a woman's right to choose was based on her having control over her own body. If publis believes this, why doesn't it extend to her kidneys as well?

It’s that I can easily imagine this logic spreading to things like eyes, or even children.

Emphasis mine. Seriously, you make the jump from letting consenting adults do something to selling parts of children? This is right up there with: If we let homosexuals get married then whats next? People marrying toasters?

I believe there was some discussion in the past (in the US), whether the organs of convicts (for life or executed) could be taken by the state after death independent of the will of the convict or his family. Does anybody here know what became of it?
---
Somebody further up the thread hinted at it, could an organ be mortgaged, if a sale was legal?
And then there is that Merchant of Venice precedent ;-)

It really comes down to this question - should everything be for sale? You used one's own body parts? How about children?

Do we have any way to estimate-- just for kicks-- what a kidney would go for on the open market, if there were such a thing?

My gut leads me in the same direction as Publius, but that's when I envision someone selling a kidney to make a few rent payments, soon to slide back into debt same as before. It comes out different if the image is "selling a kidney so that you can buy a house in cash".

"While you are living, your body parts are not things you or anyone else owns and can therefor sell."

In the U.S., you are legally allowed to sell your blood plasma, your sperm, your eggs, and your hair.

The question of what else of your body you should or should not be allwed to sell is the question under debate.

"By my reasoning above, it's not mine to donate. But I still think I or anyone else should have the right to do it."

You seem to be contradicting yourself here.

"It really comes down to this question - should everything be for sale?"

No, it doesn't. That's the slippery slope argument: not what "it really comes down to" unless you believe everything ultimately must reach the bottom of all slippery slopes, which is fallacious reasoning.

"I believe there was some discussion in the past (in the US), whether the organs of convicts (for life or executed) could be taken by the state after death independent of the will of the convict or his family"

China does it.

I don't believe it's legal in the U.S. at present, but IANAL, and could be wrong. Again, it's the point of those Larry Niven stories, and making a slippery slope argument there that it would lead to increasing the use of the death penalty.

"Do we have any way to estimate-- just for kicks-- what a kidney would go for on the open market, if there were such a thing?"

Levy Izhak Rosenbaum
:

[...] Rosembaum is accused of brokering the sale of kidneys. He is alleged to buying the organs from Israelis for $10,000 and selling them to patients in the United States for $160,000.
But that's on the black market; obviously in an open market prices would drop dramatically. To what extent, who can say?

Indian kidneys would likely go for lower prices than U.S. kidneys until incomes reached greater equivalency, for example.

On a related matter:

What do you think of http://www.youtube.com/watch?v=vJkpDNwM0lk
">this idea?

http://www.youtube.com/watch?v=vJkpDNwM0lk

I know that many people are afraid to carry an organ donor card because they fear that people in the hospital could be tempted to accelerate their demise in order to make their organs available. Since there have been convictions on exactly that* these suspicions are at least not totally unfounded.

*and reports of medical personnel pressuring terminally ill patients to give up for the same reason.

But that's on the black market; obviously in an open market prices would drop dramatically. To what extent, who can say?

I suspect that you're right, but that the relative price paid to donors would increase. The broker in any black market always takes a substantial cut, which can't be sustained once the market becomes legal. (See, e.g., booze during and after prohibition.) That's the irony of the situation: prices fall, but that doesn't necessarily mean that the monies earned by "producers" falls by as much (or at all ... indeed, in this case, it may increase).

I agree that the selling-children argument is silly. I also think the case against kidney sales can be made quite well without it.

The great potential for abuse in the selling of spare kidneys by the living would require what I think would be an onerous anti-abuse regime, making it a choice between the morally repugnant and the impractical. And I would advocate attempts to shut down the black market over supplanting it with a legal one.

"I'm applying the standard definition, JDKBrown...."

