Contention 1 – Organ sales will save lives
The ban on organ sales for transplant has created a large and growing shortage
Williams 14 Kristy L. Williams, University of Houston Law Center, Health Law & Policy Institute;
University of Texas Medical Branch, Institute of Medical Humanities.; Marisa Finley, Baylor Scott &
White Health Center for Health Care Policy; J. James Rohack, Baylor Scott & White Health March 31,
2014 American Journal of Law and Medicine, Forthcoming Just Say No to NOTA: Why the Prohibition
of Compensation for Human Transplant Organs in NOTA Should Be Repealed and a Regulated Market for
Cadaver
Organs Instituted
http://ssrn.com/abstract=2418514
Organ transplantation saves thousands of lives every year. However, many individuals die
waiting for transplants due to an insufficiency of organs.1 Currently, more than 122,000
individuals are waitlisted for organs in the United States.2 Due to financial and other barriers
to becoming waitlisted, the actual number of Americans requiring organs is likely higher.3 This
gap between available organs and the need for organs continues to widen.4 The supply of
organs is limited as only a small number of individuals die in circumstances medically eligible
for organ donation, and less than sixty-eight percent of eligible individuals donate.5 As a result of
those long waitlists and limited supply there is a substantial need to increase organ donations. This
paper will focus on increasing consent rates for cadaveric organ donation in the Unites States by
repealing current law prohibiting cadaveric donors and their estates from being financially
compensated.6 The current organ donation system in the United States relies on the altruism
of donors. The National Organ Transplantation Act (NOTA) prohibits the receipt of any form of
valuable consideration in exchange for organs to be used for transplantation.7 State statutes
also prohibit the sale of certain organs and tissue for transplantation; however, state laws vary
widely as to what body parts are covered.8 As paying for organs is prohibited, other methods have
been employed in attempts to increase donations.9 Despite the implementation of these
strategies, a severe organ shortage remains.
Varied efforts to increase voluntary donations fail – individually and in combination
Beard 8 T.RANDOLPH BEARD, JOHN D. JACKSON , AND DAVID L. KASERMAN, profs of economics,
Auburn University
Winter 2008 Regulation
The Failure of US 'Organ Procurement Policy
http://object.cato.org/sites/cato.org/files/serials/files/regulation/2007/12/v30n4-3.pdf
Aware of the increasingly dire consequences of continued reliance on the existing approach to
cadaveric organ procurement and alarmed at the figures shown above, the transplant industry has
examined and adopted a series of policy options ostensibly designed to improve the
system’s performance. All of these, however, continue to maintain the basic zero-price
property of the altruistic system. As a result, the likelihood that any of them, even in
combination, will resolve the organ shortage is remote. At least seven such actions have
been implemented over the last two decades or so: ■ INCREASED EDUCATIONAL EXPENDITURES
In the absence of financial incentives, moral suasion becomes the principal avenue through which
additional supply may be motivated. Consequently, the organ procurement organizations (opos)
created under the 1984 Act have launched substantial promotional campaigns. The campaigns have
been designed to both educate the general public about the desperate need for donated organs and
educate physicians and critical care hospital staff regarding the identification of potential deceased
donors. Over the years, a substantial sum has been spent on these types of educational activities.
Recent empirical evidence, however, suggests that further spending on these programs is unlikely to
increase supply by a significant amount. ■ ORGAN DONOR CARDS A related activity has been the
process of incorporating organ donor cards on states’ driver licenses. The cards can be easily
completed and witnessed at the time the licenses are issued or renewed. They serve as a premortem statement of the bearer’s wish to have his or her organs removed for transplantation
purposes at the time of death. Their principal use, in practice, is to facilitate the opos’ efforts to
convince surviving family members to consent to such removal by revealing the decedant’s wishes.
The 1968 Uniform Anatomical Gift Act gave all states the authority to issue donor cards and
incorporate them in drivers’ licenses. Moreover, a few states have recently begun to rely entirely on
donor cards to infer consent without requiring the surviving family’s permission when such cards are
present. Survey evidence indicates that less than 40 percent of U.S. citizens have signed their donor
cards. ■ REQUIRED REQUEST Some survey evidence published in the late 1980s and early 1990s
found that in a number of cases families of potential deceased donors were not being asked to
donate the organs. As a result, donation was apparently failing to occur in some of those instances
simply because the request was not being presented. In response to this evidence, federal
legislation was passed in 1987 requiring all hospitals receiving any federal funding (which, of
course, is virtually all hospitals) to request organ donation in all deaths that occur under
circumstances that would allow the deceased’s organs to be used in transplantation. It appears that
this legal obligation is now being met in most, if not all, cases. Yet, the organ shortage has persisted
and the waiting list has continued to grow. ■ REQUIRED REFERRAL While required-request legislation
can compel hospitals to approach the families of recently deceased potential organ donors with an
appeal for donation, it cannot ensure that the request will be made in a sincere, compassionate
manner likely to elicit an agreement. Following implementation of the required-request law, there
were a number of anecdotes in which the compulsory organ donation requests were presented in an
insincere or even offensive manner that was clearly intended to elicit a negative response. The letter
of the law was being met but not the spirit. As a result, additional legislation was passed that
requires hospitals to refer potential organ donors to the regional opo so that trained procurement
personnel can approach the surviving family with the donation request. This policy response has
resulted in no perceptible progress in resolving the shortage. ■ COLLABORATION A fairly recent
response to the organ shortage has been the so-called “Organ Donation Breakthrough
Collaborative,” which was championed by then-secretary of health and human services Tommy
Thompson. The program was initiated shortly after Thompson took office in 2001 and is currently
continuing. The program’s basic motivation is provided by the observation of a considerable degree
of variation in performance across the existing opos. Specifically, the number of deceased organ
donors per thousand hospital deaths has been found to vary by a factor of almost five across the
organizations. The presumption, then, is that the relatively successful opos employ superior
procurement techniques and/or knowledge that, if shared with the relatively unsuccessful
organizations, would significantly improve their performance. Thus, diffusion of “best practice”
techniques is seen as a promising method through which cadaveric donation rates may be greatly
improved. A thorough and objective evaluation of the Thompson initiative has not, to our
knowledge, been conducted. Figure 1, in conjunction with a recent econometric study of observed
variations in opo efficiency, suggests that such an evaluation would yield both good news and bad
news. The good news is that the program appears to have had a positive (and potentially significant)
impact on the number of donations. In particular, it appears that, after 2002, the growth rate of the
waiting list has slowed somewhat. Whether this effect will permanently lower the growth rate of the
waiting list or simply cause a temporary intercept shift remains to be seen. The bad news, however,
is unequivocal— the initiative is not going to resolve the organ shortage. Even if, contrary to
reasonable expectations, all opo relative inefficiencies were miraculously eliminated (i.e., if al
organizations’ performance were brought up to the most efficient unit), the increase in donor
collection rates would still be insufficient to eliminate the shortage. ■ KIDNEY EXCHANGES Another
approach that has received some attention recently involves the exchange of kidneys between
families who have willing but incompatible living donors. Suppose, for example, a person in one
family needs a kidney transplant and a sibling has offered to donate the needed organ. Further
suppose that the two siblings are not compatible — perhaps their blood types differ. If this family can
locate a second, similarly situated family, then it may be possible that the donor in the first family
will match the recipient in the second, and vice versa. A relatively small number of such exchanges
have recently occurred and a unos-based computerized system of matching such interfamily donors
has been proposed to facilitate a larger number of these living donor transactions. Two observations
regarding kidney exchanges are worth noting. First, such exchanges obviously constitute a crude type
of market in living donor kidneys that is based upon barter rather than currency. Like all such barter
markets, this exchange will be considerably less efficient than currency-based trade. Puzzlingly, some
of the staunchest critics of using financial incentives for cadaveric donors have openly supported
expanded use of living donor exchanges. Apparently, it is not market exchange per se that offends
them but, rather, the use of money to facilitate efficient market exchange. This combination of
positions merely highlights the critics’ lack of knowledge regarding the operation of market
processes. It is quite apparent that living donor kidney exchanges are not going to resolve the organ
shortage. Opportunities for such barter-based exchanges are simply too limited. ■ REIMBURSEMENT
OF DONOR COSTS Finally, in another effort to encourage an increase in the number of living
(primarily kidney) donors, several states have passed legislation authorizing reimbursement of
any direct (explicit) costs incurred by such donors (e.g., travel expenses, lost wages, and so on).
Economically, this policy action raises the price paid to living kidney donors from a negative amount
to zero. As such, it should be expected to increase the quantity of organs supplied from this source.
Because the explicit, out-of-pocket expenses associated with live kidney donation are unlikely to be
large relative to the longer-term implicit costs of potential health risks, however, such
reimbursement should not be expected to bring forth a flood of new donors. Moreover, recent
empirical evidence suggests that an increase in the number of living donors may have a negative
impact on the number of deceased donors because of some degree of supply-side substitutability.
Again, this policy is not a solution to the organ shortage. We must conclude that none of the
above-listed policies should be expected to resolve the transplant organ shortage. We say this
not because we oppose any of these policies; indeed, each appears sensible in its own right and
some have unquestionably succeeded in raising the number of organ donors by some (perhaps
nontrivial) amount. Rather, our concern is that every time another one of these marginalist
policies is devised, it delays the only real reform that is capable of fully resolving the organ
shortage.
The shortage means many die
Beard 8 T.RANDOLPH BEARD, JOHN D. JACKSON , AND DAVID L. KASERMAN, profs of economics,
Auburn University
Winter 2008 Regulation
The Failure of US 'Organ Procurement Policy
http://object.cato.org/sites/cato.org/files/serials/files/regulation/2007/12/v30n4-3.pdf
WAITING LISTS YET TO COME
The consequences of our failure to adapt our cadaveric organ procurement policy to the
changed technological realities of the transplant industry have been unconscionable. Figure 2, above,
suggests that more than 80,000 lives have now been sacrificed on the altar of our so-called
“altruistic” system. In addition, the unnecessary pain and suffering of those who have been
forced to wait while undergoing dialysis, unemployment, and declining health must also be
reckoned along with the growing despair of family members who must witness all of this.
Nonetheless, the pain, suffering, and death imposed on the innocents thus far pales in
comparison to what lies ahead if more fundamental change is not forthcoming . In order to
illustrate the severe consequences of a continuation of the altruistic system, we use the data presented in Figures 1 and 2 above to
generate forecasts of future waiting lists and deaths. The forecasts represent our best guess of what the future holds if fundamental
change continues to be postponed. The results should serve as a wake-up call for those who argue that we should continue tinkering with
the existing procurement system while further postponing the implementation of financial incentives. The costs of such a “wait and see”
approach are rapidly becoming intolerable. CHANGING VARIABLE To produce reasonable forecasts of future waiting lists and deaths, we
must first confront an apparent anomaly in the reported data that could cast doubt on the accuracy of some of the more recent figures.
Specifically, the reported number of deaths of patients on the waiting list (plus those too sick to receive a transplant) follows a consistently
upward trend that is very close to a constant proportion of the size of the waiting list over most of the sample period. Beginning in 2002,
however, the number of deaths levels off and even starts to decline, despite continued growth of the waiting list. It is not clear why there is
an abrupt change in the observed trend in this variable. Our investigation of this issue yielded several plausible explanations but no
definitive answer. For example, it may be the case that recent advances in medical care, such as the left ventricular assist device, have
extended some patients’ lives and, thereby, reduced the number of deaths on the list. Alternatively, it may be the case that because of
rising criticism of the current system, unos has taken steps to remove some of the relatively higher-risk patients from the list before they
die. For example, the meld/peld program, which was introduced in February 2002, removed a number of liver patients (who have a
comparatively high death rate) from the waiting list. Additionally, the increasing use of so-called “extended criteria” donor organs may
have a similar effect, getting the most critically ill patients off the list prior to their deaths. Clearly, the implications of these alternative
explanations for reliance on the data are not the same. For example, if patients are, in fact, simply living longer and the data accurately
reflect that reality, then our analysis should incorporate the observations. But if the more recent figures are, instead, a manifestation of
strategic actions taken by the reporting agency, then they should be excluded. Because we have been unable to identify a single,
convincing explanation for the observed phenomenon, we elected to perform our analysis both ways — including and excluding the post2002 observations on the number of deaths. ESTIMATES Given the two alternative sample periods, the methodology we employ to
generate our forecasts is as follows: First, because the number of deaths appears to be causally driven by the number of patients on the
waiting list, we begin by estimating a simple linear regression model of the former as a function of the latter. The results of that estimation
are reported in Table 1 for the two sample periods described above. Next, we estimate a second linear model with the number of patients
on the waiting list regressed against time, again using the two alternative sample periods. Those results are reported in Table 2. From
the results, we are able to produce forecasts of the expected size of future waiting lists for
each of our sample periods. We run the forecasts out 10 years from the end of our longer sample
period, to 2015. Given the forecasted waiting list values, we are then able to use the regression results in Table 1 to generate our
forecasts of the number of deaths over the same period. The two alternative sets of forecasts are shown graphically in Figures 3 and 4.
Depending upon the sample period chosen, the results show the waiting list reaching 145,691 to 152,400 patients by 2015. Of the patients
listed at that time, between 10,547 and 13,642 are expected to die that year. Even more tragically, over the entire
period of both
actual and predicted values, a cumulative total of 196,310 patients are conservatively expected
to die by 2015 as a consequence of the ongoing shortage. Figure 5 illustrates the results. In that
figure, we incorporate several historical reference points in order to put the numbers in perspective.
No one directly involved in the transplant industry is likely to be surprised by our results. Thirty years
of experience consistently point to a continuation of the current, long-standing trends. There is
nothing on the horizon that should lead anyone to expect a sudden reversal. But our purpose is not
to surprise the parties who are already knowledgeable about this increasingly severe problem.
Rather, our intent is to awaken the sleeping policymakers whose continuing inaction will inevitably
lead to these results. They can no longer continue to postpone meaningful reform of the U.S. organ
transplant system in the futile hope that, somehow, things will improve. They will not.
Waitlist underestimates the need for kidney transplants
Goodwin 9 MICHELE GOODWIN Everett Fraser Professor of Law and Professor of Medicine and
Public Health, University of Minnesota Law School. SAINT LOUIS UNIVERSITY JOURNAL OF HEALTH LAW
& POLICY [Vol. 2:327 2009] CONFRONTING THE LIMITS OF ALTRUISM: A RESPONSE TO JAKE LINFORD
Of the patients in line for organs, most need kidneys.29 In fact, three quarters of the transplant
waitlist consists of patients needing kidneys. At the end of February 2009, there were 83,447
registrants waiting for kidneys.30 But that number tells us less than what we really need to know. For
example, that figure undercounts the actual number of patients that would benefit from a kidney
transplant, because it does not account for the 485,000 Americans with end-stage renal disease, or
the more than 341,000 who are on dialysis, those who are registered on Internet websites, like
matchingdonor.com, or those who decided that the black market might be far more expedient than
waiting in the U.S. To be sure, the gains in organ donation pale in comparison with the number of
registered patients who can expect to die before ever receiving a transplant.
