Tuesday, April 23, 2024
Kidney Markets--my debate with Debra Satz (video)
Tuesday, April 9, 2024
Kidneys: compensation and altruism
Apropos of my debate with Debra Satz this afternoon, here are two articles about kidney donation, from pure altruism or with compensation, in the New York Times and in The Journal of Medicine and Philosophy.
In the NYT:
Let People Sell Their Kidneys. It Will Save Lives., By Dylan Walsh, April 2, 2024
"There are 100,000 people in the United States waiting for a kidney. More than half a million are on dialysis, which from my experience I know to be more of a means of survival than a form of living. ... The National Kidney Foundation estimates that without more investment in preventing diabetes and other ailments, more than one million people will be suffering from kidney failure by 2030, up from over 800,000 now.
...
"Creating a market for kidneys is not a new concept, but it’s historically been met with disgust: Sell what? To be fair, some of the ways to structure such a market would be irresponsible, coercive and deserving of that disgust.
"But others are more thoughtful and prudent. One approach is to make the federal government the sole purchaser of kidneys. Donor and recipient would never meet. Compensation would be fixed, haggling impossible. After the kidney is acquired, the transplant process would unfold in the typical manner."
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In The Journal of Medicine and Philosophy:
Semrau, Luke. "The Altruism Requirement as Moral Fiction." In The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine, p. jhae011. US: Oxford University Press, 2024.
"Abstract: It is widely agreed that living kidney donation is permitted but living kidney sales are not. Call this the Received View. One way to support the Received View is to appeal to a particular understanding of the conditions under which living kidney transplantation is permissible. It is often claimed that donors must act altruistically, without the expectation of payment and for the sake of another. Call this the Altruism Requirement. On the conventional interpretation, the Altruism Requirement is a moral fact. It states a legitimate constraint on permissible transplantation and is accepted on the basis of cogent argument. The present paper offers an alternative interpretation. I suggest the Altruism Requirement is a moral fiction—a kind of motivated falsehood. It is false that transplantation requires altruism. But the Requirement serves a purpose. Accepting it allows kidney donation but not kidney sale. It, in short, rationalizes the Received View."
Here's the concluding paragraph:
"I have argued that the Altruism Requirement is a moral fiction. No sound arguments demonstrate its truth. It continues to enjoy widespread endorsement on account of its perceived link to the Received View. It is taken as a means of allowing kidney donation but not kidney sale. Thus, it is unsurprising that, on examination, in ethical argument and in the practice of transplantation, it is, de facto, a No Payment Requirement."
Monday, April 8, 2024
Kidney Markets with Alvin Roth and Debra Satz (tomorrow, at Stanford)
Tomorrow Debra Satz and I will respectfully disagree with each other about the prospects for and desirability of compensation for kidney donors, as part of the series she is conducting on Democracy and Disagreement.
Kidney Markets with Alvin Roth and Debra Satz
FROM THE SERIES: Democracy and Disagreement
Tuesday, April 9, 2024 3:00pm - 4:50pm
CEMEX Auditorium, 655 Knight Way, Stanford, CA
Free
Stanford professors Alvin Roth and Debra Satz discuss kidney markets.
ABOUT THE SERIES: Democracy and Disagreement
Debra Satz, the Vernon R. and Lysbeth Warren Anderson Dean of the School of Humanities and Sciences, and Paul Brest, interim dean and professor emeritus at Stanford Law School, host faculty members on opposing sides of a given issue for discussions that model civil disagreement.
Open to the Stanford community.
Tuesday, February 28, 2023
Democracy & “Noxious” Markets, by Debra Satz
The Winter 2023 issue of Daedalus is about Creating a New Moral Political Economy, edited by Margaret Levi & Henry Farrell.
The article by Debra Satz will strike a chord with market designers: she takes very seriously that markets are tools that need thoughtful design.
