1AC
1AC
Plan: The United States should legalize the regulated sale of nearly all human organs
in the United States.
Advantage 1 - Exploitation
Lifting prohibition on organ sales solves the current crisis and saves thousands.
Becker and Elias Nobel Prize Winner 14 “Cash for Kidneys: The Case for a Market for Organs, There is a clear remedy for the growing shortage of organ
donors”,By GARY S. BECKER and JULIO J. ELIAS Updated Jan. 18, 2014 4:58 p.m. ET http://online.wsj.com/news/articles/SB10001424052702304149404579322560004817176 Bio Mr. Becker is
a Nobel Prize-winning professor of economics at the University of Chicago and a senior fellow at the Hoover Institution. Mr. Elias is an economics professor at the Universidad del CEMA in
In 2012, 95,000 American men, women and children were on the waiting list for new kidneys, the
most commonly transplanted organ. Yet only about 16,500 kidney transplant operations were performed
that year. Taking into account the number of people who die while waiting for a transplant, this implies an average
wait of 4.5 years for a kidney transplant in the U.S. The situation is far worse than it was just a decade
ago, when nearly 54,000 people were on the waiting list, with an average wait of 2.9 years. For all the
recent attention devoted to the health-care overhaul, the long and growing waiting times for tens of thousands of
individuals who badly need organ transplants hasn't been addressed. Finding a way to increase the
supply of organs would reduce wait times and deaths, and it would greatly ease the suffering that many sick individuals now endure while they
hope for a transplant. The most effective change, we believe, would be to provide compensation to people who give
their organs—that is, we recommend establishing a market for organs. Organ transplants are one of the extraordinary developments of modern
Argentina.
science. They began in 1954 with a kidney transplant performed at Brigham & Women's hospital in Boston. But the practice only took off in the 1970s with the development of
immunosuppressive drugs that could prevent the rejection of transplanted organs. Since then, the number of kidney and other organ transplants has grown rapidly, but not nearly as rapidly as
Many of those waiting
for kidneys are on dialysis, and life expectancy while on dialysis isn't long. For example, people age 45 to 49
live, on average, eight additional years if they remain on dialysis, but they live an additional 23 years if
they get a kidney transplant. That is why in 2012, almost 4,500 persons died while waiting for kidney
transplants. Although some of those waiting would have died anyway, the great majority died because they were
unable to replace their defective kidneys quickly enough. The toll on those waiting for kidneys and on their families is enormous, from both
greatly reduced life expectancy and the many hardships of being on dialysis. Most of those on dialysis cannot work, and the annual cost of dialysis averages
about $80,000. The total cost over the average 4.5-year waiting period before receiving a kidney transplant is $350,000,
which is much larger than the $150,000 cost of the transplant itself. Individuals can live a normal life with only one kidney, so about
the growth in the number of people with defective organs who need transplants. The result has been longer and longer delays to receive organs.
34% of all kidneys used in transplants come from live donors. The majority of transplant kidneys come from parents, children, siblings and other relatives of those who need transplants. The
rest come from individuals who want to help those in need of transplants.
In recent years, kidney exchanges—in which pairs of living would-be
donors and recipients who prove incompatible look for another pair or pairs of donors and recipients who would be compatible for transplants, cutting their wait time—
have become more widespread. Although these exchanges have grown rapidly in the U.S. since 2005,
they still account for only 9% of live donations and just 3% of all kidney donations, including after-death
donations. The relatively minor role of exchanges in total donations isn't an accident, because exchanges are really a
form of barter, and barter is always an inefficient way to arrange transactions. Exhortations and other efforts to encourage more organ
donations have failed to significantly close the large gap between supply and demand. For example,
some countries use an implied consent approach, in which organs from cadavers are assumed to be
available for transplant unless, before death, individuals indicate that they don't want their organs to be
used. (The U.S. continues to use informed consent, requiring people to make an active declaration of
their wish to donate.) In our own highly preliminary study of a few countries—Argentina, Austria, Brazil,
Chile and Denmark—that have made the shift to implied consent from informed consent or vice versa,
we found that the switch didn't lead to consistent changes in the number of transplant surgeries. Other
studies have found more positive effects from switching to implied consent, but none of the effects
would be large enough to eliminate the sizable shortfall in the supply of organs in the U.S. That shortfall isn't just an
American problem. It exists in most other countries as well, even when they use different methods to procure organs and have different cultures and traditions. Paying donors
for their organs would finally eliminate the supply-demand gap. In particular, sufficient payment to kidney donors would increase the
supply of kidneys by a large percentage, without greatly increasing the total cost of a kidney transplant. We have estimated how much individuals would need to be paid for kidneys to be
willing to sell them for transplants. These estimates take account of the slight risk to donors from transplant surgery, the number of weeks of work lost during the surgery and recovery
periods, and the small risk of reduction in the quality of life. Our conclusion is that
a very large number of both live and cadaveric kidney
donations would be available by paying about $15,000 for each kidney. That estimate isn't exact, and the true cost could be as high as $25,000 or as low as
$5,000—but even the high estimate wouldn't increase the total cost of kidney transplants by a large
percentage. Few countries have ever allowed the open purchase and sale of organs, but Iran permits the sale of kidneys by living donors. Scattered and incomplete evidence from
Iran indicates that the price of kidneys there is about $4,000 and that waiting times to get kidneys have been largely eliminated. Since Iran's per capita income is one-quarter of that of the U.S.,
this evidence supports our $15,000 estimate. Other countries are also starting to think along these lines: Singapore and Australia have recently introduced limited payments to live donors that
Since the number of kidneys available at a reasonable price would be far more
than needed to close the gap between the demand and supply of kidneys, there would no longer be any
significant waiting time to get a kidney transplant. The number of people on dialysis would decline
dramatically, and deaths due to long waits for a transplant would essentially disappear. Today, finding a
compatible kidney isn't easy. There are four basic blood types, and tissue matching is complex and involves the combination of six proteins. Blood and tissue type
determine the chance that a kidney will help a recipient in the long run. But the sale of organs would result in a large supply of most
kidney types, and with large numbers of kidneys available, transplant surgeries could be arranged to suit
the health of recipients (and donors) because surgeons would be confident that compatible kidneys would be available. The system that we're proposing
would include payment to individuals who agree that their organs can be used after they die. This is important
compensate mainly for time lost from work.
because transplants for heart and lungs and most liver transplants only use organs from the deceased. Under a new system, individuals would sell their organs "forward" (that is, for future
Relatives sometimes refuse to have organs used even when a
deceased family member has explicitly requested it, and they would be more inclined to honor such
wishes if they received substantial compensation for their assent.
use), with payment going to their heirs after their organs are harvested.
The massive shortage of organs in the United States is driving the underground organ
market.
Archer 13 Body Snatchers: Organ Harvesting For Profit Kidneys and other organs are selling to the
highest bidder on the black market. Published on November 13, 2013 by Dale Archer, M.D.
http://www.psychologytoday.com/blog/reading-between-the-headlines/201311/body-snatchers-organharvesting-profitRecently in China, a missing 6-year-old boy was found alone in a field, crying. Upon closer inspection, both eyes had been removed, presumably for the corneas.
In 2012, a young African girl was kidnapped and brought to the UK for the sole purpose of harvesting her organs. She was one of the lucky ones—rescued before she went under the knife.
Authorities feel this is just the tip of the iceberg. This isn't just an international occurrence. Kendrick Johnson, a Georgia teen, died at school January 2013. The local sheriff quickly determined
the death was a freak accident, that he suffocated after getting stuck in a rolled up mat in the school gym. Johnson's parents however, could not—would not—accept that. Six months after his
death, they obtained a court order to have the body exhumed for an independent autopsy. The pathologist was stunned when he found the corpse stuffed with newspaper. The brain, heart,
lungs and liver were missing. He also discovered Johnson's death was due to blunt force trauma to the right side of his neck. The FBI is now involved in this disturbing case with potentially
shattering reverberations. Nancy Scheper-Hughes has spent over ten years studying the dark side of organ harvesting and trafficking which is driven by greedy middle men and desperate,
Black market organs are being transplanted in New York, Philadelphia, and Los Angeles at
$150,000 a pop. She reports there are "broker-friendly" US hospitals, complete with surgeons who either don't
know or don't care where the organs come from. Organ donation is only possible if the organ in question has blood and oxygen flowing through it
wealthy recipients.
until the time of harvesting. A living donor can give a whole kidney, a portion of their liver, lung, intestine or pancreas. Otherwise, the donor must be declared brain dead while circulation and
Today, 120,771 people are waiting for an organ, and 18 will die every day while waiting.
Just one donor has the ability to save up to 8 lives. Where there's a demand, there's a way. And for the wealthy money is no object when it
comes to a vitally needed body part. Organ donation is strictly regulated in the US, yet a black market is alive and well.
Typically a broker will team up with a funeral home director, forging consent forms and a death
certificate to harvest human tissue before the body is cremated or buried. Sometimes organs are
harvested from a living victim for compensation. In the worst case it involves kidnapping for the purpose
of organ harvesting. Always at the end of the chain is a wealthy recipient, willing to pay big bucks with no questions
asked. In some countries, impoverished villagers may sell an organ for several hundred dollars. In others, organ
harvesting is tied to human trafficking. Children sold into slavery or a life of sexual abuse are also used for their organs.
There's a black market for hearts, lungs, and livers, but the kidney is the most sought after. According to
the World Health Organization, approximately 7,000 kidneys are illegally harvested annually by traffickers
worldwide and the prices vary widely by country. The average buyer spends $150,000 (though prices in excess of $200,000 are common) while
the average donor gets $5,000. The big profits go the the middle men and “organ brokers”. In the US 98,463
oxygenation remain intact.
individuals are waiting for a kidney as of October 25, 2013. Of those, about half will die before they
receive one. The profits are huge, and money is a temptation many brokers and doctors just cannot resist. In 2010 WHO estimated about 11,000
organs were obtained on the black market. WHO also claims that an organ is sold every hour of every day, 365/7.
What is your kidney worth to you? A broker located in China openly advertised "Donate a kidney, buy a new iPad!" In addition, the donor would be compensated $4,000 and it could be
There's an enormous demand for organs, and whenever there's gap
between supply and demand desperate buyers and desperate sellers will dictate a black market. Now
organized crime is involved, sometimes leaving the poor victim without their organ and quite possibly
without being paid. Even here in the U.S., there have been accusations (no proof) of allowing patients on
life support to die in order to remove the organs while the heart is still beating. This is a multi-million
dollar industry, and as the wealth gap continues to widen, it’s only expected to get worse.
harvested quickly and easily in as little as 10 days.
Organ trafficking is a modern day form of slavery – the market is widespread and
growing
The Kubrick Theme. 2012 Human Trafficking is Modern Day Slavery,
http://fightslaverynow.org/why-fight-there-are-27-million-reasons/otherformsoftrafficking/organremoval/
Organ removal, while not as prevalent as sex and labor trafficking, is quite real and widespread. Those
targeted are sometimes killed or left for dead. More frequently poor and desperate people are lured by
false promises. The World Health Organization estimates that as many as 7,000 kidneys are illegally
obtained by traffickers every year as demand outstrips the supply of organs legally available for
transplant. A black market thrives as well in the trade of bones, blood and other body tissues. This
activity is listed in the United Nations’ Trafficking in Persons Protocol: Article 3(a)… Exploitation shall
include, at a minimum, the exploitation of the prostitution of others or other forms of sexual
exploitation, forced labour or services, slavery or practices similar to slavery, servitude or the removal of
organs. The inclusion of this form of exploitation into the Protocol is intended to cover those situations
where a person is exploited for the purposes of a trafficker obtaining profit in the ‘organ market’, and
situations where a person is trafficked for the purpose of the removal of their organs and/or body parts
for purposes of witchcraft or traditional medicine. In the former situation, market forces drive supply
and demand; those in desperate need of an organ transplant will purchase an organ from those who are
desperately poor, or from ‘brokers’ who may have forcibly or deceptively obtained the organ. Kidneys
are generally supplied by live ‘donors’ in underdeveloped countries to developed ones. An article in the
medical journal Lancet reported: “…the circulation of kidneys followed established routes of capital from
South to North, from East to West, from poorer to more affluent bodies, from black and brown bodies
to white ones and from female to male or from poor, low status men to more affluent men. Women are
rarely the recipients of purchased organs anywhere in the world.” (Scheper-Hughes,Vol. 361, 10 May
2003)
These practices dehumanize and oppress of millions of persons worldwide—a
collective moral responsibility exists to combat the systemic harms of organ trafficking
Shahinian, 2013 – Special Rapporteur on Contemporary Forms of Slavery, United Nations (Gulnara,
April 26, 2013, “Slavery must be recognised in all its guises,” The Guardian,
http://www.guardian.co.uk/global-development/poverty-matters/2013/apr/26/slavery-recognised-allguises, Hensel)
Five years ago, I became the UN's first special rapporteur on contemporary forms of slavery. Since
then, I have been asked time and again by government officials, businesspeople and NGOs not to use
the word "slavery" at all. I have been asked to change the name of my mandate and not speak out about
what I have seen. They have asked me to use other words instead – ones that don't carry the same
meanings or implications.¶ ¶ Yet what other word describes people who have been beaten mercilessly,
shut indoors, made to work without pay, sexually abused, poorly fed and threatened with more abuse
against themselves and their family if they attempt to leave? This is not just violence or exploitation.
What describes the situation in which a mother has no right over her child, or a father is forced to put
down his own life – and those of his family – as collateral, working for nothing to try to repay a debt that
will never go away? These are the forms of slavery that exist today.¶ ¶ Millions of people live in some
form of enslavement. The exact numbers are impossible to calculate. Modern slavery is one of the most
powerful criminal industries (pdf), and it is because of our collective silence and refusal to acknowledge
its existence that it thrives and transforms itself into new forms year after year. By not speaking out, we
are helping to perpetuate an industry that strips millions of their humanity and rights.¶ ¶ Slavery did not
end when it was legally abolished. Instead, it is flourishing, extending its tentacles into every corner of
the planet.¶ ¶ This is something that touches all our lives. It is almost impossible not to be complicit. How
many of us ask ourselves who makes biofuels, jewellery, vegetables, fruit, clothes, shoes and even
carpets? We all enjoy the cheap fruits of enslavement, while telling ourselves that exploitation happens
"over there" and is nothing to do with our own country or community.¶ ¶ Sex trafficking is finally
starting to receive visibility as the horrendous human rights abuse it is. Yet more widespread forms of
slavery and trafficking continue to go unreported and ignored.¶ ¶ I have spent the past five years talking
to people in forced labour, domestic servitude, bonded labour, servile marriages and child slavery. These
forms of slavery remain invisible, since people are silenced by discrimination, fear of retaliation and lack
of awareness. These modern forms of human slavery and criminal acts are often excused as tradition,
culture, religion or poverty, or dismissed as nothing more than bad labour practices.¶ ¶ The slavery
industry relies on the invisibility of those it preys on. Those trapped are not visibly shackled, but they do
live their lives under the control of others.¶ ¶ For the world to tackle slavery effectively, we need to
recognise this industry in people in all of its manifestations. Human rights are equal and inalienable. I
have met organisations working on ending forced marriage, or on the abuse and exploitation of
domestic workers and children, who feel they are unable to call these abuses slavery as the word is too
loaded and they would put their work at risk. This must stop. Slavery is slavery, no matter what form it
takes.¶ ¶ We must face up to all forms of slavery or inadvertently ignore the plight of millions. One type
of slavery, such as sex trafficking, cannot be considered more worth fighting for than another. We have
a collective responsibility to end this pernicious and persistent problem.¶ ¶ All countries must ensure
that they have national legislation prohibiting and criminalising all forms of slavery, and this legislation
must be properly enforced. The failure of justice systems to put anti-slavery laws into action is one of
the props the slavery industry relies upon. This needs to change.¶ ¶ To combat slavery, we need to speak
for people who have been silenced by this most brutal of trades. We must stop being complacent, and
find the courage to hold individuals, companies and governments accountable. Complacency is no
longer an option.