Organs from cadavers don’t solve
Fry-Revere 14 Sigrid Fry-Revere. Director of bioethics studies, CATO Institute 2014
The Kidney Sellers: A Journey of Discovery in Iran p 6
At the time, what Congress did seemed reasonable, but over the following three decades, no matter
how efficient the U.S. cadaver organ procurement sys- tem became, it could not satisfy the demand.
Medical innovations keep people alive longer, and the ever-growing diabetes and hypertension
epidemics contin- ually increased the number of people who could benefit from a kidney transplant.
Today the number of kidneys provided from cadavers could never be enough, even if every organ
from every potential qualified donor could be harvested. This is true because not every death results
in useable organs. Organs can be diseased or injured, or the body can be dead too long before it
reaches the hospital. Patients who die in the hospital after a car accident or similar trauma are the
best potential organ donors because the appropriate medical equip- ment is at hand to switch gears
from saving the patient to preserving organs for transplantation. Nevertheless, given what we know
now, no matter how the process for retrieving organs from the dead improves, there will never be
enough kidneys to meet the ever-growing demand.
Artificial organs don’t work
Adhikari 14 Richard Adhikari has written about high-tech for leading industry publications since the 1990s
03/26/14 Bioprinting, Part 1: The Promise and the Pitfalls http://www.technewsworld.com/story/80198.html
[According to Jordan Miller, assistant professor of bioengineering at Rice University]. "Parts of the
body which require human cells to perform biomechanical functions, such as the liver or kidney, are
still several decades away from reaching human patients," Miller said. "We are still in the feasibility
stage -- not sure how to keep cells alive at high cell density and adequate size needed to match
human organs." A 3D structure will require nearly 1 billion functioning cells to approximate the
function of a liver or kidney, and "there are dozens of cell types in these organs," Miller pointed out.
"We are typically only looking at one or two cell types being put into a 3D printed structure."
NOTE SOURCE WITH QUALS EDITED INTO BEGINNING OF CARD
And they’re too expensive
Gopar 14 Jennifer Julisa Gopar ans Dr. Rance LeFebvre 28 July 2014 COSMOS Cluster 7: Biomedical
Sciences The Moral and Ethical Debate Regarding Artificial Organ Growth
http://cosmos.ucdavis.edu/archives/2014/Cluster7/Gopar_Jennifer_EthicsofGrowingOrgans.pdf
With these possible outcomes taken consideration, it is now becoming clear that money will play an
important role in artificial organ growth. If we begin producing artificial organs, will these be
available to everyone? Or will these be only available to the wealthy? The whole purpose of artificial
organ growth is to give hope to those waiting for an organ transplant. How would this fulfill that
purpose if only the wealthy will be able to afford it? The Scientist elaborated on this possible
problem, stating, “[Jeffrey] Platt thinks that organ engineering is too costly to meet the needs of
everyone waiting for a transplant. ‘You’d have to turn over the entire GDP of a country to
accomplish that,’ he says. On the other hand, ‘I could get a pig for a couple of hundred dollars.’ But
[Paolo] Macchiarini argues that organ engineering is in its infancy, and every advance improves
efficiency and lowers cost. ‘What we did in 2008 in 6 months, we can now do in a few weeks,’ he
says. ‘We do care about getting this to every patient.’ [Joseph] Vacanti adds that mass-producing
artificial scaffolds will make organ engineering even more cost-effective. ‘When you scale them up,
the bulk materials and manufacturing tech are extremely cheap,’ he says. ‘I think it’s going to be
cheaper than growing lots of pigs.’” So it is still unclear whether the cost of these artificial organs will
allow them to be within the reach of patients in need of an organ transplant.
Crowd-out studies are based on Titmuss, who’s wrong
Economist 11
The Economist Feb 16th 2011 Blood, not money
http://www.economist.com/blogs/blighty/2011/02/volunteering_and_profiteering
Blood donors are also unpaid, in Britain and elsewhere. A debate over whether or not they should be
compensated for their efforts has raged for at least four decades. In a classic 1970 study called "The
Gift Relationship: From Human Blood to Social Policy" Richard Titmuss compared the voluntary
British system favourably with the American one in which payments were then widely made. Titmuss
reckoned such a market was inefficient and wasteful, that it created shortages and surpluses, and led
eventually to a contaminated product. Although he was wrong, and such arguments have since been
widely discredited, Americans mostly no longer receive payment for giving blood. Too many people
in poor health lied about their medical histories in order to make a few bucks, endangering those
who were to receive the blood. As the World Health Organisation notes, people who give blood
voluntarily and for altruistic reasons have a lower prevalence of HIV, hepatitis viruses and other
blood-borne infections than do those who seek monetary reward. Presumably that is because being
rich is a great protection against disease.
New empirical data proves no altruism crowd out
Elisa J Gordon 15, PhD/MPH-Research Associate Professor in Center for Healthcare Studies - Institute
for Public Health and Medicine, Medical Education-Medical Humanities and Bioethics and Surgery-Organ
Transplantation at Northwestern University, “Does Financial Compensation for Living Kidney Donation
Change Willingness to Donate?,” American Journal of Transplantation, Volume 15, Issue 1, pages 265–
273, January 2015
This study assessed public perceptions about the impact of compensation on willingness to donate, the
amount of compensation that would begin motivating individuals to donate, and the amount that starts to be perceived as undue inducement.¶
The majority of the public surveyed perceived financial compensation for living donors acceptable in
general. However, fewer respondents considered financial compensation to themselves to donate acceptable. Moreover, the majority
(70%) would not change their willingness to donate if offered financial compensation, and 74% found
an offer of compensation to others acceptable, which, together, undermines the positive crowding out
hypothesis that the offer of compensation reduces a desired behavior in those already disposed to
pursuing the desired behavior. Bryce et al similarly found 71–76% maintaining the same willingness to be
a deceased donor, depending on the type of compensation [28]. Our finding suggests that respondents were against
personally receiving financial compensation. In other words, this disconnection between tolerance for compensating others and less support
for personal compensation suggests that financial compensation would make little difference in individuals' decisions to donate, and that in
practice, policies in support of financial compensation would have relatively little traction in increasing living donation rates.
No crowd out – donations are primarily for friends and relatives
Gill 2 Michael Gill, Ph.D., Assistant Professor, Department of Philosophy, College of Charleston AND Robert
Sade, M.D.,Professor in the Department of Surgery and Director of the Institute of Human Values in Health Care,
Medical University of South Carolina. Kennedy Institute of Ethics Journal 12.1 (2002) 17-45
Paying for Kidneys: The Case against Prohibition http://muse.jhu.edu/journals/kennedy_institute_
of_ethics_journal/v012/12.1gill.html
3. In the early 1970s, Titmuss (1971) and Singer (1973) argued that the existence of financial incentives
for blood products would decrease the amount of blood products overall, and some people might
believe that the same argument can be extended to financial incentives for kidneys, leading to the
conclusion that payment for kidneys will decrease the overall number of kidneys available for
transplant. Singer and Titmuss's criticisms of payment for blood products are consequentialist—they
argue that such payment is wrong because it would reduce the amount of blood for people who needed
it. We believe, first of all, that their consequentialist arguments against payment for blood products
have turned out to be inconclusive at best—that the available evidence does not support the conclusion
that payment for blood products has reduced blood supply in the United States. And we believe,
secondly, that because live kidney donations are usually between family members, there is a significant
difference between blood and kidneys that makes it illegitimate to transfer Titmuss and Singer's
conclusions to the kidney debate. We do, however, remain open to the possibility that future evidence
may vitiate our belief that payment for kidneys will increase supplies. For discussion of Titmuss and
Singer in relation to kidney sales, see Campbell (1992, pp. 41-42); Cherry (2000, pp. 340-41); and Harvey
(1999, p. 119).
Even if some crowd out occurred, sales would still provide an adequate supply of
organs
Study by Becker and Elias 14 Gary S. Becker, Nobel Prize-winning professor of economics at the
University of Chicago and a senior fellow at the Hoover Institution; and Julio J. Elias, economics
professor at the Universidad del CEMA in Argentina. Updated Jan. 18, 2014 Wall Street Journal Cash
for Kidneys: The Case for a Market for Organs
http://online.wsj.com/news/articles/SB10001424052702304149404579322560004817176?mod=WSJ_h
pp_MIDDLENexttoWhatsNewsFifth
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 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 the growth in the number of people with defective organs who need transplants. The result has been longer and
longer delays to receive organs. 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.
Enlarge Image 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 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 onequarter 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 compensate mainly for time lost from work. 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 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 use), with payment going to their heirs after their organs are harvested. 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. The idea of paying organ donors has met with strong opposition
from some (but not all) transplant surgeons and other doctors, as well as various academics, political leaders and others. Critics have
claimed that paying for organs would be ineffective, that payment would be immoral because it involves the sale of body parts and that the
main donors would be the desperate poor, who could come to regret their decision. In short, critics believe that monetary payments for
organs would be repugnant.
But the claim that payments would be ineffective in eliminating the
shortage of organs isn't consistent with what we know about the supply of other parts of the
body for medical use. For example, the U.S. allows market-determined payments to surrogate
mothers—and surrogacy takes time, involves great discomfort and is somewhat risky. Yet in the U.S.,
the average payment to a surrogate mother is only about $20,000. Another illuminating example is the allvolunteer U.S. military. Critics once asserted that it wouldn't be possible to get enough capable volunteers by offering them only
reasonable pay, especially in wartime. But the all-volunteer force has worked well in the U.S., even during wars, and the cost of these
recruits hasn't been excessive. Whether paying donors is immoral because it involves the sale of organs is a much more subjective matter,
but we question this assertion, given the very serious problems with the present system. Any claim about the supposed immorality of
organ sales should be weighed against the morality of preventing thousands of deaths each year and improving the quality of life of those
waiting for organs. How can paying for organs to increase their supply be more immoral than the injustice of the present system? Under
the type of system we propose, safeguards could be created against impulsive behavior or exploitation. For example, to reduce the
likelihood of rash donations, a period of three months or longer could be required before someone would be allowed to donate their
kidneys or other organs. This would give donors a chance to re-evaluate their decisions, and they could change their minds at any time
before the surgery. They could also receive guidance from counselors on the wisdom of these decisions. Though the poor would be more
likely to sell their kidneys and other organs, they also suffer more than others from the current scarcity. Today, the rich often don't wait as
long as others for organs since some of them go to countries such as India, where they can arrange for transplants in the underground
medical sector, and others (such as the late Steve Jobs ) manage to jump the queue by having residence in several states or other means.
The sale of organs would make them more available to the poor, and Medicaid could help pay for the added cost of transplant surgery. The
altruistic giving of organs might decline with an open market, since the incentive to give organs to a relative, friend or anyone else would
be weaker when organs are readily available to buy. On the other hand, the altruistic giving of money to those in need of organs could
increase to help them pay for the cost of organ transplants. Paying
for organs would lead to more transplants—and
thereby, perhaps, to a large increase in the overall medical costs of transplantation. But it would
save the cost of dialysis for people waiting for kidney transplants and other costs to
individuals waiting for other organs. More important, it would prevent thousands of deaths
and improve the quality of life among those who now must wait years before getting the
organs they need.
Contention 2 is the Illegal market
The US ban on sales has created an international illegal market
Hughes 9 J. Andrew Hughes, J.D. candidate, Vanderbilt University Law School, May 2009.
Vanderbilt Journal of Transnational Law January, 2009 42 Vand. J. Transnat'l L. 351
Note: You Get What You Pay For?: Rethinking U.S. Organ Procurement Policy in Light of Foreign Models
U.S. organ procurement policy has consequences beyond a domestic organ shortage. A
thriving global black market in human organs has resulted from U.S. policy banning organ
sales. n78 While nearly all developed nations have banned the sale and purchase of human organs,
many countries do not strictly enforce these laws. n79 The illegality of the organ trade is
insufficient to discourage many of those faced with the possibility of dying on an organ
waiting list, and "transplant tourism" has become its own industry. n80 In Bombay in 2001,
nearly US$ 10 million were exchanged for kidney transplants. n81 Patients use kidney brokers to
locate sellers, who circumvent a ban on kidney sales by signing an affidavit swearing that they are
not being paid. n82 Before the U.S. invaded Iraq in 2003, that country was known as "one of [the]
world's best black marketplaces for human organs." n83 The lack of effective prosecution of these
transactions extends beyond Asia and the Middle East to Europe, as recent cases in Estonia and
Germany suggest. n84 U.S. doctors perform illegal transplants, too, often under hospitals'
"don't ask, don't tell" policy regarding transplants involving foreigners who claim to be
related. n85 U.S. hospitals set their own rules for who can be a live organ donor, and organ brokers
can locate hospitals that do not question a purported familial relationship between "donors" and
"donees." n86 The lack of a regulated organ marketplace in the U.S. has resulted in
exploitation of the poor throughout the world. n87 Organ sellers often face debt,
unemployment, and serious health problems; as such, they are easy targets for abuse. n88 Prisoners
and the homeless are among those exploited. n89 Sellers of organs on the black market are often
paid less than what they were initially promised, while their financial situations and health often
grow worse after the transplants. n90 Data from the Indian black market trade in kidneys [*363]
support the concern about sellers' lack of adequate information about the risks involved. In one
study, 86% of the sellers there reported that their health had "deteriorated substantially" after their
organ sales, and "four out of five sellers would not recommend that others follow their lead in selling
organs." n91 In short, U.S. policy and its ban on organ sales have produced some of the same
immoral and unethical consequences the ban was designed to avoid. n92
Trafficking is increasing now—global legislation is ineffective—most recent trends
prove
Da Silva and Frontera 15 (Ivan Rocha Ferreira Da Silva, MD1; Jennifer A. Frontera, MD2 Neurocritical
Care Unit and Stroke Department, Hospital Copa D’Or, Rio de Janeiro, Brazil 2Cerebrovascular Center of
the Neurological Institute, Cleveland Clinic, Cleveland, Ohio “Worldwide Barriers to Organ Donation”
JAMA Neurol. 2015;72(1):112-118. doi:10.1001/jamaneurol.2014.3083.
