Repugnant Behavior, a conference in Montpellier in February 2021

Here's the announcement and call for papers:

WINIR Workshop on

Repugnant Behaviours

24-25 February 2021

University of Montpellier, Montpellier, France

Organiser: Alain Marciano

"Formally introduced in economics by Nobel laureate Alvin Roth, the concept of "repugnance" arises in the debate among philosophers (e.g., Elizabeth Anderson, Michael Sandel, Debra Satz) and other social scientists (e.g., Kristie Blevins, Amitai Etzioni, Kimberly Krawiec, Amartya Sen, Philip Tetlock) about how and why moral concerns, taboos and sacred values place, or ought to place, limits on market transactions. (A set of representative references is provided in the call for papers.)

Important dates

15 June 2020 – Abstract submission deadline

15 July 2020 – Notification of acceptance

15 December 2020 – Full paper submission deadline

Keynote speaker

Kimberly D. Krawiec

Kathrine Robinson Everett Professor of Law

Duke Law School, USA

REFERENCES

Anderson, E. (1990) “The Ethical Limitations of the Market” Economics and Philosophy 6(2): 179-205.

Anderson, E. (1993) Value in Ethics and Economics (Cambridge, MA: Harvard University Press).

Blevins, B., Ramirez, R. & Wight, J. B. (2010) “Ethics in the Mayan Marketplace” in M. D. White (ed.) Accepting the Invisible Hand: Market-Based Approaches to Solving Social-Economic Problems (New York: Palgrave Macmillan).

Cook, P J. & Krawiec, K. D. (2018) “If We Allow Football Players and Boxers to Be Paid for Entertaining the Public, Why Don’t We Allow Kidney Donors to Be Paid for Saving Lives?” Law and Contemporary Problems 81(3): 9-35.

Elias, J. J., Lacetera, N. & Macis, M. (2015) “Sacred Values? The Effect of Information on Attitudes toward Payments for Human Organs” American Economic Review 105(5): 361-365.

Elias, J. J., Lacetera, N. & Macis, M. (2016) “Efficiency-Morality Trade-Offs In Repugnant Transactions: A Choice Experiment” NBER, Working Paper No 22632.

Etzioni, A. (1986) “The Case for a Multiple-Preference Conception” Economics and Philosophy 2: 159-183.

Etzioni, A. (1988) The Moral Dimension: Toward a New Economics (New York: Free Press).

Healy, K. & Krawiec, K. D. (2017) “Repugnance Management and Transactions in the Body” American Economic Review 107(5): 86-90.

Held, P. J., McCormick, F., Ojo, A & Roberts, J. P. (2016) “A Cost‐Benefit Analysis of Government Compensation of Kidney Donors” American Journal of Transplantation 16(3): 877–885.

Kass L. R. (1997) “The Wisdom of Repugnance: Why We Should Ban the Cloning of Humans” New Republic 216(22):17-26.

Kekes J. (1998) A Case for Conservatism (Ithaca, NY: Cornell University Press).

Khalil, E. L. & Marciano, A. (2018) “A Theory of Tasteful and Distasteful Transactions” Kyklos 71(1): 110-131.

Krawiec, K. D. (2015) “Markets, Morals and Limits in the Exchange of Human Eggs” Georgetown Journal of Law & Public Policy 13(1): 349-365.

Krawiec, K. D. (2016) “Lessons from Law About Incomplete Commodification in the Egg Market” Journal of Applied Philosophy 33(2): 160-177.

Krawiec, K. D., Liu, W. & Melcher, M. (2017) “Contract Development in a Matching Market: The Case of Kidney Exchange” Law and Contemporary Problems 80(1): 11-35.

Kray, L. J., George, L. G., Liljenquist, K. A., Galinsky, A. D., Tetlock, P. E. & Roese, N. J. (2010) “From What Might Have Been to What Must Have Been: Counterfactual Thinking Creates Meaning” Journal of Personality and Social Psychology 98(1): 106-118.

Leider, S. & Roth, A. E. (2010) “Kidneys for Sale: Who Disapproves, and Why?” American Journal of Transplantation 10(5): 1221-1227.

McGraw, P. & Tetlock, P. E. (2005) “Taboo Trade-Offs, Relational Framing And The Acceptability Of Exchanges” Journal of Consumer Psychology 15(1): 35-38.