¶
Markets for procurement are the most ethical solution
-
Blood market disproves altruism t/o
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Costs not high enough to coerce, egg sales disprove
-
Need-based allocation
Sobota, 2004 (Margaret R. Sobota B.A. Biology (2002), B.A. Philosophy (2002), University of North
Carolina; J.D. Candidate (2005), Washington University School of Law, Fall 2004, “THE PRICE OF LIFE: $
50,000 FOR AN EGG, WHY NOT $ 1,500 FOR A KIDNEY? AN ARGUMENT TO ESTABLISH A MARKET FOR
ORGAN PROCUREMENT SIMILAR TO THE CURRENT MARKET FOR HUMAN EGG PROCUREMENT” 82
Wash. U. L. Q. 1225, lexis)
The main argument against establishing a market for organ procurement is economic coercion. n141
Market opponents insist that poor, destitute people from around the world will be forced into selling
their organs without making an informed decision. n142 There are several flaws with this argument.
n143 First, the economic coercion argument is based on the false premise that the prices donors will be
paid for their organs will be high enough to override their doubts and ethical concerns about becoming a
donor. n144 In the proposed market system for organ procurement, either OPOs or the state will be
paying the donors; thus preventing potential wealthy recipients from driving up the prices paid for
organs. n145 With only moderate prices being paid to organ donors, economic incentives would likely
not outweigh a donor's moral objections to donation, and thus no economic coercion would occur. n146
Additionally, the current market system for egg donation suggests that economic coercion would not be
a problem in a market for organ procurement. n147 A majority of egg donors are not poor or minority
women, and the amounts paid to them for their donations are usually not an "undue inducement to
undergo the medical [*1246] risks involved." n148 These facts suggest that if a system of financial
compensation for organ donation were established, comparable to the system already in place for egg
donation, there would similarly be no economic coercion of donors. A second argument commonly
advanced against proposed markets for organ procurement is that any such market would reduce
altruism and people who would have donated their organs under an altruistic system will no longer
want to donate their organs under a market system because they find a market for human organs
despicable. n149 However, there is no evidence that altruism and a market system cannot coexist. n150
A comparison to the current blood market in the United States shows that there is no evidence of
reduced altruism in that system, which relies on altruistic donations as well as paid donations. n151 A
final argument commonly advanced against proposed markets for organ procurement is that such
markets would create unequal access to organs depending on the potential recipient's wealth. n152 This
concern only applies to markets for organ allocation, not procurement as advocated here. n153 A
market for organ allocation would likely have this problem; wealthy recipients would be able to bid for
their new kidneys, while poor recipients would be left helpless. n154 However, a market system of
[*1247] procurement will not in any way affect how organs are currently allocated by UNOS.
It is actually far more exploitative to not compensate donors – circumvents undue
inducement and value to risk. Legal and regulated activity recalibrates the market.
James Stacey Taylor and Mary Simmerling, 2008 “Donor Compensation without exploitation”, Sally
Satal, MD editor When Altruism isn’t Enough: The Case for Compensating Kidney Donors, pg. 57
Yet the fact that potential donors are motivated by financial gain rather than by altruism is not sufficient
to show they are acting less than fully voluntarily, that they autonomy is impaired through pressure
applied to their will or that they are being exploited. Indeed, perhaps it is exploitative not to
compensate donors. As altruistic kidney donor Virginia Postrel has written, “expecting people to take
risks and give up something of value without compensation strikes me as a far worse form of
exploitation than paying them. I don’t expect soldiers or police officers to work for free, and I don’t
think we should base our entire organ donation system on the idea that everyone but the donor should
get paid. Like all price controls, that creates a shortage – in this case, a deadly one. And while giving up
a kidney has risks, it is no more risky and far less emotionally fraught than being a surrogate mother.
Furthermore, a compensation program can circumvent the risk of undue inducement by not catering to
the desperate. Such individuals desire cash and want it immediately. The proposed system would
establish a months long period of medical screening and education. It would also provide in kind
rewards, or cash paid out in modest amounts over a long period of time (a strategy which, incidentally
would also ensure that donors return for follow up care). Such a system of compensation would
probably not be attractive to people who might otherwise rush to flawed judgment –and surgery on the
promise of a large sum of instant cash. Thus, a legal system of compensation with strict donor
protections creates conditions in which the decision to relinquish a kidney can be informed and
influenced by an offer rather than distorted by it.
Regulated structure of compensation is the best way to prevent abuse of donors
Taylor and Stimmerling ‘8 (James Stacey Taylor is an assistant professor of philosophy at the
College of New Jersey, and Mary C. Simmerling is the assistant dean for research integrity and an
assistant professor of public health at Weill Cornell Medical College, Cornell University. When Altruism
isn’t Enough. “Donor Compensation without Exploitation”. American Enterprise Institute. 2008.)
http://www.aei.org/files/2014/07/14/-when-altruism-isnt-enough_161836373082.pdf
Participants in the organ trade are often desperately poor, living on the edge of financial ruin. As Goyal
demonstrated, they are also often worse off after kidney removal than before, for several reasons. First,
the operation itself can pose obstacles to long term gain. Surgeons in third-world countries commonly
use a so-called retroperitoneal flank approach to remove the kidney—a primitive surgical technique that
involves a nine-inch incision running from the top of the hip to the base of the ribs. The difference in the
rate of healing compared to donors in developed countries who undergo a minimally invasive
laparoscopic procedure is significant. Furthermore, most donors are laborers. It may be several weeks
before a patient with a nephrectomy can return to work. When heavy manual labor is involved, the
delay is even longer. With no money being earned during recuperation, no guarantee that medical
complications will receive attention, and no assurance that jobs will be held for them (conditions which,
for example, characterize Iran’s legal system of donor compensation), it is no surprise that donors rarely
enjoy financial benefit.47 This outcome, sad as it is, has little relevance to the donor compensation
model proposed here. First, compensated U.S. donors would undergo a much less invasive procedure.
Second, care of surgical and medical complications would be ensured. Third, expenses, including lost
wages, would be covered.
Altruism alone fails - overall organ supply would increase post plans. Empirics prove
market structure works.
Robert Steinbuch∗ Visiting Associate Professor, University of Georgia School of Law. Associate
Professor of Law, University of Arkansas at Little Rock, William H. Bowen School of Law.
J.D. from, and John M. Olin Law & Economics Fellow at, Columbia Law School 2009 ARTICLE
KIDNEYS, CASH, AND KASHRUT: A LEGAL, ECONOMIC, AND RELIGIOUS ANALYSIS OF SELLING KIDNEYS
Houston Law Review, Vol. 45, p. 1529, 2009
The Concern that a Kidney Market Will Displace Altruistic Donations. Some fear that once kidneys are
priced, altruistic donors will likely drop out of the market or, instead, become organ sellers
themselves.368 ìThere is concern that a system which allows payment for transplantable organs will
deter a voluntary donor who considers a payment system unethical or unsavory.î369 Critics cite, for
instance, that in Kuwait, ìseveral well-matched relatives of potential recipients . . . withdrew their offer
of donation after they learned that their relatives [could] go to India and buy a kidney in the market
place.î370 But allowing a market for human organs would not require donors to accept compensation
for their organs; they could and, more importantly, would often still donate freely.371 As evidence of
this fact, we need only examine the market to compensate donors of blood products, which has not
hindered those who wish to donate blood voluntarily.372 Nonprofit institutions collect roughly fourteen
million units of blood a year.373 Similarly, the market system for producing eggs has not precluded
altruistic incentives for donations.374 It coexists with altruism and functions more effectively than an
altruistic model alone would at satisfying the demand for eggs.375 No valid empirical evidence
demonstrates that any possible drop in altruistic donors would not be significantly offset by the gain in
organs obtained from permitting kidney sales.376 Indeed, there can be little debate that ìthe greater the
payment, the greater the increase in transplantable organs.
Advantage 2 - Disease
Scenario 1 is Transplant Tourism
Transplant tourism is growing and the plan solves
Torrrey 14
“Organ Trafficking and Transplant Tourism, Buying and Selling Human Organs” By Trisha Torrey Updated June 13, 2014 http://patients.about.com/od/healthcarefraud/a/Organ-Trafficking-And-
Transplant-Tourism.htm http://patients.about.com/bio/Trisha-Torrey-35320.htm Bio:Trisha is recognized by patients and professionals alike for her ability to translate the challenges patients face into t ools and solutions they can use to improve their health care. Her
work is broad-based. In addition to her writing and speaking, she has built a website called the AdvoConnection Health Advocate Directory to help connect patients and patient advocates, where she also provides business advice to the advocates who participate through The Alliance of
Professional Health Advocates (APHAdvocates.org) Trisha's first book, You Bet Your Life! The 10 Mistakes Every Patient Makes (How to Fix Them to Get the Healthcare You Deserve) was published for patients and caregivers in early 2010, later revised and updated in 2013 to address the
changes and new issues brought about by the Affordable Care Act. Her second and third books, The Health Advocate's Marketing Handbook and The Health Advocate's Start and Grow Your Own Practice Handbook,were written to help private health and patient advocates help patients.
It's not unusual to find Trisha quoted in the mainstream media, including CNN, MSNBC, NPR, The Wall Street Journal, O Magazin e, Time and More magazines.
Such commercialization of human organs, called organ trafficking should be no surprise. There is clearly
a market comprised of people who need money, and people of means who are willing to spend money
for organs. It's a black market, meaning the practice is wholly illegal and secretive. But it's a market all
the same, comprised of "haves" on the demand side, and "have nots" on the supply side. Experts from
the World Health Organization estimate 11,000 illegal organ transactions took place in 2010. This
"transplant tourism" is surging in popularity, even in the United States, for at least three reasons. First,
because the numbers of people who need organs is growing. Second, because the transplant lists, such
as those determined by UNOS in the United States are getting longer and longer. And third, because the
world economic crisis is forcing people to look at ways they can make money. Selling their organs can
put food on the table.
That’s Key to Prevent the risk of multiple disease pandemics; including AIDS and
tropical diseases.
Paredes 2010, Carlos Franco, International Journal of Infectious Diseases, Volume 14, Issue 3, March
Pages e189–e196
Many transplanted patients may live or travel to regions where some of the most frequent viral tropical
infections are prevalent. Transplant recipients traveling to resource-constrained settings endemic for
tropical infections including yellow fever, dengue, rabies, and other viral pathogens should seek expert
pretravel medical advice to maximally decrease their risk of infection. This is important as
immunosuppression associated with transplantation may affect the outcome of acute viral infections or
the course of virus latency, with potential life-threatening consequences. There are reports of
HIV, hepatitis B, hepatitis C, measles, human T-lymphotropic virus type 1 (HTLV-1) infection dengue, and
other viral pathogens being responsible for significant sequelae and mortality in transplant recipients. In
this regard, yellow fever presents a risk to transplant recipients who are traveling to endemic areas in part
Transplant tourism has been responsible for a significant
number of patients acquiring hepatitis B, hepatitis C, or HIV-infection in those
transplanted overseas. There may also be an increased risk of West Nile virus infection,
lymphocytic choriomeningitis virus, or some hemorrhagic fever virus in many tropical areas of the
world, including some parts of the Indian subcontinent, sub-Saharan Africa, and Latin America, but there are only recent descriptions, mostly in non-tropical settings. It remains to be
because the vaccine is live and therefore should be avoided.
determined if other similar flaviviruses such as Japanese encephalitis virus may pose an increased risk of complications in transplant recipients. Rabies is rarely observed after transplantation
with increasing travel of transplant recipients to
areas where rabies may be more prevalent and also due to transplant tourism, rabies
becomes a potential pathogen for transplant recipients. In addition, live rabies vaccine for use in wildlife has caused human disease
with only a few cases acquired from infected donors in industrialized countries. However,
and presents a potential risk to transplant recipients who come into direct contact with wildlife. 3 We discuss below, in more detail, some HTLV-1, measles, and dengue virus infections in
transplant recipients. Although these infections may be acquired in non-tropical settings, the risk of their acquisition is higher in developing tropical areas of the world.
Tropical diseases overcome generic defenses --- extinction
Franca et al. 13 (R. Franca, Department of Pharmacology, School of Medicine of Ribeirao Preto,
University of Sao Paulo, Brazil, C. C. de Silva, Department of General Biology, Federal University of
Vicosa, Brazil, S.O. De Paula, Laboratory of Molecular Immunovirology, Federal University of Vicosa,
Brazil, “Recent Advances in Molecular Medicine Techniques for the Diagnosis, Prevention, and Control of
Infectious Diseases,” Springer-Verlag Berlin Heidelberg, submitted November 26, 2012, published
January 22, 2013, pg. 1)
In recent years we have observed great advances in our ability to combat infectious diseases. Through
the development of novel genetic methodologies, including a better understanding of pathogen biology,
pathogenic mechanisms, advances in vaccine development, designing new therapeutic drugs, and
optimization of diagnostic tools, significant infectious diseases are now better controlled. Here, we
briefly describe recent reports in the literature concentrating on infectious disease control. The focus of
this review is to describe the molecular methods widely used in the diagnosis, prevention, and control of
infectious diseases with regard to the innovation of molecular techniques. Since the list of pathogenic
microorganisms is extensive, we emphasize some of the major human infectious diseases (AIDS,
tuberculosis, malaria, rotavirus, herpes virus, viral hepatitis, and dengue fever). As a consequence of
these developments, infectious diseases will be more accurately and effectively treated; safe and
effective vaccines are being developed and rapid detection of infectious agents now permits
countermeasures to avoid potential outbreaks and epidemics. But, despite considerable progress,
infectious diseases remain a strong challenge to human survival. Introduction Despite the great
advances in medicine, particularly in new therapeutic drugs, diagnostic tools, and even ways to pre- vent
diseases, the human species still faces serious health problems. Among these problems, those that draw
the most attention are infectious diseases, especially in poor regions. An important feature of infectious
disease is its potential to arise globally, as exemplified by known devastating past and present
pandemics such as the bubonic–pneumonic plague, Spanish flu (1918 influenza pandemic), and the
present pandemic of human immunodeficiency virus (HIV), in which an estimated 33.3 million persons
were living with the HIV infection worldwide at the end of 2009 [1–3]. In addition, other non-viral
diseases are significant public health problems, as exemplified by tuberculosis (TB). This infectious
disease accounts for one third of the world’s bacterial infections (TB infected), and in 2010 a total of 8.8
million people worldwide became sick with TB [1, 4]. In recent years, new forms of infectious diseases
have become significantly important to medical and scientific communities; these forms are now widely
known as emergent and re-emergent infectious diseases. With the appearance of new transmissible
diseases, such as SARS, West Nile and H5N1/H1N1 Influenza viruses, in addition to reemerging diseases
like dengue fever, the concerns about a global epidemic are not unfounded [5]. Moreover, in the
tropical and subtropical regions of the world, parasitic infections are a common cause of death. Since
one of the major characteristics of infectious diseases is its inter-individual transmission, advances in
personal protection, effective public policy, and immunological procedures are efficient means of
controlling the spread of these diseases. Thus, improvement of pre-existing technologies commonly
used to monitor, prevent, and treat infectious diseases is of crucial importance not only to the medical
community, but also to humankind.