http://archneur.jamanetwork.com/article.aspx?articleid=1934718)
Globally, legislation guiding organ donation and transplant varies widely.1 Only 20% of African nations
report having a transplant and organ donation coordinating structure, while 95% of countries in the Americas have such a
system in place. Even fewer countries have a mechanism for collection and analysis of data related to
donation, donor safety, and transplantation activities. Some countries report that liver and/or kidney transplants are
performed despite a lack of legislation. Such lack of oversight may promulgate illegal transplantation and organ
trafficking. Even in countries that have legislation regulating organ trafficking, there is weak
enforcement and few international regulations that can effectively police the problem.43 A recent report by
Global Financial Integrity estimates that the illicit organ trade generates illegal profits between $600 million and $1.2 billion per
year.44 It is hypothesized that this market is fueled not only by profit but also by cultural and religious barriers to organ
donation and transplantation in some countries, long waiting lists for organs, precarious infrastructure for transplants in the country
of origin, and difficult access to chronic life support (in the case of renal replacement therapy).45 A growing number of countries
report that patients have allegedly traveled to countries to buy organs on the black (illicit) market, a practice
known as transplant tourism. The World Health Organization estimates that 5% to 10% of kidney transplants worldwide occur as a
result of commercial transactions.46,47 A study of American citizens who received organ transplants abroad showed that roughly 90%
were kidney transplants and that male sex, Asian race, resident and nonresident alien status, and college education were significantly and
independently associated with foreign transplant.48 In 2006, patients from 34 states, plus the District of Columbia, received
foreign
transplants in 35 countries, led by China, the Philippines, and India.48
People sell organs out of economic desperation, but the illicit market leaves them
worse off
Jaycox 12 Michael P. Jaycox, teaching fellow and Ph.D. candidate in theological ethics at Boston
College,
COERCION, AUTONOMY, AND THE
PREFERENTIAL OPTION FOR THE POOR IN THE ETHICS OF ORGAN TRANSPLANTATION
Developing World Bioethics Volume 12 Number 3 2012 pp 135–147
http://onlinelibrary.wiley.com/doi/10.1111/j.1471-8847.2012.00327.x/pdf
Pakistani surgeon and bioethicist Farhat Moazam offers the results of a recent study in
which he interviewed thirty-two farm laborers in Pakistan, each of whom had sold a kidney
within the past three years. 14 He found that almost all of these organ vendors were in
significant debt to wealthy landlords at the time they sold their kidneys; the average debt
of each was 130,000 rupees at the time of sale. Although the vendors were promised by
third-party brokers an average price of 160,000 rupees per kidney, the amount actually
received by the vendors was an average of 103,000 rupees. As a result, a majority (17) of
them were ‘either still in debt or had accumulated new debts’ at the time of their
interviews. 15 Moreover, a majority of the vendors experienced long-term physical and
psychological malady as a result of their nephrectomies, and a majority also expressed
regret or shame for their decision because they were not freed from their debts and/or
felt they had committed a morally wrong act. When asked why they had made the decision,
‘the most common [Urdu] words they used were majboori (a word that arises from the root
jabr, which means a state that is beyond one’s control) and ghurbat (extreme
poverty).’16,Moazam summarizes his findings with the conclusion that the sale of kidneys
functions to reinforce the poverty of those who sell them: In the words of the vendors, they
sell a kidney...in order to fulfill what they see as obligations toward immediate and extended
families in which they are inextricably embedded, and within systems of social and economic
inequalities which they can neither control nor escape. They sell kidneys in hopes of paying off
loans taken to cover their families’ medical expenses or to meet the responsibilities for
arranging marriages and burying their dead. These are recurring expenses, and for most the
debts rapidly accumulate again, even if they have been partially or completely paid back with
the money from selling a kidney. 17 4 F. Moazam, R.M. Zaman & A.M. Jafarey. Conversations
with Kidney Vendors in Pakistan: An Ethnographic Study.Hastings Cent Rep 2009; 39: 29–44. Due
to recent legislation (18 March 2010), the sale of human organs is now illegal in Pakistan,
although the social effects of this new legislation remain to be studied; see T.M. Pope. Legal
Briefing: Organ Donation and Allocation. J Clin Ethics 2010; 21: 243–263: 254.
For many, the coercion is more violent
Bowden 13 Jackie Bowden, 2013 J.D. graduate from St. Thomas University School of Law.
Intercultural Human Rights Law Review 2013 8 Intercultural Hum. Rts. L. Rev. 451 ARTICLE:
FEELING EMPTY? ORGAN TRAFFICKING & TRADE: THE BLACK MARKET FOR HUMAN ORGANS lexis
[*452] Introduction
Organ trafficking has been depriving innocent people of their fundamental right to life for
decades. n1 Imagine living in a poor country, where you wake up in the morning and set out to
find work and food for the day. As you walk peacefully to your home at the end of the day, you are
grabbed and thrown into the back of an unmarked truck. n2 You wake up, screaming from
excruciating pain, as a surgeon slices through your flesh to remove your kidney. Due to the
costs associated with such a procedure, no anesthesia is administered and no medication is
given to prevent infection. n3 In the event that the surgery does not go as planned, no forms of
emergency assistance are available. Your body is then dumped on a side street, and you are
extremely lucky if you live. Should you report the incident to government officials? What if the
government is actually involved in this inhumane activity? n4 [*453] There are conflicting views on
whether people are actually kidnapped for their organs. n5 In fact, many believe these stories are
just myths. n6 However, there are reported accounts suggesting that abduction of organs is a
harsh reality of organ trafficking. n7 Reports indicate organ trafficking is so prevalent that there is
a surplus of organs available for transplantation. n8 Furthermore, there is evidence of
governmental involvement, which contributes to and exacerbates the problem. n9
Fortunately, most countries have enacted laws to prevent and prohibit organ trafficking from
occurring. n10
The illegal market is also a threat to public health – spreads antibiotic-resistant
bacteria
Kelly 13 Emily Kelly, Executive Comment Editor for the Boston College International & Comparative
Law Review. Boston College International and Comparative Law Review Spring, 2013 36 B.C. Int'l &
Comp. L. Rev. 1317 NOTE: INTERNATIONAL ORGAN TRAFFICKING CRISIS: SOLUTIONS ADDRESSING THE
HEART OF THE MATTER lexis
[*1324] With regard to recipients, the dangers of receiving medical care in developing countries can
outweigh the benefits of life-saving transplant tourism. n66 Because governmental disease
control agencies do not monitor underground organ trafficking, recipients risk contracting
infectious diseases like West Nile Virus and HIV. n67 Tragically, transplant tourists also have "a
higher cumulative incidence of acute [organ] rejection in the first year after transplantation." n68
Transplant tourism also harms global public health policies. n69 Most notably, the underground
market impedes the success of legal organ donation frameworks. n70 For example, Thai patients
have difficulty accessing health care because local doctors are preoccupied with the lucrative
practice of treating transplant tourists. n71 In 2007, China banned transplant tourism because
wealthy foreigners--rather than the 1.5 million Chinese on the waiting list--received an overwhelming
amount of organ transplants. n72 Grisly tales of transplant tourism and conspiracy theories
surrounding organ theft may also discourage individuals from agreeing to altruistic donation upon
death out of fear that their bodies may be exploited. n73 This further contributes to the global organ
shortage and exacerbates the underlying causes of OTC trafficking. n74 Additionally, transplant
tourism and broader medical tourism facilitate the spread of antibiotic-resistant bacteria.
n75 Because such bacteria are frequently found in hospitals, tourists are easily exposed and
transmit these unique strains across borders upon returning to their home countries. n76 As
a result of these effects, transplant tourism has drawn increasing attention to the root of the
problem: organ shortages. n77
The availability of organs in the US would dry up demand in the illegal market
Upchurch 12 Ryan Upchurch, Seton Hall Law 1-1-12 Seton Hall Law eRepository "The Man who
Removes a Mountain Begins by Carrying Away Small Stones: Flynn v. Holder and a Re-Examination of
The National Organ Transplantation Act of 1984" (2012).
http://erepository.law.shu.edu/student_scholarship/18
By increasing the supply of available organs in the United States through compensation,
American citizens would have less reason to travel elsewhere to pay for an organ. For
example, Aadil Hospital in Lahore, Pakistan advertises two transplant packages catered towards
foreign patients: $14,000 for the first transplant and $16,000 for the second if the first organ fails.118
If demand dried up from foreign citizens, transplant tourism in these countries would take a
major hit because brokers would fetch lower sums for organs they procure. Statistical information is
difficult to come by for obvious reasons, but presumably American citizens make up a
substantial percentage of the tourist patients seeking a new organ they cannot attain
domestically. As one report about impoverished Bangladeshi villagers taken advantage of for their
organs succinctly stated, “Most of those organs ended up transplanted into American
citizens.”119 The black market for organs in other countries is not fueled by local patients. Rather, it
is driven upwards and out of control by those American as well as European citizens who cannot
acquire what they need domestically.120 One estimate is that the black market accounts for as high
as twenty percent of all kidney transplants worldwide.121 Nadley Hakim, transplant surgeon for St.
Mary’s Hospital in London, offered an interesting take on this problem of the black market when he
said, “this trade is going on anyway, why not have a controlled trade where if someone wants to
donate a kidney for a particular price, that would be acceptable? If it is done safely, the donor will
not suffer.”122 Within the past month, an indigent Chinese teenager sold his kidney so that he could
purchase an iPad and iPhone.123 The unnamed teenager now suffers from renal deficiency.124
Sadly, the boy received roughly ten percent of what the buyer paid, with the rest going to the
surgeon and others involved in coordinating the operation.125 If those American citizens with the
means to purchase were not forced abroad to find an organ, it is very possible that stories
like this would become much less commonplace.
Legalizing sales in the US would take down the illegal market
Calandrillo 4 Steve P. Calandrillo, Associate Professor, Univ. of Washington School of Law. J.D.,
Harvard Law School. B.A. in Economics, Univ. of California at Berkeley. George Mason Law Review Fall,
2004 13 Geo. Mason L. Rev. 69 ARTICLE: Cash for Kidneys? Utilizing Incentives to End America's
Organ Shortage lexis
Moreover, if
we cannot prevent the black markets in human organs that continue to thrive
worldwide today, a thoughtful and responsible regulatory solution in America might be the
best response. Many scholars have chronicled the reality that today's black markets lead to a host of abuses, provide for no followup health care, and generally exploit the poor to the wealthy's advantage. n180 Stephen Spurr details the potential for misrepresentation
and fraud against both buyers and sellers today, as prices spiral out of control for organs that are of dubious quality. n181 Gloria Banks
decries the exploitation of society's most vulnerable individuals in the organ sale trade, and urges legal and ethical safeguards for their
protection. n182 Susan Hankin Denise adds that a properly regulated organ market may therefore be a better solution to the problem of
scarcity than the outright ban we witness today. n183 FOOTNOTE ATTACHED n183 See Denise, supra note 72, at 1035-36 (arguing that
regulated markets are superior to the existing ban on organ sales in the U.S.). Of course, even a
well-regulated legalized
market in the U.S. may not completely eliminate black markets worldwide if patients can still find
organs more cheaply abroad. However, it is reasonable to suspect that an American market would
significantly reduce the demand for black market organs, especially given the ability of a
regulated market to better ensure the quality of its product. Furthermore, a legalized market
in the U.S. (with appropriate safeguards to prevent abuse of sellers) may lead to similar
structures abroad. On the other hand, one might argue that competing markets might lead to a "race to the bottom" in terms of
regulatory standards, as each country tries to gain more market share.
Plan
The United States Federal Government should amend the National Organ Transplant
Act to permit regulated sale of human organs. A government agency should be
established to purchase organs from those living in the United States, with payment in
vouchers with a cash value set at an adjusted market-clearing price. Organs should be
placed in the Organ Procurement and Transplantation Network.
Contention 3 The Plan solves
A program with a government intermediary is viable means for "organ sales"
Wilkinson 11 Stephen Wilkinson, Professor of Bioethics, Lancaster University (UK) 10-17-11
Stanford Encyclopedia of Philosophy, "The Sale of Human Organs"
http://plato.stanford.edu/entries/organs-sale/
1. 1. Different Kinds of Organ Sale System The expression ‘organ sale’ covers a wide range of
different practices. People most readily associate it with the case in which one
individual (who needs or wants money) sells his or her kidney to another (who needs a
kidney). But there are other possibilities too. One (in countries where the prior consent of
the deceased is required for cadaveric organ donation) is to pay people living now for rights
over their body after death. Another (in countries where the consent of relatives is required for
cadaveric organ donation) is to pay relatives for transplant rights over their recently deceased
loved ones' bodies. Since the kidney is the most commonly transplanted organ and since the ethics literature on organ sale
is mainly about kidney sale from live donors, that is the practice on which this entry will focus. ‘Organ sale’ as the term is used here
does not include the sale of body products (a category which includes blood, eggs, hair, and sperm) since this is different in some
important respects. For example, the risk of permanent harm is generally much less in the case of blood and hair donation; while,
the donation of eggs and sperm raises additional issues relating to the creation and parenting of additional future people. That
said, many of the fundamental issues are similar and the very same concerns about (for example) exploitation and consent arise in
both cases. An important preliminary point is that almost all serious advocates of allowing payment for human organs argue not
for an unfettered ‘free market’ but for a regulated one. Radcliffe Richards et al. (1998, 1950) for example, in their paper “The Case
for Allowing Kidney Sales” say: It must be stressed that we are not arguing for the positive conclusion that organ sales must always
be acceptable, let alone that there should be an unfettered market. While Wilkinson (2003, 132) is typical of organ sale defenders
in wishing to distance himself from today's (largely ‘underground’) organ trade: … far from being a reason to continue the ban on
sale, the dreadfulness of present practice may be a reason to discontinue prohibition, so that the organ trade can be brought
‘overground’ and properly regulated. Different scholars have different views about the precise scope and extent of the regulation
required, but most support the requirements that organ sellers give valid consent, are paid a reasonable fee, and are provided with
adequate medical care. Taylor (2005, 110) for example, says that: At minimum … a market should require that vendors give their
informed consent to the sale of their kidneys, that they not be coerced into selling their kidneys by a third party and that they
receive adequate post-operative care. One
noteworthy policy proposal comes from Erin and Harris
(1994; 2003) who suggest that a market in human organs should have the following
features: It is limited to a particular geopolitical area, such as a state or the European Union,
with only citizens or residents of that area being allowed to sell or to receive organs. There is a
central public body responsible for making (and funding) all purchases and for
allocating organs fairly in accordance with clinical criteria. Direct sales are banned. Prices
are set at a reasonably generous level to attract people voluntarily into the market.
This would maximize organ sales
Erin and Harris 3 Charles A Erin and John Harris, Institute of Medicine, Law and Bioethics, School of
Law, University of Manchester J Med Ethics 2003; 29 :141 Janet Radcliffe Richards on our modest
proposal
http://jme.bmj.com/content/29/3/138.full.pdf+html
Thus when Radcliffe Richards says: “Of course there is something undesirable about a one way international traffic from poor to rich; but
that is not enough to settle the all things considered question of whether it should be allowed” she is again right. It is not enough to settle
that question. Our paper was not trying to settle that question. 2 We
have proposed a scheme that would
maximise organ sales by meeting the most common and persistent objections to commerce in
body parts. In our paper we note that:“In 1994, we made a proposal in which we outlined possibly the only circumstances in which a
market in donor organs could be achieved ethically, and in a way that minimises the dangers normally envisaged for such a scheme” and
this is the proposal that we repeat in abbreviated form. The claim we make, which it seems Radcliffe Richards judges tobe too strong, is
that our proposal outlines “possibly the only circumstances in which a market in donor organs could be achieved ethically”; but note that
there is a qualification to this claim, namely that if the first part of our claim is true it is so because it defends organ sales “in a way that
minimises the dangers normally envisaged for such a scheme”. It may be that organ sales could be defended (possibly by Janet Radcliffe
Richards and for that matter by the present authors) in a way that does not minimise such dangers. But that is not what we were trying to
do in our paper.
government purchaser avoids exploitation
Erin and Harris 3 Charles A Erin and John Harris, Institute of Medicine, Law and Bioethics, School of
Law, University of Manchester,
J Med Ethics 2003;29:137-138 An ethical market in human organs
http://jme.bmj.com/content/29/3/137.full
While people’s lives continue to be put at risk by the dearth of organs available for
transplantation, we must give urgent consideration to any option that may make up the
shortfall. A market in organs from living donors is one such option. The market should be ethically
supportable, and have built into it, for example, safeguards against wrongful exploitation.
