1NC K
The aff embraces a neoliberal ethic of unending consumption, false altruism, and
medical apartheid—turns the case and causes global violence against the
periphery
Hughes 3 [Nancy Scheper-Hughes (Professor of Anthropology—Cal-Berkeley; Cofounder and
Director—Organs Watch, a medical human rights organization that monitors international organ
trafficking); “Rotten trade: millennial capitalism, human values and global justice in organs trafficking”;
2003; Journal of Human Rights, 2:2, 197-226]
Amidst the neo-liberal readjustments of societies, North and South, we are experiencing today a
rapid depletion, an ‘emptying out ’ even, of traditional modernist, humanist and pastoral ideologies,
values and practices. New relations between capital and labor, bodies and the state, belonging
and extra-territoriality, and between medical and biotechnological inclusions and exclusions are
taking shape. But rather than a conventional story of the lamentable decline of humanistic social values
and social relations, our discussion is tethered to a frank recognition that the material grounds on which
those modernist values and practices were based have shifted today almost beyond recognition.
What the Comaroffs (2001) refer to as millennial or ‘second coming’ capitalism has facilitated a rapid
dissemination to virtually all corners of the world of advanced medical procedures and biotechnologies
alongside strange markets and ‘occult economies’. Together, these have incited new tastes and
desires for the skin, bone, blood, organs, tissue and reproductive and genetic material of others.
Nowhere are these processes more transparent than in the field of organ transplant, which now takes
place in a transnational space with both donors and recipients following new paths of capital and medical
technology in the global economy.
The spread of transplant capabilities created a global scarcity of transplantable organs at the
same time that economic globalization released an exodus of displaced persons and a voracious
appetite for foreign bodies to do the shadow work of production and to provide ‘fresh’ organs for
medical consumption. The ideal conditions of an ‘open’ market economy have thereby put into
circulation mortally sick bodies traveling in one direction and ‘healthy’ organs (encased in their human
packages) in another direction, creating a bizarre ‘kula ring’ of international body trade. The emergence of
strange markets, excess capital, renegade surgeons, local ‘kidney hunters’ with links to an international
Mafia (Lobo and Maierovitch 2002) (and thereby to a parallel traffic in slave workers, babies, drugs and
small arms) has produced a small but spectacularly lucrative practice of transplant tourism , much of it
illegal and clandestine.
This confluence in the flows of immigrant workers and itinerant kidney sellers who fall into the hands of
ruthless brokers and unscrupulous, notorious, but simultaneously rewarded, protected and envied outlaw
transplant surgeons is a troubling sub-text in the story of late twentieth and early twenty-first century
globalization, one that combines and juxtaposes elements of pre- and postmodernity. These new
transplant transactions are a strange blend of altruism and commerce; consent and coercion; gifts and
theft; science and sorcery; care and human sacrifice.
On the one hand, the phenomenal spread of transplant technologies, even in the murky context of black
markets in medicine, has given the possibility of new, extended or improved quality of life to a select
population of mobile kidney patients from the deserts of Oman to the rain forests of the Amazon Basin.
On the other hand, new developments in ‘transplant tourism’ have exacerbated older divisions
between North and South, core and periphery, haves and have-nots, spawning a new form of
commodity fetishism in demands by medical consumers for a quality product: ‘fresh’ and ‘healthy’
kidneys purchased from living bodies. In these radical exchanges of body parts and somatic
information, life-saving measures for the one demands a bodily sacrifice of self-mutilation by the
other. And one man’s biosociality (Rabinow 1996) is another woman’s biopiracy, depending on whether
one is speaking from a Silicon Valley biotech laboratory or from a sewage-infested banguay in Manila.
Commercialized transplant, a practice that trades comfortably in the domain of postmodern
biopolitics with its values of disposability, individuality, free and transparent circulation,
exemplifies better than any other biomedical technology the reach and the limits of economic
liberalism. In transplant gifts of life and death (Parsons et al . 1969) promise to surpass all previous
‘natural’ limits and restrictions. And the uninhibited circulation of purchased kidneys exemplifies the
neo-liberal episteme, a political discourse based on juridical concepts of the autonomous
individual subject, equality (at least equality of opportunity), radical freedom, accumulation and
universality (the expansion of medical rights and medical citizenship 3 ). The commodified kidney is, to
date, the primary currency in transplant tourism; it represents the gold standard of organ sales worldwide.
In the past year, however, markets in part-livers and single corneas from living vendors are beginning to
emerge in Southeast Asia.
This paper continues my discussion (Scheper-Hughes 2000b, 2001a, 2001b, 2002) of the darker side of
transplant practice. In all, three crucial points about the organs trade have emerged. The first is about
invented scarcities and artificial needs within a new context of highly fetishized ‘fresh’ organs.
The scarcity of cadaver organs has evolved into an active trade in ‘surplus’ organs from living ‘ suppliers’
as well as in new forms of ‘biopiracy’. The second point concerns the transplant rhetoric of altruism
masking real demands for human sacrifice. The third point concerns surplus empathy and the
relative visibility of two distinct populations – excluded and invisible organ givers and included and
highly visible organ receivers. We have found almost everywhere a new form of globalized
‘apartheid medicine’ that privileges one class of patients, organ recipients, over another class of
invisible and unrecognized ‘non-patients’, about whom almost nothing is known – an excellent
place for a critical medical anthropologist (Scheper-Hughes 1990) to begin.
The impact is multiple scenarios for extinction---it’s try or die for a radical
reconceptualization of politics.
Adrian Parr, Associate Professor of Philosophy and Environmental Studies at University of Cincinnati,
The Wrath of Capital: Neoliberalism and Climate Change Politics, ‘13
A quick snapshot of the twenty-first century so far: an economic meltdown; a frantic sell-off of public
land to the energy business as President George W Bush exited the White House; a prolonged, costly,
and unjustified war in Iraq; the Greek economy in ruins; an escalation of global food prices; bee
colonies in global extinction; 925 million hungry reported in 2010; as of 2005, the world's five hundred
richest individuals with a combined income greater than that of the poorest 416 million people, the richest
10 percent accounting for 54 percent of global income; a planet on the verge of boiling point ; melting ice
caps; increases in extreme weather conditions; and the list goes on and on and on.2 Sounds like a ticking
time bomb, doesn't it? Well it is. It is shameful to think that massive die-outs of future generations will put
to pale comparison the 6 million murdered during the Holocaust; the millions killed in two world wars; the
genocides in the former Yugoslavia, Rwanda, and Darfur; the 1 million left homeless and the 316,000
killed by the 2010 earthquake in Haiti. The time has come to wake up to the warning signs.3 The real
issue climate change poses is that we do not enjoy the luxury of incremental change anymore. We
are in the last decade where we can do something about the situation. Paul Gilding, the former head of
Greenpeace International and a core faculty member of Cambridge University's Programme for
Sustainability, explains that "two degrees of warming is an inadequate goal and a plan for failure;' adding
that "returning to below one degree of warming . . . is the solution to the problem:'4 Once we move higher
than 2°C of warming, which is what is projected to occur by 2050, positive feedback mechanisms will
begin to kick in, and then we will be at the point of no return. We therefore need to start thinking very
differently right now. We do not see the crisis for what it is; we only see it as an isolated symptom that
we need to make a few minor changes to deal with. This was the message that Venezuela's president
Hugo Chavez delivered at the COP15 United Nations Climate Summit in Copenhagen on December
2009, when he declared: "Let's talk about the cause. We should not avoid responsibilities, we should not
avoid the depth of this problem. And I'll bring it up again, the cause of this disastrous panorama is the
metabolic, destructive system of the capital and its model: capitalism's The structural conditions in which
we operate are advanced capitalism. Given this fact, a few adjustments here and there to that system are
not enough to solve the problems that climate change and environmental degradation pose.6
Adaptability, modifications, and displacement, as I have consistently shown throughout this book,
constitute the very essence of capitalism. Capitalism adapts without doing away with the threat. Under
capitalism, one deals with threat not by challenging it, but by buying favors from it, as in voluntary carbonoffset schemes. In the process, one gives up on one's autonomy and reverts to being a child. Voluntarily
offsetting a bit of carbon here and there, eating vegan, or recycling our waste, although well intended, are
not solutions to the problem, but a symptom of the free market's ineffectiveness. By casting a scathing
look at the neoliberal options on display, I have tried to show how all these options are ineffective. We
are not buying indulgences because we have a choice; choices abound, and yet they all lead us down
one path and through the golden gates of capitalist heaven. For these reasons, I have underscored
everyone's implication in this structure-myself included. If anything, the book has been an act of
outrageoutrage at the deceit and the double bind that the "choices" under capitalism present, for there is
no choice when everything is expendable. There is nothing substantial about the future when all you
can do is survive by facing the absence of your own future and by sharing strength, stamina, and
courage with the people around you. All the rest is false hope. In many respects, writing this book has
been an anxious exercise because I am fully aware that reducing the issues of environmental degradation
and climate change to the domain of analysis can stave off the institution of useful solutions. But in my
defense I would also like to propose that each and every one of us has certain skills that can contribute to
making the solutions that we introduce in response to climate change and environmental degradation
more effective and more realistic. In light of that view, I close with the following proposition, which I mean
in the most optimistic sense possible: our politics must start from the point that after 2050 it may all
be over.
The alternative is to vote negative to endorse a radical break from neoliberal
market society---we should use educational spaces to create networks of
resistance to capital.
Henry Giroux, currently holds the Global TV Network Chair Professorship at McMaster University in the
English and Cultural Studies Department and a Distinguished Visiting Professorship at Ryerson
University, “Beyond Savage Politics and Dystopian Nightmares” ‘13
Right-wing market fundamentalists want to root out those considered defective consumers and citizens,
along with allegedly unpatriotic dissidents. They also want to punish the poor and remove their children
from the possibility of a quality public education. Hence, they develop schools that are dead zones of the
imagination for most children and highly creative classroom environments free of the frenzy of empiricism
and test-taking for the children of the rich. It gets worse. In Pennsylvania, right-wing Gov. Tom Corbett
and Philadelphia Mayor Michael Nutter are intent on destroying the public school system. Instead of
funding public schools, Corbett and Nutter are intent on crushing the teachers union and supporting
vouchers and charter schools. They also are fond of claiming that money can’t help struggling public
schools as a pretext for closing more than 23 schools “while building a $400 million state prison.”[xv] As
Aaron Kase reports, “Things have gotten so bad that at least one school has asked parents to chip in
$613 per student just so they can open with adequate services, which, if it becomes the norm, effectively
defeats the purpose of equitable public education, and is entirely unreasonable to expect from the city’s
poorer neighborhoods.”[xvi] Vouchers and under-regulated charter schools have become the
unapologetic face of a vicious form of casino capitalism waging war on the imagination while imposing a
range of harsh and punitive disciplinary methods on teachers and students, particularly low-income and
poor white minorities.[xvii] The vast stores of knowledge and human creativity needed by young people to
face a range of social, economic and political problems in the future are not simply being deferred, they
are being systematically destroyed. When the emancipatory potential of education does emerge, it is
often couched in the deadening discourse of establishing comfort zones in classrooms as a way of
eliminating any pedagogy that provokes, unsettles or educates students to think critically. Critical
knowledge and pedagogy are now judged as viable only to the degree that they do not make a student
uncomfortable. There is more at stake here than the death of the imagination; there is also the elimination
of those modes of agency that make a democracy possible. In the face of such cruel injustices,
neoliberalism remains mute, disdaining democratic politics by claiming there are no alternatives to
casino capitalism. Power in the United States has been uprooted from any respect for public value, the
common good and democratic politics. This is not only visible in the fact that 1 percent of the population
now owns 40 percent of the nation’s wealth or took home “more than half of the nation’s income,” it is also
evident in a culture that normalizes, legitimates and thrives in a politics of humiliation, cruelty, racism and
class discrimination.[xviii] Political, moral and economic foundations float free of constraints. Moral and
social responsibilities are unmoored, free from any sense of responsibility or accountability in a
permanent war state. Repression is now the dominant mantra for all of society. As Zygmunt Bauman and
David Lyons point out, the American public has been turned into “ security addicts,” ingesting mistrust,
suspicion and fear as the new common sense for a security state that seems intent on causing the
death of everything that matters in a democracy.[xix] The surveillance state works hard to not only
monitor our phone conversations or track our Internet communication but to turn us into consumers,
ratchet up the desire to be watched, and enforce new registers of social exclusion between those inside
and outside the official temples of consumerism, social rights and captainship itself. Confining, excluding
and vigilantism is one register of the new face of authoritarianism in the US. As America enters a
historical era dominated by an authoritarian repressive state, the refugee camp as a symbol of exclusion
and suffering is everywhere, visible in the material encampments for the homeless, urban ghettoes, jails,
detention centers for young people, and in the tents propping up alongside highways that hold the new
refugees from the suburbs who have lost their jobs, homes and dignity. The refugee camp also has
become a metaphor for those who question authority, because they are increasingly rendered stateless,
useless and undesirable. Critical thought is now considered dangerous, discomforting and subject to
government prosecution, as is evident in the war being waged against whistleblowers in the name of
national (in)security.[xx] The technologies of smart missiles hunt down those considered enemies of the
United States, removing the ethical imagination from the horror of the violence it inflicts while solidifying
the “victory of technology over ethics.”[xxi] Sorting out populations based on wealth, race, the ability to
consume and immigration status is the new face of America. The pathologies of inequality have come
home to roost in America.[xxii] Moreover, as suffering increases among vast swaths of the population,
the corporate elite and rich use the proliferating crises to extract more wealth, profits and resources.[xxiii]
Crises become the new rationale for destroying the ideologies, values and institutions that give power to
the social contract. [xxiv] The ethos of rabid individualism , hyper-masculinity and a survival-of-thefittest ethic has created a society of throwaways of both goods and people. The savage ethic of
economic Darwinism also drives the stories we now tell about ourselves. The state of collective
unconsciousness that haunts America has its deepest roots not only in the writings of Friedrich Hyek, Ayn
Rand, Milton Friedman and other neoliberal philosophers but also in the increasing merging power of
private-sector corporations that, as John Ralston Saul has argued, has its roots in the “anti-democratic
underpinnings of Fascist Italy in particular, but also of Nazi Germany.”[xxv] Today this “corporatism [is]
so strong it that it has taken the guts out of much of daily democratic life.”[xxvi] Combined with the power
of the national surveillance state, it is fair to say, again quoting Saul, that “corporatism, with all of the
problems attached to it, is digging itself ever deeper into our society, undermining our society.”[xxvii]
Clearly, those words echoed a few years ago were not only prescient but vastly underestimated the
growing authoritarianism in the United States, in particular. We now live in a society in which leadership
has been usurped by models of corporate management, self-interest has triumphed over the ethical
imagination, and a respect for others is discarded for the crude instrumental goal of accumulating capital,
regardless of the social costs . Intellectuals in too many public spheres have become either
dysfunctional or they have sold out. Higher education is no longer the city on the hill. Instead it has
become a corporate boardroom/factory in which Bill Gates wannabes govern the university as if it were
an outpost of Wall Street. Outside of the boardrooms, intellectual violence prevails aimed largely at
faculty and students, who are reduced to either grant writers or consumers. To make matters worse
academic knowledge is drowning in firewalls of obtuseness, creating a world of dysfunctional intellectuals,
at least those who have tenure. Those who don’t have such security are tied to the harsh rhythm and
rituals of contingent subaltern labor and barely make enough money to be able to pay their rent or
mounting debts - never mind engage in teaching critically and creatively while writing as a sustained act
of dissent. At the same time, the wider culture is sinking under a flood of consumer and celebrity idiocy.