McGraw, P., Schwartz, J. & Tetlock, P. E. (2012) “From the Commercial to the Communal: Reframing Taboo Trade-Offs in Religious and Pharmaceutical Marketing” Journal of Consumer Research 39(1): 157-173.

Roth, A. E. (2007) “Repugnance as a Constraint on Markets” Journal of Economic Perspectives 21(3): 37-58.

Sandel, M. J. (2012) What Money Can't Buy: The Moral Limits of Markets (New York: Farrar, Straus & Giroux).

Sandel, M. J. (2013) “Market Reasoning as Moral Reasoning: Why Economists Should Re-Engage With Political Philosophy” Journal of Economic Perspectives 27(4): 121-140.

Satz, D. (1995) “Markets in Women's Sexual Labor” Ethics 106(1): 63-85.

Satz, D. (2008) “The Moral Limits of Markets: The Case of Human Kidneys” Proceedings of the Aristotelian Society 108(1/pt3): 269-288.

Satz, D. (2012) Why Some Things Should Not Be For Sale: The Moral Limits of Markets (New York: Oxford University Press).

Schoemaker, P. & Tetlock, P.E. (2011) “Taboo Scenarios: How To Think about The Unthinkable” California Management Review 54(2): 5-24.

Sen, A. (1987) On Ethics and Economics (Oxford: Blackwell).

Sheehan, M. (2016) “The Role of Emotion in Ethics and Bioethics: Dealing with Repugnance and Disgust” Journal of Medical Ethics 42(1): 1-2

Law and market design at Duke

It looks like Kim Krawiec et al. are up to something interesting at Duke.

Duke Law Project on Law and Markets focuses on strengths and limits of markets

SHARE

August 10, 2015Duke Law News

Duke Law faculty and students are undertaking a yearlong study of topics at the intersection of law and markets to investigate foundational questions about how law can address market inequalities, how market forces might be effective in areas where laws are ineffective, and the philosophical underpinnings of market-driven and regulatory approaches to various issues.

The Duke Law Project on Law and Markets, led by Professors Kimberly Krawiec and Joseph Blocher, includes faculty workshops, a colloquium for faculty and seminar students, a speaker series, and a symposium that will result in a volume of relevant scholarship in the journal Law and Contemporary Problems.

“Our goal is to bring the community together around a broad topic and to really think hard about it,” said Krawiec, the Kathrine Robinson Everett Professor of Law. “Joseph and I were excited about law and markets because of work that the two of us had been doing separately about the role of markets as they relate to law.”

Krawiec, a scholar of corporate law, securities, and derivatives, also studies non-traditional and taboo markets, such as those for babies — via sperm and egg donation, surrogacy, and adoption — and for transplant-ready human organs. In some of his recent works Blocher, a scholar of constitutional and property law, has contemplated interstate and sovereign border markets as a possible solution to a range of economic and political problems.

About 30 faculty members took part in the project’s first event on June 1, a discussion of a controversial 1970 article on blood donation, which argued that a system based on altruism is superior to a market-based system regulated by self-interest. “We had a very lively, two-hour discussion,” said Blocher. “It was a great kick-off.”

Other summer workshops have included a discussion of markets and environmental regulation led byJonathan Wiener, the William R. and Thomas L. Perkins Professor of Law and Professor of Environmental Policy and Professor of Public Policy, and one on the relationship between economic development and other freedoms led by Barak Richman, the Edgar P. and Elizabeth C. Bartlett Professor of Law and Professor of Business Administration.

The wide range of topics is, in many ways, the point of the overall inquiry, Krawiec said.

“It’s related to a broader notion of market design, which is popular with economists,” she said. “Lawyers have a role to play, because many of the objections to having markets operate in certain areas are things that can be dealt with by law.” The law, for example, can address inequalities by providing subsidies, she said.

“Markets involve more than money changing hands. A market is a mechanism for allocating scarce resources, and the law has a lot to say about how that should operate, given the various public policy goals we have.” That’s true, she said, of organ donation, “which is not a literal market, because it’s illegal to trade in organs.”