This can be accomplished by establishing a single purchaser system within a confined
marketplace.
We legalize sales, not purchases – their turns don’t apply
Gill 2 Michael Gill, Ph.D., Assistant Professor, Department of Philosophy, College of Charleston AND Robert
Sade, M.D.,Professor in the Department of Surgery and Director of the Institute of Human Values in Health Care,
Medical University of South Carolina. Kennedy Institute of Ethics Journal 12.1 (2002) 17-45
Paying for Kidneys: The Case against Prohibition http://muse.jhu.edu/journals/kennedy_institute_
of_ethics_journal/v012/12.1gill.html
First, we are arguing for the claim that it ought to be legal for a person to be paid for one of his or her
kidneys. We are not arguing that it ought to be legal for a potential recipient to buy a kidney in an
open market. We propose that the buyers of kidneys be the agencies in charge of kidney
procurement or transplantation; that is, we propose that such agencies should be allowed to use
financial incentives to acquire kidneys. We assume that allocation of kidneys will be based on
medical criteria, as in the existing allocation system for cadaveric organs. Kidneys will not be traded
in an unregulated market. 2 A similar system is currently in place for blood products: a person can
receive money for providing blood products, but one's chances of receiving blood are distinct from
one's financial status. We further note that transplant recipients or their agents—e.g., insurance
companies, Medicaid—pay for organs now, compensating the organ procurement organization that
organizes the organ retrieval, the surgeon who removes the organ, the hospital where the organ is
procured, and so forth. The only component of the organ procurement process not currently paid is
the most critical component, the possessor of the kidney, who is sine qua non for organ availability.
Second, we believe the legalization of kidney sales will increase the number of kidneys that are
transplanted each year and thus save the lives of people who would otherwise die. We base this
belief on two views that seem to us very plausible: first, that financial incentives will induce some
people to give up a kidney for transplantation who would otherwise not have done so; and second,
that the existence of financial incentives will not decrease significantly the current level of live kidney
donations. The first view seems to us to follow from the basic idea that people are more likely to do
something if they are going to get paid for it. The second view seems to us to follow from the fact
that a very large majority of live kidney donations occur between family members and the idea that
the motivation of a sister who donates a kidney to a brother, or a parent who donates a kidney to a
child, will not be altered by the existence of financial incentives. Although we think these views are
plausible, we acknowledge that there is no clear evidence that they are true. If subsequent research
were to establish that the legalization of kidney sales would lead to a decrease in the number of
kidneys that are transplanted each year, some of the arguments we make would be substantially
weakened. 3 Third, we are arguing for allowing payment to living kidney donors, but many of the
kidneys available for transplantation come from cadavers. [End Page 19] We believe that payment
for cadaveric organs also ought to be legalized, but we will not discuss that issue here. If we
successfully make the case for allowing payment to living donors, the case for payment for cadaveric
kidneys should follow easily. The Prima Facie Case for Kidney Sales With these preliminary points in
mind, we will proceed to the initial argument for permitting payment for kidneys. 4 This argument is
based on two claims: the "good donor claim" and the "sale of tissue claim." The good donor claim
contends that it is and ought to be legal for a living person to donate one of his or her kidneys to
someone else who needs a kidney in order to survive. These donations typically consist of someone
giving a kidney to a sibling, spouse, or child, but there are also cases of individuals donating to
strangers. Such donations account for about half of all kidney transplants. 5 Our society, moreover,
does not simply allow such live kidney donations. Rather, we actively praise and encourage them. 6
We typically take them to be morally unproblematic cases of saving a human life. The sale of tissue
claim contends that it is and ought to be legal for living persons to sell parts of their bodies. We can
sell such tissues as hair, sperm, and eggs, but the body parts we focus on here are blood products. A
kidney is more like blood products than other tissues because both are physical necessities: people
need them in order to survive. Our proposed kidney sales are more like the sale of blood products in
that both involve the market only in acquisition and not in allocation: the current system pays people
for plasma while continuing to distribute blood products without regard to patients' economic status,
just as we propose for kidneys. We do not typically praise people who sell their plasma as we do
people who donate a kidney to save the life of a sibling. At the same time, most people do not brand
commercial blood banks as moral abominations. We generally take them to be an acceptable means
of acquiring a resource that is needed to save lives. 7 It is doubtful, for instance, that there would be
widespread support for the abolition of payment for plasma if the result were a reduction in supply
so severe that thousands of people died every year for lack of blood products. If both the good donor
claim and the sale of tissue claim are true, we have at least an initial argument, or prima facie
grounds, for holding that payment for kidneys ought to be legal. The good donor claim implies that it
ought to be legal for a living person to decide to transfer one of his or [End Page 20] her kidneys to
someone else, while the sale of tissue claim implies that it ought to be legal for a living person to
decide to transfer part of his or her body to someone else for money. It thus seems initially plausible
to hold that the two claims together imply that it ought to be legal for a living person to decide to
transfer one of his or her kidneys to someone else for money. Of course, there seems to be an
obvious difference between donating a kidney and selling one: motive. Those who donate typically
are motivated by benevolence or altruism, while those who sell typically are motivated by monetary
self-interest. 8 The sale of tissue claim suggests, however, that this difference on its own is irrelevant
to the question of whether kidney sales ought to be legal, because the sale of tissue claim establishes
that it ought to be legal to transfer a body part in order to make money. If donating a kidney ought to
be legal (the good donor claim), and if the only difference between donating a kidney and selling one
is the motive of monetary self-interest, and if the motive of monetary self-interest does not on its
own warrant legal prohibition (the sale of tissue claim), then the morally relevant part of the analogy
between donating and selling should still obtain and we still have grounds for holding that selling
kidneys ought to be legal. There is also an obvious difference between selling a kidney and selling
plasma: the invasiveness of the procedure. Phlebotomy for sale of plasma is simple and quick, with
no lasting side effects, while parting with a kidney involves major surgery and living with only one
kidney thereafter. It is very unlikely, however, that there will be any long-term ill effects from the
surgery itself or from life with a single kidney. 9 Indeed, the laws allowing live kidney donations
presuppose that the risk to donors is very small and thus morally acceptable. The good donor claim
implies, then, that the invasiveness of the procedure of transferring a kidney is not in and of itself a
sufficient reason to legally prohibit live kidney transfer. If the only difference between selling plasma
and selling a kidney is the risk of the procedure, and if that risk does not constitute grounds for
prohibiting live kidney transfers, then the morally relevant part of the analogy between selling
plasma and selling a kidney still should obtain and we still have grounds for holding that kidney sales
ought to be legal. The point of the preceding two paragraphs is this: if we oppose the sale of kidneys
because we think it is too dangerous, then we also should oppose live kidney donations. But we do
not oppose live kidney donations because we realize that the risks are acceptably low and worth
taking [End Page 21] in order to save lives. So, it is inconsistent to oppose selling kidneys because of
the possible dangers while at the same time endorsing the good donor claim. Similarly, if we oppose
kidney sales because we think people should not sell body parts, then we should also oppose
commercial blood banks. But most people do not oppose blood banks because they realize that the
banks play an important role in saving lives. So, it is inconsistent to oppose selling kidneys because it
involves payment while at the same time endorsing the sale of tissue claim. 10 The considerable
emotional resistance to permitting kidney sales may be based on a combination of distaste for
payment and worry about risk. But if neither of these concerns on its own constitutes defensible
grounds for opposing payment, then it seems unlikely that the two of them together will do so. This
initial argument does not imply that we should legalize the sale of hearts and livers. The initial
argument holds only that, if it is medically safe for living people to donate an organ, then people
should also be allowed to sell that organ. But it is not medically safe for a living person to donate his
or her heart or liver. Our reliance on the good donor claim does, however, commit us to the idea that
if it is morally correct to allow someone to donate an organ or part of an organ, then it is morally
correct to allow someone to sell that organ or organ part. If, therefore, it is morally correct to allow
people to donate liver lobes and parts of lungs, then, according to our initial argument, it ought to be
legal for a person to sell a liver lobe or part of a lung as well. Our proposal does not address the
purchase of kidneys, which is a separate question. Many of the arguments against legalizing the
purchase of kidneys do not apply to the sale of kidneys. For example, one argument against
permitting the buying of kidneys is that it will lead to fewer kidneys for transplantation overall.
Another argument is that while allowing individuals to purchase kidneys might not reduce the overall
number of kidneys available for transplantation, it will reduce the number of donated kidneys and
harm the poor who will not be able to afford to buy a kidney. Both arguments rest on empirical
claims that are often stated as fact, yet have no supporting evidence. Even if the empirical claims
were accurate, moreover, their moral importance could be disputed. Perhaps there are powerful
moral reasons to legalize the buying of organs even if doing so leads to fewer organs overall or
reduces the chances of a poor person's receiving a kidney transplant. Then again, perhaps a negative
effect on the overall supply of kidneys or on the transplantation prospects [End Page 22] for the poor
will turn out to be a conclusive reason not to legalize the buying of kidneys. The important point is
that our proposal will not be affected either way. As already noted in our preliminary points, our
proposal can be reasonably expected both to increase the overall number of kidneys for
transplantation and to increase the chances that a poor person who needs a kidney will receive one.
Therefore, in arguing for the legalization of kidney sales, we put aside the separate question of
whether buying kidneys ought to be legal as well.
Review of literature concludes that sales will increase supply
Beard et al 13 T. Randolph "Randy" Beard, Professor of Economics at Auburn University.; Rigmar
Osterkamp, Fellow at the School for Political Studies at University of Munich.; And David L. Kaserman,
Torchmark Professor of Economics at Auburn University.2013 The Global Organ Shortage: Economic
Causes, Human Consequences, Policy Responses
On balance, a fair-minded reading of the evidence suggests that compensation for donors, if
done correctly and sensibly, would increase, probably substantially, the number of organs
available for transplant. In the cases of both deceased donors (and their families) and living
donors, available evidence confirms the observation that people respond to incentives.
Empirically, sales would not be primarily from the poor. All income groups would
participate.
Halpern 10 Scott D. Halpern, MD, PhD, MBioethics, Amelie Raz, Rachel Kohn, BA, Michael Rey, BA,
David A. Asch, MD, MBA, and Peter Reese, MD, MSCE, University of Pennsylvania School of Medicine
and Philadelphia Veterans Affairs Medical Center, Ann Intern Med. 2010 Mar 16; 152(6): 358–365.
Regulated Payments for Living Kidney Donation: An Empirical Assessment of the Ethical Concerns
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2865248/?report=classic%5Dab
Unjust Inducement
Higher payments increased the probabilities of donating but did so evenly across the 6 income
strata, such that no evidence of an interaction between payment and income was found (OR, 1.01
[CI, 0.99 to 1.03]) (Figure 3). Even when we restricted analyses to the 57 participants in the lowest
income stratum (annual household income ≤$20 000) and the 66 participants in the highest income
stratum (annual household income >$100 000), no significant interaction emerged (OR, 0.99 [CI, 0.97
to 1.02]) (Figure 3). Among participants in the lowest income stratum, conditionally adjusted
donation rates were 29.8% (CI, 19.5% to 42.7%) for $0, 44.1% (CI, 33.1% to 55.7%) for $10 000, and
47.9% (CI, 36.4% to 59.6%) for $100 000. Among participants in the highest income stratum, the
rates were 15.2% (CI, 9.0% to 24.5%), 27.5% (CI, 18.8% to 38.2%), and 31.3% (CI, 21.7% to 42.9%),
respectively. These results suggest that payment is not an unjust inducement for living kidney
donation.
Coercion of the poor does not apply to central purchasing –egg donations prove
Sobota 4 Margaret R. Sobota, J.D. Candidate (2005), Washington University School of Law. Washington
University Law Quarterly Fall, 2004 82 Wash. U. L. Q. 1225 NOTE: 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 lexis
A. Arguments Opposing a Market for Organ Procurement
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 in-formed 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.
Contention 4 is risk calculus
Structural violence is the largest proximate cause of war- creates priming that
psychologically structures escalation
Scheper-Hughes and Bourgois ‘4
(Prof of Anthropology @ Cal-Berkely; Prof of Anthropology @ UPenn) (Nancy and Philippe, Introduction: Making Sense of Violence, in
Violence in War and Peace, pg. 19-22) **Answers no root cause- because there is no root cause we must be attentative to structural
inequality of all kinds because it primes people for broader violence- our impact is about the scale of violence and the disproportionate
relationship between that scale and warfare, not that one form of social exclusion comes first
This large and at first sight “messy” Part VII is central to this anthology’s thesis. It encompasses everything from the routinized,
bureaucratized, and utterly banal violence of children dying of hunger and maternal despair in Northeast Brazil (Scheper-Hughes,
Chapter 33) to elderly African Americans dying of heat stroke in Mayor Daly’s version of US apartheid in Chicago’s South Side
(Klinenberg, Chapter 38) to the racialized class hatred expressed by British Victorians in their olfactory disgust of the “smelly” working
classes (Orwell, Chapter 36). In these readings violence is located in the symbolic and social structures that overdetermine and allow
the criminalized drug addictions, interpersonal bloodshed, and racially patterned incarcerations that characterize the US “inner city” to
be normalized (Bourgois, Chapter 37 and Wacquant, Chapter 39). Violence also takes the form of class, racial, political self-hatred and
adolescent self-destruction (Quesada, Chapter 35), as well as of useless (i.e. preventable), rawly embodied physical suffering, and
death (Farmer, Chapter 34). Absolutely
central to our approach is a blurring of categories and
distinctions between wartime and peacetime violence. Close attention to the “little”
violences produced in the structures, habituses, and mentalites of everyday life shifts our
attention to pathologies of class, race, and gender inequalities. More important, it interrupts the
voyeuristic tendencies of “violence studies” that risk publicly humiliating the powerless who are often forced into complicity with
social and individual pathologies of power because suffering is often a solvent of human integrity and dignity. Thus, in this anthology
we are positing a violence continuum comprised of a multitude of “small wars and invisible genocides” (see also Scheper- Hughes
1996; 1997; 2000b) conducted in the normative social spaces of public schools, clinics, emergency rooms, hospital wards, nursing
homes, courtrooms, public registry offices, prisons, detention centers, and public morgues. The
violence continuum also
refers to the ease with which humans are capable of reducing the socially vulnerable
into expendable nonpersons and assuming the license - even the duty - to kill, maim, or
soul-murder. We realize that in referring to a violence and a genocide continuum we are flying in the face of a tradition of
genocide studies that argues for the absolute uniqueness of the Jewish Holocaust and for vigilance with respect to restricted purist use
of the term genocide itself (see Kuper 1985; Chaulk 1999; Fein 1990; Chorbajian 1999). But we hold an opposing and alternative view
that, to the contrary, it
is absolutely necessary to make just such existential leaps in purposefully
linking violent acts in normal times to those of abnormal times. Hence the title of our volume: Violence
in War and in Peace. If (as we concede) there is a moral risk in overextending the concept of “genocide” into spaces and corners of
everyday life where we might not ordinarily think to find it (and there
is), an even greater risk lies in failing to
sensitize ourselves, in misrecognizing protogenocidal practices and sentiments daily
enacted as normative behavior by “ordinary” good-enough citizens. Peacetime crimes, such
as prison construction sold as economic development to impoverished communities in the mountains and deserts of California, or the
evolution of the criminal industrial complex into the latest peculiar institution for managing race relations in the United States
(Waquant, Chapter 39), constitute
the “small wars and invisible genocides” to which we refer. This applies to
African American and Latino youth mortality statistics in Oakland, California, Baltimore, Washington DC, and New York City. These
are “invisible” genocides not because they are secreted away or hidden from view, but
quite the opposite. As Wittgenstein observed, the things that are hardest to perceive are those
which are right before our eyes and therefore taken for granted. In this regard, Bourdieu’s partial and
unfinished theory of violence (see Chapters 32 and 42) as well as his concept of misrecognition is crucial to our task. By including the
normative everyday forms of violence hidden in the minutiae of “normal” social practices - in the architecture of homes, in gender
relations, in communal work, in the exchange of gifts, and so forth - Bourdieu forces us to reconsider the broader meanings and status
of violence, especially the links between the violence of everyday life and explicit political terror and state repression, Similarly,
Basaglia’s notion of “peacetime crimes” - crimini di pace - imagines a direct relationship between wartime and peacetime violence.