This isn't really responsive, since the standard definition leaves room for argument over cases. The concept of "willing"--along with the concept of "coercion"--is an "open texture" concept: it has vague and shifty boundaries, it comes in degrees, and whether or not it applies in a given instance can be (i) indeterminate and (ii) subject to a sort of conversational negotiation.

You'll notice, further, that one of the definitions given in your link is something along the lines of "free from coercion." This, I think, bolsters my case that the argument over coercion that you're trying to short-circuit is simply going to be recapitulated over willingness.

That said, I'm largely in agreement with you that it's unhelpful to talk about all markets involving coercion--though I also think it's equally unhelpful to talk about markets involving willing exchanges--since what's really at issue is the extent to which participants' options are *unacceptably* limited. And I also agree that it's much more useful to frame this discussion in terms of distorting influences on incentives than in terms of the nature of markets themselves.

Really, what the arguments over whether or not market participants are coerced or willing come down to is which influences on incentives we find acceptable.

"Under y'alls thinking, there would be complete market failures at every level for every good. But that doesn't happen."

I hope this wasn't aimed at me, since nothing I said implies anything about market failures.

Adam Smith's markets are premised upon assumptions that do not, and maybe cannot, exist in the world.\
Market apologists preach from these assumptions, but in the end markets only tend toward efficiency, and are always subject to human manipulation./
Retrospective analysis will show that markets more closely follow Darwin's, not Smith's, model./

"What do you think of this idea?"

You broke your link there by putting a spot of HTML tag there. You want to go here.

"What do you think of this idea?"

In answer, I thought I'd already responded on this point about three times already.

"I agree that the selling-children argument is silly."

On the other hand, we already have what's close to a selling babies situation in the U.S.

Technically, selling a newborn is illegal. However, making a contract to pay an expectant mother a lot of money to "compensate for her time and trouble," and you wind up getting first rights to adopt the newborn -- though the mother has the right to break the contract, and repay the money, and counter-suits can then be launched or not if she doesn't repay -- is already done a lot. For the record.

I think that the distaste towards selling body parts is not logical, it is visceral and emotional. So I think its hard to come up with an argument supporting a ban on kidney selling for basically the same reasons that its hard to come up with an argument banning prostitution or marijuana or gay marriage, etc.

I mean, poor people are also more likely to sign up to go into the military (i believe, I don't know for sure) and end up being killed in Iraq, but we tolerate that injustice in the name of our self defense. I think that gettings kidneys to people who need them to survive is an equally compelling justification to tolerate inequal pressure in the market.

I think that allowing people to die due to a lack of access to kidneys, just to satisfy some emotional attachment to the sacredness of body parts, is silly and cruel.

Extreme market situations can show the absurdity of untrammelled "freedom". How 'bout this one: Selling tickets to a contractually arranged and agreed to (by both and/or more participants) murder?

Also: The claim that markets efficiently allocate resources is simply incorrect.

I've actually made arrangements for a medical school to have rights to my body after I'm done with it, assuming that my organs won't be good for much by that point.

Wondering how Israeli medical schools deal with the conflict between the need for dissection and traditional halachic requirements, I found this article. Basically, the Isaelis have dealt with the conflict by *confronting* it, not (just) in the courts but in the dissection room.

It's not enough that there are rules -- we treat the human body with reverence, but doctors have to have direct physical knowledge of what's inside -- but medical students, rabbis, and teachers have to think about and discuss the rules and what they mean, in every cohort. It's a very Talmudic style of learning.

Dr. Science, that link is broken; you want to go here.

It's a useful idea for people to test their links when they preview.

von, this is starting to sound very much like a 'no true Scotsman' fallacy. All markets have restrictions, yes, but these are restrictions, rules and boundary conditions which have to be imposed externally either by custom or by government. These boundary conditions (for example: salary caps, minimum wage, collective bargaining, environmental laws) are not intrinsic to markets, they are not implied in the definition of a market, and it would be insanity to pretend that they are.