The Project on Law and Markets was inspired by the Duke Project on Custom and Law that occurred over the course of the 2011-2012 academic year and resulted in a symposium issue of the Duke Law Journalwith articles on such topics as customs in the art market, norms in kidney exchange programs, and how the Internal Revenue Service draws on custom to under-enforce portions of the tax code. The initiative sparked a number of scholarly collaborations and Blocher and Krawiec hope that success will be replicated in the current project.

“We’re hoping to connect people who might not otherwise be connected in dealing with problems of law, problems of scarcity, problems of inequality,” said Blocher. “Obviously the work that Jennifer Jenkins andJames Boyle do regarding the public domain and what goes into and what stays out of the market is hugely important and interesting, but other scholars might not connect it to their work. It might just be seen as a sort of walled-off, intellectual property issue.” Boyle, the William Neal Reynolds Professor of Law, is a leading scholar of intellectual property and the founder of the Center for the Study of the Public Domain, which Jenkins ’97 directs. 

The two-credit Law and Markets Colloquium will engage students in discussion of assigned readings and workshop presentations on law and markets. Along with the faculty workshops and symposium, it is likely to expose a range of assumptions and differences of opinion about the role of law and the role of markets, said Blocher. “People are going to have very different, maybe irreducible, normative visions about what’s good and proper for the use of money or other market incentives. But like any question of law, markets, or justice, we don’t anticipate a single answer.”

“It’s more about unearthing the questions we should be thinking about,” said Krawiec.

Kim Krawiec on repugnance to monetary markets

Kim Krawiec has a forthcoming article in the Journal of Institutional and Theoretical Economics (JITE), focusing on repugnance, using global kidney exchange as a main example:

Kidneys without Money 

 Krawiec, Kimberly D.

Appeared or available online: November 27, 2018

Kidneys without Money
by Kimberly D. Krawiec

"Market design and matching have been especially important for markets in which the use of money is viewed as repugnant or distasteful. This article employs the example of kidney exchange, with a particular focus on a new form, global kidney exchange (GKE), to highlight the manner by which repugnance and the law limit exchange and create scarcity. Yet it also opens the door to innovation that, at each stage of market development, prompts new repugnance concerns and initiates a renegotiation of legal rules, social norms, and institutional barriers."


It is accompanied by commentaries, also focusing on repugnance:

Kimberly D. Krawiec
Kidneys without Money
DOI: 10.1628/jite-2019-0003

CommentsI. Glenn Cohen
On Repugnance, Distribution, and the Global Kidney Exchange
DOI: 10.1628/jite-2019-0004

Weyma Lübbe

Understanding (One's Own) Repugnances
DOI: 10.1628/jite-2019-0005

****************
Here's the updated reference
 Kidneys without Money
by Kimberly D. Krawiec
Journal of Institutional and Theoretical Economics (JITE)
Jahrgang 175 (2019) / Heft 1, S. 4-19 (16)

Kidney exchange collaboration between Stanford and APKD

 I recently had occasion to review the long collaboration between my Stanford colleagues and Mike Rees and the Alliance for Paired Kidney Donation. It turns out that, together with other coauthors, Mike and his APKD colleagues have written well over a dozen papers with me and my colleagues at Stanford.  (My own collaboration with Mike and APKD goes back to when Itai Ashlagi and I were still in Boston, where my earliest papers on kidney exchange were with  Tayfun Sönmez and Utku Ünver, and with Frank Delmonico and his colleagues at the New England Program for Kidney Exchange.)

Here's the list I came up with, probably not exhaustive:

Mike Rees/APKD collaborations with Stanford scholars (Ashlagi, Melcher, Roth, Somaini)

 1. Rees, Michael A., Jonathan E. Kopke, Ronald P. Pelletier, Dorry L. Segev, Matthew E. Rutter, Alfredo J. Fabrega, Jeffrey Rogers, Oleh G. Pankewycz, Janet Hiller, Alvin E. Roth, Tuomas Sandholm, Utku Ünver, and Robert A. Montgomery, “A Non-Simultaneous Extended Altruistic Donor Chain,” New England Journal of Medicine, 360;11, March 12, 2009, 1096-1101. https://www.nejm.org/doi/full/10.1056/NEJMoa0803645

