A Legal Market for Fetal Organs? | Jacob M. Appel | Big Think

A Legal Market for Fetal Organs?

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The bioethicist believes it’s an idea whose time has come. But how could such a market be regulated to prevent abuses?

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Jacob M. Appel:

Jacob M. Appel is a bioethicist and fiction writer. He holds a B.A. and an M.A. from Brown University, an M.A. and an M.Phil. from Columbia University, an M.D. from Columbia University's College of Physicians and Surgeons, an M.F.A. in creative writing from New York University, and a J.D. from Harvard Law School. He has most recently taught at Brown University in Providence, Rhode Island, and at the Gotham Writers Workshop in New York City. He publishes in the field of bioethics and contributes to such publications as the Journal of Clinical Ethics, the Journal of Law, Medicine & Ethics, and the Bulletin of the History of Medicine. His essays have appeared in The New York Times, The New York Daily News, The Chicago Tribune, and other publications.

Appel has also published short fiction in more than one hundred literary journals. His short story, Shell Game With Organs, won the Boston Review Short Fiction Contest in 1998. His story about two census takers, "Counting," was shortlisted for the O. Henry Award in 2001. Other stories received "special mention" for the Pushcart Prize in 2006 and 2007.

He is admitted to the practice of law in New York State and Rhode Island, and is a licensed New York City sightseeing guide.

Appel contributed a Dangerous Idea to Big Think's "Month of Thinking Dangerously," advocating that we add trace amounts of lithium to our drinking water to help reduce the suicide rate.

Appel is a Big Think Delphi Fellow.

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TRANSCRIPT:

Question: Should buying and selling human organs be legal?

Jacob Appel: Sure. I've actually written about a legal market in fetal organs, which I think is somewhat different from a legal market in organs of post-born adults. And I would strongly favor legalizing the market in fetal organs because I don't feel that fetuses are people and therefore the risk of exploiting them is minimal and I feel that women are capable of making reproductive choices in relation to their fetuses particularly people who abort may want to save the lives of other individuals by making their organs available. And I think they should be able to profit from this.

In contrast, for adult organs, I think there should be a financial mechanism for allowing people to sell their organs. But I don't necessarily think there should be a market. I think a market opens itself up to abuse and will likely have the organs go to the highest bidder and make it most available to the wealthy.

In contrast, you want to create financial incentives so there are enough organs available for all 70,000 people who need kidneys, for example, in the United States. But then you don't want to distribute them based on economic opportunity, or economic -- based on assets, you want to distribute them based on need. So, I would have a system where the government bought up organs for people, let's say $10,000 for a kidney and then distributed them using the same system we have now, on a first-come, first-served, or need based approach. I think to tell people they can make other economic decisions in their lives, they can choose to be a laborer at $7.00 an hour for 40 hours a week, but they can't choose to avoid three months of work by selling a kidney is an unnecessary involvement, or an unnecessary intervention in the individual decision-making of people.

I will add, and I think this is often lost in the debate over organs. We focus excessively on the risk of exploitation of people who would sell their organs. We don't focus on the passion of people who die every year because they don't get organs. And if you are one of those individuals, or one of their relatives, you may see the question from a very different light.

Question: How difficult is it to obtain a life-saving organ in America today?

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