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Comment by rorrr | Hacker News Reader

Why doesn't he simply offer money? If I needed to survive, I'd offer something like all my savings, plus 50% of my net salary for 10 years.

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Because that is illegal. In the US, there is the National Organ Transplant Act which forbids paying for organs. In this law, bone marrow is considered an organ.

> It shall be unlawful for any person to knowingly acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation if the transfer affects interstate commerce.

> [...]

> The term ''human organ'' means the human (including fetal) kidney, liver, heart, lung, pancreas, bone marrow, cornea, eye, bone, and skin or any subpart thereof and any other human organ (or any subpart thereof, including that derived from a fetus) specified by the Secretary of Health and Human Services by regulation.

-- http://www.livingdonorassistance.org/documents/NOTA.pdf

Seth Godin and others pledged money as an incentive for a donor, but revised the offer after learning that the original offer was likely illegal.

"He now promises the money to the first person who matches Gupta, regardless of whether that person goes through with the transplant: no quid pro quo."

In a separate case, there is an ongoing lawsuit attempting to overturn the ban on offering payment for marrow donation.

http://www.bloomberg.com/news/2011-10-11/web-bone-marrow-bou...

Better be in jail but alive (with free health care btw.) then dead. You could do the procedure overseas.

The contract wouldn't be enforceable.

You could hire a trusted middle man.

Is it illegal for the person selling as well? It probably isn't worth going to jail for selling your marrow.

Why not go to the region of india where he's most likely to get a match, and give 10 dollars to people there for checking, and another 5000 to a match that goes through and get the surgery done in india?

This would most likely reduce the number of people who would screen themselves. I wouldn't undergo a possibly horrible medical procedure for $100,000, but I might do it to save someone's life and feel like a good person.

For further reading, look into social norms vs. market norms, especially the example of the Israeli day care: http://papers.ssrn.com/sol3/papers.cfm?abstract_id=180117 (paywall)

Would it be possible for someone interested in the money to get tested and ask for money in case of a match? Although I suppose the moral pressure would be quite high if you are already tested.

I suppose it's possible to ask for every penny someone has if you're a match, since they'll obviously pay you their last dime. It's an asshole move to go after someone at their most vulnerable, though, and if it became public would likely get you justifiably ostracized from any decent community. It's also currently illegal in the US.

Of course, asking your medical costs, recuperating costs, etc. to be covered is totally reasonable.

Not asking for myself, I was just wondering in response to the comment about offering money. So people who would only do it for money could opt in.

I'd be surprised if that were true; you could always refuse the money and feel like an even better person (or at least just as good). And then it would attract the people who do want/need the money on top of that.

That argument makes sense only in a fully logical environment. The whole body of research into market norms and social norms shows that people are not fully logical in such contexts.

This can easily be solved by radio options on sign up form. Choose one from:

a)I am interested in $100,000 if I match.

b) Not in it for money but please donate $100,000 on my behalf to a charity <optional Textfield>

c)I am not in this for money. If I match, I am optimistic about your recovery so please keep the $100,000 to enjoy post recovery.

I believe $30,000 has been offered by various people, starting with Seth Godin offering $10,000 and a spotlight on his blog to anyone who's a match and goes through with the procedure.

As far as I know, it is illegal to sell bone marrow. This source, from February, says that the law is being appealed but I don't know if a verdict has been given: http://articles.latimes.com/2011/feb/20/local/la-me-bone-mar...

The GOOD article, which I linked to below, mentions a $30,000 prize.

Organized crime just squealed with happiness. Abduct someone -> sedate and extract bone marrow -> PROFIT

But Amit could pay some criminal organization for that service right now; the abduction itself is illegal either way.

Allowing for cash incentives would serve to reduce the quantity of unfulfilled demand from which black markets -- and the criminal organizations which supply them -- emerge.

At the very least, such incentives would mean far more people listed in donor registries, the dearth of which is the very problem Amit is running into.

http://reason.com/archives/2011/11/11/the-case-for-legal-org...

> But Amit could pay some criminal organization for that service right now

If he could, why hasn't he then? In the link you pasted, why did so many people die awaiting transplants if was able to be obtained illegally right now? Surely they didn't want to die.

I'm not sure I want to live in a world where the economically oppressed are pressured financially to give up body parts to the wealthy in order to survive. Just my 2 cents.

>If he could, why hasn't he then?

I would suspect that he has some moral compunction against kidnapping people and killing them for their body parts.

Regardless, you now seem to be implying the opposite claim from earlier. Is it that no longer prohibiting voluntary sales of organs (e.g., bone marrow) would result in an increase in such abductions/killings, or is it that such killings don't seem to happen despite the prohibition?

>I'm not sure I want to live in a world where the economically oppressed are pressured financially to give up body parts to the wealthy in order to survive.

Would it be morally preferable to only allow people who aren't "economically oppressed" to sell their bone marrow?

Tobu's response to you pretty much sums up my opinion: http://news.ycombinator.com/item?id=3297411

Your reply to him would help me see your side better, I think.

Done, though I would appreciate a response to my earlier questions.

> Regardless, you now seem to be implying the opposite claim from earlier. Is it that no longer prohibiting voluntary sales of organs (e.g., bone marrow) would result in an increase in such abductions/killings, or is it that such killings don't seem to happen despite the prohibition?

I'm sure they happen, because there is a black market. But I think they would happen a great deal more when the market is bigger and more legitimate (legitimate from the POV of the purchaser).

> Would it be morally preferable to only allow people who aren't "economically oppressed" to sell their bone marrow?

It's more morally preferable if only those who sold their organs didn't need the money (ie, they are doing it from the goodness of their hearts, not because they were screwed by some societal systems and are down on their luck), but less morally preferable if you actually had to enforce it (which would require selectively enforcing a law based on your perception of someone's intentions).

As I think about it more though, I'm leaning more towards: Let them sell their body parts, it's their body, their choice. Even if it leads to more crime, prosecute the crime, but let people have their personal freedom.

Not that it matters anyways, science will sort this out one day. Ideally we'll be growing our replacements organs in a lab, from our own cells.

Markets only exist when some regulator sets them up and enforces the terms. Right now it would be very hard to pay for an unwilling donor and there is a high risk for everyone involved. If this were made legal, the assumption would become that every donor was willing and that they got fairly compensated for fulfilling their end of the deal. Criminals and other shady types would find this less risky and more profitable.

The current assumption is that every donor is willing. It's not clear to me how receiving payment changes anything. Your scenario would only be prevented if organ donation were banned altogether.

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