"my argument is not a lawyer’s brief against markets. No large democratic society can or should entirely dispense with markets. Not only are markets among the most powerful tools we have for generating growth in living standards and incentivizing innovation, but also Smith was right to see their democratic potential as ways of enabling cooperation among independent, free, and equal individuals. As tools, however, we should think carefully about where to use them and how to design them when we do. While a neoliberal worldview sees efficient markets enhancing freedom and well-being everywhere, the reality is more complex. Some markets foreclose options that would better support democratic institutions and culture. Sometimes, closing off market options makes everyone better off. Consider that if individuals are free not to purchase health insurance on the market, the cost of publicly provided insurance will increase: healthy individuals are more likely to opt out of health insurance, leaving sicker individuals in the pool to be insured and raising the costs of their insurance, leading more people to forgo holding such insurance, driving the prices up even higher."
Among the markets she is concerned about are school choice, and military service:
"some of the ways parents prioritize their own children can lead to worse outcomes for other children and to the furthering of educational inequities, as well as to other social ills like instability and conflict. Evidence indicates, for example, that choice schools in the United States are more homogenous than public schools with respect to social class and race. Researchers have also shown that when public school choice is available, educated parents are especially likely to factor child demographics in their school selections.11 This may be because school quality is very hard to judge and parents default to markers such as the reading and math levels of other students. These levels, in turn, are heavily influenced by social class. It is likely that some parents take race and class directly as proxies for school quality."
...
"Extending the reach of markets even more, war has been further outsourced to private military contractors: in 2009, there were more private military contractors in Afghanistan than U.S. military troops.17 Hiring private mercenaries and outsourcing national security to a subsection of our population might spare our citizens, but as political philosopher Michael Sandel has noted, it changes the meaning of citizenship.18 In what sense are we “all in this together” if most citizens never need to think hard about decisions to go to war? Whatever the efficiency pros and cons of the decision to outsource fighting and allocate military service through market means, doing so changes our relationships with one another and our sense of a common life."
"My argument so far suffers from treating the state and market as two stark alternatives for the allocation of goods and services in society. So I now want to consider ways in which the benefits of markets can be harnessed—through design—to better serve important democratic goals. "
...
"One important mechanism is providing greater roles for worker voice. This can be done through such reforms as changing labor laws to support forms of worker association, like trade unions, allowing worker representatives on company boards, and strengthening democracy at work through diverse forms of ownership including worker-managed and -owned firms. Empowering the associational organization of labor would also help redress the background social conditions that render workers vulnerable to the oligarchic power of their employers.
"There are other examples in which careful design and policy can limit the “noxiousness” of a particular market for democracy. Policies such as a negative income tax can strengthen the power of workers, and campaign finance laws can diminish the power of money in elections. Others have argued for reforms to our current system of commodified legal representation within an adversarial system, and for single-payer health care systems."
Here's her concluding paragraph:
"Beyond education, we need to pay special attention to particular markets that affect democratic functioning and stability. Such markets include but are not limited to markets in legal representation, media and news markets, markets relating to national defense, and markets governing political rights. Politicians and other commentators usually write unreflectively, as if all markets were the same. They are not. Markets affect not only the distribution of income and wealth, but also our capacities, and our views of each other. Their strengths but also their limits depend on the fact that they are radically individualizing. But in some contexts, that individualizing threatens the practice of democracy. Markets have moral and even “spiritual” consequences relevant to our shared public life, and our evaluations of them must also attend to those consequences. A new political economy needs to take this larger evaluative frame into account."
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The next article in the issue is a thoughtful essay on markets for personal care of the young and the elderly, organized in various ways, including care within families, written as a commentary on the Satz article:
Saturday, March 28, 2020
Repugnant Behavior, a conference in Montpellier in February 2021
WINIR Workshop on
Repugnant Behaviours
24-25 February 2021
University of Montpellier, Montpellier, France
Wednesday, June 6, 2018
Repugnant markets: listen to my Philosophy Talk chat with Ken Taylor and Debra Satz
Repugnant Markets: Should Everything Be For Sale?