2.     Ashlagi, Itai, Duncan S. Gilchrist, Alvin E. Roth, and Michael A. Rees, “Nonsimultaneous Chains and Dominos in Kidney Paired Donation – Revisited,” American Journal of Transplantation, 11, 5, May 2011, 984-994 http://www.stanford.edu/~alroth/papers/Nonsimultaneous%20Chains%20AJT%202011.pdf

3.     Ashlagi, Itai, Duncan S. Gilchrist, Alvin E. Roth, and Michael A. Rees, “NEAD Chains in Transplantation,” American Journal of Transplantation, December 2011; 11: 2780–2781. http://web.stanford.edu/~iashlagi/papers/NeadChains2.pdf

4.     Wallis, C. Bradley, Kannan P. Samy, Alvin E. Roth, and Michael A. Rees, “Kidney Paired Donation,” Nephrology Dialysis Transplantation, July 2011, 26 (7): 2091-2099 (published online March 31, 2011; doi: 10.1093/ndt/gfr155, https://academic.oup.com/ndt/article/26/7/2091/1896342/Kidney-paired-donation

5.     Rees, Michael A.,  Mark A. Schnitzler, Edward Zavala, James A. Cutler,  Alvin E. Roth, F. Dennis Irwin, Stephen W. Crawford,and Alan B.  Leichtman, “Call to Develop a Standard Acquisition Charge Model for Kidney Paired Donation,” American Journal of Transplantation, 2012, 12, 6 (June), 1392-1397. (published online 9 April 2012 http://onlinelibrary.wiley.com/doi/10.1111/j.1600-6143.2012.04034.x/abstract )

6.     Anderson, Ross, Itai Ashlagi, David Gamarnik, Michael Rees, Alvin E. Roth, Tayfun Sönmez and M. Utku Ünver, " Kidney Exchange and the Alliance for Paired Donation: Operations Research Changes the Way Kidneys are Transplanted," Edelman Award Competition, Interfaces, 2015, 45(1), pp. 26–42. http://pubsonline.informs.org/doi/pdf/10.1287/inte.2014.0766

7.     Fumo, D.E., V. Kapoor, L.J. Reece, S.M. Stepkowski,J.E. Kopke, S.E. Rees, C. Smith, A.E. Roth, A.B. Leichtman, M.A. Rees, “Improving matching strategies in kidney paired donation: the 7-year evolution of a web based virtual matching system,” American Journal of Transplantation, October 2015, 15(10), 2646-2654 http://onlinelibrary.wiley.com/enhanced/doi/10.1111/ajt.13337/ (designated one of 10 “best of AJT 2015”)

8.     Melcher, Marc L., John P. Roberts, Alan B. Leichtman, Alvin E. Roth, and Michael A. Rees, “Utilization of Deceased Donor Kidneys to Initiate Living Donor Chains,” American Journal of Transplantation, 16, 5, May 2016, 1367–1370. http://onlinelibrary.wiley.com/doi/10.1111/ajt.13740/full

9.     Michael A. Rees, Ty B. Dunn, Christian S. Kuhr, Christopher L. Marsh, Jeffrey Rogers, Susan E. Rees, Alejandra Cicero, Laurie J. Reece, Alvin E. Roth, Obi Ekwenna, David E. Fumo, Kimberly D. Krawiec, Jonathan E. Kopke, Samay Jain, Miguel Tan and Siegfredo R. Paloyo, “Kidney Exchange to Overcome Financial Barriers to Kidney Transplantation,” American Journal of Transplantation, 17, 3, March 2017, 782–790. http://onlinelibrary.wiley.com/doi/10.1111/ajt.14106/full  

a.     M. A. Rees, S. R. Paloyo, A. E. Roth, K. D. Krawiec, O. Ekwenna, C. L. Marsh, A. J. Wenig, T. B. Dunn, “Global Kidney Exchange: Financially Incompatible Pairs Are Not Transplantable Compatible Pairs,” American Journal of Transplantation, 17, 10, October 2017, 2743–2744. http://onlinelibrary.wiley.com/doi/10.1111/ajt.14451/full

b.     A. E. Roth, K. D. Krawiec, S. Paloyo, O. Ekwenna, C. L. Marsh, A. J. Wenig, T. B. Dunn, and M. A. Rees, “People should not be banned from transplantation only because of their country of origin,” American Journal of Transplantation, 17, 10, October 2017, 2747-2748. http://onlinelibrary.wiley.com/doi/10.1111/ajt.14485/full

c.      Ignazio R. Marino, Alvin E. Roth, Michael A. Rees; Cataldo Doria, “Open dialogue between professionals with different opinions builds the best policy, American Journal of Transplantation, 17, 10, October 2017, 2749. http://onlinelibrary.wiley.com/doi/10.1111/ajt.14484/full