There are some who suggest that such critiques of the growing authoritarianism and repression in
American society are useless and in the long run do nothing more than reinforce a crippling
dystopianism. I think this line of argument is not only wrong but complicitous with the very problems it
refuses to acknowledge. From a left suffocating in cynicism, there is the argument that people are already
aware of these problems, as if neoliberal hegemony does not exist and that its success in building a
consensus around its ideology as a mode of common sense is passé. At the same time, liberals detest
such criticism because it calls into question the totality of American politics rather than focus on one
issue and gestures toward a radical restructuring of American society rather than piecemeal and
useless reforms. The call for such a restructuring rather than piecemeal reforms sends liberals into fits of
hysteria. Of course, the right in all of its varieties views criticism as a virus that destroys everything they
admire about America - a society in which democracy has been eviscerated and largely benefits the top
ten percent of the population. Most importantly, the banality of evil lies less in the humdrum cruelty of
everyday relations but in its normalization, the depolicitizaton of culture, and, at the present moment, in
the reproduction of a neoliberal society that eradicates any vestige of public values, the ethical
imagination, social responsibility, civic education and democratic social relations. The enemy is not a
market economy but a market society and the breakdown of all forms of social solidarity that inform
democratic politics and the cultural, political and economic institutions that make it possible. The
authoritarianism that now shapes American society is not a matter of fate but one rooted in organized
struggle and a vision built on the recognition that there are always alternatives to the existing order that
speak to the promise of a democracy to come. The contradictions of neoliberalism are unraveling, but
the consensus that informs it is alive and well. And it is at that level of educational intervention that the
war against market authoritarianism in all of its diverse forms has to be fought first . Commonsense has
become the enemy of critical thought. Hope is no longer part of the discourse of the left, only a dreary
sense of despair with no vision of how to imagine a radical democracy. Manufactured ignorance has
become a virtue instead of a liability in a society ruled by the financial elite. And as such we have no
serious crisis of ideas. Instead, we have a crisis of power relations and structures that needs a new
political language if it is to be contested at the level of both a pedagogical and political struggle. The
current neoliberal drive to ruthlessly extend the never-ending task of accumulating capital is matched only
by its ruthless determination to produce a notion of common sense that reinforces the idea that there is
no way to think beyond the present system. The American public needs to break the authoritarian
dysimagination machine that affirms everyone as a consumer and reduces freedom to unchecked selfinterest while reproducing subjects who are willingly complicit with the plundering of the environment,
resources and public goods by the financial elite. Class and racial warfare are alive and well in the United
States. In fact, racism and the class warfare waged by right-wing politicians, bankers, hedge fund
managers and the corporate rich are intensifying. Americans need to reject a politics in which public
goods are demonized and eradicated, African-American youths become the fodder for wars abroad and
the military-prison-industrial complex, the underclass disappears, public servants are disparaged, youths
vanish into debt and despair, and the middle class passes into oblivion. While politics must be connected
to its material moorings, it is not enough to imagine a different future than the one that now hangs over us
like a suffocating sandstorm. Those intellectuals, workers, young people, artists and others committed to
a radical democracy need to develop a new vocabulary about how to think about the meaning of
politics, human agency and the building of a formative culture through which organized collective
struggles can develop in the effort to imagine a new and more democratic future.
1NC CP
The United States should
- Implement a strict presumed-consent policy for organ donations, protected by a tort of strict
liability
- Substantially increase public education programs about organ donation
- Establish financial incentives and governmental regulations for the for-profit private-sector
procurement of organs, and consolidate and centralize OPOs as appropriate
- Implement a priority allocation scheme under which registered donors are granted priority in the
event that they need an organ donation.
Strict presumed consent solves the Aff
Glaser 5 (Glaser, Sheri R., J.D. candidate at the Washington College of Law, "Formula to Stop the
Illegal Organ Trade: Presumed Consent Laws and Mandatory Reporting Requirements for Doctors."
Human Rights Brief 12, no. 2 (2005): 20-22.,
http://digitalcommons.wcl.american.edu/cgi/viewcontent.cgi?article=1311&context=hrbrief, ZBurdette)
APPROXIMATELY 15 TO 20 NATIONS have enacted presumed consent laws for organ donation. These
laws are intended to produce a surplus of organs for transplant surgery, establish equity in the
distribution of organs, and end any illicit trade in organs. They essentially create situations where
people must opt-out of being an organ donor, rather than opt-in, as in the United States and other
countries.
These laws vary in terms of their strength. For example, many of the European laws are weaker, meaning
they have easy opt-out provisions. In France the family is given an opportunity to stop the donation, even
if the deceased expressed his or her desire to be an organ donor. Where the system of presumed
consent is weak, it does not increase organ supply to the point of meeting demand. Instead, those
systems operate like the opt-in system in the United States because people who would have chosen to
remain a non-organ-donor in the United States may stop a family member’s donation and opt themselves
out of being organ donors. Such systems do not effectively increase the supply of organs.
In contrast , Brazil’s Presumed Organ Donor Law is an example of a strict presumed consent law,
where it is more difficult to opt-out. The law defines all Brazilian adults as universal organ donors unless
they officially declare themselves “non-donors of organs and tissues.” In order to opt-out, citizens must
have “non-donor of organs and tissues” permanently stamped on their civil identity card or driver’s
license. Citizens must pay for their documentation, which presents an economic hardship and thus a
major hurdle for many in Brazil. Additionally, citizens must navigate various bureaucratic obstacles in
order to opt-out. For example, authorities reportedly told Maria Celestina de Oliveira Pinto, adomestic
worker in Sao Paulo, that she was not allowed to declare herself a non-donor when she went to get her
new documents. She reportedly had to wait in line four times and argue before she received a “non”
before the word “donor” on her card.
Though strict presumed consent laws effectively increase supply, they may create unfair hardships
on those individuals who wish to opt-out. States that pass strict presumed consent laws should make the
process by which citizens opt-out free of charge and simpler than Brazil’s system.
IMPACT OF PRESUMED CONSENT LAWS
Presumed consent, when the state strictly follows it, is the best-practice method of legally obtaining
organs. In countries with presumed consent laws, there is a higher procurement rate for organs than in
countries without these laws. Many argue that if the demand for organs were met legally, then people
would have less incentive to illegally obtain organs and the black market would eventually diminish. On a
more basic level, if there were more organs available for transplant, then more people’s lives would be
saved.
In addition, presumed consent leads to improvements in tissue matching between donor organs
and recipients, and it allows surgeons to be more particular about which organs are selected.
Furthermore, these laws allow for more careful application of brain-death criteria because the
increased supply of donor organs diminishes incentive to obtain organs through “inappropriate”
means. For example, there have been cases in Russia and Argentina where organs were removed from
comatose patients who were prematurely declared brain-dead. Presumed consent also ensures that
organs are “fresher” because it eliminates the doctor’s need to contact the deceased’s next of kin,
thus shortening the time between death and determination of consent. Lastly, the decision as to whether
or not to donate organs is not made during the grieving period immediately following someone’s death.
Financially, presumed consent lowers costs on the part of the government. For example, in the
United States, with a federally funded dialysis program, the cost of a kidney transplant, taking into
account the cost per year after the transplant for further medical care, is less than the yearly cost of
dialysis. One could reasonably argue that, as kidney transplants become even more commonplace, the
costs will continue to fall. If a nation has a system of presumed consent and has more organs available
for transplants, then that nation will presumably be performing more transplants and will have fewer
patients on dialysis, thus lowering government costs.
And procurement reform is key
Beard 13 [T. Randolph Beard (Professor of Economics—Auburn University), David L. Kaserman
(Torchmark Professor of Economics at Auburn University), Rigmar Osterkamp (Researcher—Munich
University of Applied Sciences), “The Global Organ Shortage: Economic Causes, Human Consequences,
Policy Responses”, p. 100-103, 2013]
In the United States, as in other countries, the procurement of organs for¶ transplantation is a public
function, entrusted to monopsonistic, nonprofit au-¶ thorities. Among the provisions contained in the
1984 National Organ Trans-¶ plantation Act (NOTA) in the United States, for example, is one that
created¶ a set of regional organ procurement organizations ( OPOs) and established the¶ market
structure under which they would operate. (The German equivalent,¶ the Deutsche Stiftung Organ
transplantation, has a very similar structure, although¶ it is nationally unitary.) From the economic
perspective, these structures ex-¶ hibit two important characteristics. First, each of the 58 U.S. regional
OPOs is¶ assigned an exclusive geographic territory within which it could conduct its¶ activities.
These territories vary considerably in size, both in geographic scope¶ and population served. For
example, large OPOs serve parts of California (One¶ Legacy Transplant Donor Network in Los Angeles,
17.5 million persons) and¶ multiple states in New England (New England Organ Bank, 11.1 million per-¶
sons), while smaller, sparsely populated states are often serviced by much smaller¶ networks, as in New
Mexico (New Mexico Donor Services, 1.8 million) or¶ Nebraska (Nebraska Organ Retrieval System, 1.6
million). These assignments¶ of exclusive territories provide each OPO a "monopsony " (monopoly
on the buyer side of the market) over all organ procurement activities within its region. As a
consequence, competition among procurement organizations in primary donor recruitment is
limited.
The NOTA also established the financial incentive system under which these monopsony OPOs must
operate. In particular, these organizations are legally (private) nonprofit entities. This status has
several practical implications under the laws of the United States and most other countries. First, the
OPOs do not have ownership rights that are tradable, implying that there cannot be a conventional
market for the residual rights to income of the organizations. Hence, OPOs are not subject to
market-launched "takeovers," nor is it necessarily a simple matter for outsiders to judge the
performance of an OPO management.' Additionally, the selection of managers is made by
volunteer boards whose incentives and abilities to evaluate OPO performance may be weak.
A detailed review of these features of the U.S. organ procurement apparatus can be found in Barnett and
Kaserman (2002), so our treatment here is brief and generic. Nevertheless, these features are informative
because, with few significant exceptions, they are duplicated in all the other countries.
Consider first the geographic monopsony feature. Due to this structure, the pressure to improve
performance (i.e., lower costs and/or increase output) that is normally found in the competitive
setting is eliminated. While a few organs are transported between OPOs, there is no head-to-head
competition among OPOs at the acquisition stage. In terms of Figure 5.1, this means that the factual
quantity Q0 may be lower than some maximum feasible number that could be acquired—even at the
zero price. That this is indeed the case is overwhelmingly supported by a variety of evidence from
numerous sources. For example, the Organ Donation Breakthrough Collaborative (ODBC), discussed at
greater length in Chapter 6, is itself predicated on the existence of such inefficiencies, which it seeks to
eliminate. Plainly, OPO organ procurement rates (defined with respect to hospital deaths, for example)
vary greatly in the United States, sometimes by a factor of ten. These differences are analyzed at
length by Beard, Kaserman, and Saba (2005), who show that such variations are significantly related
to variations in OPO efficiency. Thus, U.S. OPO performances vary dramatically, a result not
inconsistent with the lack of any sort of ordinary competition among these organizations.
Priority allocation solves the shortage – majority of the population is ambivelant
towards donation AND the CP flips presumption towards donation
Kolber 3 – law professor @ Brooklyn Law School
Adam J., “A MATTER OF PRIORITY: TRANSPLANTING ORGANS PREFERENTIALLY TO
REGISTERED DONORS” Rutgers Law Review Vol 55 No 3 Pgs 671-739 //
The principal reason to institute a priority allocation scheme is purely instrumental-doing so will
increase the organs available to all. The altruistic motivation to donate has proven itself woefully
insufficient, and while many preach that it should be sufficient, people on organ waiting lists are
dying at an average rate of sixteen per day in the United States.'27¶ Many people are ambivalent
about donating and could be convinced to donate with just a small incentive to help them overcome
the inertia which protects us from mulling over our own mortality. Though we need more empirical
research, it is quite likely that if registered donors were granted priority to receive organs, we would
sway many more people into the willing-donor category.128¶ The benefits of registering under a
priority incentive program clearly exceed the costs. Even after registering, it is extremely unlikely
that a registrant will donate organs because it is rare to die with organs medically eligible for
transplantation. We have far more organ recipients than donors because each body used in
transplantation provides organs to several individuals. 9 Under a priority scheme, potential donors
can make the trade off between the very remote possibility of becoming an organ donor and the
not-quiteso remote possibility of needing an organ. Understandably, neither the role of donor nor
recipient is particularly appealing to think about. If you are in the latter category, your life is
threatened, and if you are in the former category your life is over. But, under a priority system, you
have an incentive to register because you are more likely to be rewarded by the system than made
to contribute to it.¶ More importantly, the actual rewards of registering under a priority scheme (and
thereby increasing one's life expectancy) far outstrip the costs, if any, of having some organs
removed after death. Despite the discomfort one may have about registering to donate, an actual
donation will only be made when one is dead and unaware, while the process of needing an organ
occurs only while one is alive and usually very much aware.
1NC BIO PRINTING DA
The aff’s compensation system reverses the direction of current jurisprudence
and necessarily requires common law to recognize property rights for the body
Laurel R. Siegel 2K, JD Candidate, Emory University School of Law, “Re-Engineering the Laws of
Organ Transplantation,” Summer 2000, 49 Emory L.J. 917, Lexis
2. Compensation Systems
Compensation systems would change the nature of altruistic organ donation. The theory states that people may
be more willing to provide organs if they receive compensation . n283 Several types of compensation systems
have been proposed, each attacking the organ shortage in a slightly different way, but with the same ultimate goal - to provide
Compensation systems require development of common law to increase the property
rights of individuals after death . Additionally, a compensation system could only go into effect if
NOTA and the 1987 UAGA amendments are repealed or amended. n284 NOTA, however, allows all other
remuneration.
participants in the organ procurement and transplantation process, except the donor, to receive compensation. Arguably, the donor
should receive compensation as well.
Compensation systems have several advantages. First, they help to make up for the organs wasted under the donative system.
n285 Second, if a person sells his organs, there may be less emotion and tension involved than if an altruistic donation was made
out of love or guilt. n286
Primarily, dissatisfaction with the proposed compensation systems concerns the lack of the customary altruism. n287 Critics fear
that the lack of altruism would upset society as well as reduce the organ supply. n288 Selling organs would take away from the
traditional notion of providing a generous act in the face of tragedy. n289 Allowing sales of organs encroaches into a sacred area
where such sales are controversial. The notion of profiting from the sales of body parts is repulsive to many. Critics of compensation
systems have a serious concern with coercion of the poor. n290 Destitute people, who otherwise might not chose to donate organs,
might feel compelled to sell their organs. n291 Another concern involves the allocation of organs. Under a compensation [*951]
system, those who could afford organs would have a greater chance of receiving them. n292 Finally, allowing sales of organs could
promote family strife due to pressure to sell organs. n293
a. Inter Vivos Market for Organs
In an inter vivos organ market, organs would be considered an ordinary commodity to be sold for a profit. System regulators would
have to decide where to draw the line - selling non-essential organs such as kidneys versus selling essential organs such as the
heart. The theory for such a system is based on the notion that all parties in the organ donation process are compensated, thus the
donor should be included as well. n294
Creating a market for organs may actually fail to increase the supply because otherwise altruistic donations may be curtailed. n295
It also risks offending many citizens and takes advantage of the poor who may not otherwise choose to donate or sell organs.
b. Futures Market
A less controversial version of a compensation system is a futures market. A futures market would allow healthy
individuals during life to contract for the sale of their body tissue for delivery after their death. n296 Under this
regime, if the donor's organs are successfully harvested and transplanted, the donor's estate would receive
payment. n297 Like the current donation system, people would sign donor cards, but unlike the current system, the donor or
vendor would receive compensation. n298 Proponents of this system claim it avoids ethical problems. First, by not using
live donors, proponents claim it does not exploit the poor. n299 Second, the system does not deal with allocation so the [*952] rich
will not have greater access to organs than the poor. n300 Third, people will be selling their own organs, so relatives will not have to
participate. n301
This system requires creating and legally enforcing property rights in the decedent's body . This
system is only hypothetical and has not yet been attempted in any jurisdiction. If implemented in the current system, it would clearly
violate NOTA, because it involves sales of organs. In addition, it might exploit the poor because only the poor would have incentive
to sell their organs, unless the price was high enough for moderately wealthy individuals to be interested. Even though the system
does not deal with allocation, the poor will naturally be discriminated against because they may be unable to afford the organs if
Medicaid or other government assistance does not cover them.
c. Death Benefits
A death benefits system, while not market-based, is a third type of compensation system. Such a system would merely provide
incentives to relatives of the decedent in exchange for donating the decedent's organs. n302 Examples of incentives include estate
tax deductions, funeral expense allow-ances, and college education benefits. n303 As illustrated above, Pennsylvania is
experimenting with a death benefits system in its newly enacted legislation. n304
Proponents argue that a death benefits system does not conflict with the current altruistic system. n305 Proponents also assert that
a death benefits system does not violate NOTA's prohibition of organ sales, because Congress did not intend to include this kind of
compensation. n306 With respect to the Pen-nsylvania law, proponents claim funeral expenses could be a reasonable expense
exempted from the NOTA prohibition. n307 They claim that because money does not go directly to donors or beneficiaries, the
payment is not technically for organs. n308 Opponents claim that a death benefits system con-stitutes the sale of organs; indirect
compensation is given in exchange for one's [*953] organs. This proposal, set up as a pilot program administered by individual
states, is promising.
B. Suggestions
First, solutions must be found for the problems of the current system, in which an outright market is inappropriate, but in which
incentive programs and public health education could serve as successful boosts to the organ supply. For the second stage, after
technology alters the status and supply of organs, society can plan a solution for the future. Only at that point could a full-fledged
market be an acceptable, ethical medium to exchange organs.
