
Donors of bone marrow can now be paid - jphackworth
http://www.reuters.com/article/2011/12/02/us-donors-bone-marrow-idUSTRE7B11FR20111202
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jlcx
If people own their organs, then why can't they sell them? In any case, this
seems to be a step in the right direction.

~~~
mynameishere
[http://www.bloomberg.com/news/2011-11-01/organ-gangs-
force-p...](http://www.bloomberg.com/news/2011-11-01/organ-gangs-force-poor-
to-sell-kidneys-for-desperate-israelis.html)

~~~
staunch
And in some countries people are constantly being kidnapped and held for
ransom. We don't have that problem in the US and we probably wouldn't have a
big organ gang problem either.

~~~
sidww2
The difference is that currently the amount a kidnapper could extract from an
average person is not very high. If selling organs is allowed, suddenly the
body of every person walking in the street is a worth a lot of money. It will
drastically increase the probability of getting kidnapped for one's organs.

~~~
maxharris
But the whole purpose of having a government at all is to prevent people from
murdering, defrauding, kidnapping (all of which involve force initiated
against another).

Some might say that if someone buys an expensive life insurance policy, the
probability that they will be murdered by the next of kin goes up. Or that if
you buy a nice car, the probability that it will be stolen goes up. But that
doesn't mean that anyone should be prevented from buying a nice car or a life
insurance policy.

Issues of rights and justice need to be handled on an objective basis, and
that requires an impartial arbiter to protect the rights of its citizen
masters. That ideal arbiter and protector of rights (to life, liberty, and
property) is the ideal government. Given the existence of even an imperfect
government such as our own, the right solution to kidnapping is twofold:
first, encourage the government do its job, which is to provide the conditions
necessary to live your life without worrying about others initiating force
against you; second, live your life as you see fit, without violating the
rights of any other (because to do so would go deeply against your long-term
self-interest - in the long run, lying/stealing/cheating/kidnapping etc. are
all forms of cutting your own throat).

~~~
sidww2
That is the purpose of the government but you do agree that certain policies
can make accomplishing that purpose much much harder, maybe even impossible?

A nice car is not a good analogy since 1) buying one is a matter of choice and
2) kidnapping someone for a nice car is not likely to get someone seriously
injured or killed (as long as one agrees to the kidnapper's demands) whereas
kidnapping for organ donation is completely different.

~~~
maxharris
You know, you only live so long. It's not as if you have an indefinite amount
of time and money over the course of your life.

If you work for years and save to buy that nice car, and someone steals it
from you, someone has taken part of your life away. Even if the blow is
distributed across a lot of people via an insurance policy, this is still
true.

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jphackworth
This is interesting timing because of the Amit Gupta social media attempt to
get a donor. Now, Amit is allowed to offer money for the bone marrow.

~~~
avree
It's too late now, unfortunately.

<http://amitguptaneedsyou.com/>

~~~
MichaelApproved
What was the clock counting down to?

~~~
gujk
Artificial deadline to instill a sense of urgency leveraged by the call to
action.

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ck2
There is a massive profit made along the chain from selling donated blood in
the USA to hospitals and patients - we're talking billion of dollars (the Red
Cross is very guilty, so is Baxter and other corporations).

The plasma payment model works just fine, I say try it for other things that
are renewable.

~~~
carbocation
In a recent thread I argued that renewable is not a sufficient criterion (and
perhaps not necessary, either). Risk to the donor is much more important.
Money in medicine is coercive, but if you are coercing someone into doing
something nearly never harmful (blood or sperm donation), it's not a problem.
If you're coercing them into doing something with high risk, even if the
tissue is renewable, then I believe we have a problem (liver donation).

Modern marrow collection techniques generally put the donor at low risk, and
marrow is renewable, so it appears to be a clear win.

~~~
daeken
Risk matters, but the only impact is has on anything is on price. If something
has a 0.1% chance of killing me, I'll expect far, far less money for it than
something with a 5% chance of killing me. I might still do it, but the payoff
has to be proportional to the risk I'm taking. I ride in cars knowing that I'm
taking a risk, but I do it because I want the value that riding in a car gives
me.

~~~
carbocation
In the abstract, I agree. One could create a utility function expressing the
necessary compensation (for them) in exchange for taking on a certain amount
of risk. In the concrete, I'm not so comfortable with this on a population
scale. People in general are not good at understanding risk, and they are not
good at understanding medicine.

Procedure X has a 10% chance of killing you, a 1% chance of leading to
necrotizing fasciitis that will not kill you but will require an amputation, a
3% chance of disfiguring scarring, a 4% chance of in-procedure myocardial
infarction that will leave you alive but in heart failure ... etc. If we even
had an exhaustive list of the actual risks of the actual procedures in the
hands of the actual surgeon doing the procedure (we don't), it would still be
impractical to get any particular person to understand the whole array of
risks that they face, not just mortal risk.

We would need a much better way of measuring 'understanding' than I believe we
have right now for me to get onboard with compensation for extremely high risk
procedures for donation. And that's assuming a coldly rational populace.

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mhb
Decision:
[http://www.ij.org/images/pdf_folder/economic_liberty/NOTA/no...](http://www.ij.org/images/pdf_folder/economic_liberty/NOTA/no.).

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gkoberger
I probably just don't fully understand the situation, however this seems bad.
I'm usually for capitalism and the concept of supply and demand, but not in
this case.

What's my marrow worth to me? Probably not much; a bit of time and discomfort
but overall not a huge deal. However, for the buyer, it's the matter of life
or death. Seems like it would be easy to extort someone who _needs_ it.

This is one of the rare cases where I hope the market is very heavily
regulated -- say, "Bone marrow is worth $1k. It's illegal to ask for more."

~~~
pg_bot
Having price ceilings would cause shortages in supply which would possibly
lead to more deaths than cost increases. By meddling in the marketplace you
are bound to create a lot of unintended consequences that will be detrimental
to patients.

~~~
gujk
Death is not the only measure of quality of life. ER docs are not empowered to
negotiate fees with their patients in the moments before service either.

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skylan_q
Oh no! Now there will be bone marrow thieves! </sarcasm>