Additionally, The Gram Negative Plasmid NDM-1 has potential for huge international
spread because of transplant tourism.
Tamara L. Hill Chicago Journal of International Law Summer, 2011 12 Chi. J. Int'l L. 273
COMMENT: The Spread of Antibiotic-Resistant Bacteria through Medical Tourism and Transmission
Prevention Under the International Health Regulations
Medical tourism--travel by healthcare patients to a foreign location for medical treatment--is a growing
industry. n1 Broadly, medical tourism may refer to all travel for healthcare, but the most typical
definition focuses particularly on international medical tourism, which is travel between countries for
medical treatment. This definition does not include healthcare provided to foreign tourists that is
incidental to travel for other purposes, such as business or recreation. Many patients travel abroad for
medical treatment due to significant cost savings, to utilize procedures not approved for treatment in
their resident countries, or to exercise control over healthcare where public or private [*276] insurance
plans provide limited treatment options. n2 Healthcare is nationally regulated in every country, and
difficulties arise where legal remedies and standards vary between a medical tourist's resident and
destination country. In particular, medical malpractice, safety certification and licensing, and privacy are
recurring topics in medical tourism literature. n3 Other ethical issues have been addressed by political
organizations and the media, including lack of available care for residents of medical tourism destination
countries or black market organ transplants. n4 However, not all of the repercussions of medical tourism
are limited to those affecting only the patient, such as safety, cost, and liability. Antibiotic-resistant
bacteria are typically limited to healthcare settings, and strains of antibiotic-resistant bacteria that
spread outside of a healthcare setting, like community-associated methicillin-resistant staphylococcus
aureus (MRSA), provoke more concern, since healthcare-associated strains have predictable risk factors.
n5 These predictable risk factors generally reduce concern regarding healthcare-associated strains in the
medical community because hospitals can set admission and contact policies to reduce the spread of
healthcare associated strains. As medical tourism increases, however, the spread of healthcareassociated antibiotic-resistant bacteria infections is also likely to increase, because patients are more
likely to be exposed to hospitals and healthcare settings in different countries and thus spread their
infections to facilities around the world. Exposure without patient knowledge, language barriers, and
[*277] inconsistent healthcare regulation and hospital policies reduce the predictability of transmission.
One recently discovered antibiotic-resistant strain of bacteria, named New Delhi metallo-beta-lactamase
(NDM-1), has shown evidence of fast international spread due to connections with medical tourism. n6
The Spread is quick –it makes every other disease Gram Negative – That Creates
SuperBugs
Goan Observer 2010, 8-21-10, “Delhi Bugged?”, http://goanobserver.com/delhi-bugged.html
In a summary of the study on the website of The Lancet, the team claims to have ‘identified
44 isolates with NDM-1 in Chennai, 26 in Haryana, 37 in the UK, and 73 in other sites in
India and Pakistan…. Many of the UK NDM-1 positive patients had travelled to India or
Pakistan within the past year, or had links with these countries’ and further add that ‘The
potential of NDM-1 to be a worldwide public health problem is great and co-ordinated
international surveillance is needed’. Those affected by this ‘superbug’ were reported to be
critically ill and were, at times, observed to be suffering from blood poisoning. NDM-1 enzyme,
if it is really indomitable, can be expected to make all the bacterial diseases invincible in near
future. With more people travelling to find less costly medical treatments, particularly for
procedures such as cosmetic surgery, Timothy Walsh, who led the study, said he feared the
new superbug could soon spread across the globe.
Must Act Now - Anti-biotic Bubble is Set to Burst
Katherine Xue May-June 2014 Katherine Xue ’13 is associate editor of Harvard magazine. Superbug: An
Epidemic Begins http://harvardmagazine.com/2014/05/superbug
NEARLY 80 years after the antibiotic revolution, the human relationship with S. aureus is again on the
verge of change. Genes for vancomycin resistance are increasingly prevalent, and on at least 12 separate
occasions, they have entered MRSA to create new, vancomycin-resistant strains. Resistance to last-line
drugs is brewing in many other bacterial species as well. Chance will determine when resistance finally
catches on, and resistant strains spread through the bacterial population—taking the place of what has
come before, once again transforming the game of survival that humans and microbes play. Can humans
evolve first? Bacterial evolution occurs with barely imaginable rapidity. But the antibiotic revolution that
transformed our ancient relationship started not with a gene, but with an idea. This idea, once
harnessed and spread through society at scale—the human version, perhaps, of horizontal gene
transfer—has enabled our species to remain ahead. The pieces are in place for change. We have our
own means of resistance, and they are already common in parts of the human population. Activism and
awareness are ancient, while the seeds of scientific innovation are new. What has been missing is the
impetus for change, the pressure that causes an idea to spread. “How big does this problem have to get
for us to do something about it?” asks Michael Gilmore. “The challenge is, there’s a lag between when
we realize a problem is big enough and when we can come up with a solution.” The cause may be a gene
or an idea. But sometime soon, an epidemic will begin.
Extinction
Yu 9, Victoria Yu, Dartmouth Journal of Undergraduate Science, “Human Extinction: The Uncertainty of
Our Fate”, 5-22-09 http://dujs.dartmouth.edu/spring-2009/human-extinction-the-uncertainty-of-ourfate
A pandemic will kill off all humans. In the past, humans have indeed fallen victim to viruses.
Perhaps the best-known case was the bubonic plague that killed up to one third of the
European population in the mid-14th century (7). While vaccines have been developed for the
plague and some other infectious diseases, new viral strains are constantly emerging — a
process that maintains the possibility of a pandemic-facilitated human extinction. Some
surveyed students mentioned AIDS as a potential pandemic-causing virus. It is true that
scientists have been unable thus far to find a sustainable cure for AIDS, mainly due to HIV’s
rapid and constant evolution. Specifically, two factors account for the virus’s abnormally high
mutation rate: 1. HIV’s use of reverse transcriptase, which does not have a proof-reading
mechanism, and 2. the lack of an error-correction mechanism in HIV DNA polymerase (8).
Luckily, though, there are certain characteristics of HIV that make it a poor candidate for a
large-scale global infection: HIV can lie dormant in the human body for years without
manifesting itself, and AIDS itself does not kill directly, but rather through the weakening of
the immune system. However, for more easily transmitted viruses such as influenza, the
evolution of new strains could prove far more consequential. The simultaneous occurrence of
antigenic drift (point mutations that lead to new strains) and antigenic shift (the inter-species
transfer of disease) in the influenza virus could produce a new version of influenza for which
scientists may not immediately find a cure. Since influenza can spread quickly, this lag time
could potentially lead to a “global influenza pandemic,” according to the Centers for Disease
Control and Prevention (9). The most recent scare of this variety came in 1918 when bird flu
managed to kill over 50 million people around the world in what is sometimes referred to as
the Spanish flu pandemic. Perhaps even more frightening is the fact that only 25 mutations
were required to convert the original viral strain — which could only infect birds — into a
human-viable strain (10).
Scenario 2 Is Xenotransplantation
The shortage of kidneys is driving xenotransplantation research
Cowan et al. 2014 (Peter J. Cowan, PhD, David K.C. Cooper, MD, PhD, and Anthony J.F. d’Apice, MD,
1Immunology Research Centre, St Vincent’s Hospital, 2Department of Medicine, University of
Melbourne, 3Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center,
“KIDNEY XENOTRANSPLANTATION” Kidney Int. Feb 2014; 85(2): 265–275.)
Kidney transplantation, the best treatment for end-stage renal disease, is limited by the shortage of
human donors. Although the donor pool has been expanded by strategies such as paired donation and
the use of blood group-incompatible and non-heart-beating donors, it remains unlikely to meet the
increasing demand in the foreseeable future. This has driven a search for alternative sources of donor
kidneys. Much recent activity has focused on the generation of transplantable tissue from autologous
stem cells, but the complexity of the kidney makes this a long-term prospect at best (1). In contrast,
xenotransplantation using pigs as donors has been studied for several decades (2, 3), and porcine
cellular xenografts have already reached the stage of clinical trials (4). The pig is the animal donor of
choice for a number of reasons including relatively similar organ size and physiology, high reproductive
capacity, and the potential for genetic modification to prevent rejection and correct molecular
incompatibilities. Preclinical studies indicate that pig kidney xenotransplantation is feasible, with renal
xenografts supporting life for several weeks or months in non-human primate recipients (5-8). However,
despite considerable progress in recent years, the immunological and pathophysiological barriers have
not been completely overcome. The major challenge is to place renal xenografts on at least an equal
footing with allografts i.e. with comparable survival rates under similar levels of immunosuppression.
This is likely to require a combination of ‘humanized’ donors and clinically applicable
immunosuppressive protocols. Herein we will review the mechanisms of porcine renal xenograft
rejection and describe recent progress in moving kidney xenotransplantation to the clinic.
This is in spite of the fact that its not a solution to the shortage
Fovargue & Ost, 2010 (SARA FOVARGUE AND SUZANNE OST* Law School, Lancaster University.
August 17, 2010. “WHEN SHOULD PRECAUTION PREVAIL? INTERESTS IN (PUBLIC) HEALTH, THE RISK OF
HARM AND XENOTRANSPLANTATION” Med Law Rev (2010) 18 (3): 302-329.)
As the barriers to xenotransplantation have yet to be pre-clinically addressed, there is limited evidence
that genetically engineered pigs will be a source of viable organs. It is not known whether such an organ
will be able to support the life of a human, neither is it clear what risks the xeno-recipient and others
may be exposed to. Despite these uncertainties, researchers continue to work towards clinical trials,
with some suggesting these are ‘imminent’.55 It is thus essential to consider the more theoretical
question of whether to allow trials which may benefit a few but jeopardise the health of many more
and, first, the practical question of how, if permitted, such trials are regulated.
This Inflates the Risk of a New Epidemic and Mutation
Fano et al 2000
**MAs and MDs doing a lit review of Xenotransplantation [Alix Fano, M.A., Murry J. Cohen, M.D.,
Marjorie Cramer, M.D., F.A.C.S., Ray Greek, M.D., Stephen R. Kaufman, M.D., Executive Summary, Of
Pigs, Primates, and Plagues, A Layperson's Guide to the Problems With Animal-to-Human Organ
Transplants, http://www.mrmcmed.org/pigs.html] 4. We Should Learn From the Past Responsible public
health authorities would steer clear of xenotransplantation in the interest of human health, particularly
in light of the knowledge that animal viruses can jump the species barrier and kill humans. HIV - the
virus that causes AIDS - may be a simian immunodeficiency virus (SIV) that leapt the species barrier in
central Africa. Health authorities were unable to prevent the worldwide spread of HIV infection.
Similarly, they were unable to prevent Ebola outbreaks in Sudan, Zaire (1976, 1979, 1995) and the US
(1989, 1996). Furthermore, there is evidence that humans have become ill after consuming or being
injected with animal materials. There is a reported link between the smallpox vaccine (derived from
animal cells) and AIDS, a recently acknowledged link between human lung, brain and bone cancer and
the SV (simian virus) 40 (found in old batches of the Salk polio vaccine), and the threat of emerging
infectious diseases, including human Creutzfeldt-Jakob Disease (CJD) from the consumption of "mad
cows" in Europe, the Netherlands, and the US. 5. Why Nonhuman Primates Should Not Be Used As
Organ "Donors" Baboon viruses flourish on human tissue cultures, before killing the cultures. There are
over 20 known, potentially lethal viruses that can be transmitted from nonhuman primates to humans,
including Ebola, Marburg, hepatitis A and B, herpes B, SV40, and SIV. Numerous scientists have urged US
public health agencies to exclude primates as donors for xenotransplantation. 6. Why Pigs Should Not Be
Used As Organ "Donors" Given the acknowledged danger from nonhuman primate viruses, pigs are
being considered as the choice "donor" animals for xenotransplants. However, pig retroviruses have
infected human kidney cells in vitro; and virologists believe that many pig viruses have not been
adequately studied. Viruses that are harmless to their animal hosts, can be deadly when transmitted to
humans. For example, Macaque herpes is harmless to Macaque monkeys, but lethal to humans. The
deadly human influenza virus of 1918 that killed more than 20 million people worldwide was a mutation
of a swine flu virus that evolved from American pigs and was spread around the world by US troops.
Leptospirosis (which produces liver and kidney damage), and erysipelas (a skin infection), are among the
a pproximately 25 known diseases that can be acquired from pigs, all of which could easily affect
immunosuppressed humans. There may be myriad unknown "pig diseases" still to be discovered. In
addition, physiological and anatomical differences between humans and pigs call into question the
rationale for their use. These include differences in life-span, heart rate, blood pressure, metabolism,
immunology, and regulatory hormones. A pig heart put into a human will turn black and stop beating in
fifteen minutes. There is no clinical evidence to suggest that this acute cellular and vascular rejection will
ever be overcome, or that organs from genetically bred pigs are any less likely to be rejected by the
human body than those from conventional pigs. Moreover, the massive doses of immunosuppressive
drugs that would be required for such an operation would likely cause severe toxicity, and increase the
patient's chances of developing cancer. 7. Xenotransplantation Gives Animal Viruses Easy Access to
Humans Transplanting living animal organs into humans circumvents the natural barriers (such as skin
and gastrointestinal tract) that prevent infection, thereby facilitating the transmission of infectious
diseases from animals to humans. 8. No Way To Screen For Unknown Viruses There is no way to screen
for unknown viruses. Proceeding with xenotransplantation could expose patients and non-patients to a
host of new animal viruses which could remain dormant for months or years before being detected.
Many viruses, as innocuous as the common cold or as lethal as Ebola, can be transmitted via a mere
cough or sneeze. An animal virus residing in a xenograft recipient might become airborne, infecting
scores of people, and causing a potentially deadly viral epidemic of global proportions akin to HIV or
worse. It is highly unlikely that scientists and health care workers would be prepared to cope with such a
scenario. 9. Unanswered Medico-Legal Questions Would the US government be prepared to
compensate victims of xenogeneic infections (such as people who may inadvertently contract an
infection from a xenograft recipient)? The French government was forced to establish a $2.2 billion fund
to compensate victims of AIDS-contaminated blood transfusions administered between 1980 and 1985.
