Biotechnology and Culture: Bodies, Anxieties, Ethics

By Paul E. Brodwin | Go to book overview

Chapter 10
The Ethics of the Organ Market
Lloyd R. Cohen and the Free Marketeers

DONALD JORALEMON

The U.S. Department of Health and Human Services’ Division of Transplantation (DOT) organized its 1996 annual meeting around the theme Toward the Year 2000: Concepts and Considerations in the Consent Process (Washington, D.C., 21–23 March). The goal of the conference was an exploration of the psychosocial and socioeconomic factors influencing whether people agree to donate their own or loved ones’ organs. The meeting was motivated by the frustration of the transplantation profession over a growing gap between organ supply and demand.1

Citing the “tragedy of lives lost due to organ scarcity,” conference speakers declared that it was time to “push the limits” of current procurement practices for “the good of the cause.” Physician Michael Rohr, director of transplantation services at Bowman Gray School of Medicine at Wake Forest University, related the challenge faced by the profession of transplantation medicine to the space program and urged a new “science of donation” aimed at a better understanding of the process of donation requests. Rohr also advised his audience to reconsider the ethical objections and “legal impediments” that have stood as obstacles to two alternative approaches to organ procurement: taking organs unless the deceased had registered an objection (that is, presumed consent) and offering financial incentives for permission to take organs.

Rohr’s plenary address set the stage for a smaller afternoon session on the topic of alternatives to procurement. Among the speakers was Lloyd R. Cohen, a jurist and professor of economics at George Mason University. Cohen has long been an outspoken advocate of market forces as the solution to the present organ shortage. He summarized the argument of his recent book, Increasing the Supply of Transplant Organs: The Virtues of an Options Market, which favors a “futures market” in which a per-organ fee of $5,000 would be paid to the estate of those who agree to sign contracts for the removal of their organs, should they die in a fashion that permits transplantation.2

After defending his proposal and urging that it be given a “fair test,”3 Cohen responded to questions from the audience. An elderly, white-haired

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