1. The Current System
As illustrated above, problems are inherent in the current organ transplantation system. Society must cope with the problems as
they exist today, using currently available technology and resources. The best way to address the immediate organ shortage is to
administer pilot programs providing incentives for organ donations, following the lead of Pennsylvania. Congress should propose an
Amendment to NOTA that would allow the Department of Health and Human Services to oversee pilot programs. Compensation
would rise incrementally, beginning with small payments, such as funeral expenses or hospital bills. The prohibition of sales of
organs should remain in place for live organs because allowing sales of live organs jeopardizes existing life and brings into play
many ethical issues. Thus, the amendment would only apply to organs of decedents.
In addition to avoiding the ethical problems inherent in a market for organs, allowing an incentive system would probably increase
awareness of donation, increase actual donation, and fairly and tactfully compensate the donor. The approach is an important
bridge to the future when engineered organs will make compensation systems viable. Most importantly, more patients, who would
otherwise die, will benefit from receiving life-saving organs.
Organ donation does not have to be perceived as a grim, avoidable topic; donating organs transforms death into a positive
experience - essentially bestowing the gift of life. In addition to the pilot programs, governmental efforts should focus on public
health education. If the public is made more aware of the plight, the decision to donate organs would be made prior to death. This
tactic would avoid difficult, uncomfortable situations for families and doctors, which often prevent donation. Many states already
have [*954] implemented organ donor awareness funds, funded through donations when renewing driver's licenses or filing taxes.
n309 Similar programs must be established. Public health officials should talk to high school students about organ donation. Special
task forces could explain the organ transplant system to people, in the form of television commercials or advertisements in
magazines. The erection of billboards with organ donation messages would implant the seed in people's minds.
2. The Future System
The current solution only affects organs from decedents. In the foreseeable future, technology will create live organs from existing
cells and biodegradable scaffolds. When that occurs, the organ shortage will no longer be a problem. But in order to have potentially
unlimited organs, cell donation must occur. This may eventually be done individually at birth, but phased in by adults contributing to
a generic pool. Will these donors be compensated for their pre-organ donation? The donation of cells differs from a functioning
organ and probably lies outside of organ transplantation laws. Most likely, providing compensation for this stage would be allowable
and beneficial. An individual donating his cells would face no risk to his health by donating. Fewer ethical issues are involved.
Therefore, for
the organ system of the future, allowing incentives to donors is a sound idea. This can only
become a reality if the common law develops, allowing a property right in live tissue and organs .
This will be established in the marketplace as long as common law and statutory law do not prohibit
sales.
That wrecks biotech research
Spinello 4 – Clinical Associate Professor @ Carroll School of Management at Boston College
Richard A., “Property rights in genetic information” Ethics and Information Technology 6:29–42 //
It is axiomatic, therefore, that a property right will efficiently protect the interests of patients and
donors. But, despite the laudable intentions embodied in this property rights approach to genetic
source material, there are notable disadvantages and externalities. The major problem with the
adoption of a property rights regime for genetic information is economic ineffi- ciency. Fragmented
property rights in the genetic data coming from multiple sources would require a substantial
integration effort if that data were needed for a particular research project. The higher trans- action
costs imposed by a property regime would almost certainly constitute an obstacle for biomedical
research. A market which recognizes these ‘‘up- stream’’ property rights, such as monopolistic
patents for genes or proprietary rights in genetic data, would function by licensing this ‘‘property’’ to
downstream researchers and biotech firms which are working to develop treatments of genetically
based diseases and diagnostic tools. Consider the impediments to that downstream research such
as the negotiations with multiple owners required by this property regime, the payment of licensing
fees to these owners, the likeli- hood that some of the owners will act opportunisti- cally and hold
up the project. All of this will greatly inhibit research and increase the cost of important end
products . Thus, the adverse social and economic effects of recognizing these rights seems
beyond dis- pute. But what does the law have to say about the property rights of sources? ¶ In the
most pertinent legal case of Moore v. Re- gents of California 22 the California Supreme Court
rejected Moore’s claim that his property right had been violated when doctors did not share the
com- mercial gains they had obtained through the use of his surgically excised spleen cells. A key
issue in this case was whether or not Moore owned his human tissue source along with the genetic
information co- ded into his cells, but the court concluded that he did not have a valid ownership
claim. The court’s ratio- nale was that the bestowal of such a property right would hinder scientific
research: ‘‘this exchange of scientific materials, which is still relatively free and efficient, will surely
be compromised if each cell sample becomes the potential subject matter of a lawsuit’’ ( Moore v.
Regents of California , 1990). The court was worried that the nascent biotechnology industry would
be irreparably harmed if researchers were forced to ‘‘investigate the consensual pedigree of each
human cell sample used in research’’ ( Moore v. Regents of California , 1990). In making its
decision the Moore court at least implicitly rejected the claim that researchers were bound to share
the sometimes ample rewards of that research with those who con- tribute human tissue (or other
samples) like Mr. Moore.¶ The problem, underscored in the Moore decision, is that society has a
critical interest in stimulating biomedical research. And this includes the kind of research that is
being conducted by deCODE Genetics. As Harrison 23 observes, progress in bio- technology
research will become ‘‘unduly burdened by the existence of too many intellectual property rights in
basic research tools.’’ Property held in common is subject to a ‘‘tragedy of the commons,’’ since
individual incentives are often at variance with the collective good. Each individual’s marginal
exploitation of some common property (such as a fertile track of land) ultimately destroys that property. But if we effectively remove valuable scientific data from the intellectual commons through the
assignment of proprietary rights we get the opposite of a tragedy of the commons, that is, a tragedy
of the anti-commons. 24 In this case too few resources are held in common and researchers are
blocked from using source material (such as genes or genetic data) that have become privatized
unless they negotiate with a multiplicity of owners. The rights of usage become so fragmented that
it is virtually impossible to conduct productive research. The end result is an unfortunate
suboptimal underconsumption of human genetic material, and that material is obviously criti- cal for
the development of downstream products such as diagnostic tests and gene therapies.¶ There is
considerable risk, therefore, that excessive ownership of information inputs, such as genetic data,
and other source material will impose high costs and formidable burdens on the flow of critical scientific information. Biomedical research depends upon the open availability of genetic data
resources so long as privacy is ensured. High transaction costs and perverse anti-commons effects,
however, will undermine that availability if property rights are granted. Also, while ownership might
result in some compensation for those individuals who license their genetic sequences or sell their
genetic information, that compensation will be trivial in most cases, and it will be far offset by the
social good of better health- care that will be realized by research efforts unen- cumbered by these
transaction costs.¶ One of the ironies of the Moore case, however, is that the court seemed to
contradict itself. It refused to recognize a property right for Moore in the name of research but it
concluded that the collectors of genetic data would need such a property right (in the form of a
patent) as an incentive. Otherwise, the Court rea- soned, ‘‘the theory of liability that Moore urges us
to endorse threatens to destroy the economic incentive to conduct important medical research’’ (
Moore v. Re- gents of California , 1990). As Boyle 25 points out, the notion that ‘‘property rights must
be given to those who do the mining [of genetic material]’’ is indicative of the ‘‘doctrinal chaos’’ of
intellectual property law.¶ DNA material including genes, gene fragments (called expressed
sequence tags or ESTs), and related products, are considered to be patentable subject matter. The
Patent Act does not cover ‘‘the gene as it occurs in nature’’ (Utility Examination Guidelines), 26 but
when a gene has been isolated and purified it is considered to have been modified. This makes it a
‘‘new composition of matter’’ eligible for patent protection. This conclusion seems consistent with
the U.S. Congress’s apparent intention that the patent statute cover ‘‘anything under the sun that is
made by man’’. 27 Three types of patents are possible: structure patents, covering the isolated and
purified gene; function patents, covering a new use for the DNA in question (such as a diagnostic
test or gene therapy); and process patents which cover a new method of isolating, purifying, or
synthesizing this DNA mate- rial. 28¶ The patentability of genetic material such as DNA sequences
is an intricate and complex issue. Sup- porters of those patents argue that without the incentive of
patents the genome will not be ade- quately exploited by researchers. Opponents such as Hettinger
29 argue against patents out of respect for life, which should not be the subject of patents. The
source or raw material for the gene patents is human tissue, and some ethicists claim that patents
should not be given for human material.¶ The validity and scope of patent protection in the human
genome is a question we cannot settle here. But the issue of gene patentability is analogous to the
question of ownership of an individual’s genetic information and deserves some treatment. What is
particularly significant in the Moore decision is the claim that ‘‘private ownership of genetic
materials could dull the pace of medical innovation’’. 30 We have argued that this principle should
apply to the ultimate sources, that is, patients and donors sup- plying genetic information and raw
material (such as human tissue). But it should also apply to a limited extent to third party
researchers and their claims for human gene patents.¶ As we have observed, the problem is that
sub- stances which are upstream in the research cycle must be made easily accessible for
downstream research. According to Horn, 31 ‘‘This kind of information is considered basic research
and provides the data that is necessary for making end products such as drugs, diagnostic tests,
and other treatments based on genes and their products.’’ The gene is a basic tool of re- search,
and according to some critics, seeking an exclusive right to a gene by means of a patent is like
‘‘trying to gain ownership of the alphabet’’. 32 When DNA is abstracted from human tissue or blood
the goal is to produce a gene that functions exactly as it would in the human body. The lab that
does this work can get a patent for this gene or DNA sequence even though the utility of this
‘‘invention’’ is sometimes vague or trivial and the gene in question may be critical for future research
projects conducted by other scientists. We now know, for example, that there are many diseases
caused by defects in multiple genes. According to Pinto (2002), research has shifted from
Mendelian diseases (involving a single gene) to ‘‘polygenic disorders’’ involving several genes. But
under the current system researchers will need to lo- cate the patentees of these genes and pay
royalty fees for doing research. As Horn (2002) points out, ‘‘if the licensing and transaction costs
are too high, these valuable downstream innovations [such as therapeutic and diagnostic products]
will never take place.’’¶ It is a mistake, therefore, to award proprietary rights too far upstream in the
research and develop- ment value chain for biotech products. This includes patents for genes and
gene fragments and it also in- cludes providing property rights in the ultimate source material:
human tissue and the genetic information that it contains. As we have seen, the upshot of granting
such rights is a tragedy of the anti-commons: resources will be under utilized and downstream research and commercialization efforts will be hampered.¶ In addition, loosely awarding proprietary
rights too far upstream in the value chain will most likely raise the cost of downstream innovations.
According to Pollack (2002), about 14 % of the cost of gene therapies is attributable to the royalties
that must be paid to gene patent holders. Those costs will surely increase even further if donors of
DNA samples or participants in genetic studies also demand royalties for therapeutic products
based on their genetic information.¶ It is also worth considering whether or not gene patents can be
justified on a normative basis. For example, are they justifiable when viewed from the perspective of
Locke’s labor-desert theory? Stripped of its subtleties, that theory claims that labor engen- ders a
property right. According to Locke, people engage in labor not for its own sake but to reap its
benefits; as a result, it would be unjust not to let people have these benefits they take such pains to
procure. In short, property rights are required as a return for the laborers’ painful and strenuous
work. As Locke 33 maintains, one who takes the laborer’s property ‘‘desire[s] the benefit of
another’s pains, which he has no right to.’’ In the case of gene frag- ments the labor desert view
provides no support since little labor is involved in sequencing these frag- ments. 34 On the other
hand, sequencing the entire gene is more labor intensive so a patent for a full length gene appears
to be on firmer ground. ¶ But Locke calls for limits on the acquisition of property even when a
property right seems to be commensurate with the labor performed. According to Locke, the
bestowal of a property right should be denied unless there is ‘‘enough, and as good left for others’’
(Locke, 1952). This proviso, when applied to intellectual property, implies that the granting of a
property right should not harm the intellectual com- mons. In this context, awarding an exclusive
entitle- ment will interfere with the research activities of other scientists who will find it difficult to
pursue related or similar research trajectories. As Shaw 35 indicates, there is compelling evidence
that gene patents are having ill-effects on research: ‘‘With genetic patents staking private claims to
huge chunks of [genetic] code, researchers and clinicians are finding their ge- netic research and
diagnostic efforts thwarted by various restrictions imposed by commercial, and in some instances,
academic, patent holders.’’ Given that the commons is impaired by the removal of a gene that has
been patentented, a Lockean justification for genetic patents seems dubious. Arguably, a modified
property right that requires access at a reasonable cost (for example, some form of compulsory
licensing) will resolve this problem and be more consistent with Locke’s liberal philosophy of
property rights.¶ Given the high social costs of strong and broad patent rights, they are also hard to
justify from a utilitarian perspective. There is a case to be made, however, on utilitarian grounds for
some types of gene patents as a basis for stimulating genetic re- search. The American Medical
Association advocates patents on processes used to isolate and purify gene sequences, substance
patents on purified proteins, and gene patents ‘‘only if the inventor has demon- strated a practical,
real world, specific and substantial use (credible utility) for the [gene] sequence’’. 36 Thus,
according to this policy a gene patent would not be awarded as a tool for scientific research but
only in cases where a practical use has been demonstrated. The AMA policy also calls for access
to gene patents by all ‘‘certified laboratories at a reasonable cost’’ so that other researchers will be
able to build upon these innovations (Horn, 2002). These limited genetic pat- ents would preserve
incentives but minimize inter- ference with downstream research initiatives.¶ But what about the
protection of privacy and autonomy rights? Are we sacrificing these basic hu- man goods for the
sake of biomedical research? Absolutely not. We have made a tenable case on utilitarian grounds
that property rights in genetic material are unsound since the social costs are dis- proportionate to
the benefits received. Those costs include the inhibition of research and higher prices for
therapeutic products and genetic screenings. Society benefits tremendously from the enhancement
of human health through biomedical research and when that research is constrained the social
welfare loss (such as undeveloped treatments or genetic screening products) is quite substantial. It
may be that privacy and autonomy are marginally safer with a property right, but, as we will
demonstrate in the next section, sound privacy legislation based on in- formed consent can also be
an effective means of ensuring genetic privacy and autonomy.
Critical to avoid extinction
Noble 13
RONALD K. NOBLE is Secretary General of Interpol, Foreign Affairs, November/December 2013,
"Keeping Science in the Right Hands", http://www.foreignaffairs.com/articles/140157/ronald-knoble/keeping-science-in-the-right-hands
But science still must proceed unhindered. If biological research and the development of new scientific
techniques are not allowed to progress, the very fabric of human existence could be affected .
Diseases will continue to mutate, and without robust scientific research to produce better
vaccines, human health could be endangered. Therefore, all nations should safeguard their sciences
and ensure that future scientific developments generate significant advances for the good of all.
[end of article]
1NC POLITICS
Keystone supporters are courting moderate dems for a veto-proof majority
Colman 12/15
Zack, “Keystone XL: So will it finally get built?” [http://www.washingtonexaminer.com/keystone-so-will-itfinally-get-built/article/2557281?custom_click=rss] //
REPUBLICANS PUSH AHEAD
Republicans say passing legislation to build the pipeline will be a top legislative priority when the
GOP takes control of both chambers in January. They see it as a way to present a contrasting
agenda to Obama, whose administration has been reviewing and stalling on Keystone XL since
2008.¶ "It shows the fundamental difference. You've got the Obama administration that's held up
the project for six years. That is about a $7.9 billion investment, not one penny of federal
government spending. But it creates energy, it creates jobs, it created hundreds of millions in tax
revenue," Sen. John Hoeven said.¶ "It shows the difference in approach," the North Dakota
Republican said.¶ Hoeven is leading the charge to put legislation approving the remaining 1,200
miles of pipeline on Obama's desk early next year.¶ A bill to approve the pipeline failed by one vote
in November, one of the last orders of business for the Democratic-held Senate. GOP lawmakers
think that, with support from centrist Democrats, they could get the 67 Senate votes needed
to override a veto from Obama.¶ Republicans and Democrats who support the pipeline say it will
create a gusher of construction jobs. The State Department said it would support 42,100 direct and
indirect jobs during the two-year construction phase and would boost property tax revenue for
communities along the route. It also would strengthen energy security by getting crude from
Canada, an ally, rather than less friendly nations such as Venezuela.¶ Still, even with Republicans
in the majority, Hoeven is cautious.¶ "I know that we're over 60, but I don't know that we can get to
67," he said. "If he vetoes it, then we can try to attach it to other legislation."¶ Obama likely would
reject any bill that forces his hand on the pipeline, as he has consistently threatened to veto bills
that circumvent the State Department's review. That review is on hold until the Nebraska Supreme
Court rules on whether a new pipeline route the state legislature approved was constitutional. That
decision is expected any day.¶ Congress might have the legal authority to authorize pipeline
construction as the State Department dallies. A 2012 report by the Congressional Research
Service found that doing so "appears likely to be a legitimate exercise of Congress’s constitutional
authority to regulate foreign commerce."¶ The pipeline has become a political albatross around
Obama's neck.¶ It has kept centrist Democrats at odds with the president. A clutch of Democratic
senators who pleaded with Obama to approve the project lost their seats in last month's midterm
elections, as Republicans tied their opponents to the president and his policies. ¶ Many labor unions,
too, have broken ranks with the president over the pipeline because they want the jobs it would
provide.¶ Even environmental groups have largely moved on, at least in the political sense. Several
senators who publicly supported Keystone XL netted official endorsements and funding from the
same green organizations that are trying to kill the project.¶ That has some Keystone XL boosters
thinking that Obama might want to end the whole episode.¶ "I don't expect it's going to have to be a
veto override. I think we can find a way to resolve it with a strong bipartisan vote because there's a
lot of Democrats who would tell the president, 'You know, enough's enough. Let's move on with this
issue.' So I suspect that is what's going to happen," Gerard said.¶ ¶ OBAMA KICKS THE CAN¶
Perhaps that's wishful thinking, considering the political capital Obama has spent
continually punting the project.¶ In August 2011, the State Department released its first final
environmental review of the pipeline, saying it wouldn't significantly alter the Earth's climate. The
announcement came during two weeks of Washington demonstrations against the pipeline that led
to more than 1,200 arrests and elevated Keystone XL into the national conscience. ¶ Three months
later, when he was running for re-election, the president said the State Department needed to
conduct another environmental review to analyze the new pipeline route that Nebraska's legislature
had just approved.¶ The review process hasn't been transparent, and it has faced several delays.