Compensation claims in the US have been filed by Persian Gulf War veterans, victims of secret
government-sanctioned radiation and syphilis experiments, Vietnam war veterans exposed to Agent
Orange, and parents of vaccine-damaged children. The government may now also be held liable for
failing to protect citizens fr//om SV40-contaminated polio vaccine. And what about patients who may
choose to participate in privately-funded research where there are no mechanisms of accountability to
federal health authorities, and little chance (for patients and non-patients) of receiving remuneration for
injury or death. Can we afford another public health catastrophe? 10. The Myth of the "Germ-Free"
Animal Xenotransplant proponents claim that they will breed "germ-free" animals to diminish the risk of
viral transmission. But in its June 1996 report, the Institute of Medicine acknowledged that "it is not
possible to have completely pathogen-free animals, even those derived by Cesarean section, because
some potentially infectious agents are passed in the genome and others may be passed
transplacentally." Some British virologists say that it would be "a daunting task to eliminate infectious
retroviruses from pigs to be used for xenotransplantation, given that [they] estimate approximately 50
PERV [pig endogenous retroviruses] per pig genome." 11. Weak Regulatory Oversight, and Human Error
and Negligence, Would Facilitate Disease Transmission Proposed regulatory oversight of
xenotransplantation procedures is weak and would likely be highly flawed. Virologist Jonathan Allan has
stated that, "in choosing voluntary guidelines to be enforced at a local level [via local institutional review
boards], . . . the FDA/CDC committee has chosen the least stringent and possibly least successful method
of policing these transplant procedures. Moreover, in all areas of human activity, particularly when
money is involved, the potential for fraud, error, and negligence exists. In the past, such behavior has
placed human health at considerable risk. Witness the HIV-contaminated blood scandals in France,
China, Japan, and the US, for example, in which employees and/or medical authorities knowingly
allowed HIV-contaminated blood to be used for transfusions and blood-clotting treatments for
hemophiliacs. Given the enormous amount of data, paperwork, and filing xenotransplant procedures
would generate, it would be naive (given human nature) to assume that data will be properly recorded,
stored, reviewed, and updated. Regulatory mechanisms often fail to prevent or correct these errors
and/or behaviors, the consequences of which could be disastrous in the face of a xenogeneic infection.
Extinction
Bach, Ivinson, & Weeramantry 01 a. Lewis Thomas Professor at Harvard Medical School and
Director of the Immunobiology Research Center at Beth Israel Deaconess Medical Center b. Former
Editor of Nature Medicine and former Publisher of the Nature monthly journals c. Former Vice President
and presently Judge Ad Hoc of the International Court of Justice [Prof. Fritz H. Bach+, Dr. Adrian J.
Ivinson++ and H.E. Judge Christopher Weeramantry*, Ethical and Legal Issues in Technology:
Xenotransplantation, American Journal of Law & Medicine]
One potential risks of xenotransplantation is that a pig virus might infect the human recipient, mutate
and spread first to the close contacts of the patient and then to the general population. The genetic
coding of pig viruses lie in the DNA of all pig cells, including the cells of the transplanted organ. While we
do not know how many pig viral sequences exist that could be of concern to us, we do know from
laboratory experiments that some pig viruses can infect human cells. Of course this laboratory
demonstration of infection is a long way from the natural world, and a simple, isolated, real life infection
is in turn a long way from an epidemic. Nonetheless, the [*286] risk, however remote, that a pandemic
could result as a consequence of pig-to-human organ transplantation exists. The viruses of most
concern, referred to as porcine endogenous retroviruses (PERV), n8 belong to the same family of
retroviruses that causes AIDS. Investigators have shown that in the test tube, a pig PERV can infect
human cells. PERV's have captured the headlines, probably because it is a relative of HIV and we really
have no effective treatment for AIDS. However, one must realize that PERV are not the only infectious
particle that could cause trouble. Just over a year ago, 104 pig farmers died and many more became sick
due to a previously unknown pig virus. What is the likelihood that a PERV or other pig viruses would
infect a human recipient, cause disease and be transmitted to others? There is no way of quantifying
that potential risk. What is known is that if the worst happened, i.e. the PERV did get out into the
general population and cause widespread disease, the consequences could be devastating by any
measure. Even if we did recognize that a patient had an illness caused by a pig virus, there is no
guarantee that we could identify the disease before that patient passed the disease to a close contact or
others. Complicating this picture of ignorance is the fact that we have no way of predicting when a virus
may manifest itself. The expression of the virus could occur after only a few or perhaps thousands of
xenotransplants have been performed. Almost certainly, we would have to perform xenotransplantation
on humans to ascertain this risk. And only if a patient became infected would we be able to begin
estimating the risk. 3. Different Approaches to the Risk. How does one balance the clear clinical value of
pig-to-human transplants (once the problems of rejection are solved) with this potential, unproven risk
to all of humanity? It seems almost an unsolvable problem. Therefore, classical risk-benefit analysis is
most difficult in this situation. Those concerned with this problem can be split into two groups. There
are those who are willing to start xenotransplantation to humans once the research warrants it (a
judgment that will not have uniform consensus). n9 These individuals propose a cautious approach: an
iterative process in which some small number of transplants would be performed and those patients
would be watched for some period [*287] of time before more transplants are done. n10 If there are no
signs of an infection by a pig virus, more procedures could be performed. Over time, this approach
would decrease, but not eliminate, the potential risk that an infectious epidemic would later emerge
due to a dormant virus that manifests only after many years of residence in the human host. Others feel
that the potential risks associated with xenotransplantation are too great to undertake the procedure.
n11 They point out that no matter how small the risk, if a viral outbreak does occur, the consequences
could be globally catastrophic. Further, they contend that alternative therapies to transplantation are
under development that may not carry such a risk and that may be available as soon as, or almost so, as
xenotransplantation.
Framing
Nuclear weapons- ensures safety of all great powers
Ikenberry 2014 [G. John Ikenberry is Albert G. Milbank Professor of Politics and International Affairs
at Princeton University and George Eastman Visiting Professor at Balliol College, University of Oxford.
May/ June 2014 Foreign Affairs “The Illusion of Geopolitics:The Enduring Power of the Liberal Order”]
Then there are the nuclear
weapons. These arms, which the United States, China, and Russia all possess (and Iran is seeking), help the
to the logic of mutual assured destruction, they radically reduce the
likelihood of great-power war. Such upheavals have provided opportunities for past great powers, including the United States in
World War II, to entrench their own international orders. The atomic age has robbed China and Russia of this opportunity. Second, nuclear
weapons also make China and Russia more secure, giving them assurance that the United States will
never invade. That’s a good thing, because it reduces the likelihood that they will resort to desperate
moves, born of insecurity, that risk war and undermine the liberal order.
United States in two ways. First, thanks
Liberal order is resilient
Ikenberry 2014 [G. John Ikenberry is Albert G. Milbank Professor of Politics and International Affairs
at Princeton University and George Eastman Visiting Professor at Balliol College, University of Oxford.
May/ June 2014 Foreign Affairs “The Illusion of Geopolitics:The Enduring Power of the Liberal Order”]
Ultimately, even
if China and Russia do attempt to contest the basic terms of the current global order, the
adventure will be daunting and self-defeating. These powers aren’t just up against the United States; they would also have
to contend with the most globally organized and deeply entrenched order the world has ever seen, one
that is dominated by states that are liberal, capitalist, and democratic. This order is backed by a U.S.-led network of alliances, institutions,
geopolitical bargains, client states, and democratic partnerships. It
has proved dynamic and expansive, easily integrating
rising states, beginning with Japan and Germany after World War II. It has shown a capacity for shared
leadership, as exemplified by such forums as the G-8 and the G-20. It has allowed rising non-Western countries
to trade and grow, sharing the dividends of modernization. It has accommodated a surprisingly wide variety of political
and economic models -- social democratic (western Europe), neoliberal (the United Kingdom and the United States), and state capitalist (East
Asia). The
prosperity of nearly every country -- and the stability of its government -- fundamentally depends on this
order.¶ In the age of liberal order, revisionist struggles are a fool’s errand. Indeed, China and Russia know this.
They do not have grand visions of an alternative order. For them, international relations are mainly about the search for
commerce and resources, the protection of their sovereignty, and, where possible, regional domination. They have shown no
interest in building their own orders or even taking full responsibility for the current one and have
offered no alternative visions of global economic or political progress. That’s a critical shortcoming, since
international orders rise and fall not simply with the power of the leading state; their success also hinges
on whether they are seen as legitimate and whether their actual operation solves problems that both weak and powerful states
care about. In the struggle for world order, China and Russia (and certainly Iran) are simply not in the game.¶
More evidence – economic interdependence, socio-economic conditions, and nuclear
deterrence - checks on conflict are irreversible.
Chirstopher J. Fettweis, 2006, is assistant professor of political science at Tulane University, where he
teaches classes on international relations, US foreign policy and security, Treasurer of the World Affairs
Council, National Security Decision Making Department, US Naval War College International Studies
Review, Ebsco Host
However, one need not be convinced about the potential for ideas to transform international politics to
believe that major war is extremely unlikely to recur. Mueller, Mandelbaum, Ray, and others may give
primary credit for the end of major war to ideational evolution akin to that which made slavery and
dueling obsolete, but others have interpreted the causal chain quite differently. Neoliberal
institutionalists have long argued that complex economic interdependence can have a pacifying effect
upon state behavior (Keohane and Nye 1977, 1987). Richard Rosecrance (1986, 1999) has contended
that evolution in socio-economic organization has altered the shortest, most rational route to state
prosperity in ways that make war unlikely. Finally, many others have argued that credit for great power
peace can be given to the existence of nuclear weapons, which make aggression irrational ( Jervis 1989;
Kagan et al. 1999). With so many overlapping and mutually reinforcing explanations, at times the end of
major war may seem to be overdetermined ( Jervis 2002:8–9). For purposes of the present discussion,
successful identification of the exact cause of this fundamental change in state behavior is probably not
as important as belief in its existence. In other words, the outcome is far more important than the
mechanism. The importance of Mueller’s argument for the field of IR is ultimately not dependent upon
why major war has become obsolete, only that it has. Almost as significant, all these proposed
explanations have one important point in common: they all imply that change will be permanent.
Normative/ideational evolution is typically unidirectionalFfew would argue that it is likely, for instance,
for slavery or dueling to return in this century. The complexity of economic interdependence is
deepening as time goes on and going at a quicker pace. And, obviously, nuclear weapons cannot be
uninvented and (at least at this point) no foolproof defense against their use seems to be on the
horizon. The combination of forces that may have brought major war to an end seems to be unlikely to
allow its return. The twentieth century witnessed an unprecedented pace of evolution in all areas of
human endeavor, from science and medicine to philosophy and religion. In such an atmosphere, it is not
difficult to imagine that attitudes toward the venerable institution of war may also have experienced
rapid evolution and that its obsolescence could become plausible, perhaps even probable, in spite of
thousands of years of violent precedent. The burden of proof would seem to be on those who maintain
that the ‘‘rules of the game’’ of international politics, including the rules of war, are the lone area of
human interaction immune to fundamental evolution and that, due to these immutable and eternal
rules, war will always be with us. Rather than ask how major war could have grown obsolete, perhaps
scholars should ask why anyone should believe that it could not.
Diseases are a bigger threat than war.
WHO, 00, “Overcoming Antimicrobial Resistance”, WHO Report on Infectious Diseases, A Message
From the Director-General of WHO http://www.who.int/infectious-diseasereport/2000/other_versions/index-rpt2000_text.html
Today - despite advances in science and technology - infectious disease poses a more deadly
threat to human life than war. This year – at the onset of a new millennium – the international
community is beginning to show its intent to turn back these microbial invaders through
massive efforts against diseases of poverty – diseases which must be defeated now, before they
become resistant. When diseases are fought wisely and widely, drug resistance can be
controlled and lives saved.
Nuclear war does not cause extinction
Nyquist 1999 [J.R., WorldNetDaily contributing editor and author of ‘Origins of the Fourth World
War,’ May 20, Antipas, “Is Nuclear War Survivable?”
http://www.antipas.org/news/world/nuclear_war.html]
The truth is, many prominent physicists have condemned the nuclear winter hypothesis. Nobel
laureate Freeman Dyson once said of nuclear winter research, “It’s an absolutely atrocious
piece of science, but I quite despair of setting the public record straight.” Professor Michael
McElroy, a Harvard physics professor, also criticized the nuclear winter hypothesis. McElroy
said that nuclear winter researchers “stacked the deck” in their study, which was titled
“Nuclear Winter: Global Consequences of Multiple Nuclear Explosions” (Science, December
1983). Nuclear winter is the theory that the mass use of nuclear weapons would create enough
smoke and dust to blot out the sun, causing a catastrophic drop in global temperatures.
According to Carl Sagan, in this situation the earth would freeze. No crops could be grown.
Humanity would die of cold and starvation. In truth, natural disasters have frequently
produced smoke and dust far greater than those expected from a nuclear war. In 1883
Krakatoa exploded with a blast equivalent to 10,000 one-megaton bombs, a detonation greater
than the combined nuclear arsenals of planet earth. The Krakatoa explosion had negligible
weather effects. Even more disastrous, going back many thousands of years, a meteor struck
Quebec with the force of 17.5 million one-megaton bombs, creating a crater 63 kilometers in
diameter. But the world did not freeze. Life on earth was not extinguished. Consider the views
of Professor George Rathjens of MIT, a known antinuclear activist, who said, “Nuclear winter
is the worst example of misrepresentation of science to the public in my memory.” Also
consider Professor Russell Seitz, at Harvard University’s Center for International Affairs, who
says that the nuclear winter hypothesis has been discredited. Two researchers, Starley
Thompson and Stephen Schneider, debunked the nuclear winter hypothesis in the summer
1986 issue of Foreign Affairs. Thompson and Schneider stated: “the global apocalyptic
conclusions of the initial nuclear winter hypothesis can now be relegated to a vanishingly low
level of probability.” OK, so nuclear winter isn’t going to happen. What about nuclear fallout?
Wouldn’t the radiation from a nuclear war contaminate the whole earth, killing everyone? The
short answer is: absolutely not. Nuclear fallout is a problem, but we should not exaggerate its
effects. As it happens, there are two types of fallout produced by nuclear detonations. These
are: 1) delayed fallout; and 2) short-term fallout. According to researcher Peter V. Pry,
“Delayed fallout will not, contrary to popular belief, gradually kill billions of people everywhere
in the world.” Of course, delayed fallout would increase the number of people dying of
lymphatic cancer, leukemia, and cancer of the thyroid. “However,” says Pry, “these deaths
would probably be far fewer than deaths now resulting from ... smoking, or from automobile
accidents.” The real hazard in a nuclear war is the short-term fallout. This is a type of fallout
created when a nuclear weapon is detonated at ground level. This type of fallout could kill
millions of people, depending on the targeting strategy of the attacking country. But short-
term fallout rapidly subsides to safe levels in 13 to 18 days. It is not permanent. People who
live outside of the affected areas will be fine. Those in affected areas can survive if they have
access to underground shelters. In some areas, staying indoors may even suffice. Contrary to
popular misconception, there were no documented deaths from short-term or delayed fallout at
either Hiroshima or Nagasaki. These blasts were low airbursts, which produced minimal fallout
effects. Today’s thermonuclear weapons are even “cleaner.” If used in airburst mode, these
weapons would produce few (if any) fallout casualties.