Peacetime crimes suggests the possibility that war crimes are merely ordinary, everyday
crimes of public consent applied systematically and dramatically in the extreme context
of war. Consider the parallel uses of rape during peacetime and wartime, or the family resemblances between the legalized
violence of US immigration and naturalization border raids on “illegal aliens” versus the US government- engineered genocide in 1938,
known as the Cherokee “Trail of Tears.” Peacetime crimes suggests that everyday forms of state violence make a certain kind of
domestic peace possible. Internal “stability” is purchased with the currency of peacetime crimes, many of which take the form of
professionally applied “strangle-holds.” Everyday forms of state violence during peacetime make a certain kind of domestic “peace”
possible. It is an easy-to-identify peacetime crime that is usually maintained as a public secret by the government and by a scared or
apathetic populace. Most subtly, but no less politically or structurally, the phenomenal growth in the United States of a new military,
postindustrial prison industrial complex has taken place in the absence of broad-based opposition, let alone collective acts of civil
disobedience. The
public consensus is based primarily on a new mobilization of an old fear of
the mob, the mugger, the rapist, the Black man, the undeserving poor. How many public
executions of mentally deficient prisoners in the United States are needed to make life
feel more secure for the affluent? What can it possibly mean when incarceration becomes the “normative” socializing
experience for ethnic minority youth in a society, i.e., over 33 percent of young African American men (Prison Watch 2002). In the end
it is essential that we recognize the existence of a genocidal capacity among otherwise
good-enough humans and that we need to exercise a defensive hypervigilance to the less
dramatic, permitted, and even rewarded everyday acts of violence that render
participation in genocidal acts and policies possible (under adverse political or economic conditions), perhaps
more easily than we would like to recognize. Under the violence continuum we include, therefore, all
expressions of radical social exclusion, dehumanization, depersonal- ization,
pseudospeciation, and reification which normalize atrocious behavior and violence
toward others. A constant self-mobilization for alarm, a state of constant hyperarousal is,
perhaps, a reasonable response to Benjamin’s view of late modern history as a chronic
“state of emergency” (Taussig, Chapter 31). We are trying to recover here the classic anagogic thinking that enabled Erving
Goffman, Jules Henry, C. Wright Mills, and Franco Basaglia among other mid-twentieth-century radically critical thinkers, to perceive
the symbolic and structural relations, i.e., between inmates and patients, between concentration camps, prisons, mental hospitals,
nursing homes, and other “total institutions.” Making
that decisive move to recognize the continuum of
violence allows us to see the capacity and the willingness - if not enthusiasm - of ordinary
people, the practical technicians of the social consensus, to enforce genocidal-like crimes
against categories of rubbish people. There is no primary impulse out of which mass
violence and genocide are born, it is ingrained in the common sense of everyday social
life. The mad, the differently abled, the mentally vulnerable have often fallen into this
category of the unworthy living, as have the very old and infirm, the sick-poor, and, of
course, the despised racial, religious, sexual, and ethnic groups of the moment. Erik Erikson
referred to “pseudo- speciation” as the human tendency to classify some individuals or social groups as less than fully human - a
prerequisite to genocide and one that is carefully honed during the unremark- able peacetimes that precede the sudden, “seemingly
unintelligible” outbreaks of mass violence.
Collective denial and misrecognition are prerequisites for
mass violence and genocide. But so are formal bureaucratic structures and professional roles. The practical technicians
of everyday violence in the backlands of Northeast Brazil (Scheper-Hughes, Chapter 33), for example, include the clinic doctors who
prescribe powerful tranquilizers to fretful and frightfully hungry babies, the Catholic priests who celebrate the death of “angel-babies,”
and the municipal bureaucrats who dispense free baby coffins but no food to hungry families. Everyday
violence
encompasses the implicit, legitimate, and routinized forms of violence inherent in
particular social, economic, and political formations. It is close to what Bourdieu (1977, 1996) means by
“symbolic violence,” the violence that is often “nus-recognized” for something else, usually something good. Everyday violence is
similar to what Taussig (1989) calls “terror as usual.” All these terms are meant to reveal a public secret - the hidden links between
violence in war and violence in peace, and between war crimes and “peace-time crimes.” Bourdieu (1977) finds domination and
violence in the least likely places - in courtship and marriage, in the exchange of gifts, in systems of classification, in style, art, and
culinary taste- the various uses of culture. Violence, Bourdieu insists, is everywhere in social practice. It is misrecognized because its
very everydayness and its familiarity render it invisible. Lacan identifies “rneconnaissance” as the prerequisite of the social. The
exploitation of bachelor sons, robbing them of autonomy, independence, and progeny, within the structures of family farming in the
European countryside that Bourdieu escaped is a case in point (Bourdieu, Chapter 42; see also Scheper-Hughes, 2000b; Favret-Saada,
1989). Following Gramsci, Foucault, Sartre, Arendt, and other modern theorists of power-vio- lence, Bourdieu treats direct aggression
and physical violence as a crude, uneconomical mode of domination; it is less efficient and, according to Arendt (1969), it is certainly
less legitimate. While power and symbolic domination are not to be equated with violence - and Arendt argues persuasively that
violence is to be understood as a failure of power - violence, as we are presenting it here, is more than simply the expression of
illegitimate physical force against a person or group of persons. Rather, we need to understand violence as encompassing all forms of
“controlling processes” (Nader 1997b) that assault basic human freedoms and individual or collective survival. Our task is to recognize
these gray zones of violence which are, by definition, not obvious. Once again, the point of bringing into the discourses on genocide
everyday, normative experiences of reification, depersonalization, institutional confinement, and acceptable death is to help answer
the question: What makes mass violence and genocide possible? In this volume we are suggesting that
mass violence is
part of a continuum, and that it is socially incremental and often experienced by
perpetrators, collaborators, bystanders - and even by victims themselves - as expected,
routine, even justified. The preparations for mass killing can be found in social sentiments and institutions from the family,
to schools, churches, hospitals, and the military. They harbor the early “warning signs” (Charney 1991), the “priming” (as
Hinton, ed., 2002 calls it), or the “genocidal continuum” (as we call it) that push social consensus toward
devaluing certain forms of human life and lifeways from the refusal of social support and humane care to vulnerable
“social parasites” (the nursing home elderly, “welfare queens,” undocumented immigrants, drug addicts) to the militarization of
everyday life (super-maximum-security prisons, capital punishment; the technologies of heightened personal security, including the
house gun and gated communities; and reversed feelings of victimization).
Great power war is obsolete – globalization, nuclear deterrence, and the cooperative
liberal order ensure no conflict
Ikenberry and Deudney 9 (Daniel – Professor of Politics and International Affairs at Princeton
University, and G. John – professor of political science at Johns Hopkins University, Jan/Feb, “The Myth
of the Autocratic Revival,” Foreign Affairs, Vol. 88, Issue 1, p. 8)
It is in combination with these factors that the regime divergence between autocracies and democracies will become increasingly dangerous. If all the states in the
world were democracies, there would still be competition, but a world riven by a democratic-autocratic divergence promises to be even more conflictual. There are
even signs of the emergence of an "autocrats international" in the Shanghai Cooperation Organization, made up of China, Russia, and the poorer and weaker
the picture of an international system marked by rising levels
of conflict and competition, a picture quite unlike the "end of history" vision of growing convergence and cooperation. This bleak outlook is based
on an exaggeration of recent developments and ignores powerful countervailing factors and forces. Indeed, contrary to
what trhe revivalists describe, the most striking features of the contemporary international landscape are the
intensification of economic globalization, thickening institutions, and shared problems of interdependence. The
overall structure of the international system today is quite unlike that of the nineteenth century. Compared to older
orders, the contemporary liberal-centered international order provides a set of constraints and
opportunities — of pushes and pulls — that reduce the likelihood of severe conflict while creating strong
imperatives for cooperative problem solving. Those invoking the nineteenth century as a model for the twenty-first also fail to
acknowledge the extent to which war as a path to conflict resolution and great-power expansion has become largely obsolete. Most
important, nuclear weapons have transformed great-power war from a routine feature of international politics into an
exercise in national suicide. With all of the great powers possessing nuclear weapons and ample
means to rapidly expand their deterrent forces, warfare among these states has truly become an option of last resort. The
prospect of such great losses has instilled in the great powers a level of caution and restraint that
effectively precludes major revisionist efforts. Furthermore, the diffusion of small arms and the near
universality of nationalism have severely limited the ability of great powers to conquer and
occupy territory inhabited by resisting populations (as Algeria, Vietnam, Afghanistan, and now Iraq have demonstrated). Unlike during the days of
Central Asian dictatorships. Overall, the autocratic revivalists paint
empire building in the nineteenth century, states today cannot translate great asymmetries of power into effective territorial control; at most, they can hope for
loose hegemonic relationships that require them to give something in return. Also unlike in the nineteenth century, today the
density of trade,
investment, and production networks across international borders raises even more the costs of
war. A Chinese invasion of Taiwan, to take one of the most plausible cases of a future interstate war, would pose for the Chinese communist regime daunting
economic costs, both domestic and international. Taken together, these changes in the economy of violence mean that the international system is far more primed
for peace than the autocratic revivalists acknowledge. The autocratic revival thesis neglects other key features of the international system as well. In the nineteenth
century, rising states faced an international environment in which they could reasonably expect to translate their growing clout into geopolitical changes that would
in the twenty-first century, the status quo is much more difficult to overturn.
Simple comparisons between China and the United States with regard to aggregate economic size
and capability do not reflect the fact that the United States does not stand alone but rather is
the head of a coalition of liberal capitalist states in Europe and East Asia whose aggregate assets far
exceed those of China or even of a coalition of autocratic states. Moreover, potentially revisionist autocratic states, most notably
China and Russia, are already substantial players and stakeholders in an ensemble of global institutions that
make up the status quo, not least the UN Security Council (in which they have permanent seats
and veto power). Many other global institutions, such as the International Monetary Fund and the World Bank, are
configured in such a way that rising states can increase their voice only by buying into the
institutions. The pathway to modernity for rising states is not outside and against the status quo but
rather inside and through the flexible and accommodating institutions of the liberal international order. The fact that these
benefit themselves. But
autocracies are capitalist has profound implications for the nature of their international interests that point toward integration and accommodation in the future.
The domestic viability of these regimes hinges on their ability to sustain high economic growth rates, which
in turn is crucially dependent on international trade and investment; today's autocracies may be illiberal, but they remain
fundamentally dependent on a liberal international capitalist system. It is not surprising that China made major domestic changes in order to join the WTO or that
Russia is seeking to do so now. The dependence of autocratic capitalist states on foreign trade and investment means that they have a fundamental interest in
maintaining an open, rulebased economic system. (Although these autocratic states do pursue bilateral trade and investment deals, particularly in energy and raw
materials, this does not obviate their more basic dependence on and commitment to the WTO order.) In the case of China, because of its extensive dependence on
industrial exports, the WTO may act as a vital bulwark against protectionist tendencies in importing states. Given their position in this system, which so serves their
interests, the autocratic states are unlikely to become champions of an alternative global or regional economic order, let alone spoilers intent on seriously damaging
the existing one. The prospects for revisionist behavior on the part of the capitalist autocracies are further reduced by the large and growing social networks across
Not only have these states joined the world economy, but their people — particularly
upwardly mobile and educated elites — have increasingly joined the world community . In large and growing numbers, citizens
of autocratic capitalist states are participating in a sprawling array of transnational educational, business, and avocational
networks. As individuals are socialized into the values and orientations of these networks, stark: "us versus them" cleavages
become more difficult to generate and sustain. As the Harvard political scientist Alastair Iain Johnston has argued, China's ruling elite has
international borders.
also been socialized, as its foreign policy establishment has internalized the norms and practices of the international diplomatic community. China, far from
cultivating causes for territorial dispute with its neighbors, has instead sought to resolve numerous historically inherited border conflicts, acting like a satisfied
These social and diplomatic processes and developments suggest that there are
strong tendencies toward normalization operating here. Finally, there is an emerging set of global problems stemming from
status quo state.
industrialism and economic globalization that will create common interests across states regardless of regime type. Autocratic China is as dependent on
, India, Japan, and the United States, suggesting an alignment of interests against petroleumexporting autocracies, such as Iran and Russia. These states share a common interest in price stability and supply security that could
imported oil as are democratic Europe
form the basis for a revitalization of the International Energy Agency, the consumer association created during the oil turmoil of the 1970s. The emergence of global
warming and climate change as significant problems also suggests possibilities for alignments and cooperative ventures cutting across the autocratic-democratic
divide. Like the United States, China is not only a major contributor to greenhouse gas accumulation but also likely to be a major victim of climate-induced
desertification and coastal flooding. Its rapid industrialization and consequent pollution means that China, like other developed countries, will increasingly need to
import technologies and innovative solutions for environmental management. Resource scarcity and environmental deterioration pose global threats that no state
.
will be able to solve alone, thus placing a further premium on political integration and cooperative institution building Analogies between the nineteenth century
and the twenty-first are based on a severe mischaracterization of the actual conditions of the new era. The
declining utility of war, the thickening of
international transactions and institutions, and emerging resource and environmental interdependencies together undercut
scenarios of international conflict and instability based on autocratic-democratic rivalry and autocratic revisionism. In fact, the
conditions of the twenty-first century point to the renewed value of international integration and
cooperation.
Prefer the affirmative’s impacts to highly specific long term disadvantages – cognitive
bias means you will think their impact is better than it really is
Yudkowsky 06 [Eliezer, 8/31/2006. Singularity Institute for Artificial Intelligence Palo Alto, CA.
“Cognitive biases potentially affecting judgment of global risks, Forthcoming in Global Catastrophic
Risks, eds. Nick Bostrom and Milan Cirkovic, singinst.org/upload/cognitive-biases.pdf.
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 - 6 - 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.)
Overly detailed reassurances can also create false perceptions of safety:
"X is not an existential risk and you
don't need to worry about it, because A, B, C, D, and E"; where the failure of any one of propositions A, B, C, D, or E potentially extinguishes the
human species. "We don't need to worry about nanotechnologic war, because a UN commission will initially develop the technology and
prevent its proliferation until such time as an active shield is developed, capable of defending against all accidental and malicious outbreaks
Vivid, specific scenarios can
inflate our probability estimates of security, as well as misdirecting defensive investments into
needlessly narrow or implausibly detailed risk scenarios.
that contemporary nanotechnology is capable of producing, and this condition will persist indefinitely."