When the review finally came out in January, which largely backed the August 2011 findings, many
hoped for a quick 90-day inter agency review to determine whether the project was in the national
interest. But then the Obama administration said it would wait for the Nebraska Supreme Court
decision before resuming the process.¶ Meanwhile, Obama has made repeated public comments
that appear to side with environmental groups. He has made light of the 35 permanent jobs
Keystone XL is expected to create. He has said he would kill the pipeline if it "exacerbates the
problem of carbon pollution."¶ "It's good for Canada, it could create a couple thousand jobs in the
initial construction of the pipeline. But we've got to measure that against whether or not it is going
to contribute to an overall warming of the planet that could be disastrous," Obama said last week
on "The Colbert Report."¶ A recent remark Obama made during a November speech in Burma
caught the attention of Charles Ebinger, a senior fellow with the Brookings Institution's Energy
Security Initiative.¶ The president contended oil sands piped from Alberta would be exported to
other nations, echoing attacks from environmental groups such as NextGen Climate Action, the
super PAC backed by Tom Steyer, a billionaire former hedge fund manager. But Ebinger said
refineries would be the ideal destination for the oil sands. Drillers sending oil to refineries in the
upper Midwest had to reduce their crude prices last year because of transportation bottlenecks.
And Gulf Coast refineries are equipped to process the heavier crude from the oil sands. ¶ Petroleum
products such as gasoline might be exported, Ebinger said, but much of the oil would remain in the
country.¶ "The fact that he made that statement, to me, is that he believes Keystone isn't important
to the U.S.," Ebinger said.¶ That comment also caught the attention of Deborah Gordon, director of
the Energy and Climate Program with the Carnegie Endowment for International Peace. ¶ "I just
don't know that he's going to put his guns down on this," she said.¶ At this point, it's not clear how
Obama would benefit politically from approving Keystone XL after years of waiting. Congressional
Republicans are unlikely to cut a deal to approve one of the administration's priorities, such as
raising the federal minimum wage, just to get the pipeline through.¶ The same goes for the
increasingly liberal Democratic Party. Keystone XL backers in Alaska, Louisiana, North Carolina
and Arkansas all pushed Obama to approve the project. All of them lost their elections. A Democrat
winning a Senate race in any of those states appears unlikely for some time.¶ "I'm not sure what the
president gains from it at this point, or what the Democratic Party gains in the long term," Ebinger
said. "I think the president would like to punt this indefinitely."¶ Delays are starting to annoy even
Democrats who have opposed the project. Some are starting to speak out against what they
consider disingenuous climate change concerns posed by environmental groups.¶ Sen. Tom
Carper, D-Del., said more progress on climate change is occurring in other arenas. He pointed to a
nonbinding agreement between Obama and Chinese President Xi Jinping on reducing greenhouse
gas emissions beyond 2020, a move that would get the world's top two emitters on the same page
for the first time.¶ "That dwarfs the concerns that we've heard now for a number of years on
Keystone," Carper said recently. "I think the other factor that's working here is we have waited for
not months, but years, to get a decision on Keystone." ¶ Hoeven said he thinks the legislative
style that incoming Senate Majority Leader Mitch McConnell, R-Ky., hopes to install would
smooth passage for a bipartisan Keystone XL bill that includes energy items important to
some Democrats.¶ McConnell has hinted he would operate with an open amendment process,
unlike current Majority Leader Harry Reid, D-Nev., who has blocked amendments.¶ "I fully expect
that we will bring the bill to the floor, and there will be an open amendment process," Hoeven said.
"Maybe there will be some amendments offered that have some broad support to get over the
67-vote threshold."¶ That could lure other Democrats. Sen. Chris Coons, D-Del., for example,
voted against the Keystone XL bill in November. But given the chance to advance one of his top
priorities — for years he has advocated extending a tax structure known as "master limited
partnerships" to renewable energy — he might vote for building the pipeline.
Obama PC key to sustainable veto – he’s successfully corralling democrats now
Eilperin 12/3
Juliet, “Obama, looking to mend fences with Congress, is reaching out. To Democrats.”
[http://www.washingtonpost.com/politics/obama-looking-to-mend-fences-with-congress-is-reaching-out-todemocrats/2014/12/03/3fdf9078-7a40-11e4-9a27-6fdbc612bff8_story.html] //
President Obama and his closest aides have determined that their best chance of success in
the next two years will depend on improved relationships on Capitol Hill, but their behind-thescenes efforts are more focused on Obama’s own party rather than the Republicans who are about
to take full charge of Congress in January.¶ Obama’s attention on congressional Democrats, allies
whom he once regarded as needing little attention, marks a shift in his view on how to deal with
Congress. The president now sees his path to success as running through Hill Democrats, a group
that has been disenchanted by the treatment it has received from the White House over the years.¶
The remedial work has included frequent calls to Democratic leaders since the midterm elections
and comes as Republicans prepare to take control of both chambers for the first time since Obama
took office. While the president and GOP leaders have pledged to seek common ground, Obama’s
use of executive action to alter immigration enforcement procedures and other steps have already
angered Republicans, making significant legislative accomplishments more difficult. ¶ And White
House officials are looking to Hill Democrats as a defense against Republican efforts to
undo key elements of Obama’s legislative legacy, including the Affordable Care Act, his
immigration action and climate policy.¶ The president’s ability to sustain the vetoes he is likely
to issue will depend on whether he is able to mend relations with congressional Democrats
— many of whom blame the president for the party’s large midterm losses — and persuade
Republican legislators to work with him in a way that has eluded the two parties for the past six
years.¶ On Wednesday, the outreach effort began publicly as Obama hosted Sen. Mitch McConnell
(R-Ky.) — who will lead the Senate starting in January — in the Oval Office. It was the first time the
two have met one on one for an extended period in more than four years. The most recent small
gathering they had was with Vice President Biden, nearly 3 1/2 years ago. ¶ McConnell spokesman
Don Stewart called the session “a good meeting” but did not release additional details. ¶ By contrast,
House Minority Whip Steny H. Hoyer (D-Md.) has been in near-constant communication with the
White House since the midterm elections. He received back-to-back calls from Obama on Nov. 24
and 25, the first to discuss the administration’s handling of sanctions against Iran amid ongoing
negotiations over that nation’s nuclear program, and the second to confer on the two men’s shared
opposition to a pending proposal extending a series of federal tax breaks.¶ “In the past couple of
months, I’ve seen heightened outreach,” Hoyer said in an interview Tuesday. “To some degree, we
become even more relevant than we were before. Now he needs to rely on both houses to sustain
a veto.”¶ Those are not the only calls Hoyer has received from the White House recently. Obama’s
chief of staff, Denis McDonough — who paid a visit to House Minority Leader Nancy Pelosi (DCalif.) on Tuesday — called Hoyer on Nov. 13 to discuss an effort by lawmakers to force federal
approval of the Keystone XL oil pipeline and on Nov. 25 to talk about tax policy. The White House
legislative-affairs staff also called him Nov. 6 to discuss immigration policy, a day after Obama
called him at home in the evening to discuss immigration and ongoing efforts to counter the Islamic
State.¶ Hoyer, who was also part of a group of Democratic leaders who had dinner with the
president last month in advance of his immigration announcement, said those discussions have
allowed him to have an impact on issues such as how the administration is working to fund its
military strategy in Iraq and Syria.¶ “I do believe I was part of the conversation that has hopefully
focused us all on accomplishing the president’s objectives,” he said.¶ Outreach efforts¶ Sen. Robert
P. Casey Jr. (D-Pa.), another White House ally, said there have been “substantial improvements” in
the president’s legislative outreach, in large part because Obama’s director of legislative affairs,
Katie Beirne Fallon, has revived an operation that had been moribund for an extended period. ¶
“Just speaking as a Democratic senator, that was not a problem-free area,” Casey said, adding that
he had this advice for the White House a few months ago: “My main suggestion is they needed to
have more ‘What do you think?’ meetings instead of ‘Here’s what we’re doing’ meetings.” ¶ Rep.
Joseph Crowley (D-N.Y.), who co-chairs the Congressional Caucus on India and Indian-Americans,
got McDonough to meet with about a dozen members of the bipartisan group in late May. Crowley
said the group pushed for more of a focus on India. “Obviously, there has been a tremendous
enhancement in that relationship,” he said.¶ The White House has dramatically stepped up its use
of perks for lawmakers in the past year. At the president’s request, his staff is making more room
for members on Air Force One (eight lawmakers flew with him to Las Vegas for his immigration
event there last month), and he now gives a shout-out to nearly all lawmakers who attend his public
speeches. This year his staff issued more than 4,270 invitations to come to the White House, travel
with the president or attend his events, almost double the number handed out in 2012, and it is
letting lawmakers use the President’s Box at the Kennedy Center more often. ¶
The plan is political suicide
Calandrillo 4 [Steve Calandrillo (Law Prof—U of Washington); George Mason Law Review, Vol. 13,
pp. 69-133, 2004; “Cash for Kidneys? Utilizing Incentives to End America's Organ Shortage”]
REAL REFORMS: UTILIZING INCENTIVES TO END THE NATION’S ORGAN SHORTAGE
Despite the above analysis, any form of legalized human organ market would be far from a utopian
solution: it would be political suicide to propose, entail significant administrative costs to establish
and monitor, and remain morally distasteful to many Americans. While such markets havebeen
debated without much progress in the past, far less attention has been paid to dozens of other monetary
and nonmonetary incentives that could be employed. Taking an incentive-based approach would avoid
imposing risk on living donors, dramatically expand the pool of available organs, and shock the
conscience far less than allowing living-seller markets.190
Keystone approval causes fast, catastrophic climate change
Joe Romm, Think Progress, 6/5/11, James Hansen slams Keystone XL Canada-U.S. Pipeline:
“Exploitation of tar sands would make it implausible to stabilize climate and avoid disastrous global
climate impacts”, thinkprogress.org/climate/2011/06/05/236978/james-hansen-keystone-pipeline-tarsands-climate/
The Canadian tar sands are substantially dirtier than conventional oil as the chart above shows (longer
analysis here). They may contain enough carbon-intensive fuel to make stabilizing atmospheric
concentrations of carbon dioxide at non-catastrophic levels all but impossible.
And that is the point of Dr. James Hansen in a must-read essay on the proposed Keystone XL Pipeline to
bring that dirty fuel into this country, “Silence Is Deadly: I’m Speaking Out Against Canada-U.S. Tar
Sands Pipeline.”
Hansen, director of NASA’s Goddard Institute for Space Studies, has been right longer about the climate
than just about anyone else (see “Right for 27 years: 1981 Hansen study finds warming trend that could
raise sea levels“). So he deserves to be heard.
Here is his essay, to which I’ve added some commentary with links:
The U.S. Department of State seems likely to approve a huge pipeline, known as Keystone XL to carry tar
sands oil (about 830,000 barrels per day) to Texas refineries unless sufficient objections are raised. The
scientific community needs to get involved in this fray now. If this project gains approval, it will become
exceedingly difficult to control the tar sands monster. The environmental impacts of tar sands
development include: irreversible effects on biodiversity and the natural environment, reduced water
quality, destruction of fragile pristine Boreal Forest and associated wetlands, aquatic and watershed
mismanagement, habitat fragmentation, habitat loss, disruption to life cycles of endemic wildlife
particularly bird and Caribou migration, fish deformities and negative impacts on the human health in
downstream communities. Although there are multiple objections to tar sands development and the
pipeline, including destruction of the environment in Canada, and the likelihood of spills along the
pipeline’s pathway, such objections, by themselves, are very unlikely to stop the project.
For more on the pipeline controversy, see “WikiLeaks reveals State Department discord over U.S. support
for Canadian tar sands oil pipeline.”
An overwhelming objection is that exploitation of tar sands would make it implausible to stabilize
climate and avoid disastrous global climate impacts. The tar sands are estimated (e.g., see IPCC
Fourth Assessment Report) to contain at least 400 GtC (equivalent to about 200 ppm CO2). Easily
available reserves of conventional oil and gas are enough to take atmospheric CO2 well above 400 ppm,
which is unsafe for life on earth. However, if emissions from coal are phased out over the next few
decades and if unconventional fossil fuels including tar sands are left in the ground, it is conceivable to
stabilize earth’s climate.
Extinction
Flournoy 12 (Citing Dr. Feng Hsu, a NASA scientist at the Goddard Space Flight Center, in 2012, Don
Flournoy, PhD and MA from the University of Texas, Former Dean of the University College @ Ohio
University, Former Associate Dean @ State University of New York and Case Institute of Technology,
Project Manager for University/Industry Experiments for the NASA ACTS Satellite, Currently Professor of
Telecommunications @ Scripps College of Communications @ Ohio University, Citing Dr. "Solar Power
Satellites," Chapter 2: What Are the Principal Sunsat Services and Markets?, January, Springer Briefs in
Space Development, Book)
In the Online Journal of Space Communication, Dr. Feng Hsu, a NASA scientist at Goddard Space Flight
Center, a research center in the forefront of science of space and Earth, writes, “The evidence of
global warming is alarming,” noting the potential for a catastrophic planetary climate change is real and
troubling (Hsu 2010). Hsu and his NASA colleagues were engaged in monitoring and analyzing cli- mate
changes on a global scale, through which they received first-hand scientific information and data relating
to global warming issues, including the dynamics of polar ice cap melting. After discussing this research
with colleagues who were world experts on the subject, he wrote: I now have no doubt global
temperatures are rising, and that global warming is a serious problem confronting all of humanity.
No matter whether these trends are due to human interference or to the cosmic cycling of our solar
system, there are two basic facts that are crystal clear: (a) there is overwhelming scientific evidence
showing positive correlations between the level of CO2 concentrations in Earth’s atmosphere with respect
to the historical fluctuations of global temperature changes; and (b) the overwhelming majority of the
world’s scientific community is in agreement about the risks of a potential catastrophic global climate
change. That is, if we humans continue to ignore this problem and do noth- ing, if we continue dumping
huge quantities of greenhouse gases into Earth’s biosphere, humanity will be at dire risk (Hsu 2010).
As a technology risk assessment expert, Hsu says he can show with some confi- dence that the planet
will face more risk doing nothing to curb its fossil-based energy addictions than it will in making a
fundamental shift in its energy supply. “This,” he writes, “is because the risks of a catastrophic
anthropogenic climate change can be potentially the extinction of human species, a risk that is simply
too high for us to take any chances” (Hsu 2010). It was this NASA scientist’s conclusion that humankind
must now embark on the next era of “sustainable energy consumption and re-supply, the most obvious
source of which is the mighty energy resource of our Sun” (Hsu 2010) (Fig. 2.1).