10.  Danielle Bozek, Ty B. Dunn, Christian S. Kuhr, Christopher L. Marsh, Jeffrey Rogers, Susan E. Rees, Laura Basagoitia, Robert J. Brunner, Alvin E. Roth, Obi Ekwenna, David E. Fumo, Kimberly D. Krawiec, Jonathan E. Kopke, Puneet Sindhwani, Jorge Ortiz, Miguel Tan, and Siegfredo R. Paloyo, Michael A. Rees, “The Complete Chain of the First Global Kidney Exchange Transplant and 3-yr Follow-up,” European Urology Focus, 4, 2, March 2018, 190-197. https://www.sciencedirect.com/science/article/pii/S2405456918301871

11.  Itai Ashlagi, Adam Bingaman, Maximilien Burq, Vahideh Manshadi, David Gamarnik, Cathi Murphey, Alvin E. Roth,  Marc L. Melcher, Michael A. Rees, ”The effect of match-run frequencies on the number of transplants and waiting times in kidney exchange,” American Journal of Transplantation, 18, 5, May 2018,  1177-1186, https://onlinelibrary.wiley.com/doi/full/10.1111/ajt.14566

12.   Stepkowski, S. M., Mierzejewska, B., Fumo, D., Bekbolsynov, D., Khuder, S., Baum, C. E., Brunner, R. J., Kopke, J. E., Rees, S. E., Smith, C. E., Ashlagi, I., Roth, A. E., Rees, M. A., “The 6-year clinical outcomes for patients registered in a multiregional United States Kidney Paired Donation program- a retrospective study,” Transplant international 32: 839-853. 2019. https://onlinelibrary.wiley.com/doi/10.1111/tri.13423

13.   Roth, Alvin E., Ignazio R. Marino, Obi Ekwenna, Ty B. Dunn, Siegfredo R. Paloyo, Miguel Tan, Ricardo Correa-Rotter, Christian S. Kuhr, Christopher L. Marsh, Jorge Ortiz, Giuliano Testa, Puneet Sindhwani, Dorry L. Segev, Jeffrey Rogers, Jeffrey D. Punch, Rachel C. Forbes, Michael A. Zimmerman, Matthew J. Ellis, Aparna Rege, Laura Basagoitia, Kimberly D. Krawiec, and Michael A. Rees, “Global Kidney Exchange Should Expand Wisely, Transplant International, September 2020, 33, 9,  985-988. https://onlinelibrary.wiley.com/doi/full/10.1111/tri.13656

14.  Vivek B. Kute, Himanshu V. Patel, Pranjal R. Modi, Sayyad J. Rizvi, Pankaj R. Shah, Divyesh P Engineer, Subho Banerjee, Hari Shankar Meshram, Bina P. Butala, Manisha P. Modi, Shruti Gandhi, Ansy H. Patel, Vineet V. Mishra, Alvin E. Roth, Jonathan E. Kopke, Michael A. Rees, “Non-simultaneous kidney exchange cycles in resource-restricted countries without non-directed donation,” Transplant International,  Volume 34, Issue 4, April 2021,  669-680  https://doi.org/10.1111/tri.13833

15.   Afshin Nikzad, Mohammad Akbarpour, Michael A. Rees, and Alvin E. Roth “Global Kidney Chains,” Proceedings of the National Academy of Sciences, September 7, 2021 118 (36) e2106652118; https://doi.org/10.1073/pnas.2106652118 .