More generally, people tend to overestimate conjunctive probabilities and underestimate disjunctive
probabilities. (Tversky and Kahneman 1974.) That is, people tend to overestimate the probability that, e.g., seven
events of 90% probability will all occur. Conversely, people tend to underestimate the probability that at
least one of seven events of 10% probability will occur. Someone judging whether to, e.g., incorporate a new startup,
must evaluate the probability that many individual events will all go right (there will be sufficient funding, competent employees, customers
will want the product) while also considering the likelihood that at least one critical failure will occur (the bank refuses - 7 - a loan, the biggest
project fails, the lead scientist dies). This may help explain why only 44% of entrepreneurial ventures3 survive after 4 years. (Knaup 2005.)
Low probability impacts should not be evaluated-- even if there’s some risk, policy
decisions can’t be justified by vanishingly small probabilities
Rescher 03 (Nicholas, Prof of Philosophy at the University of Pittsburgh, Sensible Decisions: Issues of Rational Decision in Personal Choice
and Public Policy, p. 49-50)
On this issue there is a systemic disagreement between probabilists working on theory-oriented issues in mathematics or natural science and
decision theorists who work on practical decision-oriented issues relating to human affairs. The former takes the line that small number are
small numbers and must be taken into account as such—that is, the small quantities they actually are. The latter tend to take the view that
small probabilities represent extremely remote prospect and can be written off.
(De minimis non curat
lex, as the old precept has it: in human affairs there is no need to bother with trifles.) When something is about as probable as a thousand fair
dice when tossed a thousand times coming up all sixes, then, so it is held, we
can pretty well forget about it as a worthy of
concern. As a matter of practical policy, we operate with probabilities on the principle that when x ≤ E, then x = 0. We take
the line that in our human dealings in real-life situations a sufficiently remote possibility can—for all sensible
purposes—be viewed as being of probability zero. Accordingly, such remote possibilities can simply be
dismissed, and the outcomes with which they are associated can accordingly be set aside. And in “the
real world” people do in fact seem to be prepared to treat certain probabilities as effectively zero, taking
certain sufficiently improbable eventualities as no long representing real possibilities. Here an extremely
improbable event is seen as something we can simply write off as being outside the range of appropriate concern, something we can dismiss
for all practical purposes. As one writer on insurance puts it: [P]eople…refuse
to worry about losses whose probability is
below some threshold. Probabilities below the threshold are treated as though they were zero. No
doubt, remote-possibility events having such a minute possibility can happen in some sense of the term,
but this “can” functions somewhat figuratively—it is no longer seen as something that presents a
realistic prospect.
Evaluating risk with a one percent doctrine makes life impossible – everything could
theoretically cause extinction
Meskill 09 (David, professor at Colorado School of Mines and PhD from Harvard, “The "One Percent Doctrine" and Environmental Faith,”
Dec 9, http://davidmeskill.blogspot.com/2009/12/one-percent-doctrine-and-environmental.html)
Tom Friedman's
piece today in the Times on the environment (http://www.nytimes.com/2009/12/09/opinion/09friedman.html?_r=1) is one of the
flimsiest pieces by a major columnist that I can remember ever reading. He applies Cheney's "one percent doctrine" (which is similar to the
environmentalists' "precautionary principle") to the risk of environmental armageddon. But this doctrine is both
intellectually incoherent and practically irrelevant. It is intellectually incoherent because it cannot be applied
consistently in a world with many potential disaster scenarios. In addition to the global-warming risk,
there's also the asteroid-hitting-the-earth risk, the terrorists-with-nuclear-weapons risk (Cheney's original
scenario), the super-duper-pandemic risk, etc. Since each of these risks, on the "one percent doctrine,"
would deserve all of our attention, we cannot address all of them simultaneously. That is, even within
the one-percent mentality, we'd have to begin prioritizing, making choices and trade-offs. But why then should
we only make these trade-offs between responses to disaster scenarios? Why not also choose between them and other, much more
cotidien, things we value? Why treat the unlikely but cataclysmic event as somehow fundamentally
different, something that cannot be integrated into all the other calculations we make? And in fact, this is how we behave all the time.
We get into our cars in order to buy a cup of coffee, even though there's some chance we will be killed
on the way to the coffee shop. We are constantly risking death, if slightly, in order to pursue the things
we value. Any creature that adopted the "precautionary principle" would sit at home - no, not even there, since there is
some chance the building might collapse. That creature would neither be able to act, nor not act, since it would nowhere
discover perfect safety . Friedman's approach reminds me somehow of Pascal's wager - quasi-religious faith masquerading as rational deliberation (as
Hans Albert has pointed out, Pascal's wager itself doesn't add up: there may be a God, in fact, but it may turn out that He dislikes, and even damns, people who
believe in him because they've calculated it's in their best interest to do so). As my friend James points out, it's
striking how descriptions of the
environmental risk always describe the situation as if it were five to midnight. It must be near midnight,
since otherwise there would be no need to act. But it can never be five *past* midnight, since then
acting would be pointless and we might as well party like it was 2099. Many religious movements - for
example the early Jesus movement - have exhibited precisely this combination of traits: the looming apocalypse, with
the time (just barely) to take action.
2AC
2ac nearly all
We meet—we legalize nearly all sales of organs through the central buyer—don’t need to eliminate
state restrictions.
We meet—we legalize all SALES of organ—all organs can be sold to the federal government —they’re
talking about PURCHASING—that’s Gill 02
We meet-Wilkinson says the plan is one way to legalize organ sales and Erin-Harris say
it would maximize sales
CI: Sales are the act of selling—anyone can sell an organ
Business Dictionary 2014
http://www.businessdictionary.com/definition/sales.html
sales
Definitions (2)Add to FlashcardsSave to FavoritesSee Examples
1. The activity or business of selling products or services.
2. An alternative term for sales revenue or sales volume. See also sale.
Sales do not have to be free market – can have a third party
Knox 8 Richard Knox NPR May 21, 2008 Should We Legalize the Market for Human Organs?
http://www.npr.org/2008/05/21/90632108/should-we-legalize-the-market-for-human-organs
Sally Satel, a psychiatrist and resident scholar at the American Enterprise Institute who received a
kidney from a friend in 2006, says: "Despite decades and decades of public education about the
virtues of organ donation, the waiting list just gets longer, and the time to transplantation just gets
longer. ... It's past time to face the fact that altruism is just not enough. Many people need more of
an incentive to give. And that's why we need to be able to compensate people who are willing to give
a kidney to a stranger, to save a life. ... We are not talking about a classic commercial free-for-all, or a
free market, or an eBay system. We're talking about a third-party payer. For example, today you
could decide to give a kidney. You'd be called a Good Samaritan donor. ... The only difference in a
model that I'm thinking about is where you go and give your organ, and your retirement account is
wired $40,000, end of story."
They overlimit—the resolution only says nearly all sales—they force nearly everyone to buy it
Also kill predictble limits—preventing governmental purchasing limits out core areas of the aff—it’s
central to organ lit
Beard et al 13
T. Randolph "Randy" Beard, Professor of Economics at Auburn University.; Rigmar
Osterkamp, Fellow at the School for Political Studies at University of Munich.; And David L. Kaserman,
Torchmark Professor of Economics at Auburn University.2013 The Global Organ Shortage: Economic
Causes, Human Consequences, Policy Responses
11. Almost all analysts who favor compensation for organ donation envision a state-sponsored and
tightly regulated monopsony structure so financial incentives would be used solely to obtain organs,
while organ distribution among potential recipients would continue to be based on medical and
ethical criteria and would be subject to public oversight.
Substantially and functional limits checks
Reasonability – the aff has to have a reasonable way to know if they’re
topical
Case
Framing
Structural violence is the largest proximate cause of war- creates priming that
psychologically structures escalation.
Scheper-Hughes and Bourgois ‘4
(Prof of Anthropology @ Cal-Berkely; Prof of Anthropology @ UPenn) (Nancy and Philippe, Introduction: Making Sense of Violence, in
Violence in War and Peace, pg. 19-22) **Answers no root cause- because there is no root cause we must be attentative to structural
inequality of all kinds because it primes people for broader violence- our impact is about the scale of violence and the disproportionate
relationship between that scale and warfare, not that one form of social exclusion comes first
Prefer the affirmative’s impacts to highly specific long term disadvantages – cognitive
bias means you will think their impact is better than it really is
Yudkowsky 06 [Eliezer, 8/31/2006. Singularity Institute for Artificial Intelligence Palo Alto, CA.
“Cognitive biases potentially affecting judgment of global risks, Forthcoming in Global Catastrophic
Risks, eds. Nick Bostrom and Milan Cirkovic, singinst.org/upload/cognitive-biases.pdf.
Low probability impacts should not be evaluated-- even if there’s some risk, policy
decisions can’t be justified by vanishingly small probabilities
Rescher 03 (Nicholas, Prof of Philosophy at the University of Pittsburgh, Sensible Decisions: Issues of Rational Decision in Personal Choice
and Public Policy, p. 49-50)
Problems with the DA—
Counterplan
Theirs
It's unkown whether incentives will increase donations
Gill 14 John S. Gill, MD, MS, University of British Columbia et al (6 others) Am J Kidney Dis.
2014;63(1):133-140 Financial Incentives to Increase Canadian Organ Donation:Quick Fix or Fallacy?
http://www.ajkd.org/article/S0272-6386%2813%2901226-2/abstract link to pdf
Pragmatic Considerations
It is unknown whether financial incentives will increase the number of organs available for
transplantation in Canada. According to the crowding out motivation theory, payment for organs
could compromise intrinsic motivation and decrease existing organ donations for which no payment
currently is provided.18 The proposed standards for a regulated system of financial incentives
excludes payment for directed donations to guard against the risk of corruption, increasing the
likelihood that adoption of financial incentives could crowd out existing unpaid donations.2 The
extent of crowding out also is unknown. For example, it is unknown whether the introduction of
financial incentives for one type of donation (ie, living donation) also would compromise existing
unpaid deceased donations.
Economic modeling proves central purchasing would increase supply
Matas 13 A. J. Matas, University of Minnesota, American Journal of Transplantation 2013; 13:
1926–1927 Book Review - The Global Organ Shortage: Economic Causes, Human Consequences, Policy
Responses , by T. Randolph Beard, David L. Kaserman and Rigmar Osterkamp. Stanford University Press,
2013. http://onlinelibrary.wiley.com/doi/10.1111/ajt.12273/pdf
The Global Organ Shortage: Economic Causes, Human Consequences, Policy Responses was written
by three economists. Given that one, David Kaserman, has previously championed incentives for
donation, it is not surprising that the authors’ conclusion favors incentives. The book starts, ‘‘The organ transplantation
policies by the vast majority of the world’s nations have failed.’’ That said, the authors have made a superb attempt to
acknowledge and present detailed strengths of arguments both for and against incentives (1–3). Their stated goal is to
focus attention on the problem and provoke further discussion of solutions.
The book has excellent flow, with each of its nine chapters building on momentum from previous ones.
The first chapter (Introduction) defines the problem of a global shortage of organs and outlines the format of the book; the
last (Conclusions) reviews the authors’ arguments.
Chapter 2 describes the evolution of transplant policies throughout the world and their almost universal basis in the
concept of ‘altruism.’ Chapter 3 states the human consequences of these policies—an organ shortage with thousands of
candidates dying or becoming too sick to transplant each year while waiting on the list for a transplant.
Chapter 4 discusses the social costs and benefits of transplantation versus alternate therapies. As noted in
previous publications, transplantation can save health care systems billions (4). Consequently, the authors believe that
reforms increasing the number of transplants would be advantageous for both patient outcomes and society. They
show through economic modeling how incentives would increase both living (LDs) and deceased
(DDs) donation. Although cost–benefit analysis is most clear for kidneys, they note that with increased
DDs, candidates on all lists could benefit. Chapter 5 outlines the consequences of a ‘‘zero (dollar/euro) point price for
organs’’ and the causes of a lack of system reform. Although the authors believe that the major cause of the organ shortage
is that compensation is illegal, they acknowledge other contributing factors, and comment that those opposed to incentives
favor other
reforms to increase donation, albeit ‘‘within the current paradigm.’’ Chapter 6 provides a history of attempts to reform the
donation system to increase both living and deceased donation. The authors note that some—e.g. Spanish Model, use of
ECDs—have made an impact, but a severe shortage persists. They conclude, ‘‘In our view, the introduction of more radical
reforms, including [compensation for LDs and DDs], is imperative.’’
Chapter 7 addresses the moral basis of objections to compensation. The authors portray these objections
realistically, stating that the organ shortage is ‘‘perhaps the most complex and morally controversial medical issue aside
from abortion and euthanasia.’’ Each previously described concern is addressed; ultimately the authors believe that the
possibility of saving lives outweighs any other argument. Chapter 8 provides their proposal for a Public Monopsony
for Organ Acquisition (for both LDs and DDs) (4,5). Again, acknowledging counterarguments, the
authorsstate, ‘‘The reformwe proposetriesto advancethe
policy of preserving life while respecting important social taboos and taking seriously widely shared
moral convictions.’’ Their modeling shows how a variety of incentive systems could increase both LDs
and DDs, and they comment that different systems may work better for different countries.
Politics DA
TPA – 2AC – NDT
Worst climate impacts take decades to arrive and don’t assume adaptation
Robert O. Mendelsohn 9, the Edwin Weyerhaeuser Davis Professor, Yale School of Forestry and
Environmental Studies, Yale University, June 2009, “Climate Change and Economic Growth,” online:
http://www.growthcommission.org/storage/cgdev/documents/gcwp060web.pdf
The heart of the debate about climate change comes from numerous warnings from scientists and
others that give the impression that human- induced climate change is an immediate threat to society
(IPCC 2007a, 2007c; Stern 2006). Millions of people might be vulnerable to health effects (IPCC 2007a),
crop production might fall in the low latitudes (IPCC 2007a), water supplies might dwindle (IPCC 2007a),
precipitation might fall in arid regions (IPCC 2007a), extreme events will grow exponentially (Stern
2006), and between 20 and 30 percent of species will risk extinction (IPCC 2007a). Even worse, there
may be catastrophic events such as the melting of Greenland or Antarctic ice sheets, causing severe sealevel rise, which would inundate hundreds of millions of people (Dasgupta and others 2009). Proponents
argue that there is no time to waste. Unless greenhouse gases are cut dramatically today, economic
growth and well-being may be at risk (Stern 2006). These statements are largely alarmist and
misleading. Although climate change is a serious problem that deserves attention, society’s immediate
behavior has an extremely low probability of leading to catastrophic conse- quences. The science and
economics of climate change are quite clear that emissions over the next few decades will lead to only
mild consequences. The severe impacts predicted by alarmists require a century (or two, accord- ing to
Stern 2006) of no mitigation. Many of the predicted impacts assume that there will be no or little
adaptation. The net economic impacts from climate change over the next 50 years will be small
regardless. Most of the more severe impacts will take more than a century or even a millennium to
unfold, and many of these “potential” impacts will never occur because people will adapt. It is not at all
apparent that immediate and dramatic policies need to be developed to thwart long-range climate risks.