The problem isn't with von's understanding of markets, it is that you have expanded the definition of coercion to include pretty much any human interaction which has influences. And if everything is coercive, the word isn't very useful anymore. I'm very serious about the suggestion that family relations--especially once you look beyond the US and Europe, tend to be much more coercive than markets if we start taking such a broad view of 'coercion'.

"The problem isn't with von's understanding of markets, it is that you have expanded the definition of coercion to include pretty much any human interaction which has influences."

No, it's in between those two extremes: I won't speak for anyone else, but I'd say it's closer to coercion when there's an extreme differential of power between the two parties, such that one party is put in the position of suffering significant harm by exercising their option to agree to whatever is put forward. Something like that, anyway.

That's a lot stronger than any mere "influence," but not as exclusive as directly putting a gun to someone's head.

An example would be the options offered to people in company towns. They were free to live, if they thought that somehow they could find another way to survive, but that was a highly dangerous and uncertain option. Similarly, signing yourself into indentured servitude was often "voluntary," but people often did it because they felt they had little choice.

And so on.

I think there's a middle ground to not exclude between direct threats of violence, or the equivalent, and "everything is coercive," that is necessary to acknowledge for discussion of possible human arrangments with each other, and their morality, to be useful.

"They were free to live, if they thought that somehow they could find another way to survive, but that was a highly dangerous and uncertain option."

Should be: "They were free to live elsewhere, if they thought that somehow they could find another way to survive, but that was a highly dangerous and uncertain option."

And this is a better example of what can be a bad result of, in the past, "freely choosing" to live in a company town, than the anodyne entry I linked to above.

Sebastian: I'm very serious about the suggestion that family relations--especially once you look beyond the US and Europe, tend to be much more coercive than markets if we start taking such a broad view of 'coercion'.

Family relationships are necessarily coercive where some family members are completely economically dependent on others. It's not "US and Europe" - it's economic coercion even there. Survival, in some instances: if a person has the choice of being supported by their family or dying of poverty, that's the same lack of choice as we're discussing with selling kidneys, half a liver, the use of a uterus, etc.

I signed up with the National Bone Marrow Registry when a relative of a friend of a friend needed a donor and my friend organized locally for people to get tested. Even though I'm findamentally cowardly and lazy, I felt that letting someone jab me for testing and thereby potentially later receiving moral pressure to agree to having a really big ugly needle stuck into my thigh bone were a pretty small price to pay for saving the life of a stranger.

So far, about a decade later, if I ever came up as a match the Registry didn't bother to contact me; I know they still have good contact information, because they check occasionally (and ask for money to pay for the cost of typing people who sign up to the registry, because other wise they have to charge the potential marrow donors).

Thing is, I don't know whether I'd have signed up for a National Kidney Registry. The procedure is a lot more scary, and the backup kidney does not grow back (unlike the marrow). The costs of donating a kidney are just much greater. And it was a long time ago, but I don't remember anything about signing up to possibly donate marrow putting me on a registry for possible kidney donors, and I don't see anything of the sort at the Registry's FAQ. People are just scared of donating kidneys, and as far as I can tell even the bone marrow donation registry doesn't want to scare people with the notion that they'll be contacted with a request that they undergo surgery and lose a kidney to save someone's life. This should tell you something about the system we have now in the absence of other incentives.

Also, with America's cockamamie health insurance system, I don't even know whether it's safe to donate a kidney, because of the whole "pre-existing condition" issue.

One idea I heard of, in a recent Bloggingheads with Mark Kleiman and Virginia Postrel, was that Israel examined the issue of kidney donation and realized that, in the context of a national healthcare system, the state saves a lot of money compared to dialysis, and it makes sense to give some of that money to the donor to defray their hassle. That notion, were an individual wealthy recipient gains no advantage, appeals to me - so long as donors must also be full citizens eligible for state-funded medical care, rather than migrants transiently appearing to sell their kidney.