16.    Alvin E. Roth, Ignazio R. Marino, Kimberly D. Krawiec, and Michael A. Rees, “Criminal, Legal, and Ethical Kidney Donation and Transplantation: A Conceptual Framework to Enable Innovation,” Transplant International  (2022), 35: doi: 10.3389/ti.2022.10551, https://www.frontierspartnerships.org/articles/10.3389/ti.2022.10551/full

17.   Ignazio R. Marino, Alvin E. Roth, and Michael A. Rees, “Living Kidney Donor Transplantation and Global Kidney Exchange,” Experimental and Clinical Transplantation (2022), Suppl. 4, 5-9. http://www.ectrx.org/class/pdfPreview.php?year=2022&volume=20&issue=8&supplement=4&spage_number=5&makale_no=0

18.  Agarwal, Nikhil, Itai Ashlagi, Michael A. Rees, Paulo Somaini, and Daniel Waldinger. "Equilibrium allocations under alternative waitlist designs: Evidence from deceased donor kidneys." Econometrica 89, no. 1 (2021): 37-76.

And here’s a report of work in progress:

The First 52 Global Kidney Exchange Transplants: overcoming multiple barriers to transplantation by MA Rees, AE Roth , IR Marino, K Krawiec, A Agnihotri, S Rees, K Sweeney, S Paloyo, T Dunn, M Zimmerman, J Punch, R Sung, J Leventhal, A Alobaidli, F Aziz, E Mor, T Ashkenazi, I Ashlagi, M Ellis, A Rege, V Whittaker, R Forbes, C Marsh, C Kuhr, J Rogers, M Tan, L Basagoitia, R Correa-Rotter, S Anwar, F Citterio, J Romagnoli, and O Ekwenna.  Transplantation: September 2022 - Volume 106 - Issue 9S - p S469 doi: 10.1097/01.tp.0000887972.53388.77  https://journals.lww.com/transplantjournal/Fulltext/2022/09001/423_9__The_First_52_Global_Kidney_Exchange.697.aspx

Kim Krawiec to UVA

 Controversial markets are coming to Virginia:

Here's the announcement from the U. of Virginia:

Kimberly Krawiec, Expert in Controversial Markets, To Join Faculty

"Kimberly D. Krawiec, a leading expert in market regulation, will join the University of Virginia School of Law faculty in the fall.

...

“Kim is a major contemporary voice on misconduct and trade within forbidden or contested markets,” Dean Risa Goluboff said in welcoming Krawiec to the faculty.

...

"Krawiec, who visited at UVA Law in 2004, has taught both large lecture classes and smaller ones, including her recent favorites Taboo Trades and Forbidden Markets, and Advanced Contracts. “Taboo Trades” is also the name of the podcast she launched in August, which so far has covered topics ranging from marijuana legalization to blood and other “repugnant transactions.”

Organs and Inducements: Special Issue of Law and Contemporary Problems edited by Cook and Krawiec

Volume 77	2014	Number 3
Organs and Inducements
Philip J. Cook & Kimberly D. Krawiec Special Editors
Foreword PDF		Philip J. Cook & Kimberly D. Krawiec	i
A Primer on Kidney Transplantation: Anatomy of the Shortage PDF		Philip J. Cook & Kimberly D. Krawiec	1
Six Decades of Organ Donation and the Challenges That Shifting the United States to a Market System Would Create Around the World PDF		Alexander M. Capron	25
Regulating the Organ Market: Normative Foundations for Market Regulation PDF		I. Glenn Cohen	71
Perceptions of Efficacy, Morality, and Politics of Potential Cadaveric Organ-Transplantation Reforms PDF		Christopher T. Robertson, David V. Yokum & Megan S. Wright	101
Philanthropically Funded Heroism Awards for Kidney Donors? PDF		Muriel Niederle & Alvin E. Roth	131
Reverse Transplant Tourism PDF		Kimberly D. Krawiec & Michael A. Rees	145
Organs Without Borders? Allocating Transplant Organs, Foreigners, and the Importance of the Nation-State (?) PDF		I. Glenn Cohen	175
State Organ-Donation Incentives Under the National Organ Transplant Act PDF		Sally Satel, Joshua C. Morrison & Rick K. Jones	217
Designing a Compensated–Kidney Donation System PDF		T. Randolph Beard & Jim Leitzel	253
Altruism Exchanges and the Kidney Shortage PDF		Stephen J. Choi, Mitu Gulati & Eric A. Posner	289
Reciprocal Altruism—the Impact of Resurrecting an Old Moral Imperative on the National Organ Donation Rate in Israel PDF		Jacob Lavee & Avraham Stoler	323
Organ Quality as a Complicating Factor in Proposed Systems of Inducements for Organ Donation PDF		Michael L. Volk	337

Super bowl thought by Kim Krawiec: football players are paid, why not kidney donors?

