Friday, March 13, 2020

The organ as a fictitious commodity, by Nicolas Brisset

Here, in French (and in English via Google Translate) an effort to understand, from writings on the subject, what underlies the widespread repugnance towards compensation for kidney donors, but mostly does not cause objections to kidney exchange.

L’organe comme marchandise fictive, Nicolas Brisset, Dans Actuel Marx 2020/1 (n° 67), pages 167 à 184
The organ as a fictitious commodity, Nicolas Brisset, In Actuel Marx 2020/1 (n ° 67) , pages 167 to 184

From the introduction:

"Finding out in the name of what individuals resist is an inexhaustible source of intuitions and reflections. Not that everything must be accepted as a whole, but understanding these moral systems is a necessary step from the perspective of both a social theory and a normative point of view on societal organization. We find in the history of social sciences several types of proposals in this regard  [5].
Our work will consist in starting from a social choice between two systems proposed to manage the distribution of a specific entity (the organ taken from living donors) in order to infer the moral foundations. In fact, in a 2007 issue of the Journal of Economic Perspective , two purely economic articles proposed very different ways of organizing the distribution of kidneys taken from living donors. On the one hand, Gary Becker and Julio Jorge Elìas proposed what seems at first sight (we will come back to this) to a trading system  On the other, Alvin Roth favored a system centered on organ donation  [7].
However, it turns out that one of these two proposals has been implemented in several countries, while the other seems for the moment to face a strong social rejection. Briefly, the trading system was rejected, while the donation-based system was retained. In this work, we will begin by analyzing the moral system that could have led to the rejection of the market solution in the context of the distribution of organs for the benefit of a system putting donation at the center. What is this rejection based on? We will try to decide between three hypotheses commonly put forward to explain the border between the merchant and the non-merchant. In turn, the use of money, the institution of the market and the problem of coercion were put forward as possible reasons for a refusal to market the organism."

and the Conclusion:
"The objective of this article has been limited, namely to show how the refusal of a method of matching, the organ market, could be understood as supported by a particular moral economy. The heart of the rejection seems to be that nobody would sell their organ if they weren't there obliged. A representation opposed to the idea according to which the prohibition of the markets to the organs would be inherently paternalistic. Here we find the heart of all debates relating to contested goods or activities. Prostitution, blood, gametes, surrogate mothers, the center of debate can be systematically summed up by the question: would these goods and services be produced and sold in the absence of a situation of loss of autonomy? We have seen that this question was also at the heart of Marxist historiography: to build capitalism is to build the political conditions for market efficiency in orienting work towards industrial activity. It seems that the only coherent explanation for the rejection of the market formulas proposed within the framework of the organs is precisely the rejection of such a construction."

Professor Brisset has examined kidney exchange before--here's an earlier blog post with links to his work:

Wednesday, June 29, 2016

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