1NC SHORTAGES
Cadaveric organs can’t meet demand
Hughes 3 [Nancy Scheper-Hughes (Professor of Anthropology—Cal-Berkeley; Cofounder and
Director—Organs Watch, a medical human rights organization that monitors international organ
trafficking); “Rotten trade: millennial capitalism, human values and global justice in organs trafficking”;
2003; Journal of Human Rights, 2:2, 197-226]
The present scenario began over two decades ago with the realization by transplant professionals in the
USA and elsewhere that cadaver organs , for many complex social reasons (Lock 2002) would never
supply the growing demand for a steady supply of transplantable organs. Meanwhile, advances in
immunology and the development of powerful new anti-rejection drugs such as cyclosporin made
close tissue matching between donor and recipient unnecessary. The positive outcomes for kidney
transplant patients who have purchased kidneys from impoverished vendors in various parts of the world
where basic blood- but not tissue-matching procedures are followed, in clandestine commercialized
transactions, lead to a growing realization that an excellent HLA tissue match is no longer required to
achieve a successful transplant outcome. Today almost any person willing to be an organ donor, ideally
medically suited or not , can do so. And living donor organs – one kidney, half a liver and lobe of one
lung – are becoming the organs of choice to supply the growing demands for transplant from ever
expanding waiting lists. Meanwhile, living donor organs are also preferred by surgeons and their
patients to increase the longevity and viability of transplants. In 2001, for the first time, in the United
States live donor kidney transplant accounted for 50% of all transplants, and living donor liver
transplants rose to 10% (Delmonico 2002).
The consumers: the body and commodity fetishism Transplant procedures are astronomically expensive (in the United States a heart transplant costs more than $300 000) and are frequently hindered by so-called shortages in organs. The media, prompted by
organs procurement organizations, produce frequent references to the numbers of people who will die each year waiting for an organ. (There is no system to track or record the health, medical problems, or deaths of those who have donated organs.) In the United
States over 70 000 people appear on organs waiting lists. Every year the demand for organs increases as transplant organizations, transplant professionals and patients’ rights groups demand that new (and marginal) categories of p eople become eligible for organ
transplants. For example, at their annual meetings in Leiden, The Netherlands, in September 2000, members of Eurotransplant actively and enthusiastically supported new experiments that expanded transplant waiting lists to include the medical margins – those
over 70 years, infants, those with hepatitis C and HIV seropositivity, and those proven to be immunologically prone to organ rejection. There was no consciousness or recognition that these experiments would inflate the dem and for organs and promote desperate
means, including the black market, to obtain them. Instead, these programs were defended as democratic in their inclusiveness and as a service to medical consumers demanding the right to any and all advanced medical procedures now available. Similarly, kidney
and transplant patient advocacy groups in many parts of the world – from Brazil to Israel to Iran to the United States – have articulated a new medical consumers bill of rights, one that includes a patient’s right to transplant and even to unobstructed access to the
life-saving and healthy spare organs of ‘the other’, for which patients are willing to travel great distances and to pay a negotiable, market-based price. In continuing to articulate the current dilemma of transplant, under these new social conditions, in terms of sc arcity,
supply and demand – when the precious ‘commodities’ in question are increasingly attached to living bodies – serious ethical dilemmas are created for the patients and for their doctors who find themselves in the position of passively and inadvertently or actively
creating a medically protected space for the kidney commerce.
‘Who am I to second guess, let alone to judge, my patients?’, asked Michael Friedlaender, 14 kidney
transplant specialist at Hadassah Hospital, with reference to the growing numbers of patients in his
hospital-based practice who have returned from overseas having purchased a kidney. Later, he was to
write (2002: 971–972): ‘Here began my conversion from fierce objection to kidney marketing to passive
acquiescence in this trade. We could not prevent our patients travelling to Iraq [later to Turkey,
Romania, and the USA]. We gave patients who asked our advice all the information I have presented
here, and warned them that we could not help them outside our national boundaries, but assured them
that we would immediately assist them on their return.’ Part of the information that is given to his
dialysis patients is the differential survival rates for living donor kidneys vs. cadaveric kidneys,
based on research by Wolfe and his colleagues (1999) – a median (50%) graft survival of 21.6 years
(living donor kidney) compared with 13.8 years for a cadaver kidney. ‘If my own kidneys failed I would
opt for a transplant from a living donor’, Dr Friedlaender has said on more than one public occasion. The
data on differential survival rates are circulated widely among kidney transplant surgeons around
the world, and are frequently cited by their patients and directly contribute to the decision to
abandon conventional cadaver organ waiting lists in pursuit of ‘fresh’ kidneys from living people.
Another consumer-based stimulus behind the occult economy in living donor kidneys (and part livers) is
the growing rejection of hemo-dialysis by increasingly sophisticated kidney patients. Dialysis treatment
for any period of time, even as a bridge while waiting for transplant, is increasingly viewed by kidney
activists as unacceptable suffering , as time on the cross. In September 2000 a young man I will call
Amatai, a 23-year-old university student from Jerusalem, flew to New York City for a kidney transplant
with an organ purchased from a local ‘donor’ arranged through a broker in Brooklyn. Most of the cost of
the surgery ($200 000) was paid for by his Israeli ‘sick funds’ (medical insurance that is guaranteed to all
Israeli citizens). Particularly noteworthy in his narrative was the almost seamless naturalization of living
donation and the rejection of the artificiality of the dialysis machine:
Kidney transplant from a living person is the most natural solution because you are free of the [dialysis]
machine. With transplant you don’t have to go to the hospital three times a week to waste your time for
three or four hours. And after each dialysis you don’t feel very well, and you sleep a lot, and on weekends
you feel too tired to go out with your friends. There are still a lot of poisons left in the body and when you
can’t remove them, you feel tired. Look, dialysis isn’t a normal life. And also you are limited to certain
foods. You are not allowed to eat a lot of meat, salt, fruits, vegetables. Every month you do tests to see
that the calcium level is OK, and even if so your skin becomes yellow. Aesthetically, dialysis isn’t very
nice. A kidney transplant from a living donor is the very best, and the most natural solution.
At the same time many kidney patients resist the idea of conventional ‘waiting lists’ for cadaver
organs as archaic vestiges or residues of wartime triage and rationing or worse as reminiscent of
socialist bread lines and petrol ‘queues’. In the present climate of biotechnological optimism and
biomedical triumphalism, the very idea of a shortage, even an organs shortage, suggests a basic
management, market or policy failure. The ideology of the global economy is one of unlimited and
freely circulating goods. And those new commodities are evaluated, like any other, in terms of
their quality, durability and market value.
The cadaver kidney has been consigned to the dustbins of surgical history by those with the
ability to get a living donor, like 71-year-old Avirham, a retired lawyer with end-stage kidney disease for
whom time was running out and for whom neither a spectral waiting list nor a dead man’s kidney seemed
like reasonable options. So, in 1999 Avraham took the decisive step to fly with Dr Zaki Shapira and
several other Israeli and Italian kidney patients to an undisclosed location in Eastern Europe where they
were all transplanted with kidneys purchased from displaced rural workers. The entire venture was,
Avriham admits, an enormous risk. ‘You have no idea how poor where we went to was!’ he said. ‘The
hospital was like something you would expect maybe in a third world country.’ But it was a risk he was
willing to take to avoid the queue at home for a cadaveric kidney transplant:
Why should I have to wait months and years for a kidney from someone who was in a traffic accident,
pinned under the car for many hours, then in miserable condition in the ICU [intensive care unit] for weeks
and only after all that trauma, have that same organ put inside me? It’s really a disgusting idea to
think about putting that dead man’s organ inside you. That organ is not going to be any good! His
kidney is practically dead. After it was kept on ice for several hours, how can you expect it to go right back
to work for me? Or worse, I could get the kidney of an elderly person, or an alcoholic, or a person who
died of a stroke. That kidney is all used up. No, it is far better to get a kidney from a healthy man or
woman who can also benefit from the money I can afford to pay. Where I went for my transplant the
people were so poor they did not even have bread to eat. Do you have any idea what one thousand, let
alone five thousand dollars means to a peasant? The money I paid was a gift equal to the gift that I
received.
Obviously, free-market medicine requires a divisible body with detachable and demystified organs
seen as ordinary and ‘plain things’, simple material for medical consumption. But these same
‘plain’ objects have a way of reappearing and returning like the repressed, when least expected,
almost like medieval messengers and gargoyles from the past in the form of highly spiritualized and
fetishized objects of desire . As Veena Das once wryly observed: ‘An organ is never just an organ’.
And the fetishized or ‘designer’ kidney purchased from a living donor conjures up primitive beliefs in
human immortality, transcendence and magical energy. As Averham explained his frantic and
dangerous search for a living kidney donor: ‘I chose the better way. I was able to see my donor [in a
small town in Eastern Europe]. My doctor pointed him out to me. He was young, strong, healthy –
everything that I was hoping for!’ Here, the symbolic equations between kidney market, slave market
and brothel come to the surface.
Meanwhile, international Internet brokers prey on consumer prejudices and on the anxieties of
transplant candidates. For example, ‘Livers-4-You’, until a few weeks ago when it was forced off
cyberspace, advertised the following via kidneysurgery@s-s-net.com: ‘Want a healthy living donor next
week, or a morgue organ in five years? We are a new organization with a New York City phone
number and unique experience in locating the overseas pathway for those waiting too long for a
transplant.’
Bioprinting solves the organ shortage – less than a decade away
*momentum/new tech answers solvency deficits
DAEF 14
An online platform launched by the Directorate General for Communications Networks, Content and
Technology of the European Commission to facilitate a broad reflection on future European policies,
“Advances in bio-artificial and 3D-printed organs” [http://ec.europa.eu/digitalagenda/futurium/en/content/advances-bio-artificial-and-3d-printed-organs] Accessed September 2, 2014
//
Organs such as kidneys, livers and lungs have always been in high demand by patients with severe
illnesses. In 2008, 56 000 people were waiting for a suitable organ within the European Union. The
demand exceeds the number of available organs in Member States and is increasing faster than organ
donation rates. Bio-artificial and 3D-printed organs are critical for overcoming this challenge.¶
Advances in bio-artificial organs¶ Bio-artificial organs are the products of tissue engineering. Scientists
explain that tissue engineering uses the concepts and tools of biotechnology, molecular and cell
biology, material science and engineering to understand the structure-function relationships in
mammalian tissues and to develop biological substitutes for the repair or replacement of tissue or
organ functions (Bioartificial Organs as Outcomes of Tissue Engineering).¶ The generation of bioartificial organs takes part in 3 steps:¶ Obtaining the patient’s autologous cells with the help of biopsy
procedure, isolating the cells from the tissue biopsy and increasing their number in the cell culture
(outside the human).¶ Transferring the cells onto a carrier structure (matrix) which is usually generated
from animal tissue or from synthetic components. In the lab cells sprout on the matrix, dissolve it and
replace it by private proteins.¶ After reaching a level of maturation in the laboratory, the bio-artificial
tissue is transplanted as replacement tissue into the patient.¶ Dr Anthony Atala, director of the Institute
for Regenerative Medicine at the Wake Forest Baptist Medical Center in North Carolina (US) breaks
tissue engineering into four levels of complexity:¶ Flat structures that are made up of just one type of
cells are the simplest to engineer. Skin is an example.¶ Tubes like blood vessels and urethras which
have two types of cells and act as a conduit.¶ Hollow non-tubular organs like the bladder and the
stomach. These have more complex structures and functions.¶ Solid organs like the kidney, hearth and
liver are the most complex to engineer because they have many different cell types and also require
blood supply.¶ German researchers are already mass producing swatches of real human skin. As of
2009, the price per unit was 34 Euros. The skin produced by Fraunhofer-Gesellschaft is exactly like
the skin on human bodies – made up of different cell types whereas skin manufactured previously
used to be one thin layer made up of only one type of cell.¶ Between March 2004 and July 2007, the
research team at Wake Forest University led by Dr Atala built artificial urethras for five boys using the
patients' own cells. Tests measuring urine flow and tube diameter confirmed that the engineered
tissue remained functional throughout the six-year follow-up period. Scientists say that bio-artificial
urethras can be used successfully in patients and could be an alternative to the current treatment,
which has a high failure rate.¶ Anthony Atala also reported the successful transplantation of laboratorygrown urinary bladders into beagles in 1999. Less than 10 years later the same procedure was
repeated in humans suffering from end-stage bladder disease - functional bioartificial bladders were
successfully implanted into patients.¶ Growing solid organs in the lab is however is much more
complex. Organs like kidneys, lungs or hearts requires putting a number of different cell types into the
right positions and simultaneously growing complete networks of blood vessels to keep them alive.
Although the task is indeed challenging, scientists continue to make advances – Doris Taylor created
a beating rat hearth at the Texas Heart Institute in Houston. At the University of Michigan David
Humes created a cell-phone-size artificial kidney that has passed tests on sheep. ¶ Some scientists
believe that implanting bio-artificial solid organs into humans is achievable, other remain more
sceptical.¶ Advances in 3D-printed organs¶ The bioprinting trend is being driven by three factors - more
sophisticated printers, refined CAD software and advances in regenerative medicine. Scientists are
becoming increasingly interested in the field – from 2008 to 2011, the number of scientific papers
referencing bioprinting almost tripled.¶ Bio 3D printers function in the same way as traditional 3D
printers – tissue is printed layer by layer. Once a layer of cells is laid down by the printer, a layer of
hydrogel that operates as a scaffold material follows and the process repeats. When the cells fuse, the
hydrogel is removed to create material made entirely of human cells. The material is then moved to a
bioreactor where the tissue continues to grow into its final form.¶ 3D printing has already been used to
create personalised prosthetics, human bones and human tissue. For example, LayerWise, a Belgian
metal parts manufacturer successfully printed a jaw bone in 2012. The artificial jaw was implanted into
a 83-year old patient. San Diego-based company Organovo successfully prints small pieces of blood
vessel or liver tissue. Although the mini-livers are half a millimetre deep and 4 millimetres across, they
can perform most functions of the real organ. The ultimate goal of Organovo is to create human-sized
structures suitable for transplantation.¶ Currently, the biggest challenge in 3D bioprinting is producing
larger branched networks of blood vessels to nourish complex organs. Stuart William, executive and
scientific director of the Cardiovascular Innovation Institute (US), suggests that scientists will be able
to print fully functional hearts from a patient’s own cells within 10 years. First steps have already been
made – in the first half of 2013 researchers printed and implanted a portion of a heart and blood
vessels in mice.¶ Given the progress to date, further advances in bioprinting might even enable bionic
organs – body parts that restore and extend human ability. Scientists at Princeton University have
conducted experiments aiming to integrate electronics into bioprinting. Earlier in 2013 they created an
ear that receives a wide range of frequencies using a coiled antenna printed with silver nanoparticles.
The artificial ear can pick up frequencies beyond the range of normal human hearing. ¶ Bio-artificial and
3D-printed organs can not only alleviate the shortage of donor organs. Artificially created organs can
also be used to test the impact of new drugs, thus eliminating the need to test new drugs on humans.
3D models of organs could also be used for educational and research purposes.
1NC EXPLOITATION
It’s not a true choice – the people most likely to sell their organs face material
constraints that dictate the decision
Hughes 9
[Paul M. Hughes, PhD, Department of Philosophy, University of Michigan-Dearborn, Med Philos (2009)
34 (6), “Constraint, Consent, and Well-Being in Human Kidney Sales,”
http://jmp.oxfordjournals.org/content/34/6/606.full, accessed 8/22/14]
I have argued in this article that recent advocates of markets in human bodily organs have sought
to defend a conception of autonomy that makes it possible for a person to autonomously choose to
sell a body organ irrespective of the fact that he does so involuntarily, is coerced, is compelled to
do so by unjust poverty, or is exploited. I have also shown how the hierarchical conception of
autonomy typically employed to articulate the nature and value of personal autonomy in these
arguments actually implies that conditions of constraint sometimes generate volitional ambivalence,
a state in which an agent cannot wholly identify with her higher order desires and, thus, cannot
choose or act autonomously. If the circumstances of those most likely to sell a body organ in
commercial organ markets constrain potential vendors in this sort of volitionally ambivalent way,
then potential vendors are not autonomous . This is an important corrective to those who claim
that on the preferred conception of autonomy, an agent may act autonomously even when she acts
involuntarily, from coercion, or by being exploited.¶ I have also offered an analysis of how the wellbeing of potential organ vendors is marginalized in pro-market perspectives. It is disregarded in its
full sense because these perspectives tend to conflate people's choices to sell organs with their
consent to the contexts of constraint within which those choices are made possible and desirable.
Even if people may autonomously choose within contexts of constraint that are economically
unjust, those constraints define a comparatively impoverished level of well-being that can only be
temporarily allayed by selling an organ.¶ Moreover, the idea that exploited persons may make
autonomous choices misses the deeper reality that what makes the option of selling an organ
attractive to economically disadvantaged people are the economic constraints within which they
make their choices. And these, in turn, are the result of broader social, political, and economic
structures over which they have no control, no meaningful voice in establishing or revising, and
from which there is no exit. This is the deeper concern about exploitation that advocates of markets
in human bodily organs fail to appreciate.