Gary, " won't speak for anyone else, but I'd say it's closer to coercion when there's an extreme differential of power between the two parties, such that one party is put in the position of suffering significant harm by exercising their option to agree to whatever is put forward."

Yes, but I'm arguing against the contention (as raised in this thread) that "Occurs to me that all markets are coersive by their very definition".

I'm not arguing that it is impossible for any market anywhere to be coercive. I'm arguing against the idea that markets are by nature coercive. They aren't. They are much less coercive "by nature" than most human institutions. Can they be used in a coercive fashion? Sure. But are they definitionally coercive? No. And they are less definitionally coercive than governments, families, and most religious structures.

Jes, "Family relationships are necessarily coercive where some family members are completely economically dependent on others. It's not "US and Europe" - it's economic coercion even there."

I agree completely. But I don't agree if you are saying that they are only coercive when economic dependence is at stake. If we are opening it up to a level where all economic market transactions are coercive by their very definition, most family interactions are coercive at least that much if not more so.

"Survival, in some instances: if a person has the choice of being supported by their family or dying of poverty, that's the same lack of choice as we're discussing with selling kidneys, half a liver, the use of a uterus, etc."

Well for at least selling kidneys in the US or UK, there are very few people (if any) where the literal choice would be between selling a kidney and DYING of poverty.

Laws against selling organs largely come out of the same spirit that adoptions are highly regulated. No ethical system can capture the totality of the market, and most laws liberalizing kidney sales will see it being used to expand aquisition techniques or launder illegal adoption through a part of the system.

Global grain markets have killed over 100million people over the last couple of centuries via the famines caused. The immorality of a similar and more intimate dynamic is a bit more immediate and gruesome than we're willing to buy grain at a price higher than starving people can pay.

What societal or individual good are we talking about here?

Is the issue making organs available for those who need them, or creating a market for organs that anyone can participate in?

I have a visceral response to the latter possibility, predicated exactly on the potential for coercive interactions. Not only the potential coercive interactions already mentioned here, but an added one: advertising.

Imagine what happens to the poor and the working poor once organ-procurement companies start advertising. "Pay off your debt!" "Put your children through school!" Advertising would normalize the concept of selling off one's body parts, until people who don't want any part of the idea would be considered the weird ones (just as people who don't want cell phones/Blackberrys because they don't *want* to be available to everyone all the time are considered weird).

We do have a history of seeing what happens when previously non-commodified things become commodified, and it is never a positive thing. Ever.

Here's another issue: The organ-selling moral dilemma would become moot if we could grow our own replacement organs from our own stem cells. Growing our own replacement organs from our own stem cells also obviates a lot of ancillary problems, such as rejection issues, and the need to avoid rejection by, essentially, gutting one's own immune system.

I don't know if growing our own replacement parts from our own stem cells is possible, but I do know that refusing to allow or fund stem cell research will keep us from ever finding out if it is possible.

It would be a moral travesty, an absolute moral travesty, for us to allow an open market in organ selling while oh-so-fastidiously refusing to even try to develop a technology for growing cloned organs.

"I'm not arguing that it is impossible for any market anywhere to be coercive. I'm arguing against the idea that markets are by nature coercive. They aren't. They are much less coercive 'by nature' than most human institutions. Can they be used in a coercive fashion? Sure. But are they definitionally coercive? No. And they are less definitionally coercive than governments, families, and most religious structures."

Okay, I don't disagree with any of that.

"Is the issue making organs available for those who need them, or creating a market for organs that anyone can participate in?"

Much more the former than the latter, in my thinking, anyway.

"Here's another issue: The organ-selling moral dilemma would become moot if we could grow our own replacement organs from our own stem cells."

I was going to point out that I brought this up long ago in this thread, but that post no longer appears to be there. Apparently it was eaten by Typepad while I wasn't looking. Sigh.