Failure to incorporate methods of dealing with structural violence into our politics is
the failure of politics all together
Winter and Leighton 1999 (Deborah DuNann Winter and Dana C. Leighton. Winter: Psychologist
that specializes in Social Psych, Counseling Psych, Historical and Contemporary Issues, Peace Psychology.
Leighton: PhD graduate student in the Psychology Department at the University of Arkansas.
Knowledgable in the fields of social psychology, peace psychology, and ustice and intergroup responses
to transgressions of justice) (Peace, conflict, and violence: Peace psychology in the 21st century. Pg 4-5)
Finally, to recognize the operation of structural violence forces us to ask questions about how and why
we tolerate it, questions which often have painful answers for the privileged elite who unconsciously
support it. A final question of this section is how and why we allow ourselves to be so oblivious to
structural violence. Susan Opotow offers an intriguing set of answers, in her article Social Injustice. She
argues that our normal perceptual/cognitive processes divide people into in-groups and out-groups.
Those outside our group lie outside our scope of justice. Injustice that would be instantaneously
confronted if it occurred to someone we love or know is barely noticed if it occurs to strangers or those
who are invisible or irrelevant. We do not seem to be able to open our minds and our hearts to
everyone, so we draw conceptual lines between those who are in and out of our moral circle. Those who
fall outside are morally excluded, and become either invisible, or demeaned in some way so that we do
not have to acknowledge the injustice they suffer. Moral exclusion is a human failing, but Opotow
argues convincingly that it is an outcome of everyday social cognition. To reduce its nefarious effects, we
must be vigilant in noticing and listening to oppressed, invisible, outsiders. Inclusionary thinking can be
fostered by relationships, communication, and appreciation of diversity. Like Opotow, all the authors in
this section point out that structural violence is not inevitable if we become aware of its operation, and
build systematic ways to mitigate its effects. Learning about structural violence may be discouraging,
overwhelming, or maddening, but these papers encourage us to step beyond guilt and anger, and begin
to think about how to reduce structural violence. All the authors in this section note that the same
structures (such as global communication and normal social cognition) which feed structural violence,
can also be used to empower citizens to reduce it.
Conjunctive fallacy--- Specificity makes their disads less likely
Yudkowsky 2006 (Eliezer Yudkowsky, Research Fellow at the Singularity Institute for Artificial
Intelligence “Cognitive biases potentially affecting judgment of global risks” Forthcoming in Global
Catastrophic Risks, eds. Nick Bostrom and Milan CirkovicDraft of August 31, 2006. Eliezer
Yudkowsky(yudkowsky@singinst.org)
The conjunction fallacy similarly applies to futurological forecasts. Two independent sets of professional
analysts at the Second International Congress on Forecasting were asked to rate, respectively, the
probability of "A complete suspension of diplomatic relations between the USA and the Soviet Union,
sometime in 1983" or "A Russian invasion of Poland, and a complete suspension of diplomatic relations
between the USA and the Soviet Union, sometime in 1983". The second set of analysts responded with
significantly higher probabilities. (Tversky and Kahneman 1983.) In Johnson et. al. (1993), MBA students
at Wharton were scheduled to travel to Bangkok as part of their degree program. Several groups of
students were asked how much they were willing to pay for terrorism insurance. One group of subjects
was asked how much they were willing to pay for terrorism insurance covering the flight from Thailand
to the US. A second group of subjects was asked how much they were willing to pay for terrorism
insurance covering the round-trip flight. A third group was asked how much they were willing to pay for
terrorism insurance that covered the complete trip to Thailand. These three groups responded with
average willingness to pay of $17.19, $13.90, and $7.44 respectively. According to probability theory,
adding additional detail onto a story must render the story less probable. It is less probable that Linda is
a feminist bank teller than that she is a bank teller, since all feminist bank tellers are necessarily bank
tellers. Yet human psychology seems to follow the rule that adding an additional detail can make the
story more plausible. People might pay more for international diplomacy intended to prevent
nanotechnological warfare by China, than for an engineering project to defend against
nanotechnological attack from any source. The second threat scenario is less vivid and alarming, but the
defense is more useful because it is more vague. More valuable still would be strategies which make
humanity harder to extinguish without being specific to nanotechnologic threats - such as colonizing
space, or see Yudkowsky (this volume) on AI. Security expert Bruce Schneier observed (both before and
after the 2005 hurricane in New Orleans) that the U.S. government was guarding specific domestic
targets against "movie-plot scenarios" of terrorism, at the cost of taking away resources from
emergency-response capabilities that could respond to any disaster. (Schneier 2005.)
Probability outweighs magnitude--- extended link chains and minimax risk calculus
should be rejected as bad scholarship
Berube 2000 (David Berube, professor of speech comm at University of South Carolina, Debunking
Minimax Reasoning: The Limits of Extended Causal Chains in Contest Debating,” CAD, 53-73,
http://www.cedadebate.org/cad/index.php/CAD/article/view/248/232)
The lifeblood of contemporary contest debating may be the extended argument. An¶ extended
argument is any argument requiring two or more distinct causal or¶ correlational steps between initial
data and ending claim. We find k associated with¶ advantages to comparative advantage cases, with
counterplan advantages, with¶ disadvantages, permutation and impact turnarounds, some kritik
implications, and even¶ probabilistic topicality arguments In practice, these often are not only extended
arguments¶ they are causal arguments using mini-max reasoning. Mini-max reasoning is defined as an¶
extended argument in which an infinitesimally probable event of high consequence is¶ assumed to
present a highly consequential risk. Such arguments, also known as low-¶ probability high-consequence
arguments, are commonly associated with “risk analysis.”¶ The opening statement from Schell
represents a quintessential mini-max argument. Schell¶ asked his readers to ignore probability
assessment and focus exclusively on the impact of his¶ claim. While Schell gave very specific reasons why
probability is less important than¶ impact in resolving this claim, his arguments are not impervious to
rebuttal.¶ What was a knotty piece of evidence in the 1980s kick-started a practice in contest¶ debating
which currently is evident in the ubiquitous political capital disadvantage code-¶ named “Clinton.” Here
is an example of the Clinton disadvantage. In theory, plan action¶ causes some tradeoff (real or
imaginary) that either increases or decreases the President’s¶ ability to execute a particular agenda.
Debaters have argued the following: Clinton (soon¶ to be Gore or Bush) needs to focus on foreign affairs.
A recent agreement between Barak¶ and Assad needs presidential stewardship. The affirmative plan
shifts presidential focus to¶ Nigeria that trades off with focus on the Middle East. As a result, the deal for
the return of¶ the Golan Heights to Syria fails. Violence and conflict ensues as Hezbollah terrorists
launch¶ guerilla attacks into northern Israel from Lebanon. Israel strikes hack. Hezbollah incursions¶
increase, Chemical terrorism ensues and Israel attacks Hezbollah strongholds in southern¶ Lebanon with
tactical nuclear weapons. Iran launches chemical weapons against Tel Aviv.¶ Iraq allies with Iran. The
United States is drawn in- Superpower miscalculation results in¶ all-out nuclear war culminating in a
nuclear winter and the end of all life on the planet. This¶ low-probability high-consequence event
argument is an extended argument using mini-max¶ reasoning.¶ The appeal of mini-max risk arguments
has heightened with the onset of on-tine text¶ retrieval services and the World Wide Web, both of
which allow debaters to search for¶ particular words or word strings with relative ease. Extended
arguments are fabricated by¶ linking evidence in which a word or word string serves as the common
denominator, much¶ in the fashion of the soritics (stacked syllogism): AcaB, BaC, CaD, therefore ActD.
Prior to¶ computerized search engines, a contest debater’s search for segments that could be woven¶
together into an extended argument was incredibly Lime consuming.¶ The dead ends checked the
authenticity of the extended claims by debunking especially¶ fanciful hypotheses. Text retrieval services
may have changed that. While text ettieval¶ services include some refereed published materials, they
also incorporate transcripts and¶ wire releases that are less vigilantly checked for accuracy. The World
Wide Web allows¶ virtually anyone to set up a site and post anything at that site regardless of its
veracity.¶ Sophisticated super search engines, such as Savvy SearchC help contest debaters track down¶
particular words and phrases. Searches on text retrieval services such as Lexis-Nexis¶ Universes and
Congressional Universes locate words and word strings within n words of¶ each other. Search results are
collated and loomed into an extended argument. Often,¶ evidence collected in this manner is linked
together to reach a conclusion of nearly infinite¶ impact, such as the ever-present specter of global
thermonuclear war.¶ Furthermore, too much evidence from online text retrieval services is unqualified
or¶ under-qualified. Since anyone can post a web page and since transcripts and releases are¶ seldom
checked as factual, pseudo-experts abound and are at the core of the most egregious¶ claims in
extended arguments using mini-max reasoning.¶ In nearly every episode of fear mongering . . . people
with fancy titles appeared. .¶ . . [F]or some species of scares. . . secondary scholars arc standard fixtures.
. . .¶ Statements of alarm by newscasters and glorification of wannabe experts are two¶ telltales tricks
of the fear mongers trade. . . : the use of poignant anecdotes in place of scientific evidence, the
christening of isolated incidents as trends,¶ dep,ctions of entire categories of people as innately
dangerous. . . (Glassner 206,¶ 208)¶ hence, any warrant by authority of this ilk further complicates
probability estimates in¶ extended arguments using mini•max reasoning. Often the link and internal link
story is the¶ machination of the debater making the claim rather than the sources cited in the linkage.¶
The links in the chain may be claims with different, if not inconsistent, warrants. As a¶ result, contextual
considerations can be mostLy moot.¶ Not Only the information but also the way it is collated is suspect.
All these engines use¶ Boolean connectors (and, or, and not) and Boolean connectors are dubious by
nature,¶ Boolean logic uses terms only to show relationships — of inclusion or exclusion¶ among the
terms. It shows whether or not one drawer fits into another and ignores¶ the question whether there is
anything in the drawers. . . . The Boolean search¶ shows the characteristic way thai we put questions to
the world of information.¶ When we pose a question to the Boolean world, we use keywords,
buzzwords, and¶ thought bits to scan the vast store of knowledge. Keeping an abstract, cybernetic¶
distance from the source of knowledge, we set up tiny funnels. . . . But even if we¶ build our tunnels
carefully, we still remain essentially tunnel dwellers. . . .¶ Thinking itself happens only when we suspend
the inner musings of the mind long¶ enough to favor a momentary precision, and even then thinking
belongs to musing¶ as a subset of our creative mind. . . . The Boolean reader, on the contrary, knows¶ in
advance where the exits are, the on-ramps, and the well-marked rest stops. . . .¶ The pathways of
thought, not to mention the logic of thoughts, disappear under a¶ Boolean arrangement of freeways.”
(Heim 18, 22-25)¶ Helm worries that the Boolean search may encourage readers to link together nearly
empty¶ drawers of information, stifling imaginative, creative thinking and substituting empty ideas¶ for
good reasons. The problems worsen when researchers select word strings without¶ reading its full
context, a nearly universal practice among contest debaters. Using these¶ computerized research
services, debaters are easily able to build extended mini-max¶ arguments ending in Armageddon,¶
Outsiders to contest debating have remarked simply that too many policy debate¶ arguments end in allout nuclear war: consequently, they categorize the activity as foolish.¶ How many times have educators
had contest debaters in a classroom discussion who strung out an extended mini-max argument to the
jeers and guffaws of their classmates? They¶ cannot all be wrong. Frighteningly enough, most of us
agree. We should not ignore Charles¶ Richct’s adage: “The stupid man ¡s not the one who does not
understand something — but¶ the man who understands it well enough yet acts as if he didn’t” (Tabori
6).¶ Regrettably. mini-max arguments are not the exclusive domain of contest debating.¶ “Policies driven
by the consideration of low risk probabilities will, on the whole, lead to low¶ investment strategies to
prevent a hazard from being realized or to mitigate the hazard’s¶ consequences. By comparison, policies
driven by the consideration of high consequences,¶ despite low probabilities, will lead to high levels of
public investment” (Nehnevajsa 521).¶ Regardless of their persuasiveness, Bashor and others have
discovered that mini-max claims¶ are not useful in resolving complex issues. For example, in his
assessment of low-¶ probability, potentially high-consequence events such as terrorist use of weapons of
mass¶ destruction, Bashor found simple estimates of potential losses added little to contingency¶
planning. While adding little to policy analysis, extended arguments using mini-max¶ reasoning remain
powerful determinants of resource allocation. As such, they need to he¶ debunked.¶ Experts agree. For
example, Slovic advocates a better understanding of all risk analysis¶ since it drives much of our public
policy. “Whoever controls the definition of risk controls¶ the rational solution to the problem at hand. ¡f
risk is defined one way, then one option will¶ rise to the top as the most cost-effective or the safest or
the best. If it is defined another¶ way, perhaps incorporating qualitative characteristics or other
contextual factors, one will¶ likely get a different ordering of action solutions. Defining risk is thus an
exercise in¶ power” (699). When probability assessments are eliminated from risk calculi, as is the case¶
in mini-max risk arguments, it is a political act, and all political acts need to be scrutinized¶ with a critical
lens.
2AC
Exploitation
Squo solves
Ev is from 2010
Deceaced donations solve
Cadaverous organs aren’t sufficient
Becker & Elias, 2007 (Gary S. Becker is University Professor of Economics, University of Chicago,
Chicago, Illinois, and Senior Fellow, Hoover Institution. Julio Jorge Elias Assistant Professor of Economics,
State University of New York. Journal of Economic Perspectives—Volume 21, Number 3—Summer
2007—Pages 3–24 “Introducing Incentives in the Market for Live and Cadaveric Organ Donations”)
The long-term outcome of medical transplantation depends on the quality of the match between organs
of donors and recipients, and the “timing” of surgical interventions. Factors like blood type and tissue
type determine match quality, and a good match raises the chance that an organ will help a recipient.