What is needed are long-run balanced responses.
Obama’s not involved and there’s no agreement
Politico 4/2/2015 (http://www.politico.com/story/2015/04/trade-promotion-authority-tpa-bill-timeline-could-push-senate-to-act116640.html)
Negotiations between Hatch (R-Utah), who chairs the committee, its ranking member Wyden (D-Ore.) and House Ways and
Means Committee Chairman Paul Ryan (R-Wis.) are taking place at the staff level over the spring congressional
break and “continue to make progress,” Hatch spokesman Julia Lawless said, confirming only that the
senator hopes to move legislation “this spring.” Wyden has sought to include provisions to give
Congress more power and oversight over the fast-tracking of trade deals. Quick movement on the bill,
which the White House is seeking to expedite congressional consideration of a sprawling Asia-Pacific trade deal, could send Senate Majority
Leader Mitch McConnell the signal to carve out floor time in the upcoming six-week legislative period — a
session that will be jammed with major issues ranging from the budget reconciliation process to political fallout over the
nuclear energy deal with Iran, and from cybersecurity legislation — a priority of the Kentucky Republican — to the highway funding bill.
Meanwhile, the fate of Trans-Pacific Partnership with Japan and 10 other Asia-Pacific countries hangs in the balance. The legislation is
considered vital for easing congressional passage of the deal, which would be the biggest in world history, because it would shield it from
amendments and put it to a simple up-or-down vote. Before countries put their final offers on the table, they’ve said they want assurance
through the legislation that lawmakers won’t be able to tear the agreement apart during congressional debate — and their trade ministers have
been growing more vocal about the need for the bill as a TPP gathering meant to wrap up the deal approaches in late-May. Japan, the world’s
third-largest economy, in particular has been at an impasse with the United States over agricultural and auto tariff cuts. Its economic minister,
Akira Amari, told the Financial Times this week that President Barack Obama needs to step up his efforts to win support for fast track legislation
from fellow Democrats. Chile’s deputy trade minister, Andres Rebolledo, echoed the point in an interview with POLITICO, saying that
negotiations could continue in parallel, “But of course we are aware that it’s important to have TPA before the last minute of the negotiation.”
The tentative dates for introducing and marking up the bill could be an effort to create some momentum for its
consideration, a trade lobbyist who is following the issue closely said. And, because Hatch scheduled and then postponed a hearing on the bill
in late February, he won’t have to comply with the seven-day notification requirement for hearings. But “that doesn’t
solve your issue
of floor time,” the lobbyist said. Since negotiations began after the midterm elections, Hatch and Wyden have winnowed
down their differences to a handful of issues, including a provision Wyden is pushing that would make it
easier to remove trade deals from fast-track procedures if lawmakers’ negotiating priorities aren’t met.
The two sides are also discussing the content of and process for amendments, with Hatch seeking to make the bill’s path to passage as smooth
as possible, congressional aides said. The Utah Republican wants not only to protect the bill, but also to give certain vulnerable Republican
committee members, such as Rob Portman of Ohio, opportunities for political cover as they go into elections in 2016 where trade could be a
sensitive issue, lobbyists and aides said. At least one opponent, former Ohio Gov. Ted Strickland, is expected to attack Portman for his pro-trade
stance, which could resonate in the manufacturing state. Giving Portman, a former U.S. trade representative under George W. Bush, an
opportunity to offer an amendment on currency manipulation or another worker-friendly issue — without substantively changing what Hatch
wants in a final bill — could provide the Ohio Republican with some political cover. Wyden, too, wants to reach an agreement by the end of this
recess, a Democratic aide said. But if the two sides can’t reach one then or fairly soon after, observers say the window for passing a bill in the
six-week legislative period could close. McConnell
initially promised floor time for the measure in the last
legislative session, but took it away when it became clear Hatch and the Oregon Democrat couldn’t reach a deal, trade lobbyists
said. “[T]hat floor time was pretty much given away,” one of the lobbyists said. On the House side, Ryan was undeterred as recently as last
week by the Senate Finance panel leaders’ delay in reaching an agreement on the fast-track bill, telling reporters at a pen-and-pad briefing that
he planned to move it and other trade legislation in the upcoming session. “My goal is to mark up as many trade bills as I can in the spring,” the
Wisconsin Republican said, ticking off bills to renew tariff-cuts under the Generalized System of Preferences program, which expired in July
2013, and the African Growth and Opportunity Act, which expires in September. Right now, several Republicans — some of whom are highranking — say they have been left out of the substance of the fast-track talks and are leaning against voting for the legislation, another trade
lobbyist said. That means the House Republican leadership will need to do some legwork to bring the conference in line once a bill is
introduced, the lobbyist said, adding that intense, coordinated lobbying would have to happen to get sufficient votes in just a few weeks. But a
Republican aide said the votes will be there when the bill comes to the floor. “A lot of members — on both sides of the aisle — are hesitant to
throw their support behind something right now because legislation doesn’t exist yet,” the aide said, noting that outside lobbying groups have
made a significant push in favor of the bill theory. “I expect that it [a vote] will be close but will feel much more confident once language
actually exists and is introduced,” the aide said. Still, Hatch
expressed worry as late as last week that if he and Wyden
couldn’t strike a deal in April the fast-track bill might not get passed at all this year. When asked this
week how quickly the bill could move, McConnell’s spokesman Don Stewart said, “It’s a priority for the leader, but I
don’t have timing yet.”
Won’t pass and even if it does- conditions and controversy sink TPP
WSJ 3/30/2015 (http://www.wsj.com/articles/divisions-in-congress-hamper-pacific-trade-deal-1427739980)
Wavering support in Congress has emerged as the biggest obstacle holding up completion of a 12-nation Pacific
trade pact under negotiation for nearly a decade. The Obama administration’s push to win fast-track powers from
Congress to expedite the deal’s passage has stalled amid disagreements among lawmakers over how much
leverage they should have over the pact’s final form. That uncertainty is stirring fear among many of the 11
countries negotiating the Trans-Pacific Partnership with the U.S., who say they need proof Congress is on board before agreeing to final
conditions in the deal. Passing the legislation, also known as trade promotion authority, would let negotiators finalize outstanding issues such
as auto-industry tariffs, dairy-market access and sensitive rules on intellectual property, areas where negotiators need to get a final signoff
from top political leaders. “We can get this deal done, but we’re not going to get there without the U.S. Congress declaring its formal support
through an appropriately drafted TPA,” New Zealand Trade Minister Tim Groser said in a recent interview. Australia’s trade minister, Andrew
Robb, said the Pacific pact could be wrapped up in a month if there is sufficient political will. But “unless the TPA is completed in the U.S., there
won’t be the political will,” he told reporters last week. The TPP pact would lower tariffs and other barriers at the border and set commercial
rules of the road for everything from the drug patents to the arbitration of disputes with governments. Countries negotiating the deal include
Japan, Australia and New Zealand, as well as less developed economies such as Vietnam and Malaysia. The agreement is the economic
centerpiece of President Barack Obama’s efforts to rebalance foreign policy toward fast-growing Asia, and Mr. Obama is selling the deal as a
way to ensure that Washington writes the trade rules of the region rather than China. While Republicans in Congress largely back the deal,
most lawmakers in Mr. Obama’s own party look set to oppose it out of concern that American workers
will have to compete with low-wage counterparts in countries with lower standards. Mr. Obama says the deal will level the
playing field with workers in these countries. A similar tension exists in Japan, where farmers in the party of Prime Minister Shinzo Abe oppose
the deal out of concern they will have to compete with more efficient American agriculture. Previously, U.S. officials complained about a lack of
Japanese political support to strike a deal, but now all eyes are on Washington. The U.S. has been working out final provisions with Japan on
automobile tariffs, regulatory trade barriers for cars and access to Japan’s agricultural markets. The U.S. has agreed to lower its tariff on
Japanese imports over time, but Tokyo also wants Washington lower its duties on car parts. In exchange, the U.S. is seeking easier access to the
Japanese market for Detroit auto makers and a substantial lifting of Japanese barriers to pork and other agricultural goods. American and
Japanese official would like to get a two-way deal covering cars, agriculture and other market issues in the TPP by the time Mr. Abe visits
Washington at the end of April, but officials say the divisions in Congress are weighing on the bilateral talks. “Hearing
about the
political debate in Congress makes people worried,” said Takeo Mori, the Japanese official handling the auto negotiations, in
Washington Friday.
Both the AMA and the American Society of Transplant Surgeons support sales—link
doesn’t turn case
Austin Cline no date, Is it ethical to let organs be sold on the open market?,
http://atheism.about.com/library/FAQs/phil/blphil_ethbio_organsale.htm
Should people be allowed to sell their organs? Currently, exchanging organs for money or other "valuable
considerations" is illegal, but some members of the medical and business communities would like to change
that. One of those is the American Medical Association's influential Council on Ethical and Judicial Affairs. Convinced that the balance of moral and
ethical concerns favors the ability to sell organs, they would like the laws to change, and the AMA's governing house of delegates is scheduled
to vote in June on whether to support a pilot program. The American Society of Transplant Surgeons has already endorsed
giving money for cadaveric organs to the families of the deceased.
Legal sale is popular
Nagro 14 Jessica Nagro, Health Policy and Management student at NYU Wagner Graduate School of
Public Service, She currently serves as the Philanthropy Fellow in the area of Health and People with
Special Needs at the New York Community Trust and, before coming to Wagner, worked in political
communications and health care policy on Capitol Hill and at Washington DC-based nonprofits. The
Wagner Review / December 17, 2014
Is it time to start paying for organs?Is it time to start paying for organs?
http://www.thewagnerreview.org/2014/12/is-it-time-start-paying-for-organs/
Compensation for organ donation is also a fairly popular idea in the U.S. An NPR-Thomson Reuters
Health Poll conducted in 2012 showed that approximately 60 percent of Americans would support
some type of moderate compensation for living organ donors. Specifically, 60 percent supported
compensation in the form of credits for health care needs and even 41 percent viewed cash
payments favorably.
No internal link – zero evidence that organs causes swing senators to vote switch
Iran deal thumpsNYT 4/2/2015 (New York Times, Iran Agrees to Detailed Nuclear Outline, First Step Toward a Wider Deal,
http://www.nytimes.com/2015/04/03/world/middleeast/iran-nuclear-talks.html?_r=0)
Now, attention will
shift to Mr. Obama and Hassan Rouhani, the Iranian president, who was elected on a platform of ending
the agreement at home to constituencies deeply suspicious of both the deal and the
sanctions. They share a common task: selling
prospect of signing any accord with an avowed enemy. The
White House has promised a lobbying campaign by the
president unlike any seen since he pushed through health care legislation.
Nonintrinsic – a logical policymaker could do the plan and not sanction Iran – condo
justifies
Obama doesn’t push the plan– empirics
AP 13 Associated Press Health24 Updated 27 November 2013 US keeps ban on organ sales intact
http://www.health24.com/News/US-keeps-ban-on-organ-sales-intact-20131127
The US government has proposed legislation to keep the ban on buying or selling organs intact. Could
paying for bone marrow cells really boost the number of donors? The Obama administration is taking
steps to block a federal court ruling that had opened a way to find out. Buying or selling organs has long been
illegal, punishable by five years in jail. The 1984 National Organ Transplantation Act that set the payment ban didn't just refer to solid
organs it included bone marrow transplants, too. Thousands of people with leukaemia and other blood diseases are saved each year by
bone marrow transplants. Thousands more, particularly minorities, still have trouble finding a genetically compatible match even though
millions of volunteers have registered as potential donors under the current altruistic system. Rewrite of legal definitions A few years ago,
the libertarian Institute for Justice sued the government to challenge that system. It argued that more people with rare marrow types
might register to donate and not back out later if they're found to be a match if they had a financial incentive such as a scholarship paid by
a non-profit group. Ultimately, a panel of the 9th US Circuit Court of Appeals ruled that some, not all, marrow donors could be
compensated citing a technological reason. Years ago, the only way to get marrow cells was to extract them from inside bone. Today, a
majority of donors give marrow-producing cells through a blood-filtering process that's similar to donating blood plasma. Because
it's
legal to pay plasma donors, the December 2011 court ruling said marrow donors could be paid, too, as long as
they give in that newer way. "They're not even transplanting your bone marrow. They're transplanting these baby blood cells," said Jeff
Rowes, an attorney with the Institute for Justice. It represented some families who'd had trouble finding donors, and was pushing for a
study of compensation as a next step. Not
so fast, says the Obama administration. The government now has
proposed a regulation to keep the ban intact by rewriting some legal definitions to clarify that it covers marrow-producing
stem cells no matter how they're derived.
Winners win and political capital’s not key
Hirsch 13 (Michael, Michael Hirsh is chief correspondent for National Journal. He also contributes to 2012 Decoded. Hirsh previously served
as the senior editor and national economics correspondent for Newsweek, based in its Washington bureau. He was also Newsweek’s
Washington web editor and authored a weekly column for Newsweek.com, “The World from Washington.” Earlier on, he was Newsweek’s
foreign editor, guiding its award-winning coverage of the September 11 attacks and the war on terror. He has done on-the-ground reporting in
Iraq, Afghanistan, and other places around the world, and served as the Tokyo-based Asia Bureau Chief for Institutional Investor from 1992 to
1994. “There’s No Such Thing as Political Capital,” http://www.nationaljournal.com/magazine/there-s-no-such-thing-as-political-capital20130207?page=1)
Naturally, any president has practical and electoral limits. Does he have a majority in both chambers of Congress and a cohesive coalition
behind him? Obama has neither at present. And unless a surge in the economy—at the moment, still stuck—or some other great victory gives
him more momentum, it is inevitable that the closer Obama gets to the 2014 election, the less he will be able to get done. Going into the
midterms, Republicans will increasingly avoid any concessions that make him (and the Democrats) stronger. But the abrupt emergence of the
immigration and gun-control issues illustrates how suddenly shifts in mood can occur and how political
interests can align in new ways just as suddenly. Indeed, the pseudo-concept of political capital masks a
larger truth about Washington that is kindergarten simple: You just don’t know what you can do until
you try. Or as Ornstein himself once wrote years ago, “ Winning wins.” In theory, and in practice, depending on
Obama’s handling of any particular issue, even in a polarized time, he could still deliver on a lot of his
second-term goals, depending on his skill and the breaks. Unforeseen catalysts can appear, like
Newtown. Epiphanies can dawn, such as when many Republican Party leaders suddenly woke up in panic
to the huge disparity in the Hispanic vote. Some political scientists who study the elusive calculus of how
to pass legislation and run successful presidencies say that political capital is, at best, an empty concept,
and that almost nothing in the academic literature successfully quantifies or even defines it. “It can
refer to a very abstract thing, like a president’s popularity, but there’s no mechanism there. That makes
it kind of useless,” says Richard Bensel, a government professor at Cornell University. Even Ornstein
concedes that the calculus is far more complex than the term suggests. Winning on one issue often
changes the calculation for the next issue; there is never any known amount of capital. “The idea here is,
if an issue comes up where the conventional wisdom is that president is not going to get what he wants,
and he gets it, then each time that happens, it changes the calculus of the other actors” Ornstein says.
“If they think he’s going to win, they may change positions to get on the winning side. It’s a
bandwagon effect.”