Anyway, my basic point is that technoqlogy in another twenty years or so, maybe a bit sooner, maybe a bit later, will make this an obsolete question.

I seem to recall addressing other issues in the same comment.

"If only we had a real philosopher who blogged here…"


Hilzoy, we miss you!!!

Sebastian: Well for at least selling kidneys in the US or UK, there are very few people (if any) where the literal choice would be between selling a kidney and DYING of poverty.

At least 18 000 people a year die of poverty in the US - I mean the uninsured, of course: poverty is peculiarly lethal in a country where access to health is rationed by money. More, probably, if we count those who die of hunger, though I suspect that American households where people go without enough food are more likely also to be households whether they do without health insurance.

You think, if it was legal for a parent to sell a kidney, that some children wouldn't end up growing up with only one kidney? You think, even if a person was only allowed to sell their own kidney, that some people wouldn't end up selling a kidney because it was that or death - if not for them, for someone they cared for enough to run the risk of living with just one kidney?

Though you evidently prefer to dismiss sight unseen the people who die of poverty in the US, they still exist: they die below your field of vision, Sebastian, but they still die. They'll die a little faster if they're allowed to sell a kidney or half a liver: and you will still never notice them. Too poor for you to see them.

Jes, could you please try to have an argument in which you do not denounce the inhumanity of your interlocutor?

Do you think Sebastian wasn't appearing intentionally inhuman? That for all his vaunted interest in healthcare, he really didn't know that people die for lack of it?

From an opportunity cost perspective, Wal-Mart’s offer exerts more force on someone with a salary of $25,000, than it does on someone who makes $100,000. The former is essentially throwing away 20% of their yearly salary, while the latter is throwing away 5%. Both individuals are “free” – but the lower income makes the offer harder to refuse for the $25K person. It exerts more force on that person.

That is an odd use of the word, force. The willingness of a seller to pay a specified price is quite a different thing from the application of physical power, strength or compulsion. Even in the context of opportunity cost, a missed opportunity hardly constitutes "force".

Some commenters have suggested that a pregnant woman can be "forced" to carry the pregnancy to term. I suppose that that is hypothetically possible, in the sense of a husband, partner or parent telling the woman that if she aborts, he will kill or maim her in retaliation.

The more common use of the phrase "forced pregnancy", however, is to suggest that criminalizing abortion will result in forcing pregnant women to carry to term. To the contrary, the unimpeded development of the embryo/fetus to term occurs naturally as a result of the absence of force.

"They'll die a little faster if they're allowed to sell a kidney or half a liver: and you will still never notice them. Too poor for you to see them."
The poor on the organ transplant lists are going to die a lot faster if they don't get the organs they need.

John: The more common use of the phrase "forced pregnancy", however, is to suggest that criminalizing abortion will result in forcing pregnant women to carry to term.

In point of fact, criminalizing abortion merely results - statistically - in about the same number of abortions taking place, legally or illegally, plus an increased maternal mortality and morbidity rate, reflecting the legal requirement on doctors to refrain from advising women that continued pregnancy will threaten their health or their life, plus the increased incidence of unsafe illagel abortions.

It would therefore probably be more accurate to refer to the people who advocate criminalizing abortion as people who attempt forced pregnancy, since that's the goal they claim: and even if, as a general trend they never achieve it, in particular cases, making abortion illegal probably does result in some success for the forced pregnancy movement.

To the contrary, the unimpeded development of the embryo/fetus to term occurs naturally as a result of the absence of force.

No: it occurs naturally - presuming no miscarriage - if a woman decides not to terminate. Unimpeded development of an embryo/fetus does not occur in a random vaccum of golden light: a woman is required, and unless you believe in slavery, that woman must get to decide for herself if that's what she wants to do.

The phrases, "forced pregnancy" and "forced pregnancy movement" never cease to puzzle me. For what it's worth, I support abortion rights prior to fetal viability. A pregnant woman, and no one else, should be the one to decide whether she carries her not-yet-viable fetus to term. I also support using language accurately.