One shortcoming of cadaver markets is that organs harvested must be transferred immediately to organ
transplant surgery. Harvested organs remain viable for transplant for 48 to 72 hours for kidneys, and 24
to 48 hours for livers. These time constraints make it harder to get an excellent match between organ
donors and recipients and lead to more wasting of organs than would happen in a live organ market. In
addition, live transplants give much greater flexibility on timing of trans- plants than with cadaver organ
transplants, so transplant surgery with live donors can take place when both the donor and recipient are
in the best possible condi- tion. In particular, live transplants can occur when recipients are in relatively
good health. Partly for reasons of match and timing, the long-term success rate of live organ transplants
is generally greater than for cadaver organ transplants. The renal graft survival rates at one year are 89
percent for cadaveric donor transplants and 95 percent for living donor transplants, while the renal graft
survival rates at ten years are 35.8 percent for cadaveric donor transplants and 55.8 percent for living
donor transplants. For livers, the graft survival rates at one year are 82 percent for cadaveric donor
transplants and 82.7 percent for living donor transplants, but the graft survival rates at ten years are
43.7 percent for cadaveric donors and 53.3 percent for live transplants.4 Perhaps most crucially, the
present gap between demand and supply of kidneys could not be fully met from cadavers, even with
full payments for cadaver organs. For their organs to be usable, cadaver donors must have had healthy,
well-functioning organs and been free of infections at the time of their death. The majority of cadaveric
organs come from accident or stroke victims who have been declared brain dead. In 2000, stroke victims
accounted for over 40 percent of all cadaveric donors. Table 4 presents various estimates from different
studies of the maximum potential supply of cadaveric organs. The geographical area and the year
consid- ered in the studies are reported in the second and third column respectively. The fourth column
of the table reports the estimates of the potential cadaveric donors rates in per million of population. In
the last column, we estimate the maximum potential supply of cadaveric donors for the United States by
taking the rates of potential donors reported in column four and scaling up to the 2006 U.S. population.
Taking into account the need to have healthy organs, these estimates suggest that between 10,000 and
16,000 of those dying annually are considered medically suitable for organ donation. Since all organs are
not always useable from any single cadaver, the number of organs available for transplantation per
cadaveric organ donor is limited even further. In 2000, the average number of kidneys and livers
recovered per cadaveric organ donor was 1.82 and 0.83, respectively. The average number of kidneys
and livers recovered and actually transplanted per cadaveric organ donor are much lower. In 2000 it was
1.57 for kidneys and 0.76 for livers. These numbers and the number of useable cadavers indicate that
the most reasonable estimates of the supply of cadaveric kidneys—in row 6 of Table 4 (the Evans et al.
study)—imply a maximum number of cadaveric kidneys harvested between 15,500 and 24,000 (8,510
times 1.82 and 13,048 times 1.82). This overlaps the actual demand for kidneys transplants in 2005 at
21,500. Yet only a fraction of all these potentially useable cadaveric kidneys are likely to be offered for
sale, or to be useable even if offered since they may not be matched with any of the potential
recipients. Moreover, once a market for organs is in place, the actual demand would surpass present
demand, since currently kidney transplants are only offered to people who have irreversible kidney
failure. Other medical or surgical treatments for kidney problems are usually tried before consideration
of a kidney transplant. Thus, it is highly unlikely that the full demand for kidney transplants could be
met with organs of deceased persons. This insight is illustrated in Figure 4, which plots the supply curve
of kidney organs in a market with kidneys from both cadavers and live donors. This fi assumes a market
with a single price for kidneys, no matter what the source, although our analysis suggests that organs
from live donors are more valuable to recipients. For simplicity, the demand curve is taken to be the
same as that in Figure 3. The supply curve in this market would start just slightly above the cost of
surgery, since some cadaver organs would be made available at low or no cost. A rise in price would
induce more cadaver organs to be offered, and perhaps even a few from live donors. Eventually, the
available organs from cadavers would run out, and the supply price would rise sharply to reach the main
market for live donors. At that point the supply elasticity rises sharply because the potential live donor
market is huge relative to demand.
Doesn’t end black market
Financial incentives will eliminate the black market because it reduces the
comparative advantage of the process.
RICHARD A. EPSTEIN is the James Parker Hall Distinguished Service Professor of Law at the University
of Chicago and the Peter and Kirsten Bedford Senior Fellow at the Hoover Institution The Journal of
Legal Studies June, 2008 37 J. Legal Stud. 459 ARTICLE: The Human and Economic Dimensions of
Altruism: The Case of Organ Transplantation
This selection effect should influence how to think about the control of fraud and sharp practice in any
organ¶ market. Thus, it is a mistake to assume that the current players in the illegal organ market will
remain after legalization.¶ As their comparative advantage diminishes, their numbers should dwindle.
The first approach to organ markets with¶ cash or other valuable consideration should not be to add
tough new sanctions to curb the rascals. The risk is that tough¶ sanctions will deter honest people from
entering the legal market. The key argument for liberalization, therefore,¶ stresses how the legalization
encourages reputable traders, including middlemen and agents, to enter into the market and¶ to brand
themselves by advertisement and repeat play, so that potential organ transferors and transferees can
have¶ confidence in someone who knows the ropes. In this view, the least desirable reforms are to block
the use of brokers and¶ other intermediaries from appearing in the marketplace (see Matas [2007] for
that proposal). Once again the change in¶ circumstances makes it perilous to draw inferences about the
behavior in legal markets from the behavior in illegal¶ ones. One might as well say that all real estate
markets are filled with intrigue because of the peculiar landlords who¶ operate in rent-controlled
markets. Yet if we [*483] remove the price controls, the queues vanish, and ordinary¶ individuals who
have no stomach for intrigue come back into the market.
¶
TT
Xeno transplants
Impact Framing
Politics
Won’t pass – new ceasefire agreement between moderate rebels and ISIS and
lawmakers don’t trust Syrians/think the weapons will end up in the wrong hands.
Rebecca Shabad - 09/13/14 12:43 PM EDT http://thehill.com/policy/international/217645-syrianrebels-isis-agree-to-non-aggression-pact
Moderate Syrian rebels and the Islamic State in Iraq and Syria (ISIS) reportedly struck a cease-fire deal
on Friday, according to a group that has monitored Syria's civil war. The groups agreed to a nonaggression pact in which they promised not to attack each other. The development could influence
members of Congress to vote “no” on an authorization to train and equip moderate rebel groups as
early as next week. The White House has requested the authorization, but some lawmakers have
already been skeptical the opposition groups can be trusted. The Syrian Observatory for Human Rights, a
monitoring group based in the United Kingdom, said the groups reached the agreement in a suburb of
Damascus, Syria’s capital. ADVERTISEMENT Under the deal, "the two parties will respect a truce until a
final solution is found and they promise not to attack each other because they consider the principal
enemy to be the Nussayri regime,” Agence France-Presse reported. Nussayri is a negative term for
Syrian President Bashar al-Assad’s Alawite regime. This comes as House lawmakers mull over the option
to provide Obama with the authorization to train and arm the Syrian rebels. A vote on a short-term
spending bill was delayed this week after the White House asked House Republicans to attach the
authorization to the bill. It’s possible GOP leaders might decide to hold a separate vote on the
authorization to equip the rebels. Some Republicans and Democrats have long called on the
administration arm the rebels, but other lawmakers in both parties are afraid the weapons could wind
up in the wrong hands. A spokesman for the family of slain journalist Steven Sotloff told CNN this week
that Sotloff was captured by “so-called moderate rebels” in Syria and was sold to ISIS. ISIS militants
released videos in the last month showing them beheading Sotloff and U.S. journalist James Foley.
ISIS Nuclear Material is Useless D-U
HAYES BROWN JULY 10, 2014 AT 1:43 PM editor of the World vertical at ThinkProgress.org. Prior to
joining ThinkProgress, Hayes worked as a contractor at the Department of Homeland Security. He’s been
a blogger since 2011, and had his writing on international affairs appear at Foreign Policy and The Week.
He's also given commentary on radio and television with the BBC, CBC, and MSNBC. No, There Are Still
No WMDs In Iraq http://thinkprogress.org/world/2014/07/10/3458691/still-no-wmd-iraq/
If you were to read only the headlines, it’d be easy to believe that the Islamic State in Iraq and Greater
Syria (ISIS) has managed to do what the United States failed to over a decade ago: find Iraq’s weapons of
mass destruction materials. What you’d miss, however, is the reporting beneath those headlines which
explains that the chemicals and uranium that ISIS has seized aren’t just less than weapons-quality,
they’re for the most part completely unusable. Reuters reported on Wednesday that the Iraqi
government had informed the United Nations that the terrorist group had seized “nuclear materials”
from a university in Mosul, the city that kicked-off its string of military successes in Northern Iraq. In all,
the group managed to capture around 88 pounds worth of uranium compounds, according to a letter
from Iraq’s U.N. ambassador to U.N. Secretary-General Ban Ki-Moon. A quick search of Twitter on the
story finds comments from conservatives convinced that somehow the militants of ISIS had proved that
Saddam Hussein was in fact carrying out the nuclear program that the Bush administration used as the
first justification for the invasion of Iraq. But it turns out that while the headline reading “Iraq tells U.N.
that ‘terrorist groups’ seized nuclear materials” is quite provocative and easily used to slam the Obama
administration, the reality of the reporting is much more mundane. The capture was confirmed on
Thursday in a release from the International Atomic Energy Association, which said that the nuclear
watchdog is “aware of the notification from Iraq and is in contact to seek further details.” But it turns
out that the “uranium compounds” seized are of little to no threat to the general population.
Spokesperson Gill Tudor continued on to say that the organization believes “the material involved is
low-grade and would not present a significant safety, security or nuclear proliferation risk. Nevertheless,
any loss of regulatory control over nuclear and other radioactive materials is a cause for concern.” When
the IAEA says that the uranium captured is “low-grade,” they mean that the radioactive material has not
been further enriched to a point that it can be used in a nuclear weapon. While lower enriched uranium
can possibly used in a “dirty bomb” — a weapon where conventional explosives are used to spread
radioactive material across a wide area — that doesn’t appear to be a concern in this situation either. In
a follow-up story, Reuters found the same thing in speaking with Olli Heinonen, a former IAEA chief
inspector. “You cannot make a nuclear explosive from this amount, but all uranium compounds are
poisonous,” Heinonen told Reuters. “This material is also not ‘good’ enough for a dirty bomb.”
Americans Support Compensation for Organ Donation
Hensley 12
SCOTT HENSLEY, May 16, 2012 3:00 AM ET, NPR, “Poll: Americans Show Support For Compensation Of
Organ Donors,” http://www.npr.org/blogs/health/2012/05/16/152498553/poll-americans-showsupport-for-compensation-of-organ-donors, web.
So we asked 3,000 adults across the country as part of the NPR-Thomson Reuters Health Poll, and here's
what they told us. If compensation took the form of credits for health care needs, about 60 percent of
Americans would support it. Tax credits and tuition reimbursement were viewed favorably by 46
percent and 42 percent, respectively. Cash for organs was seen as OK by 41 percent of respondents.
Among people who said some form of compensation was acceptable, 72 percent said it should come
from health insurers, followed by private charities at 62 percent and the federal government at 44
percent. As it was, we asked about three different donations, and the results came in about the same.
About 87 percent of respondents in favor of compensation though it was OK for kidneys. About 85
percent felt that way about livers, and 83 percent for bone marrow. It seems worth noting that the 9th
U.S. Circuit Court of Appeals in March affirmed an earlier decision that compensating people for marrow
cells drawn from their blood wouldn't run afoul of the federal law banning payment for organ donations.
OK, so let's say donors could be compensated. How much should it be? Thirty-seven percent of
respondents said it should be less than $10,000, and 27 percent said it should be more than $10,000 and
less than $25,000. Finally, we asked if there is a difference between compensating people for organ
donations compared with buying them outright. Around 40 percent don't see one. Sixty percent of
people said compensation isn't the same thing as a purchase.
And, even if nuclear war could cause extinction, the aff’s won’t. The most likely
scenario is a counterforce strike.
Mueller 2009 (John Mueller, Woody Hayes Chair of National Security Studies and Professor of Political
Science @ Ohio State University, 2009, Atomic Obsession: Nuclear Alarmism from Hiroshima to AlQaeda, p. 8)
To begin to approach a condition that can credibly justify applying such extreme
characterizations as societal annihilation, a full-out attack with hundreds, probably thousands,
of thermonuclear bombs would be required. Even in such extreme cases, the area actually
devastated by the bombs' blast and thermal pulse effects would be limited: 2,000 I-MT
explosions with a destructive radius of 5 miles each would directly demolish less than 5 percent
of the territory of the United States, for example. Obviously, if major population centers were
targeted, this sort of attack could inflict massive casualties. Back in cold war days, when such
devastating events sometimes seemed uncomfortably likely, a number of studies were
conducted to estimate the consequences of massive thermonuclear attacks. One of the most
prominent of these considered several possibilities. The most likely scenario--one that could be
perhaps be considered at least to begin to approach the rational-was a "counterforce" strike in
which well over 1,000 thermonuclear weapons would be targeted at America's ballistic missile
silos, strategic airfields, and nuclear submarine bases in an effort to destroy the country's
strategic ability to retaliate. Since the attack would not directly target population centers, most
of the ensuing deaths would be from radioactive fallout, and the study estimates that from 2 to
20 million, depending mostly on wind, weather, and sheltering, would perish during the first
month.
CP
Framing: Permutations don’t have to be topical and counterplan competition should be based on
the maximum action the CP allows, also cps have to be textually and functionally competitive
Perm: Do the counterplan then the plan
Time-based competition is bad: shifts debate away from the topic to time-sensitive uniqueness
arguments, justifies delay CPs- makes it impossible to be AFF- and discourages argument depth.
Also, “immediately” isn’t in the plan text.
Perm: do the counterplan
Certainty-based competition is bad: makes it impossible to weigh the AFF; there are infinite,
unpredictable conditions, shifts debate away from the topic
Reccomendation CPs are bad- robs the aff of the 1AC which is the only locus for offense- no way
to keep up with Neg mechanisms means affs cant win a solvency deficit- anti educational because
the debate becomes stale after the block
Should ≠ Mandatory
Atlas, 1999 (Collaboration, “Use of shall, should, may can”
rd13doc.cern.ch/Atlas/DaqSoft/sde/inspect/shall.html)
shall' describes something that is mandatory. If a requirement uses 'shall', then that requirement _will_
be satisfied without fail. Noncompliance is not allowed. Failure to comply with one single 'shall' is
sufficient reason to reject the entire product. Indeed, it must be rejected under these circumstances.
Examples: "Requirements shall make use of the word 'shall' only where compliance is mandatory." This
is a good example. "C++ code shall have comments every 5th line." This is a bad example. Using 'shall'
here is too strong. should 'should' is weaker. It describes something that might not be satisfied in the
final product, but that is desirable enough that any noncompliance shall be explicitly justified. Any use of
'should' should be examined carefully, as it probably means that something is not being stated clearly. If
a 'should' can be replaced by a 'shall', or can be discarded entirely, so much the better.
AIDs DA
Preventing kidney sales doesn’t protect the poor it closes off additional options and is
coercive. If coercion is a reason to reject sales, then organ donations should be
rejected as well.