Legalized markets remove the choice for those in poverty – creates social and
legal pressure to sell their organs
Rippon 12 – assistant professor in philosophy @ Central European University
Simon, “Imposing options on people in poverty: the harm of a live donor organ market” J Med Ethics
2014;40:145-150 //
Why an organ market would harm people in poverty ¶ Let us begin with the observation that the
introduction of a legal market in bodily organs would allow many of us an additional option to get
cash that we would not otherwise realistically have. We should then also recognise that the
introduction of this option would fundamentally change the norms of the relationships of each of us
to our bodily organs and to each other. As things stand currently, organs do not generally have a
monetary value for their owners. But if organs can be easily exchanged for cash they will then
become commodified, and naturally subject to the kinds of social and legal demands and
responsibilities that govern our other transactions in the marketplace. For example, faced with a
rent demand and inadequate cash to pay for it under the status quo, a couple of the choices you
could make currently would be to sell some of your possessions, or to find (additional) employment
and sell some of your labour. One choice that most of us do not realistically have as things stand
(and therefore do not have to consider) is to sell an organ to raise the funds. This means that even
if you have no possessions to sell and cannot find a job, nobody can reasonably criticise you for,
say, failing to sell a kidney to pay your rent. If a free market in organs was permitted and became
widespread, then it is reasonable to assume that your organs would soon enough become
economic resources like any other, in the context of the market. Selling your organs would become
something that is simply expected of you as and when financial need arises. Our new ‘option’ can
thus easily be transformed into a social or legal demand, and it can drastically change the attitudes
that others adopt towards you. In another context, Dworkin puts the point nicely: "Once I am aware
that I have a choice, my failure to choose now counts against me. I now can be responsible, and be
held responsible, for events that prior to the possibility of choosing were not attributable to me. And
with the fact of responsibility comes the pressure (social and legal) to make “responsible”
choices.5"¶ My contention, then, is that because people in poverty often find themselves either
indebted or in need of cash to meet their own basic needs and those of their families, they would
predictably find themselves faced with social or legal pressure to pay the bills by selling their
organs, if selling organs were permitted. So we would harm people in poverty by introducing a legal
market that would subject them to such pressures.¶ Are the harms at stake significant enough to
prohibit a market in live donor organs? Oddly, when Dworkin himself writes about organ selling
about a decade after having done much to elucidate the ways in which options can be bad for you,
he only gives cursory consideration to the question of what harms would arise from these new
options and how significant they might be. He admits that once a market price for organs is
established, ‘individuals may choose not to sell [organs] in the knowledge that they have made a
choice which leaves their family worse off economically than they might have been,’ and says that
this may have a ‘psychic cost’.3 But this cost, he thinks, pales in comparison with the ‘psychic costs
that are incurred by individuals and their families who face … death as a result of an inadequate
supply of organs.’ Dworkin also identifies a second psychic cost, where if we assume that organs
from family members are preferable because of tissue matches, then ‘introducing markets is likely
to strain family relations’ because ‘[f]amily members are likely to be resentful of being asked to
contribute without compensation when a stranger would receive substantial payment.’ But he
speculates that developing immunosuppressant technology will overcome this problem.¶ But we
should not limit our consideration of the potential harms imposed by the market to Dworkin's
psychic costs alone. Once we have come to conceptualise our ‘excess’ organs and organ parts as
pieces of unnecessary property by commodifying them, there would naturally follow genuine social
and legal costs to pay for failing to sell them when economically necessary, just as there are social
and legal costs to pay for failing to take employment when you are able to do so. We should ask
questions such as the following: Would those in poverty be eligible for bankruptcy protection, or for
public assistance, if they have an organ that they choose not to sell? Could they be legally forced
to sell an organ to pay taxes, paternity bills or rent? How would society view someone who asks for
charitable assistance to meet her basic needs, if she could easily sell a healthy ‘excess’ organ to
meet them?¶ Such social and legal pressures do not merely impose psychic costs, and markets
that introduce them can make large numbers of people considerably worse off. It is in view of the
harms imposed by pressures like these that we think it necessary to enact restrictive laws for
labour markets that stipulate, for example, minimum wages, minimum vacation days, parental and
sick leave, and workplace safety standards, which cannot be contracted out of. These potential
harms also provide us with grounds for enacting laws aimed at preventing commodification of other
things, for example, laws against prostitution or against selling our children (even into the most
loving homes). Wherever there is great value in not being put under social or legal pressure to sell
something as a result of economic forces, we should think carefully about whether it is right to
permit a market and to thereby impose the option on everyone to sell it. ¶ The prevalence of
exploitation and the enormous impact of economic, social and legal pressure in real-world organ
markets are supported empirically by research conducted by Goyal et al.14 They surveyed about
300 people in Chennai, India, who had sold a kidney, on average 6 years prior to the survey. They
found that 96% of participants had sold their kidneys to pay off debts, and received an average of
only about $1000 in return. Moreover, they found little evidence of any long-term benefit to the
participants: their participants' average family incomes had declined by a third after nephrectomy,
and three-fourths of them were still in debt at the time of the survey. Seventy-nine per cent of the
participants would not recommend that others sell a kidney.
Iran proves a legal market doesn’t solve
Corwin 6
Julie, “World: The Risks, Benefits Of A Free Market In Organs”
[http://www.rferl.org/content/article/1068445.html] May 16 //
But Scheper-Hughes says there are no guarantees that legalizing kidney sales would end all the
abuses now associated with the black market. She says that in Iran legal sales have not corrected
a problem of the black market: the exploitation of poor people as organ suppliers for middle- and
upper-class recipients.¶ "We know from research, including research conducted by a postdoctoral
fellow of mine who was working in Iran, that the donors are often recruited from marginal
populations that include, in addition to very poor people and people in debt, also include
populations of young people who are disaffected from their families -- some of whom are spending
a great deal of their time in the street and some of whom are drug-using people and so forth,"
Scheper-Hughes says.
Laundry list of other countries for organ brokers to shift too
Sack 14
[Kevin Sack, New York Times, 8/17/14, “Transplant Brokers in Israel Lure Desperate Kidney Patients to
Costa Rica,” http://www.nytimes.com/2014/08/17/world/middleeast/transplant-brokers-in-israel-luredesperate-kidney-patients-to-costa-rica.html?_r=0, accessed 8/21/14]
Experts list China, Egypt, India, Pakistan, Sri Lanka, Turkey, Eastern Europe and the former Soviet
republics as hot spots for organ trafficking. But illicit transplants usually go undetected unless there
is a surgical mistake or a payment dispute. Prosecutions are thwarted by false affidavits, toothless
laws and lack of international cooperation, particularly regarding extradition.¶ Over the last decade,
the authorities have pursued only a handful of cases worldwide. Few have sidelined the brokers,
who seem bolder than ever. Some, like Mr. Volfman, who leases office space atop a mirrored
skyscraper in Ramat Gan, have moved out of the shadows. They brazenly ply their trade even
while under police scrutiny, posting Facebook photos of the luxury cars and five-star hotel rooms
they rent on the road.
Economic incentives outweigh regulatory safeguards – brokers will continue
operating sales in the illicit market b/c it’s more profitable
Mendoza 11
[Roger Lee Mendoza, Professor, Wilmington University/University of Pennsylvania, J Public Health (2011)
33 (1), “Price deflation and the underground organ economy in the Philippines,”
http://jpubhealth.oxfordjournals.org/content/33/1/101.full#ref-10, accessed 8/22/14]
The dividing line between the underground and legal transplant systems becomes razor-thin when
several participants (matching agencies, foundations, hospitals, doctors and law-enforcers) in one
system consciously or unconsciously perform the same roles or functions in the other with relative
ease. Kidney patients pay huge sums for new kidneys, but most of them go to brokers, including
some doctors/medical facilities, for locating and transporting poor donors. Without brokers
operating in a relatively unrestrained market, it is doubtful if many poor vendors will find kidney
buyers. Without incentives (e.g. cash rewards) to report these brokers and their vast networks, and
swift government action, the underground kidney trade will continue to flourish , entrench
market inequalities based on asymmetric information and dent government reform efforts. ¶ The
Philippine experience thus yields valuable public health policy insights that are transferable to other
countries, particularly in the developing world: (i) grassroots-based educational and health
promotion strategies are vital considering vendors' socio-demographic profile and limited
awareness of legal prohibitions and health risks; (ii) a carefully designed mix of supply-side and
demand-side incentives complements law-enforcement (e.g. cash incentives to report buy-and-sell
transactions and swift government action with on-the-spot media coverage); (iii) criminal deterrence
is insufficient and costly in the absence of creative policing and prosecution strategies to cope with
ever-changing trading environments (e.g. online, sham marriages between foreign patients and
Filipino vendors) and rules (e.g. sub-contracting); (iv) donor post-operative care and long-term
health deserve equal attention (e.g. making organ recipients partly responsible for donors' health
care promotes a more equitable transplantation model); and (v) policy debate should not be
confined to legitimacy issues (e.g. prohibition and punishment of compensated donations), but
should address other relevant aspects of transplantation, including better renal care programs,
promotion of cadaveric (brain-death and cardiac-death) organ donations, the health hazards of illicit
organ-selling and sources of information asymmetries.¶ Collectively, these policy implications
underscore the need to evaluate government action in terms of its net effect on participants in the
underground organ commerce. A carefully designed mix of effective regulation and lawenforcement and public education should raise the costs and lower the benefits of brokered organ
trading. It should also encourage the exchange of useful and symmetric information concerning
organ donation and transplantation. Otherwise, organ traders will likely find it economically
inefficient to distinguish between what is legal and prohibited in organ donation and
transplantation.
Illegal brokers circumvent the plan – they’ll just move to a new country
Sack 14
[Kevin Sack, New York Times, 8/17/14, “Transplant Brokers in Israel Lure Desperate Kidney Patients to
Costa Rica,” http://www.nytimes.com/2014/08/17/world/middleeast/transplant-brokers-in-israel-luredesperate-kidney-patients-to-costa-rica.html?_r=0, accessed 8/21/14]
A broker who trades in human organs might seem a difficult thing to find. But Ms. Dorin’s mother
began making inquiries around the hospital where she worked, and in short order the family came
up with three names: Avigad Sandler, a former insurance agent long suspected of trafficking; Boris
Volfman, a young Ukrainian émigré and Sandler protégé; and Yaacov Dayan, a wily businessman
with interests in real estate and marketing.¶ The men were, The New York Times learned during an
investigation of the global organ trade, among the central operators in Israel’s irrepressible
underground kidney market. For years, they have pocketed enormous sums for arranging overseas
transplants for patients who are paired with foreign donors, court filings and government
documents show.¶ The brokers maintain they operate legally and do not directly help clients buy
organs. Dodging international condemnation and tightening enforcement, they have nimbly
shifted operations across the globe when any one destination closes its doors. ¶ The supply
of transplantable organs is estimated by the World Health Organization to meet no more than a
tenth of the need. Although there is no reliable data, experts say thousands of patients most likely
receive illicit transplants abroad each year. Almost always, the sellers are poor and ill-informed
about the medical risks.¶ The vast marketplace includes the United States, where federal
prosecutors in New Jersey won the first conviction for illegal brokering in 2011. ¶ But a Times
analysis of major trafficking cases since 2000 suggests that Israelis have played a disproportionate
role. That is in part because of religious strictures regarding death and desecration that have kept
deceased donation rates so low that some patients feel they must turn elsewhere. ¶ “When
someone needs an organ transplant, they’ll do everything in their power,” said Meir Broder, a top
legal adviser to Israel’s Ministry of Health.
Legalization doesn’t increase the quality of organs – creates an incentive for
donors to lie about preexisting conditions
*DDOC = deceased donor organ commercialism
Epstein et al 11 – senior Lecturer in Medical Ethics and Law @ Barts and The London School of
Medicine and Dentistry,
Miran, Dominique Martin, and Gabriel Danovitch, “Caution: deceased donor organ commercialism!”
Transplant International Volume 24, Issue 9, pages 958–964, September 2011 //
DDOC also risks impairing the safety of organ transplantation. Commercial organ donation, both
from the living and deceased, is accompanied by an increased risk of infection [67]. Although such
complications may be related to the quality of transplantation services, in particular the screening of
organ vendors and the hazards of maintaining continuity of patient care in the setting of transplant
tourism, DDOC may nevertheless contribute to increased risks. For example, prospective organ
providers or their relatives may be reluctant to reveal information about the provider’s health that
might jeopardize the chance of sale, such as the presence of risk factors for infection or disease.
Medical staff may also conceal such information to profit from organ recovery or transplantation. In
this regard it is worth noting that in the U.S., paid blood donation was discontinued precisely
because of the increased infection risk. The larger the amount of money at stake the greater may
be the propensity to conceal critical information [68].
Antibiotic use doesn’t spike resistance
THOMAS, M.E., et al., 08
("Risk factors for the introduction of high pathogenicity Avian Influenza
virus into poultry farms during the
epidemic in the Netherlands in 2003." Preventive veterinary medicine 69, (10 June 2005): 1-11. Agricola.
EBSCO. [1 Aug. 2008,
http://search.ebscohost.com/login.aspx?direct=true&db=agr&AN=IND43716042&site=ehost-live]
With the exception of ciprofloxacin resistance, there
is a paucity of scientific evidence to document the association
of antimicrobial agents used in veterinary medicine with increases in antimicrobial-resistant pathogens
(Phillips et al., 2004). For example, it has been suggested that the increased prevalenc e of extended-spectrum
cephalosporin-resistant strains is in part related to the use in food animals of ceftiofur, which is an extended-spectrum
cephalosporin approved for use in veterinary medicine (White et al., 2001); however, scientific evidence is lacking.
Antimicrobial agents used for intensive calf rearing in the 1970–1980s have also been speculated to contribute to the emergence of
multiple-antibiotic resistant Salmonella Typhimurium DT104 strains. Genes included in the antibiotic resistance gene cluster of
Salmonella Typhimurium DT104 confer resistance to four of the five antimicrobials used during that time to treat veal calves,
therefore co-selection of the entire cluster could have arisen from the use of any one of those drugs (Velge, Cloeckaert, & Barrow,
2005). While there is no definitive evidence for this scenario, several reviews have been published presenting contrasting views
regarding the role of veterinary usage of antimicrobials in the emergence of antibiotic-resistant foodborne pathogens. In support of a
causal relationship are reviews by Angulo et al., 2004 and Mølbak, 2004, whereas reviews by Phillips et al., 2004 and Wassenaar,
2005 advocate that veterinary usage of antimicrobial agents are inaccurately incriminated as being a major
contributor to antibiotic-resistant pathogens in humans. Debate on this topic will continue but should consider the
additional routes which lead to resistant bacterial populations, that antimicrobial usage in animals is required for animal health and
well-being, and that not every antimicrobial-resistant pathogen has human health consequences. On this latter point, clearly not all
infections caused by resistant pathogens fail to respond to treatment. For example, in a study of 23 diarrhea cases in Thailand,
nearly all were infected with ciprofloxacin-resistant Campylobacter, yet 58% of patients receiving ciprofloxaxin treatment were cured.
This response implies that treatment with ciprofloxacin could still be effective in many cases (Sanders et al., 2002). Another
consideration is that acquisition of drug resistance could entail a biological cost to the pathogen resulting in reduced fitness and
competitiveness in the absence of antibiotic selection pressure. For example, most data on E. coli suggest that increased antibiotic
resistance results in decreased fitness (Wassenaar, 2005). Alternatively, for some foodborne pathogens such as fluoroquinoloneresistant C. jejuni, resistance can be neutral or even beneficial in terms of fitness (Luo et al., 2005). When coinoculated into
chickens, fluoroquinolone-resistant Campylobacter isolates either outcompeted or were outcompeted by most of the
fluoroquinolone-susceptible strains, with the outcome being dependent on the genetic background of the recipient strain. These
variable results highlight the complex nature of antibiotic resistance and the large data gaps that exist in
making informed scientific decisions on use of antimicrobials in animals used for food.
