[Avodah] Is there any issur here al pi halacha?

[Chana Luntz]

RAM writes:

> It seems to me that RJK's comment is accurate only if the poor person
> could have gotten that kidney through other channels. But if the rich
> person got a kidney which would not have been available any way other
> than via payment, then the poor person could not have gotten it any
> way.
> 
> Phrased another way: RJK's comment presumes a fixed number of available
> kidneys. But if market forces are allowed to come into play, it can
> increase the number of available kidneys, because people who had been
> unwilling to donate them, might now be willing to sell them. This
> is indeed good for the donor/seller, and good for the richman/buyer,
> without being bad for the poor man.
> 
> BUT!!! Lest anyone think I'm endorsing these organ sales, let's also be
> honest enough to admit that there will indeed be some people who were
> previously willing to donate their kidney to the patient who needs it
> the most, but will now change their mind and offer it only to the
> highest
> bidder. I do NOT deny them the right to do so, but let's all admit that
> this scenario would indeed be bad for the poor man.

But you are missing the most cogent part of RJK's argument - and certainly
the one that is accepted in Britain as being true (RJK is mesupik, which is
why he wants hard data, which I don't know enough about the area to give,
only that it is an "accepted truth" in Britain).

That is, once you bring "market forces" into play, it pushes away the
altruists, so in fact the number of kidneys available from altruistic
sources goes down.  In particular, one of the "best" sources for all forms
of organs, and these presumably include kidneys, is from people killed in
some sort of accident - which is the situation when altruistic giving (by
the relatives) tends to be at its height, but once money enters the
equation, most relatives (according to this argument) will not give, not
wanting to take money from the situation.  Ah you say, well then let them
give without paying - but once there is a market for such things, most
relatives say - let the market deal with it, and will not agree to give.
The argument thus is that in fact if you pay, you end up with a more
restricted and limited market than you had before for everybody, although
you indeed do have the rich getting a better chance at what there is.

Note of course that the British are big on this, they will not pay for
blood, because they feel they get more and better quality blood from
altruistic giving.  Certainly I think that is true for my husband, I cannot
imagine him giving blood for money - I am sure whatever they paid him would
not equal his hourly charge out rate at the office, which is what he would
compare it to.  Nor would I imagine the various law firms I worked in
running blood drives for their workers if there was payment.  Nor would the
various shuls run blood drives. So most of the people I know who give blood
would stop giving if there was payment, rather assuming that poor people
would pick up the slack.  But whether they would I don't know - and indeed,
there is also concern that once payment comes into the equation, there is
greater incentive for people to lie about things like being HIV+ - an
altruist is much less likely to lie, (and again, I don't know about the hard
data, but they certainly claim here that there have been far fewer blood
transfusion problems due to contaminated blood that places where there is
payment).

So you may actually have a situation where not only does the rich get the
kidney and the poor does not, that there are fewer kidneys to go around,
because of reduced altruistic giving, and the kidneys are of poorer quality,
so in fact more people miss out on kidneys overall that will get them from
people prepared to donate and even then...

> (And of course, as I wrote before, I am also fearful that market forces
> could exert undue pressure on some people to sell their kidneys against
> their best interests. 


> Akiva Miller

SHavuah tov

Chana