Janet Radcliffe Richards, (professor of practical philosophy at the Univ of Oxford and Distinguished
Research Fellow at the Oxford Uehiro Centre for Practical Ethics, The Ethics of Transplants: Why Careless
Thought Costs Lives, 2012 Pg. 63-64
This is why it is quite wrong to say that the poor should be protected from selling their kidneys,
‘preferably of course by being lifted out of poverty’ but otherwise by the complete prevention of kidney
sales. Of course it would be much better to remove poverty, but putting the matter this way implies
that prohibition and ‘lifting out of poverty’ are unequally desirable variations on the same general
theme. The foregoing argument shows them to be in the relevant sense, direct opposites. Protecting
the poor from kidney selling by removing poverty works by increasing the options until something more
attractive is available –and, of course, is strongly preferable. But prevention of sales, in itself, only
closes a miserable range of options still further – like the police’s preventing you from saving your
daughter. To the coercion of poverty is added the coercion of the supposed protector, who comes and
takes away what the prospective vendor sees as the best that poverty has left. In other words, the
argument depends on a straightforward confusion. Particular kinds of coercion do justify a declaration
of invalid consent under particular circumstances, but those do not include the metaphorical coercion
involved in having only a limited range of choices. And, furthermore, the purpose of declaring consent
invalid is to remedy an injustice to the coerced individual. The supposed remedy proposed here
(prohibition) just exacerbates the injustice –or at least disadvantage—that is being complained of.
To this it is perhaps worth adding that even if you could make these inferences from coercion by
poverty, it could make no distinction between sales and unpaid donations. If vendors can be said to be
coerced by circumstances, then so, for the same reasons can donors. If losing a kidney is intrinsically
undesirable, it is just as undesirable for a donor as for a vendor, and chosen only because constricted
circumstances – someone else’s imminent risk of death—have made it the best option all things
considered. If coercion is supposed to be a reason for not allowing organ sales, and poverty is supposed
to count as a relevant kind of coercion, this kind of coercion by threat of the death of a friend or
relative—quite a heavy kind of coercion, you would think—should equally rule out donation. The logic is
the same, so unpaid organ donation would have to be ruled out on the same grounds.
Trying to end exploitation by prohibition is like ending slum dwelling by bulldozing
slums – it make situation worse for the poor, assumes they can’t make rational
decisions, and cannot be resolved with the fact that we pay people money to
participate in other risky jobs or drug trials.
Robert Steinbuch∗ Visiting Associate Professor, University of Georgia School of Law. Associate
Professor of Law, University of Arkansas at Little Rock, William H. Bowen School of Law.
J.D. from, and John M. Olin Law & Economics Fellow at, Columbia Law School 2009 ARTICLE
KIDNEYS, CASH, AND KASHRUT: A LEGAL, ECONOMIC, AND RELIGIOUS ANALYSIS OF SELLING KIDNEYS
Houston Law Review, Vol. 45, p. 1529, 2009
3. The Concern for Economic Coercion of the Poor. Some argue that the tantalization of remuneration
will coerce the poor so as to foreclose them from making a truly voluntary decision to sell a kidney.405
The claim, essentially, is that the poor cannot act rationally in the face of the potential for significant
compensation. The argument not only demeans the ability of poor people to think for themselves, it
indeed contradicts how we otherwise treat their right to make difficult decisions concerning their lives
and health. The destitute, however, often work significantly more risky and unpleasant jobs relative to
the well-off. Coal mining, for instance, is dangerous and associated with reduced lifespan.406 No one
seriously responds that instead of allowing those with limited resources to work these jobs, only
altruists or wealthy individuals should perform such work.407 Soldiers, ìcoal miners, bridge builders,
firemen, police, and bomb disposal expertsóall take risks for differing degrees of societal benefit and
financial reward.î408 Similarly, we are hard-pressed to distinguish between prohibiting individuals from
selling kidneys and allowing them to receive compensation for volunteering as subjects in drug trials.409
Generally, economic security inversely relates to the value potential donors place on future
compensation from selling kidneys.410 If the concern is that those living in poverty lack real choice
because of their financial situation, a decrease in their economic prospects is ultimately unhelpful.411
ìTrying to end exploitation by prohibition is rather like ending slum dwelling by bulldozing slums: it ends
the evil in that form, but only by making things worse for the victims.
On balance the crowding out thesis is not a reason to reject organ sales – chances are
strong supply would overwhelm.
RICHARD A. EPSTEIN is the James Parker Hall Distinguished Service Professor of Law at the University
of Chicago and the Peter and Kirsten Bedford Senior Fellow at the Hoover Institution The Journal of
Legal Studies June, 2008 37 J. Legal Stud. 459 ARTICLE: The Human and Economic Dimensions of
Altruism: The Case of Organ Transplantation
The crowding-out thesis typically does not clearly distinguish among these various cases. But it does
assert that the¶ total supply will be lower with payment than without, which will not be true once the
cash or other benefits supplied¶ become large enough. In any event, any assumption of crowding out is
testable in principle. We could decide to relax¶ the prohibition against valuable consideration and
observe the various responses. What happens to uncompensated¶ donations? How many new entrants
join the market and take the compensation offered? If it turns out that the aggregate¶ supply is lower
than before, it will be important to check whether the price levels exceeded the dollar figure that
would¶ drive all altruists out of the market or to demonstrate that the organ market is so oddly
configured that even egoists flee¶ once cash or other valuable consideration is offered. If a real payment
schedule experiment turned out to curtail the totalcontributions, we should stop the program and treat
the present and growing shortages as an immutable fact of life that¶ is only made worse by injecting
cash into the equation. But the chance that a strong supply response among egoists¶ would swamp
these effects is substantial as well. The current shortages are so easily predicted by standard theory,
with¶ or without altruism, that we should be wary of making extreme assumptions in untested waters.
And given the potential¶ number of lives to be saved, the test is surely worth the gamble. [*477]
Signaling effects proving the crowd out hypothesis are not statistically valid
RICHARD A. EPSTEIN is the James Parker Hall Distinguished Service Professor of Law at the University
of Chicago and the Peter and Kirsten Bedford Senior Fellow at the Hoover Institution The Journal of
Legal Studies June, 2008 37 J. Legal Stud. 459 ARTICLE: The Human and Economic Dimensions of
Altruism: The Case of Organ Transplantation
To buttress the above analysis, let us assume that Titmuss ([1971] 1997) was correct in¶ observing that
the level of voluntary blood donations went down when payment was introduced. What explains this¶
counterintuitive response? One possible explanation is that a low stated price signals to altruists that
their gift is of little¶ social value. I find it difficult to credit this signaling explanation because so many
other sources of public information¶ are available. Surely it is not beyond the power of blood banks and
hospitals to talk up the gift of life. Who will think¶ that a life is worth only $ 10 or $ 100 because that is
the administrative price set for blood? Even if that were the case,¶ then raise the price to $ 1,000 per
unit and watch to see if the altruists stream back in. The signaling explanation predicts¶ a boost in
altruism if high prices are paid, which is not what most of its adherents actually believe. [*478] Figure 6.¶
Market with full, continuous crowding out of altruists¶ Even if the blood studies proved robust, the
transfer of that behavior to the donation of kidneys is doubtful. The¶ personal cost of making a blood
donation is several orders of magnitude smaller than that of making a kidney donation.¶ Altruists who
accept that their personal cost for a blood donation is worth $ 100 and donate anyway might not
donate¶ organs if they believed their personal cost would equal $ 50,000, given that we expect the
amount of altruism to¶ decrease as the perceived level of sacrifice increases. Whatever signaling effects
hold for blood donation need to carry¶ over to kidney donation, for which the number of altruists is far
smaller. And for liver donation it will be essentially¶ zero, given that the risks of liver transplantation are
huge relative to those for kidney [*479] transplantation. It is,¶ therefore, very iffy to draw inferences
about behavior from one market to another, even within the broad class of organ¶ donors. Altruists, like
everyone else, will respond to the incentives created by costs, benefits, and the ratio between¶ them,
and they should do so, more or less, in line with the model outlined above.
K
Commodification of the human body is non unique – we do it all the time – to
compensate injuries, selling blood and eggs, etc.
Robert Steinbuch∗ Visiting Associate Professor, University of Georgia School of Law. Associate
Professor of Law, University of Arkansas at Little Rock, William H. Bowen School of Law.
J.D. from, and John M. Olin Law & Economics Fellow at, Columbia Law School 2009 ARTICLE
KIDNEYS, CASH, AND KASHRUT: A LEGAL, ECONOMIC, AND RELIGIOUS ANALYSIS OF SELLING KIDNEYS
Houston Law Review, Vol. 45, p. 1529, 2009
The Concern that Legalizing the Sale of Kidneys Will Compromise Human Dignity. Critics also oppose
compensating kidney donors out of a reluctance to commodify the human body because doing so, they
say, dehumanizes society.382 The suggestion is that ìthe human body especially belongs in that category
of things that defy or resist commensurationólike love or friendship or life itself.î383 According to
philosopher Immanuel Kant, ìa human being is not entitled to sell his limbs for money, even if he were
offered ten thousand thalers for a single finger.î384 However, we already commodify our bodies all the
time. We have gone so far as to determine the worth of our body parts for compensation models
pertaining to accidents covered by workersí compensation, tortious and criminal injury, and injury
obtained during military service.385 Admittedly, these are post-hoc payment systems, but we also
commodify other body parts for direct sale, such as blood products, sperm, ova, skin, hair, and even
saliva.386 The prohibitions of NOTA do not include the sale of human tissues and cells sold for research,
commercial, or other purposes.387 In fact, ì[Eighty-five] percent of blood plasma donors are paid for
their donations.î388 Sperm and eggs, too, are actively purchased and sold.389 Reproductive fertility has
become a $3 billion industry.390 Similarly, a Google search for ìegg donation + compensationî returns
approximately 41,500 results.391 Sperm donors typically receive $45 for a single donation or $200 per
week for six months of weekly donations, with the highest bids reaching $15,000 for a single
donation.392 Ova, on the other hand, command a higher selling price due to their greater scarcity and
because fewer women agree to part with their eggs without significant compensation.393 Fertility
centers throughout the United States compensate women an average of $5,000 per egg donation, and
some hopeful parents pay women who possess rare and sought after genetic traits, such as high
intelligence or attractiveness, as much as $100,000 for a single egg harvest. In contrast, Britian currently
experiences a shortage in eggs for fertility treatment exactly because donors are prohibited from
receiving payment beyond reimbursement for reasonable expenses.
Status quo commodifies organs now
J. Randall Boyer, Gifts of the Heart . . . and Other Tissues: Legalizing the Sale of Human Organs and
Tissues Brigham Young University Law Review , Vol. 2012, No. 1
The societal interests supporting the prohibition of organ sales also assume that quantifying the value
of the human¶ body is bad. n137 However, the current system, to which no ethical qualms are raised, in
fact quantifies the value of the¶ human body. n138 As such, an analysis of the consequences of
¶
quantification does not have to be simply hypothetical,¶ but can be based on current observation. In the
context of this current commoditization, the ethical objections to the sale¶ are simply not as grave as
when viewed in isolation.¶ On an empirical level, there is no disputing that the human corpse now has a
substantial economic value. n139 And¶ while the law has prohibited at least the initial sale of organs, it
has not prohibited the purchase of an organ. n140¶ Simply put, to say that the law prohibits attaching a
price tag to a donated organ is to ignore reality. n141¶ The high demand and willingness to pay for
organs, coupled with the short supply, has created a lucrative business¶ for organ-brokering
middlemen, who flip essentially costless, donated organs for large profits. n142 In fact, the prices¶ at
which organs are traded are [*334] so high that they have enticed many to undertake more creative
methods of¶ procurement. n143¶ Further, organs are often subject to a string of transactions in which
they are appraised and exchanged for money.¶ Organs are first donated by individuals, then sold by
hospitals to tissue banks, then sold by tissue banks to biotech¶ companies, then processed and
refurbished before being sold to hospitals and dentists, and finally implanted into the¶ "end-consumer."
n144 At each of these transfers - with the exception of the very first - money is exchanged for the¶
organ. n145 Perhaps more importantly, current jurisprudence recognizes a legal interest in the organ of
each of these¶ players in each transaction - again with the exception of the first - and has validated sales
contracts for human tissue.¶ n146 Thus, both markets and the law itself treat organs as a commodity in
all but one of the series of transactions from¶ donor to recipient.¶ Empirical evidence aside, the more
fundamental cause of commoditization of organs lies in the distinction between¶ goods and services.
Services are valuable only through performance. Therefore, by prohibiting performance, laws can¶
remove all value since no one is willing to pay for nonperformance. n147 Contrarily, goods have
inherent value that¶ exists prior to any transaction because the good itself is useful. Laws can stop a sale,
and therefore the realization of the¶ value, but the value still exists. Thus, laws regulating goods can only
serve as wealth distribution mechanisms,¶ determining who has access to the value of a good and who is
restricted from it. n148 Therefore, in the context of a¶ transaction for an organ, while services such as
removal, transportation, processing, and implanting may facilitate the¶ transaction, the organ itself is the
useful item and has inherent value. However, because the law treats organs as a¶ [*335] service, n149
the law assumes that by proscribing the initial sale of an organ it can remove all of the organ's¶ value.
Also, it does not restrict access to that value from any of the actors in the transaction - with the
exception of the¶ donor. The end result is that the value of the organ, unassigned by the law, is
commoditized as other actors in the¶ market divide that value among themselves. n150
The organ donation system is already steeped in commercialization – commerce in
organs necessary at all levels of the system – so it shouldn’t be excluded in obtaining
the organs.
Julia Mahoney, (professor of law – University of Virginia), Summer 2009 “Show me the money:
making markets in forbidden exchange: altruism, markets, and organ procurement” 72 Law & Contemp
Prob. 17
Refusing to compensate sources means not that organs are not commodities but that commodification
begins after the initial transfer of rights. Put baldly, the mix of both compensated and uncompensated
transfers in the organ distribution chain results in a curious system in which a precious resource that
starts out as a gift becomes an object of exchange. But far from being adjudged illegal or immoral,
purchases and sales of organs by procurement organizations hospitals and other institutions engaged in
transplantation are uncontroversial. On first impression, this placid acceptance is baffling. If
commercial activity in human organs is so objectionable, why is the policy debate devoid of discussion
about how to stop it? A moment’s consideration yields the answer: To end commerce in organs would
require a complete transformation of the distribution network so that nothing of value is exchanged for
rights to possess or use organs. Simply put, the distribution system could be comprised of nothing but
gratuitous transfers. Not even the most fervent opponent of commerce in organs has endorsed such a
departure from established practice. Instead, trafficking in organs in tacitly accepted and the sound and
fury of the debate over organ sales is directed at whether the first transfer of property rights ought to
be a donation or a sale.
The absence of serious proposals to shut down commerce in transplantable organs is both telling and
poignant. Notwithstanding the distaste and disgust the idea of profiting from human biological material
stirs, it is a truth universally grasped, just not universally acknowledged, that forces of altruism alone are
unlikely to deliver organs to all those in critical need of transplants. The inadequacy of altruism is due
not only to a paucity of individual selflessness—although it is hard to envision hospitals, physicians, and
others who profit from the organ business foregoing remuneration altogether-but to the formidable
information and coordination problems inherent in the organization of altruistic activities.
Medicine is already a commodity – well before payment for donation was introduced
– no unique impact.