While checking up on the super bowl, I'm reminded that Kim Krawiec posted this:
 Super Bowl Week OpEd

"As the Super Bowl approaches, Phil Cook and I have an OpEd running in the Raleigh News & Observer and a few other publications:

Why ban payment to kidney donors but not football players?

BY PHILIP J. COOK AND KIMBERLY D. KRAWIEC 

February 01, 2018 01:06 PM

Super Bowl week rivets national attention on America’s most popular and lucrative sport, professional football. If stories of concussion and permanent injury to players make some fans uneasy, there is always the reassuring fact that the players volunteer for the job and are well compensated – so well compensated that there are untold thousands of young men who would gladly take their place.

Football is so ingrained in our culture that we generally accept this situation without much scrutiny. However, our research got us thinking about the stark contrast with another risky but valuable activity – kidney donation.

About 6,000 people per year donate one of their two kidneys. This selfless act has some risk to the donor, both from the surgery and years later when there is a chance the remaining kidney will fail. In return, kidney donors are rewarded with the knowledge they helped save the life of a loved one. They receive nothing tangible. Indeed, federal law bans compensation for kidney donors, as do the laws of all other countries except Iran (really).

So, why do we pay football players to entertain the public, but are unwilling to pay kidney donors to save lives?

The stakes in both cases are high, but much higher in kidney donation. The total value of NFL teams is about $60 billion. If, in some unlikely future, the risk of serious permanent injury to players led to a ban on professional play, that value would be destroyed.

Meanwhile, the ban on compensation for living kidney donation currently costs thousands of lives and billions of dollars in taxpayer money every year. The waiting list for a kidney now includes 100,000 patients, who for the most part are kept alive by renal dialysis at federal government expense. If they survive long enough, typically more than five years, in this debilitated state, they may hope to rise to the top of the list and receive a kidney from a deceased donor.

Deceased donors are a limited resource: few people die under conditions that permit donation and the United States already procures a large percentage of healthy kidneys from deceased donors. What is needed are many more living donors. Current estimates suggest an offer of $50,000 per living donation would be adequate to recruit sufficient numbers to meet the needs of all transplant-eligible renal patients. This would eliminate the waiting list and prevent thousands of unnecessary deaths and years of unnecessary disability. Given standard value-of-life estimates, the present value of the public benefit of converting to a system of compensated donation would exceed $1 trillion – many times the value of professional football.

It should be noted that the alternative to the current ban on compensation is not a laissez-faire free market. Rather, the current system for regulating the allocation of available kidneys could be readily expanded. A nonprofit or government organization could offer a fixed payment to living donors who were screened to be physically and mentally sound, and then fully informed of the risks. To avoid “impulse” donations, there could be a mandatory waiting period.

And it should be noted that the medical risks to kidney donors are far less than the risks of a football career; most donors lead normal lives, while most NFL veterans are, to some degree, disabled.

Inevitably the chance to sell a kidney for $50,000 would be most attractive to people who are struggling financially. Some ethicists opine that a compensated system would exploit the poor. Yet, more than a few NFL players also come from poor homes and 70 percent are black, causing many to view the concussion crisis as another example of racial inequality. In our view, the risk of exploitation is not a legitimate reason for forbidding compensation to kidney donors, thus denying the poor full use of one of their potential assets.

Millions of Americans, not just NFL players, work in occupations that have a substantial risk ofserious injury. Loggers, fishermen and others accept these risks in exchange for compensation. Extending that list to include kidney donors is just common sense.

PHILIP COOK IS TERRY SANFORD PROFESSOR EMERITUS OF PUBLIC POLICY AND PROFESSOR OF ECONOMICS AND SOCIOLOGY AT DUKE UNIVERSITY’S SANFORD SCHOOL OF PUBLIC POLICY. KIMBERLY KRAWIEC IS THE KATHRINE ROBINSON EVERETT PROFESSOR OF LAW AT DUKE LAW SCHOOL."