With the exception of a rapist, I know of no one who favors "forcing pregnancy" upon any woman. Pregnancy, however, does sometimes occur from unforced sex. That natural process is not a forced pregnancy; it is a pregnancy. The zygote/embryo/fetus develops to term (inside the woman, for the pedantic among us) in the absence of a naturally occurring miscarriage or spontaneous abortion. Should the mother choose a surgical abortion, that procedure forcibly terminates the pregnancy.

For some reason which I don't understand, many abortion rights advocates seem squeamish about calling the procedure by its name. Let's leave both the euphemisms and the pejoratives to the Orwellians on the other side of the debate. Abortion is what it is, and it should not be the fundamental constitutional right that dare not speak its name.

John, don't be euphemistic. If a woman has made the decision to terminate her pregnancy, and some outside force prevents her, from that point on it's a forced pregnancy.

Your notion that it's OK to force a woman to die or be permanently damaged/disabled because the fetus she is carrying could, in theory, survive if she terminated her pregnancy by live delivery, is just... well: dismissive of women as human beings. Women retain the right to care for their own bodies even when they are carrying a fetus older than 24 weeks. Doctor George Tiller was murdered by people who agreed with you that women ought not to be allowed to make decisions like that in the third trimester...

For reasons which I understand perfectlt, many forced pregnancy advocates are squeamish about calling what they advocate for by its name: they're against safe legal abortion, and therefore for forced pregnancy.

John in Nashville: "To the contrary, the unimpeded development of the embryo/fetus to term occurs naturally as a result of the absence of force."

Like in rape? Oh, wait. You figured that one out. How about forced marriages? Arranged marriages? Restrictions on birth control? Polygamy? Restrictions on sex education? Basically, anti-aborters of all stripes desire to use the state's monopoly of force to achieve a desired social end--pregnancy to term.

Hence the term.

"Do you think Sebastian wasn't appearing intentionally inhuman? That for all his vaunted interest in healthcare, he really didn't know that people die for lack of it."

Fascinating that you take this tact when you are advocating a position that by your logic means that you DESIRE that those who can't get kidneys will die by the thousands. Why do you hate people with kidney disease, Jes?

Jesurgislac, I did not express an opinion about post-viability abortions. I am accordingly puzzled by the non sequitur whereby you attribute such views to me as you surmise.

Had you asked, I would have acknowledged that there are extraordinary circumstances under which I would support--on a choice among bad alternative outcomes theory--the right of a pregnant woman to abort a viable fetus. I recognize, however, that it is easer to posit a straw man than to ask.

Easier, but nonetheless pathetic.

I read a very interesting book in college 30+ years ago called "The Gift Relationship." (Sorry, don't remember the author.) It was about the purchasing of blood by blood banks, which was a common practice back then. Predictably, most of the sellers were poor people, often hardcore alcoholics looking for quick money for a bottle. The book was an eloquent argument against the practice, which was curtailed, thankfully before the AIDS epidemic (easy to imagine the havoc that could have happened there). I think the same arguments apply even more strongly to selling organs.

While we are at donating bodies to science ;-)
http://www.youtube.com/watch?v=pnvZpi3nbsc
http://www.youtube.com/watch?v=pnvZpi3nbsc>medical love song.

Romania under Ceaucescu came close to 'forced pregnancy' policies iirc. And a lot of (usually right-wing) thinkers especially in the late 19th and early 20th century proposed such schemes (usually in combination with abortion/sterilization programs for the 'undesired'). The Nazis did not invent the concept and actually did not even come near the more radical ones.

We should probably be happy that organ transplants were not yet really feasible at the time or the Holocaust could have turned into operation harvest (although there were racial theoreticians, Hitler among them, that thought that 'Jewishness' could be transmitted via body fluids and tissue like an infectious disease).

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