1NC SOLVENCY
Most people don’t donate cadaveric organs because they’re averse for reasons
that financial incentives can’t overcome
Newton 11 – Research Fellow in the Department of Marketing @ Monash University
Joshua D., “How does the general public view posthumous organ donation? A meta-synthesis of the
qualitative literature” BMC Public Health 2011, 11:791 //
Background¶ Many individuals are unwilling to become posthumous organ donors, resulting in a
disparity between the supply and demand for organ transplants. A meta-synthesis of the qualitative
literature was therefore conducted to determine how the general public views posthumous organ
donation.¶ Methods¶ Three online databases (PubMed, PsycINFO, Scopus) were searched for
articles published between January 1990 and May 2008 using the following search terms: organ
donation, qualitative, interview. Eligibility criteria were: examination of beliefs about posthumous
organ donation; utilization of a qualitative research design; and publication in an English peerreviewed journal. Exclusion criteria were examining how health professionals or family members of
organ donors viewed posthumous organ donation. Grounded theory was used to identify the beliefs
emerging from this literature. Thematically-related beliefs were then grouped to form themes.¶
Results¶ 27 articles from 24 studies met the inclusion criteria and were reviewed. The major themes
identified were: religion, death, altruism, personal relevance, the body, the family, medical
professionals, and transplant recipients. An altruistic motivation to help others emerged as the most
commonly identified motivator for becoming an organ donor, although feeling a sense of solidarity
with the broader community and believing that donated organs are put to good use may be
important preconditions for the emergence of this motivation. The two most commonly identified
barriers were the need to maintain bodily integrity to safeguard progression into the afterlife and the
unethical recovery of organs by medical professionals. The influence of stakeholder groups on
willingness to become an organ donor was also found to vary by the level of control that each
stakeholder group exerted over the donation recovery process and their perceived conflict of
interest in wanting organ donation to proceed.¶ Conclusions¶ These findings afford insights into how
individuals perceive posthumous organ donation.¶ Background¶ Demand for transplantable organs
currently exceeds supply [1], and one of the principle reasons for this disparity is that many next of
kin are reluctant to allow organ donation to proceed. In the United States of America, for example,
next of kin withhold consent for organ donation in 47% of eligible cases [2], and similar rates of
refusal have been reported in both Australia [3] and the United Kingdom [4]. However, next of kin
are more likely to grant permission for organ recovery if the deceased had indicated during their
lifetime a willingness to become an organ donor [5,6]. Understanding the beliefs that encourage or
dissuade individuals from becoming willing organ donors is therefore of particular importance.¶
Early efforts to examine the factors that influence donation willingness made use of quantitative
research designs [7-10]. While such designs are well suited to enumerating the beliefs that
influence behavior, they are less amenable to understanding how individuals perceive,
conceptualize, and give meaning to issues such as organ donation [11]. To redress this limitation,
qualitative methods have more recently been used to complement the results obtained by
quantitative studies. One of the strengths of qualitative designs is that they allow researchers to
explore the multifaceted, inter-related, private, and often conflicting beliefs held by individuals [11].
Qualitative designs also allow researchers to clarify what individuals actually mean when they
describe particular beliefs or experiences [11]. Qualitative research can therefore provide unique
insights into how individuals perceive organ donation. Unfortunately, much of the qualitative
research on organ donation has been conducted with small samples or among populations with
unique characteristics (see Table 1). As a result, findings from qualitative studies are often of
limited generalizability.¶ Table 1. Characteristics of the Studies Reviewed in the Meta-synthesis¶
One way of addressing the limited generalizability of qualitative research is to conduct a metasynthesis of the available research [12]. In a meta-synthesis, findings from multiple qualitative
studies are aggregated so that the factors that shape social phenomena across multiple
populations can be identified [12]. In the context of organ donation, such an analysis would provide
clinicians, policy makers, and researchers with a deeper understanding of the beliefs that
encourage or dissuade individuals from becoming willing organ donors. A meta-synthesis of the
qualitative research on organ donation has not, however, been previously conducted. The current
study was therefore designed to address this gap.¶ Methods¶ Study selection¶ Three electronic
bibliographic databases (PubMed, PsycINFO, Scopus) were searched using the following terms:
"organ donation AND interview" and "organ donation AND qualitative". These search terms were
applied to articles published between January 1st 1990 and May 31st 2008. Articles were also
found by hand-searching the reference lists of relevant articles. Articles identified through this
process were selected for analysis if they: (i) utilized a qualitative study design; (ii) were published
in an English-language, peer-reviewed journal; and (iii) investigated the beliefs that individuals hold
about posthumous organ donation. Studies were excluded if their primary aim was to examine: (i)
how individuals arrive at a decision about donating the organs of a deceased family member; or (ii)
the reactions of health professionals to posthumous organ donation. Multiple papers from a single
study were included for analysis if each paper presented unique data. A summary of the search
strategy and selection criteria utilized in the current study is presented in Figure 1. Twenty-seven
articles from 24 studies [13-39] satisfied the selection criteria and were included in the review (see
Table 1). These studies represented the views of 1,213 participants towards organ donation. ¶
thumbnailFigure 1. Literature search strategy. Figure 1 illustrates the number of articles that were
identified through database searches and a hand search of article reference lists. The inclusion
criteria used to select the final 27 articles for review are also presented.¶ Analysis¶ Qualitative data
extracted from the results section of each reviewed study were analyzed using a grounded theory
framework [40], a method of analysis that has also been used in other meta-syntheses [41,42].
Following a grounded theory methodology, data about individuals' perceptions of organ donation
were inductively coded to create a series of belief-based concepts. Constant comparisons between
and within belief concepts were undertaken throughout this process to ensure that each concept
provided an accurate representation of the original qualitative data. Similar concepts were then
grouped to form thematic categories. To enhance methodological rigor, a second coder
independently analyzed the data using the belief-based concepts generated by the first coder.
Feedback from the second coder also led to several minor changes being made to the belief-based
concepts. The coding schemes from the first and second coders were then compared, and any
coding inconsistencies were resolved through discussion.¶ Results¶ Seven key thematic categories
that impacted on individuals' willingness to become an organ donor were identified. Each theme
encapsulated a series of positive or negative beliefs about organ donation (see Table 2). ¶ Table 2.
Beliefs Identified in the Reviewed Studies
Theme 1: Religion¶ Religious beliefs about organ donation existed along a continuum that ranged
from outright rejection of organ donation to unequivocal support. The religious belief most
commonly used to reject organ donation was the notion that bodily integrity should be maintained
to safeguard progression into the afterlife.¶ "The organs will be witness to your actions on
Judgement Day." UK, Indo-Asian, Muslim, male, 37 years old [14]¶ This belief was by no means
universal among those who shared the same faith, however, suggesting that many religious beliefs
are personalized interpretations of more general religious precepts. ¶ "When we die it's not our body
that goes, it's our soul that goes." UK, Pakistani, Muslim, female [24]¶ A second religious belief
perceived as being in opposition to organ donation was concern that organ retrieval could prevent
the observance of specific funeral or burial rituals.¶ "With us, only close relatives, no more than
four, should touch the body (to wash it) and place it in the grave." UK, South Asian, Muslim [35]¶
Fatalism, or the notion that all events are predestined, also shaped views about organ donation.
Fatalistic individuals typically spoke about organ transplantation as being either unnecessary or
against the will of a divine being. As a consequence, they opposed the need for both organ
donation and transplantation.¶ "You die when the Creator thinks it's time for you to die, not to
extend a person's life simply because of their age, or, you know, because there is a chance to do
so." Canada, Coast Salish [28]¶ At the other end of the continuum were religious beliefs that were
seen as providing support for organ donation. While many of the religious barriers to organ
donation were very specific in nature, religious support for becoming an organ donor was derived
from more general precepts about the importance of helping others.¶ "It's better to give than to
receive." Canada, Indian, Christian [30]¶ "If you save the one life, then you save the whole world."
Canada, Indian, Muslim [30]¶ Although many individuals believed their religion either supported or
opposed organ donation, some expressed uncertainty about their religion's stance towards organ
donation. One of the reasons for this uncertainty was the perception that religious texts provide
little instruction concerning the appropriateness of organ donation. These individuals therefore
wished to clarify their religion's position before they made a decision about organ donation.¶ "I do
not know anything myself, but I would ask the scholars... If they tell us it is alright, then it is alright
... If they say no, that is no." UK, Indo-Asian, Muslim, male, 38 years old [14]
Theme 2: Death¶ Concerns about death intersected with beliefs about organ donation. Those who
feared thinking or talking about death, for instance, were often reluctant to consider the issue of
organ donation. Declaring one's donation wishes was also seen to be tempting fate.¶ "Buying a lot
in the cemetery, they [would] rather not talk about it. So if you raise the question about donating
your parts after you die, they probably don't want to hear about it." Canada, Chinese [29] ¶ "Talking
about bad things sometime gives them the power to happen." USA, African-American, female [39]¶
Others, in contrast, saw organ donation as a way to transcend the finality of death and achieve
symbolic immortality by allowing the donor to 'live on' in the transplant recipient. ¶ "You often hear
people say, well my child, my brother gave something to another person, so therefore they live on."
Australia, male [27]¶ Theme 3: Altruism ¶ Willingness to become an organ donor was often
expressed in terms of an altruistic, non-religiously-motivated desire to help individuals in need.¶
"When you give an organ, you're doing it to help somebody." USA, African-American [15]¶
Alternative altruistic motivations for becoming an organ donor also emerged. Some respondents,
for instance, situated their desire to become an organ donor within the broader context of helping
the general community.¶ "I am also in favour [of organ donation] because it is a service to humanity
and it is giving life ... because you are, of course, dying so it is better off that you save someone
else's life, like a gift for society." Australia, male [27]¶ Others justified their support for organ
donation by making reference to indirect reciprocity. Indirect reciprocity refers to the notion that an
individual is duty bound to help others as they themselves would want to be helped. ¶ "I'm sure if
you needed an organ you would want someone to donate if it was going to save your life. You
would want somebody to donate." USA, African-American [15]¶ Identifying with the broader
community may, however, be an important precondition for the expression of these altruistic ideals.
Specifically, some respondents who felt socially or culturally isolated indicated an unwillingness to
donate their organs.¶ "It's like, you're black first, a man second. That stops you feeling part of it."
UK, Caribbean, male [31]
Theme 4: Personal relevance¶ Personal relevance appeared to play an important role in how
respondents interacted with the notion of organ donation. For many, consideration of organ
donation did not take place until it became contextualized within the lived experience of an
acquaintance or family member.¶ "It didn't dawn on us to discuss it [organ donation] unless, of
course, there's a situation - when it's close to home. But if you are comfortable right now, it seldom
happens." USA, Filipino [13]¶ Personal relevance also appeared to act as a catalyst for broader
attitude change. One respondent, for instance, described the experience of watching a close
friend's daughter receive dialysis while waiting for an organ transplant. ¶ "I had an aversion to
donation, but with the sort of awareness I have now, it is important that everyone, everyone carries
a donor card." UK, African, male, 31-44 years old [19]
Theme 5: The body¶ The body was an integral component of many individuals' self-identity. As
such, actions that could dehumanize or threaten the dignity or individuality of the body were viewed
with suspicion and distress. Examples of such beliefs included the notion that organ donation could
lead to the body being treated as a collection of 'spare parts' or as cuts of meat in a butchers shop.¶
"Thinking of them as a hunk of meat, like a piece of sheep or something. That is how doctors
think." Australia, male [27]¶ "The human body is not a machine. Organ transplantation is abusing
the body's dignity. Our organs are not mere spare parts. They are a gift from Allah." UK, IndoAsian, male, 24 years old [14]¶ As a result, the prospect of organ donation often fuelled a desire to
retain control over the body, even after death.¶ "It (the body) is your possession. The more you use
it, the more you value it, the more prize possession it becomes, the less you want it harmed, or
taken apart, or damaged or illness to come to you." UK, female, 21 years old [26]¶ Nevertheless,
there was some evidence to suggest that such concerns may be resolved by reassuring individuals
that organ recovery is carried out respectfully and in a manner that preserves the outward
appearance of the body.¶ "I can donate everything just as long I look OK in my coffin." USA, Filipino
[13]¶ While some individuals rejected organ donation out of a desire to preserve the dignity of the
whole body, others felt that organ recovery could take place so long as certain parts of the body
were left untouched. The eyes and heart, for instance, were sometimes thought to hold particular
significance because of the perceived centrality of these parts of the body to an individual's sense
of self.¶ "I don't want to give my heart and my eyes because I feel like you think things with your
heart." UK, white, female [24]¶ An associated belief was the notion that aspects of an individual's
personality are situated within specific body parts. Individuals who held this belief therefore feared
that organ transplantation could result in personality contamination.¶ "I don't like the idea of my
organs living in another body, it may affect their personality and make them more like me." UK,
Pakistani, female [35]¶ Other individuals held more utilitarian views of the body, believing that the
body gave physical form to the self but was not an integral component of their self-identity. For
these individuals, the body held little intrinsic importance after death.¶ "Who cares what happens to
my body ... after I die. I don't care one way or the other. If there's someone who needs my organs,
sure, why not, my soul will be gone anyway." USA, Oglala Lakota Sioux [22]¶ As a result, refusing
to become an organ donor was deemed to be a waste of healthy and potentially life-saving
organs.¶ "I'd rather not go to waste if someone could use it." USA [32]¶ One way that individuals
explained this utilitarian view to others was by equating organ transplantation with the replacement
of faulty parts in a machine. As outlined earlier, this view was seen by others as dehumanizing the
body.¶ "Cynically speaking, it's machine parts, in principle nothing strange." Sweden [37]
Theme 6: The family¶ Individuals appeared desirous of maintaining family cohesion and stability
and were consequently influenced by the donation attitudes held by their family members.¶ "I
personally have no objection but my father does, so I am not sure." UK, Indo-Asian, female, 20
years old [14]¶ Further indicative of this desire to maintain family stability was an inclination to
minimize stress among surviving family members. For some, this meant making their donation
wishes known to family members in order to take:¶ "The emotive onus away from your relatives."
UK, white, female [24]¶ For others, it meant refusing to become an organ donor so that their
families would not have to see their body following organ recovery.¶ "I don't like the idea of my
relatives having to see my body having been carved up." UK, Gujarati, male [35]
Theme 7: The medical profession¶ Mistrust of the medical profession was a common cause of
anxiety across the reviewed papers. The most common variant of this concern was that organs
would be recovered unethically. Some, for instance, feared that doctors would deliberately remove
a patient's organs before the patient had died, while others believed that life-saving medical care
would be withheld so that patients could become eligible for organ donation. There was also a
belief that medical staff go beyond an individual's terms of consent to obtain additional organs. ¶ "If I
sign up to donate a kidney, they may take out everything else as well." UK, Caribbean, male, 31-44
years old [19]¶ While some believed that organs may be unethically procured, others thought that
organs could be taken prematurely as a result of mistakes made during organ recovery. The
concept of brain death was particularly singled out as a potential barrier to becoming a willing
donor, with questions being raised about doctors' ability to determine if a patient met the criteria for
brain death or whether the medical profession more generally was mistaken for using brain death
as the basis for allowing donation to proceed.¶ "Brain death may not be definitive so if you do
donate your organs you've given away your (or someone else's) last chance at life." Australia [27] ¶
Fears about more routine medical errors were also identified.¶ "The medical team, although they
admitted making the mistake, made that mistake ... that's really going to, uh, cause some thinking
now before anyone wants to donate or receive an organ." USA, African-American [15]¶ Juxtaposed
with the notion that organs are removed prematurely was the belief that doctors prolong life
unnecessarily to obtain organs. There was also concern that the medical profession was too eager
to push the boundaries of nature.¶ "The desire to play that many doctors have is really dangerous.
In the end they will breach the borders that nature has determined." Sweden [37] ¶ Other medicalrelated beliefs about organ donation also emerged. One concern was that the process of allocating
organs was biased, particularly against ethnic minorities or the poor.¶ "I still think it's a racial thing
too because most Black people feel that they're never going to get an organ anyway because the
organs are going to go to those people with money, or those people who know someone, or White
people." USA, African-American [16]¶ There was also a fear that organs could be used for
unintended purposes, violating the altruistic reasons for which these organs had been donated.
These unintended purposes included the illicit trading of organs, especially for monetary gain, and
the use of donated organs in unauthorized medical experiments.¶ Perceived knowledge gaps,
either about organ recovery or the method for recording donation wishes, were also identified as
barriers to becoming an organ donor. Likewise, health system constraints were seen as reducing
the impetus to record donation wishes. An individual living on a reservation in the United States of
America, for instance, questioned whether health professionals at the local hospital examined
drivers' licenses to identify the donation wishes of the deceased.