Property DA
Property – 2AC - NDT
Property link does not apply to our plan. Government buyer would not establish a
property right – courts have ruled that way
Ghosh 14 Samantak Ghosh, Ph.D. in Chemistry, Stanford University; J.D., University of California,
Berkeley, School of Law April, 2014 California Law Review 102 Calif. L. Rev. 511 COMMENT: The
Taking of Human Biological Products
A number of commentators have "appropriately criticized" Moore's logic. n71 Indeed, the California
Supreme Court's assurance that fiduciary duties would sufficiently protect tissue donors' interests
proved mistaken when a number of other state courts dismissed such causes of action on very similar
sets of facts. n72 Regardless of whether doctors' fiduciary duties can sufficiently [*522] protect
patients' rights, Moore's circular reasoning for denying property rights needs further examination.
According to Moore, government regulation limiting personal rights in excised body parts militates
against finding property rights in them. n73 But if property rights were dictated by government
regulations alone, then the takings jurisprudence would be made wholly irrelevant. The circularity of
Moore's reasoning is obvious: since the government regulates the sale and disposal of body parts,
they are not private property; and since they are not private property, the government can subject
them to additional regulatory regimes such as the patent system. But ""property' cannot be defined
by the procedures provided for its deprivation." n74
Transplant organs are treated as a "service"
Boyer 12 J. Randall Boyer, J.D. candidate, April 2012, J. Reuben Clark Law School, Brigham Young
University. 2012 Brigham Young University Law Review 2012 B.Y.U.L. Rev. 313 COMMENT: Gifts of
the Heart ... and Other Tissues: Legalizing the Sale of Human Organs and Tissues lexis
In addition to the common law, statutes specifically regulating organ transfers have resulted in
similar unintended consequences. Blood Shield Statutes n59 and other state health and safety
legislation categorically treat the transfer of organs from one individual to another as a service rather
than a transaction for goods or products. n60 In other words, even though a tangible, physical item
(the organ) is traded between doctors, hospitals, and medical companies, and is [*322] treated as a
good for the purposes of those transactions, when the end recipient enters the equation, the organ
is deemed a service. n61 The end result of this classification is to preclude products liability claims,
essentially exculpating tissue banks whose negligence may result in contaminated products. n62
Because the tissue is not a good, tissue recipients are not protected by the standard product
warranties that might otherwise deter tissue banks from negligently supplying infected tissue. n63
Further, because the tissue is a service, an injured party's primary recourse is through medical
malpractice suits against the doctors and hospitals involved in the transplant. n64 Thus, the law shifts
the burden of ensuring that tissue is safe for implantation from tissue banks and other suppliers, who
are in the best position to test for disease and ensure proper handling of tissues, to doctors and
hospitals, who have much less control over the quality of tissues they receive. n65
Such negligent treatment of tissue transplants can result in tragic consequences. n66 Bryan Lykins
stands as a poign-ant example. Bryan received a cadaveric tendon as part of a knee surgery. n67
Although the surgery was common, and in many ways routine, the tendon Bryan received was from a
cadaver that had been unrefrigerated for nineteen hours. n68 The bacteria that had been allowed to
grow during that time resulted in Bryan's death only four days after the surgery. n69 Even worse is
the fact that Bryan's story is not a singular or isolated incident. n70 Yet, even though tissue banks
may negligently place contaminated tissue on the market, they cannot be held liable if their products
result in illness or even death. n71 Further, insofar as lawmakers have been slow to act, n72 tissue
banks have little incentive [*323] to change their behavior, and some have been continually careless
in the products and "services" they are providing. n73
Privacy right would be sufficient for judicial doctrine
Boyer 12 J. Randall Boyer, J.D. candidate, April 2012, J. Reuben Clark Law School, Brigham Young
University. 2012 Brigham Young University Law Review 2012 B.Y.U.L. Rev. 313 COMMENT: Gifts of
the Heart ... and Other Tissues: Legalizing the Sale of Human Organs and Tissues lexis
The jurisprudence underpinning the legal status of human body parts is, at best, confused. This, in
part, is due to the various legal theories that interact when discussing the transfer of human organs.
The common law tradition that has protected some interests in body parts is now inadequate since
the value in a dead body has only recently been - and is continually being - established by modern
technology. Additionally, statutes concerned with tissue transfer have sought to preserve a
distinction between the body and property, but with unintended consequences. Finally, this debate
implicates recent doctrines of the constitutional right of privacy, adding yet another wrinkle to the
legal framework.
Link applies just as much to donated organs – you can't give away what does not
belong to you. A property perspective applies to transfers whether paid for or not
Boyer 12 J. Randall Boyer, J.D. candidate, April 2012, J. Reuben Clark Law School, Brigham Young
University. 2012 Brigham Young University Law Review 2012 B.Y.U.L. Rev. 313 COMMENT: Gifts of
the Heart ... and Other Tissues: Legalizing the Sale of Human Organs and Tissues lexis
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
No need to establish a property right for the plan
Boyer 12 J. Randall Boyer, J.D. candidate, April 2012, J. Reuben Clark Law School, Brigham Young
University. 2012 Brigham Young University Law Review 2012 B.Y.U.L. Rev. 313 COMMENT: Gifts of
the Heart ... and Other Tissues: Legalizing the Sale of Human Organs and Tissues lexis
The law has struggled to define rights to one's own body in the face of increasing value created by
new medical tech-nologies. The lack of appreciation for the new value of the body in the current
law's prohibition of organ sales has cre-ated a system whereby control, rights, and value are severed
from the donor and recipient and transferred to third par-ties. While there may be substantial
reasons to continue to prohibit the inter vivos sale of human organs, the broader prohibition on all
sales - including futures contracts - is not supported by these reasons. While many have suggested
drastic changes to the legal structure surrounding the human body, existing laws need only to be
amended to restrict their prohibitions to inter vivos sales. Such changes would not require the
finding of a new controversial fundamental right with a potentially expansive holding and unforeseen
consequences, nor would it require an enormity of legislative action to invent a new statutory
framework. These limited changes would, however, recognize that individuals do have legal interests
in their own tissues, giving them recourse should the tissues be misused. Most importantly, these
limited changes would vest the power to designate who receives value and where and how organs
should be used in the individual with the most at stake in these transactions. Such changes would
lead to more efficient and just results in this increasingly important market.
Global biotech inevitable—solves their biotech good impacts
D'Haeze, ‘7 [Wim, Bio-Engineer in Chemistry and received his Ph.D. in Biotechnology at Ghent
University, Senior Technical Writer in the pharmaceutical, "Blooming Biotech and Pharmaceutical
Industries," 10-15, The Science Advisory Board,
http://www.scienceboard.net/community/perspectives.193.html]
Whoever regularly follows the news will recognize that the
Biotech and Pharmaceutical Industry is still expanding – booming
China, and Japan. A pattern that is often
observed for pharmaceutical companies is headquartering in a major location in the United States or Europe
while branching elsewhere in the United States, Europe, and/or Asia. Those processes are highly dependent on how
– in the United States and Europe, but also in major Asian countries such as India,
successfully drug candidates move through the drug development pipelines and on how the drug development process is organized, planned,
and executed. Research and Development hubs are located at the East coast (e.g., New York, Boston, Philadelphia, Atlanta, and Northern and
Central New Jersey) and West coast (e.g., San Francisco, Los Angeles, San Diego, and Seattle) of the United States and throughout major cities
in Europe, but multinational
companies have been or are stepping on land in countries throughout Asia as
well. Reasons for the latter development may include substantial cheaper labor as compared to that in
developed countries and the ability to produce medicines close to the market place. During recent years,
India, for example, has become the home of a few hundred registered biotech and pharmaceutical
companies and is now positioned within the top-5 producers of pharmaceuticals. Interestingly, the majority of its
export (e.g., production of diphtheria, tetanus, pertussis (DTP) vaccine) goes to developing countries. Companies such as Biocon, Novo Nordisk,
Aventis Pharma, Chiron Behring Vaccines, GlaxoSmithKline, Novozymes, Eli Lilly & Company, and Advanced Biochemicals are all represented in
major Indian cities, including Bangalore, Calcutta, Hyderabad, Mumbai, Pune, and New Delhi. In 2005, Indian biotech and pharmaceutical
companies represented a revenue of more than US$1 billion and the governmental goal articulated by the Indian Department of Biotechnology
is to create a biotechnology and pharmaceutical industry generating US$5 billion in revenues annually and representing one million jobs by
roughly three years from now. The government
tries to achieve this goal in part by facilitating foreign-owned
companies to establish in India, making it easier for investors by centralizing the process, creating at
least ten new science parks by 2010, financially supporting new drug discovery proposals and research,
and by supporting small biotech and pharmaceutical businesses and start-up companies.
No intenral link--Biotech companies would just shift production to places like India
Husain 11 (Shahbaaz Husain, Symbiosis Law School, Pune, Article Assistant at Yogesh & Jain, Chartered
Accountants, “Foreign Direct Investment In Indian Pharmaceutical Industry”
cci.gov.in/images/media/ResearchReports/shahbaazInternreportdec2011.pdf)//kyan
Due to the pharmaceutical industry‘s capital and know- how intensity, most of the world‘s production is located in the developed countries.
India is one of the few developing countries with a large production base in pharmaceutical products.
India‘s trade in pharmaceutical products has increased a lot since the liberalization reforms and it has comparative
advantages in trade with pharmaceutical products, both bulk drugs and formulations. The Indian pharmaceutical industry ranks
very high among developing countries, in terms of technology and quality, and is today in the front rank of India‘s science
based industries23 . The growth of the Indian pharmaceutical industry has been remarkable. The industry is today the fourth
largest globally, in terms of volume, and 13 th largest in terms of value24. The industry accounts for 8% of the global sales in
volume but in terms of value it is barely 1%. The role of the Indian pharmaceutical industry in the international market today is as a supplier of
good quality, low cost generic bulk and formulation Potential growth of the Indian pharmaceutical industry is great.
Nearly 65% of India‘s population does not enjoy comprehensive access to quality healthcare today. A large share of the population use
alternative medicine and per capita consumption of drugs in India is one of the lowest in the world25 . Multinationals
are, in addition to
part of India‘s pharmaceutical foundation. Foreign companies entered the Indian market
merely as trading companies with small investments. The new industrial policies emphasized the importance of foreign
capital and industrial know- how. The Indian government carried out liberal FDI policies and incentives to invite foreign
firms to start manufacturing facilities in order to get an inflow of know- how in the sector. The leading pharmaceutical
companies from the West came to India and established manufacturing facilities. Subsequently, the
the public sector, a
multinationals brought in technology and international manufacturing practices26. Domestic firms were encouraged to tie up with foreign
firms, with participation in capital, and there were collaboration agreements in the private sector. The foreign firm Hoechst established a
research centre, which enhanced basic research in India27 . During this time product patent
laws8, which were favourable for the
MNCs, were in force India was attractive to foreign firms mainly due to its large market and increasing demand for drugs.
At that time there was lack of competition in the Indian pharmaceutical industry and the MNCs did well in India. They had good
knowledge and technology to develop antibiotics and synthetic drugs and advantage of their financial assets and
management abilities. Consumer preference for foreign world- wide known drugs was also an advantage for the MNCs in India. They were
aggressive in marketing and managed to create a market for themselves in branded products. The foreign companies had, more or less, a
monopoly in the Indian pharmaceutical market at this time
1AR
Shortages
None of their ev assumes organs
Robertson 13 John A. Robertson,Vinson & Elkins Chair in Law, University of Texas at Austin Law
School
Hastings Constitutional Law Quarterly Winter, 2013 40 Hastings Const. L.Q. 221
Organ Donations and the Constitutionality of the National Organ Transplant Act
ARTICLE: Paid
lexis
3. Crowding Out Altruism
A main argument against paid organ donation is that it will undermine or crowd out the unpaid
altruistic system, which itself is a public good. People who would otherwise donate without payment
will now refuse to do so because others are paid, or will do so only if they are paid as well.
Richard Epstein, Julia Mahoney, and others have examined this claim and have found that the main
data used to support it are drawn from situations that are greatly different than organ donation.
n193 As Mahoney notes, "whether a particular reward will "crowd out,' "crowd in,' or have a
"crowding neutral' effect ... is hard to predict." n194 She goes on to note that "most situations in
which researchers have detected "crowding out' differ markedly from organ procurement." n195 She
concludes that "until far more work is done, "crowding out' must remain an interesting, but
unconvincing, hypothesis." n196 Richard Epstein also agrees. n197 At the very least such speculation
would not in itself satisfy the stronger justification needed to ban paid live kidney donations when
necessary to protect another person's life.
Iran system has eliminated shortage and illicit market
Kelly 13 Emily Kelly, Executive Comment Editor for the Boston College International & Comparative
Law Review. Boston College International and Comparative Law Review Spring, 2013 36 B.C. Int'l &
Comp. L. Rev. 1317 NOTE: INTERNATIONAL ORGAN TRAFFICKING CRISIS: SOLUTIONS ADDRESSING THE
HEART OF THE MATTER lexis
Although the global consensus opposes commoditizing organs, the wide gap between organ supply
and demand has led economists to [*1330] propose market-based incentives. n129 While some
countries permit compensation for reasonable expenses associated with donation, n130 Iran is the
only country with a legal organ market. n131 Prospective donors contact the Iranian Dialysis and
Transplant Patients Association (DATPA) and undergo medical and psychological examinations before
attaining its approval. n132 Donors receive one year of free health insurance and a $ 1200
government subsidy, in addition to $ 2000-$ 5000 from recipients. n133 Recipients without the
means to pay donors often seek funding from charities and nonprofit organizations. n134
Following the legalization of financial incentives for organ donation in 1988, Iran's kidney waitlist
disappeared in just over a decade. n135 DATPA's medical screenings encouraged patients to pursue
safer legal channels rather than risk buying unregulated organs in the underground market. n136
Additionally, DATPA's close monitoring displaced organ brokers and removed opportunities for
financial exploitation. n137 The advent of a legal organ market destroyed the previously thriving
underground Iranian market. n138 Only Iranian citizens may participate as donors and recipients,
eliminating any legal opportunity for transplant tourism. n139
DA
Research is done on tissue and cells, not organs
Erin and Harris 94 Charles A Erin and John Harris, Institute of Medicine, Law and Bioethics, School of
Law, University of Manchester 1994 A monopsonistic market: or how to buy and sell human organs,
tissues and cells ethically in Life and Death Under High Technology Medicin, edited by Ian Robinson
We are about to propose a possible commercial scheme, but first let us draw a distinction between
human biological materials. For reasons which will become apparent below we divide these materials
into two classes according to the use to which they are to be put: (i) those which are to be used for
therapeutic purposes; and (ii) those which are to be utilized in research. In very general terms, this
approximates to the distinction between organs and tissues/ cells respectively. An organ is an
aggregation of tissues constituting a structural unit with a particular function or functions. A tissue is
a collection of cells, again with a specific function. Whilst John Moore’s spleen was removed as part
of his therapy for hairy cell leukaemia, it was the tissues and cells of his spleen which were used in
the derivation of the Mo cell line (Erin 1994). However, blood, a fluid tissue, defies such a taxonomy
as it is put to both therapeutic and research purposes. [140]