MARK J. CHERRY St. Edward’s University, Austin, Texas, USA Journal of Medicine and Philosophy, 34 :
649 – 673, 2009 Why Should We Compensate Organ Donors When We Can Continue to Take Organs for
Free? A Response to Some of My Critics doi:10.1093/jmp/jhp048 Advance Access publication on
October 21, 2009
Having failed to appreciate the ways in which transplantation medicine already instrumentalizes human
organs, treating organs as medical resources, the author of the editorial then leaves conveniently
unstated the fact that surgeons, nurses, hospital administrators, organ procurement agencies, and other
staff charge significant amounts of money for access to medical goods and services. A great deal of
money changes hands in hospitals. Medicine is a commodity: its goods and services are bought and
sold, valued over against other goods and services, are the subject of economic choices, and are given a
monetary equivalence. Physicians and hospitals demand payment for services rendered. Consider the
following financial policy statements posted on medical practice Web sites: Please plan to pay at the
time of service. We accept Visa, Mastercard, Discover, and ATM debit cards. Many of our patients are
members of the health care plans that require a copayment for each office visit. Others have more
complex payment requirements. We welcome your business as well and will work with you to
understand your health care plan’s payment requirement.
1AR
Comm
Disease
India Transplant Tourism Key
India is Key – Unique Conditions Make it the zero Point for the next plague
SIMON ROBINSON/NEW DELHI Friday, Feb. 01, 2008 – Writer – Time magazine India's Black Market
Organ Scandal http://content.time.com/time/world/article/0,8599,1709006,00.html
Shocked but not surprised. That might be the best way to sum up India's reaction to the revelation this
week that a black market organ transplant ring had been harvesting kidneys from poor Indian laborers,
sometimes against their wishes, and using them in foreigners desperate for transplants. Police who
busted the ring last week say doctors paid as little as $1000 for the kidneys and then sold them for as
much as $37,500. The racket, based in Gurgaon, a business center close to the capital, New Delhi, drew
victims from as many as eight Indian states and lasted for almost a decade. Police say the black market
doctors may have illegally transplanted as many as 500 kidneys. The ring, according to the police, was
run by two Indian brothers, neither of whom had any medical training but who oversaw the surgery.
One of the brothers has been arrested in Mumbai, but the other, Amit Kumar, who police say was the
racket's kingpin, is now the focus of an international manhunt and may have fled to Canada. But while
the details of this particular case are appalling, and the scam is the first — or at least first to be exposed
— involving foreigners from as far away as the U.S. and U.K flying in for transplants, Indians are sadly all
too familiar with organ rackets. In 2007, police in southern India uncovered an illegal kidney trade
involving fishermen whose jobs had been destroyed by the Indian Ocean tsunami. A massive transplant
ring in Punjab was also uncovered in 2003. Police there believe at least 30 of the donors, who as in this
latest case were poor, illiterate workers promised riches for their organs and bused in to be operated
on, died, despite promises that they would receive excellent post-operation medical care and that they
had nothing to worry about. India's illegal organ trade is driven in part by the incredible imbalance
between supply and demand for legal organs. The Indian government banned the sale of kidneys for
commercial gain in 1994; lawbreakers can be jailed for up to five years. But legal organ donations
remain rare in India. The Multi Organ Harvesting Aid Network (MOHAN), a Chennai-based nongovernment group that promotes legal organ donation, puts donation rates in India at well under 1 per
million, compared to rates of more than 20 per million in places such as Spain, the U.S. and France. The
group's head Dr Sunil Shroff rejects the idea that Indian culture or religion is behind the low donation
rates. "The reason is we haven't got our act together basically," he says. "The infrastructure is not there.
The general perception is lacking."
US Key
U.S. Medical Policy is Modelled Globally – Specifically Solves India
Tony Mira, Ajuba International, May 27, 2014 Tony Mira is President and CEO at Anesthesia Business
Consultants, President and CEO at MiraMed Global Services, CEO at Ajuba International What India can
learn from the U.S. about health care delivery
http://www.informationweek.in/informationweek/perspective/295976/india-learn-us-about-healthcare-delivery
On the other hand, while Indian health care systems are considered to be one of the best low-cost
models, it must be understood that out of the pocket payments account for 70 percent of health care
costs in India and this merits a strong work up on the financial instruments like medical insurance. India
lags in broader measures, too, most notably in health insurance. Over 450 million Indians do not have
insurance coverage as it is not mandated by the government. This can also be attributed to the lack of a
proper micro-health-insurance system in place and as a result, the insurance penetration is low. On the
other hand in U.S. the out of pocket expenditure stands at around 10-12 percent. The other issue that
needs to be looked into is India’s under-staffed, underfinanced government hospitals, which also
provide affordable healthcare to all. The result is counter-productive and this forces many people to visit
private medical practitioners. A recent article (S. Rice. Truven’s 15 Top systems: Consistency boosts
quality. Modern Healthcare, April 19, 2014) noted that other Top health systems in the U.S. say “a key
lesson they have learned is the importance of finding collaborative ways to work with doctors and
nurses to identify areas that need improvement. Several systems said they identified staff members who
were trusted by other staff and were seen as clinical practice leaders. These individuals, they say, not
only helped identify best practices, but also led the way in implementing them.” The importance of
effective clinical leadership is another major theme in any review of the strengths of the U.S. health care
system. Leadership alone, however, is not as effective as leadership with financial accountability in
enhancing health care’s value proposition, i.e., improving quality while lowering costs – a goal that is as
desirable in the U.S. as it is in India. One significant focus of the U.S. Affordable Care Act, the farreaching health care reform legislation adopted in 2010, was to establish incentives for collaborative
efforts seeking to deliver high-quality care with greater cost effectiveness and seeks to have nearuniversal healthcare insurance coverage to legal residents. As part of integrated healthcare system, U.S.
adopted different strategies, including: Bundled Payments: This aggregates the total amount paid to the
various providers involved in a single episode of care (.e.g., for an orthopedic procedure, the surgeon,
anesthesiologist, radiologist, physical therapist and the hospital) and leaves it to the providers to
determine their individual shares of the “bundle.” Bundled payments encourage providers to work in
teams, share information, and take collective responsibility for a patient's health so as to achieve
improved outcomes with greater efficiency. A more advanced model of integration and alignment of
incentives is found in accountable care organizations or “ACOs.” The care coordination offered by ACOs
includes integrated clinician workflow; agreement on practice standards and quality metrics; proactive
preventive, acute, chronic and end of life care and patient navigators serving as care coordinators within
participating hospitals and medical groups. As newer and better models of care emerge, we hope that
health care leaders, including within the U.S., will use the knowledge in whatever ways might lead to
better healthcare for people everywhere across geographies.
Framing
CP
PTX
Key concession – bottom docket
Concede lpm both
Concede internal warrant to hunter
Cheney Pushes Rebels Bill
Alex Seitz-Wald 09/10/14 04:51 PM Alex Seitz-Wald is a political correspondent for the National
Journal. Before joining the National Journal, he was the Washington corespondent for Salon and
previously worked for the Hotline, the PBS NewsHour and ThinkProgress. His writing has also appeared
in the Washington Post, the Atlantic, and the Nation. Congress debates arming moderate Syrian rebels
to fight ISIS http://www.msnbc.com/msnbc/congress-debates-arming-moderate-syrian-rebels-fight-isis
Republicans have also been circumspect, with Senate Minority Leader Mitch McConnell dismissing
Obama’s speech as little more than a “lecture.” Instead, he called for a “clear plan.” To build support
abroad, Kerry also visited Amman, Jordan, where he was scheduled to meet with King Abdullah. Obama
called Saudi King Abdullah bin Abdulaziz, who agreed “that a stronger Syrian opposition is essential to
confronting extremists,” the White House said. Earlier in the day, former Vice President Dick Cheney
visited the American Enterprise Institute, a conservative Washington think tank, to lambaste Obama’s
alleged inaction. “So often President Obama responds to crises by announcing all the things that he will
not do. And here again, we can only hope that pattern ends tonight,” Cheney said. On Tuesday, Cheney
gave what some described as a “pep talk” to House Republicans in a closed-door meeting, urging the
GOP to draw a harder line on national security at a time when a more isolationist libertarian wing of the
party is ascendant. “The reception I got on the Hill yesterday from my former colleagues was very
warm,” Cheney said at AEI. “I just believe those who advocate an isolationist course are dead wrong.”
Elsewhere on Capitol Hill, lawmakers heard from administration officials in two hearings that looked at
the potential threat of ISIS to the American homeland.
Ayson wrong
U.S. Can Identify Origin – Overstating Risk of Nuke Terror is the Biggest Internal link to
Making it Happen
Keir A. Lieber September 2013 Keir A. Lieber is Associate Professor in the Edmund A. Walsh School of
Foreign Service and the Department of Government at Georgetown University. Daryl G. Press is
Associate Professor of Government at Dartmouth College "States Will Not Give Nuclear Weapons to
Terrorists"
http://belfercenter.ksg.harvard.edu/publication/23385/states_will_not_give_nuclear_weapons_to_terr
orists.html
STOP UNDERSTATING U.S. NUCLEAR ATTRIBUTION CAPABILITIES U.S. officials and analysts should stop
understating the ability of the United States to attribute nuclear terrorist attacks. Many U.S. officials
have publicly lamented the limits of U.S. "nuclear forensic" capabilities—that is, the use of a bomb's
isotopic fingerprints to trace the fissile material device back to the reactors, enrichment facilities, or
uranium mines from which it was derived. They warn that existing nuclear forensic capabilities do not
permit the United States to reliably attribute nuclear detonations, and they urge greater spending on
those programs. Those programs have merit and perhaps require additional funding, but U.S. attribution
capabilities do not rest upon nuclear forensics. Instead, attribution is the result of day-to-day,
multisource intelligence, diplomacy, and bare-knuckled coercion. Historically, terrorist incidents are
attributed because of cellphone intercepts, computer surveillance, human intelligence, routine
investigative work, and tips from allies. Those mundane tools are the basis for the 97 percent attribution
rate, which applies to even moderately destructive attacks on U.S. and allied territory. The investigative
effort after a nuclear incident would be unprecedented. Disparaging assessments of U.S. attribution
capabilities are not merely inaccurate; they inadvertently undermine deterrence by misleading enemies
to overestimate the feasibility of an anonymous attack. The best way to deter countries from passing
weapons to terrorists is to demonstrate the ease of nuclear attribution and the devastating
consequences that would befall the sponsoring state.
S the bunn ev
Snatch Teams Solve 100% of the Risk
Robert Windrem Wednesday Aug 3, 2011 4:00 AM BC News Investigative Producer for Special
Projects US prepares for worst-case scenario with Pakistan nukes
http://investigations.nbcnews.com/_news/2011/08/03/7189919-us-prepares-for-worst-case-scenariowith-pakistan-nukes
Jeffrey T. Richelson, an intelligence historian, has written extensively about the possibility of a U.S.
military operation aimed at Pakistan’s nuclear arsenal, notably in his 2009 book “Defusing
Armageddon.” The book focuses on the U.S. Nuclear Emergency Search Team (NEST), which might play
leading a role in disarming Pakistani weapons along with elements of the Joint Special Operations
Command (JSOC). The nuts-and-bolts of how such an operation would work – such as whether teams
would attempt to disarm or destroy the weapons – remain highly classified. But Richelson notes that
without referring to Pakistan by name, Gen. Peter Pace, then-chairman of the Joint Chiefs of Staff, in
2006 discussed two types of operations where in which the U.S. military would seek to keep nuclear
weapons out of the hands of al-Qaida or other militants. Detailed in a military policy document titled
“National Strategy to Combat Weapons of Mass Destruction,” the two scenarios were: “elimination
operations” – defined as “operations systematically to locate, characterize, secure, disable and/or
destroy a State or non-State actor’s WMD programs and related capabilities” – and “interdiction
operations” – finding and seizing nuclear devices or nuclear material it has been removed from a
nation’s storage bunkers but not yet delivered to a terrorist group. Richelson also obtained an
unclassified PowerPoint presentation titled “Detecting, Identifying and Localizing WMD” by the Office of
Assistant Secretary of Defense for Special Operations and Low-Intensity Conflict (SOLIC). In it were slides
referring to “clandestine or low-visibility special operations taken to: locate, seize, destroy, capture,
recover or render safe WMD,” either on land or sea. He said such a mission has been a special
operations forces priority since 2002. Neither the report nor the PowerPoint presentation specify where
such operations would be considered, but Richelson says that both were prepared with Pakistan in
mind. “The focus on Pakistan,” he wrote, “is the result of its being both the least stable of the nine
nuclear weapons states and the one where there has been significant support for Osama bin Laden and
al-Qaida, not only among the general population but also within the military and intelligence forces.”
Publicly, U.S. officials don’t want to embarrass or infuriate Pakistani officials by suggesting such an
operation would be possible, a point brought home in a White House press conference on April 29,
2009. After President Barack Obama spoke of the confidence he had in the Pakistani Army’s ability to
secure the nuclear weapons, NBC News’ Chuck Todd began to ask if the U.S. military would step in and
seize weapons that were at risk. Obama quickly cut him off. “I’m not going to engage in hypotheticals of
that sort. I feel confident that nuclear arsenal will remain out of militant hands, OK?”
No coalitions
No State Sponsor – Laundry List
Keir A. Lieber September 2013 Keir A. Lieber is Associate Professor in the Edmund A. Walsh School of
Foreign Service and the Department of Government at Georgetown University. Daryl G. Press is
Associate Professor of Government at Dartmouth College "States Will Not Give Nuclear Weapons to
Terrorists"
http://belfercenter.ksg.harvard.edu/publication/23385/states_will_not_give_nuclear_weapons_to_terr
orists.html
States Won't Give Nuclear Weapons to Terrorists. Giving a nuclear weapon to terrorists would be as
suicidal as launching a nuclear strike directly. Evidence shows that guilty terror groups in normal highcasualty attacks are almost always identified. Attribution of nuclear terrorism would be even easier;
tracing a guilty group to its state sponsor would be simple. The fear of nuclear attack by proxy is
unfounded. • Nuclear Terrorism Would Not Remain Anonymous. Seventy-three percent of past highcasualty terrorist attacks have been traced back to the perpetrators. More important, 97 percent of
moderate- and high-fatality attacks conducted on U.S. territory or that of a major U.S. ally were
attributed. Furthermore, the suspect list of state sponsors would be short: few countries sponsor
terrorism; and of the few that do, only Pakistan has nuclear weapons or enough fissile material to
manufacture one. • Fear of Nuclear Handoff Does Not Justify Costly Military Action. The fear that Iran
will transfer nuclear weapons or materials to terrorists does not warrant costly steps like military action
to prevent proliferation. To be persuasive, arguments for military strikes need to be based on other
potential negative consequences of proliferation. • Stop Understating U.S. Nuclear Attribution
Capabilities. The United States has gaps in its "nuclear forensics" capabilities, which should be
addressed. The strength of U.S. attribution capabilities, however, lies elsewhere—in the day-to-day
intelligence gathering that routinely thwarts other terror strikes. History shows that U.S. attribution
capabilities are very strong, and saying otherwise undermines deterrence.
AIDS DA
Commodification K