- by Philosophy Talk
- Length:
Sunday, June 3, 2018
Repugnant markets on the radio
Repugnant Markets on the radio: I'll join Ken Taylor and Debra Satz on Philosophy Talk today, June 3
Get Philosophy Talk
Radio
REPUGNANT MARKETS, Ken Taylor
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Update: and here we are at KALW:
Ken Taylor, Debra Satz, and Al Roth in the studio at Philosophy Talk https://pbs.twimg.com/media/DeyV20-VQAAApPH.jpg |
Repugnant markets: listen to my Philosophy Talk chat with Ken Taylor and Debra Satz
Monday, May 7, 2018
I am slandered (or at least misunderstood) by The Economist for writing about repugnant transactions
Yet here, in a piece on what economists do
Economists focus too little on what people really care about
The fourth in our series on the profession’s shortcomings,
is this:
"Indeed, economists often work on the basis that tangible costs and benefits outweigh subjective values. Alvin Roth, for example, suggests that moral qualms about “repugnant transactions” (such as trading in human organs) should be swept aside in order to realise the welfare gains that a market in organs would generate. Perhaps so, but to draw that conclusion while dismissing such concerns, rather than treating them as principles which might also contribute to human well-being, is inappropriate. "
I don't think I dismiss such concerns when I write about them, e.g. here:
Repugnance as a Constraint on Markets
Alvin E. Roth, JOURNAL OF ECONOMIC PERSPECTIVES, VOL. 21, NO. 3, SUMMER 2007, (pp. 37-58)
But reading is hard, and deadlines are short.
For those who prefer to listen, I'll be speaking about repugnance with my colleague, the eminent philosopher Debra Satz, on Philosophy Talk Radio on Sunday, June 3, at 11am (pacific) on KALW 91.7 FM Local Public Radio, San Francisco. (I believe there will be a podcast of the show available afterwards...)
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Update: now that I think of it, repugnance is one of the parts of economics The Economist has trouble with. Here's an earlier blog post, in which I remarked "It's nice to be quoted, not so nice to be misunderstood."...
Friday, March 2, 2018
******Further update: Economists and economic journalists might have different ideas about this sort of thing, so I was gratified by this expression of support from Tim Harford, one of this generation's most distinguished economic journalists:
I choked on my coffee when I read that line in The Economist. I think they owe Al an apology. It seemed a strange claim.
Saturday, December 2, 2017
Limits of the market--conference in Paris (call for papers)
Friday, October 13, 2017
Pictures from the celebration of Ken Arrow
One memorable quote from Bob Solow (from memory). He told the story of a project he and Ken had worked on in the early days of the Rand Corporation, a project that had failed. He said something like this: "So you see, even Ken couldn't turn a failed project into a success. He was an economist just like you and me. Only smarter. Much smarter. Much much smarter."
Update: now that I've had a chance to hear the video (you can see many videos of the celebration here), I can quote Solow correctly (from the closing sentences of his keynote): "Kenneth was not a superman, he could not with some brilliant insight out of his head make a success out of a failed project, that wasn't Kenneth at all. What he was was an economist just like you and me, only he was smarter. He was much smarter. He was very much smarter."
The photos below are ones that I took with my iPhone, you can find professional ones, by Steve Castillo, here.)
Finance. William Sharpe.Hersh Sheffrin.Hugo SonnenscheinDarrell Duffie.Marcus Brunnermeier |
GE.John Geanakoplos. Andreu Mas-Colell. Robert Lucas. Herakles Polemarchakis. Chris Shannon |
Joe Stiglitz.Partha Dasgupta.Debra Satz.Richard Cottle.Matt Jackson |
Social choice. Roger Myerson.Eric Maskin.Kotaro Suzumura.Amartya Sen.Salvador Barbera |
Health:Vic Fuchs.Amy Finkelstein.Alan Garber.Angus Deaton |
Bob Solow |
11 Nobel prize winners |
There was also some discussion of how many Nobel prizes have been awarded to students of Arrow. I thought of four: Harsanyi, Spence, Maskin, and Myerson. But it turns out that when Arrow visited U. Cambridge he served as the outside chair of Jim Mirrlees' dissertation committee. And Dan McFadden reported that a few hours of conversation with Arrow when he was a grad student had a decisive effect on his work. And of course the clock is still running...