Plan doesn’t solve demand EVEN IF everyone agreed to sell their organs – not
enough eligible cadavers die every year – also assumes a legal market
Becker and Elias 7 – professor of economics @ University of Chicago and assistant professor of
economics @ State University of New York at Buffalo
Gary S. and Julio Jorge, “Introducing Incentives in the Market for Live and Cadaveric Organ Donations”
Journal of Economic Perspectives Vol. 21, No. 3 (Summer) pp. 3-24 //
Perhaps most crucially, the present gap between demand and supply of kidneys could not be
fully met from cadavers, even with full payments for cadaver organs. For their organs to be
usable, cadaver donors must have had healthy, well-functioning organs and been free of infections
at the time of their death. The majority of cadaveric organs come from accident or stroke victims who
have been declared brain dead. In 2000, stroke victims accounted for over 40 percent of all cadaveric
donors.¶ Table 4 presents various estimates from different studies of the maximum potential supply
of cadaveric organs. The geographical area and the year consid- ered in the studies are reported in the
second and third column respectively. The fourth column of the table reports the estimates of the
potential cadaveric donors rates in per million of population. In the last column, we estimate the
maximum potential supply of cadaveric donors for the United States by taking the rates of potential
donors reported in column four and scaling up to the 2006 U.S. population.¶ Taking into account the
need to have healthy organs, these estimates suggest that between 10,000 and 16,000 of those
dying annually are considered medically suitable for organ donation. Since all organs are not
always useable from any single cadaver, the number of organs available for transplantation per
cadaveric organ donor is limited even further. In 2000, the average number of kidneys and livers
recovered per cadaveric organ donor was 1.82 and 0.83, respectively. The average number of kidneys
and livers recovered and actually transplanted per cadaveric organ donor are much lower. In 2000 it
was 1.57 for kidneys and 0.76 for livers.¶ These numbers and the number of useable cadavers indicate
that the most reasonable estimates of the supply of cadaveric kidneys-in row 6 of Table 4 (the Evans
et al. study)-imply a maximum number of cadaveric kidneys harvested between 15,500 and 24,000
(8,510 times 1.82 and 13,048 times 1.82). This overlaps the actual demand for kidneys transplants in
2005 at 21,500. Yet only a fraction of all these potentially useable cadaveric kidneys are likely to be
offered for sale, or to be useable even if offered since they may not be matched with any of the
potential recipients.¶ Moreover, once a market for organs is in place, the actual demand would
surpass present demand, since currently kidney transplants are only offered to people who have
irreversible kidney failure. Other medical or surgical treatments for kidney problems are usually tried
before consideration of a kidney transplant. Thus, it is highly unlikely that the full demand for
kidney transplants could be met with organs of deceased persons.
Legalizing cadaveric organ sales decreases the organ pool – crowds out altruistic
donations
Caplan 8 – director of the Center for Bioethics @ the University of Pennsylvania
Arthur, “Cash for kidneys? Sales won’t widen donor pool”
[http://www.nbcnews.com/id/25370851/ns/health-health_care/#.VA9AoEj85Xw] June 25 //
If this country were to allow financial incentives for organs, the money would presumably go to the
family or the deceased’s designee. But if these people have their hand on the life-support plug and
know they stand to make good money as soon as the owner of the valuable body parts is dead,
how hard are they going to try to keep that owner alive? While offering money for organs might
persuade a few more to donate, it is more likely to turn off those now willing to consider giving out
of fear or knowing there’s a reward for their death. Net result: A loss in the overall number of
organs available.
1NC RISK
Their 1AC card is backwards – Yudkowsky is saying we should be more worried
about extinction-level impacts and less worried about high-probability systemic
impacts
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 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 that contemporary nanotechnology is capable of
producing, and this condition will persist indefinitely." Vivid, specific scenarios can inflate our probability
estimates of security, as well as misdirecting defensive investments into needlessly narrow or implausibly
detailed risk scenarios. 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 a loan, the biggest project fails, the lead scientist dies). This may help explain why only 44% of
entrepreneurial ventures survive after 4 years. (Knaup 2005.) Dawes (1988, p. 133) observes: 'In their
summations lawyers avoid arguing from disjunctions ("either this or that or the other could have occurred,
all of which would lead to the same conclusion") in favor of conjunctions. Rationally, of course,
disjunctions are much more probable than are conjunctions.' The scenario of humanity going extinct in
the next century is a disjunctive event. It could happen as a result of any of the existential risks
discussed in this book - or some other cause which none of us foresaw. Yet for a futurist, disjunctions
make for an awkward and unpoetic-sounding prophecy.
Multiplying probability by magnitude is the only moral option –
Yudkowsky, Research Fellow at the Singularity Institute for Artificial Intelligence, 1/22/2008
(“Circular Altruism,” http://www.overcomingbias.com/2008/01/circular-altrui.html)
Suppose that a disease, or a monster, or a war, or something, is killing people. And suppose you only
have enough resources to implement one of the following two options: 1. Save 400 lives, with certainty.
2. Save 500 lives, with 90% probability; save no lives, 10% probability. Most people choose option 1.
Which, I think, is foolish; because if you multiply 500 lives by 90% probability, you get an expected value
of 450 lives, which exceeds the 400-life value of option 1. (Lives saved don't diminish in marginal utility,
so this is an appropriate calculation.) "What!" you cry, incensed. "How can you gamble with human lives? How can you
think about numbers when so much is at stake? What if that 10% probability strikes, and everyone dies? So much for your damned
logic! You're following your rationality off a cliff!" Ah, but here's the interesting thing. If you present the options this way: 1. 100
people die, with certainty. 2. 90% chance no one dies; 10% chance 500 people die. Then a majority choose option 2. Even
though it's the same gamble. You see, just as a certainty of saving 400 lives seems to feel so much more comfortable than an
unsure gain, so too, a certain loss feels worse than an uncertain one. You can grandstand on the second description too: "How can
you condemn 100 people to certain death when there's such a good chance you can save them? We'll all share the risk! Even if it
was only a 75% chance of saving everyone, it would still be worth it - so long as there's a chance - everyone makes it, or no one
does!" You know what? This isn't about your feelings. A human life, with all its joys and all its pains, adding
up over the course of decades, is worth far more than your brain's feelings of comfort or discomfort with a
plan. Does computing the expected utility feel too cold-blooded for your taste? Well, that feeling
isn't even a feather in the scales, when a life is at stake. Just shut up and multiply. Previously on
Overcoming Bias, I asked what was the least bad, bad thing that could happen, and suggested that it was
getting a dust speck in your eye that irritated you for a fraction of a second, barely long enough to notice,
before it got blinked away. And conversely, a very bad thing to happen, if not the worst thing, would be
getting tortured for 50 years. Now, would you rather that a googolplex people got dust specks in their
eyes, or that one person was tortured for 50 years? I originally asked this question with a vastly larger
number - an incomprehensible mathematical magnitude - but a googolplex works fine for this illustration.
Most people chose the dust specks over the torture. Many were proud of this choice, and indignant that anyone
should choose otherwise: "How dare you condone torture!" This matches research showing that there are "sacred values", like
human lives, and "unsacred values", like money. When you try to trade off a sacred value against an unsacred value, subjects
express great indignation (sometimes they want to punish the person who made the suggestion). My favorite anecdote along
these lines - though my books are packed at the moment, so no citation for now - comes from a team of
researchers who evaluated the effectiveness of a certain project, calculating the cost per life saved, and
recommended to the government that the project be implemented because it was cost-effective. The
governmental agency rejected the report because, they said, you couldn't put a dollar value on human
life. After rejecting the report, the agency decided not to implement the measure. Trading off a sacred
value (like refraining from torture) against an unsacred value (like dust specks) feels really awful. To
merely multiply utilities would be too cold-blooded - it would be following rationality off a cliff... But let me
ask you this. Suppose you had to choose between one person being tortured for 50 years, and a googol
people being tortured for 49 years, 364 days, 23 hours, 59 minutes and 59 seconds. You would choose
one person being tortured for 50 years, I do presume; otherwise I give up on you. And similarly, if you had to
choose between a googol people tortured for 49.9999999 years, and a googol-squared people being tortured for 49.9999998 years,
you would pick the former. A googolplex is ten to the googolth power. That's a googol/100 factors of a googol. So we can
keep doing this, gradually - very gradually - diminishing the degree of discomfort, and multiplying by a
factor of a googol each time, until we choose between a googolplex people getting a dust speck in their
eye, and a googolplex/googol people getting two dust specks in their eye. If you find your preferences
are circular here, that makes rather a mockery of moral grandstanding. If you drive from San Jose to San
Francisco to Oakland to San Jose, over and over again, you may have fun driving, but you aren't going anywhere. Maybe you think
it a great display of virtue to choose for a googolplex people to get dust specks rather than one person being tortured. But if you
would also trade a googolplex people getting one dust speck for a googolplex/googol people getting two dust specks et cetera, you
sure aren't helping anyone. Circular preferences may work for feeling noble, but not for feeding the hungry or
healing the sick. Altruism isn't the warm fuzzy feeling you get from being altruistic. If you're doing it for
the spiritual benefit, that is nothing but selfishness. The primary thing is to help others, whatever the
means. So shut up and multiply! And if it seems to you that there is a fierceness to this maximization, like the bare sword
of the law, or the burning of the sun - if it seems to you that at the center of this rationality there is a small cold flame - Well, the
other way might feel better inside you. But it wouldn't work. And I say also this to you: That if you set aside your regret for all the
spiritual satisfaction you could be having - if you wholeheartedly pursue the Way, without thinking that you are being cheated - if you
give yourself over to rationality without holding back, you will find that rationality gives to you in return. But that part only works if
you don't go around saying to yourself, "It would feel better inside me if only I could be less rational." Chimpanzees feel, but
they don't multiply. Should you be sad that you have the opportunity to do better? You cannot attain
your full potential if you regard your gift as a burden.
Throwing out scenarios is a terrible corrective—they replace probability neglect
with consequence neglect—the best middle ground is to balance magnitude with
probability
Friedman, PhD candidate in public policy, and Zeckhauser, professor of political economy – Kennedy
School @ Harvard, ‘12
(Jeffrey A. and Richard, “Assessing Uncertainty in Intelligence,” HKS Faculty Research Working Paper
Series RWP12-027)
To provide empirical support for its discussion, this article examines a broad range of National
Intelligence Estimates (NIEs). Though NIEs comprise only a small fraction of overall estimative
intelligence, their production is so highly scrutinized that it is reasonable to assume that their flaws would
characterize lower-profile estimates as well.8 In addition to examining more than a dozen specific
estimates, the following sections describe general patterns across a database of 379 declassified NIEs
that were written between 1964 and 1994 and that were released through the Central Intelligence
Agency’s Historical Review Program.9 Throughout the following sections, this combination of deductive
and inductive analysis helps to draw out the tensions between eliminating uncertainty and assessing
uncertainty in estimative intelligence.
Analyzing Alternatives
Intelligence analysts often wrestle with alternatives. To return to the example of an analyst studying Syria
in 2012, this analyst would have had to consider a wide range of possibilities. If al-Assad were to survive
the year, his domestic and international standing could presumably change in any number of ways. If alAssad left power, the transition might be stable but it might also descend into widespread violence, while
al-Assad’s eventual successors could be relatively friendly or hostile to the United States. There are many
relevant scenarios here. An intelligence analyst who seeks to eliminate uncertainty would argue that one
of them constitutes the ‘correct answer’, and that her ideal goal should be to identify what that answer is.
Intelligence tradecraft often encourages this kind of thinking when it comes to analyzing alternative
possibilities.
When estimates focus on a single possibility, it is called ‘single-outcome forecasting’. This practice has
been criticized for some time, because analysts often have insufficient information for making definitive
predictions, and because policymakers should be aware of a range of potential contingencies.10 Yet
even when analysts do consider multiple possibilities, several elements of standard practice reveal a
tendency to assume that one of those scenarios should be considered the most important or the most
correct.
For instance, most NIEs highlight a ‘Best Estimate’ or ‘Key Judgments’. In principle, calling some
estimates ‘Best’ does not exclude the idea that there are other possibilities. Meanwhile, the Key
Judgments section of an NIE is generally intended to serve the function of an executive summary, so it
does not inherently privilege one alternative over another. In practice, however, these sections often
highlight a subset of relevant possibilities and encourage consumers to give these possibilities special
attention. NIEs typically present their judgments in sequence, often with one or two possibilities receiving
the bulk of explanation and support. Many NIEs contain a distinct section enumerating ‘Alternatives’ that
often receive relatively limited discussion.
This treatment can suggest that certain alternative views are relatively insignificant , and the 2002 NIE
on Iraq’s Continuing Programs for W eapons of M ass Destruction serves as a prominent example. The
Key Judgments section of this NIE begins with 42 paragraphs supporting the assessment that Iraq ‘has
continued its weapons of mass destruction (WMD) programs’ and that ‘if left unchecked, it probably will
have a nuclear weapon during this decade’. That conclusion, as is now widely known, was based on
controversial information. Doubts about the NIE’s main judgment were raised in a two-paragraph text box
at the end of the opening section, arguing that the evidence does not ‘add up to a compelling case that
Iraq is currently pursuing… an integrated and comprehensive approach to acquire nuclear weapons’. It is
almost impossible to miss this objection – but it is equally difficult to miss the disparity in emphasis
between these very different points of view about Iraq’s nuclear program.
The tendency to privilege particular judgments goes beyond the structure of intelligence estimates.
Ironically, it permeates many of the conceptual frameworks that are intended to encourage analysts to
consider multiple possibilities in the first place. For instance, one prominent text on analytic tradecraft
recommends that analysts approach complex questions by generating multiple hypotheses, evaluating
the ‘credibility’ of each hypothesis, sorting hypotheses ‘from most credible to least credible’, and then
‘select[ing] from the top of the list those hypotheses most deserving of attention’.11 Though its authors
intend for this method of ‘multiple hypothesis generation’ to ensure that important alternatives do not get
overlooked, the instruction to focus on the ‘most credible’ predictions indicates an assumption that
unlikely possibilities are less ‘deserving of attention’. Yet that is often untrue. The most consequential
events (such as major terrorist attacks, the outbreak of conventional wars, and the collapse of state
governments ) are often perceived as unlikely before they occur, yet they can have such enormous
impact that they deserve serious consideration. The overall significance of any event is a product of its
probability and its consequences, and so both of these factors must be considered when comparing
alternative scenarios.
To give another example, many intelligence analysts are trained in a practice called Analysis of
Competing Hypotheses (ACH). ACH seems to embrace the goal of assessing uncertainty. It instructs
analysts to form a matrix of potential hypotheses and available information that helps to show how much
evidence supports (or contradicts) each possibility. This practice combats first impressions and promotes
alternative thinking.12 Yet the word ‘Competing’ is important here. Competing for what? The original
description of ACH explains its goal as being to determine ‘Which of several possible explanations is the
correct one? Which of several possible outcomes is the most likely one?’13 A recent manual introduces
ACH as a tool for ‘selecting the hypothesis that best fits the evidence’.14 To this end, ACH instructs
analysts to ‘focus on disproving hypotheses’.15 This does not mean that ACH always generates singleoutcome estimates, and the method is designed to indicate places where the evidence sustains multiple
interpretations. When this occurs, ACH tells analysts to rank remaining possibilities from ‘weakest’ to
‘strongest’.
An analyst seeking to assess uncertainty would approach the issue differently. She would not see the
relevant possibilities as rival or competing. She would say that no possibility merits attention for being
‘correct’ and that focusing on disproving hypotheses places unnecessary emphasis on eliminating
relevant scenarios from consideration. Moreover, she would argue that it makes little sense to say that
any possibility is ‘weak’ or ‘strong’ so long as analysts accurately assess its likelihood. 16 This is not to
claim that all scenarios have equal significance. But to repeat, the significance of any possibility is the
product of its likelihood and its potential consequences. For that reason, ACH’s method of ranking
hypotheses based on probability exposes analysts to consequence neglect.
2NC CP
All of their evidence says it doesn’t reduce the shortage 100% - other planks and neither does the aff
And the surplus would be huge in the US—the gap between the number willing to
donate and those that state a preference is massive
Zümrüt 9 (Murat Civaner1, Zümrüt Alpinar2, Yaman Örs3 1Uludag University School of Medicine,
Department of Medical Ethics, Gorukle Campus, TR–16059 Bursa 2Middle East Technical University,
Department of Philosophy, İnönü Bulvarı, TR–06351 Ankara 3Akdeniz University Faculty of Medicine,
Department of Medical Ethics, “Why Would Opt-Out System for Organ Procurement be Fairer?*”, PDF,
ZBurdette)
Furthermore, we argue that the opt-out system respects one’s autonomy more than opt-in. Because it
is well-known that most of the people are willing to donate their organs but only few of them do
actually donate. Many researchers have found that 70–95% of people are willing to donate while
only 20–24% of them actually register their wish to do so.37,38,39,40,41 So, as English correctly
emphasises, unless opinion polls are wrong, presuming that an individual wishes to donate would likely
reinforce the autonomy of that individual rather than presuming an individual does not wish to donate.42
The best stats go neg
Zümrüt 9 (Murat Civaner1, Zümrüt Alpinar2, Yaman Örs3 1Uludag University School of Medicine,
Department of Medical Ethics, Gorukle Campus, TR–16059 Bursa 2Middle East Technical University,
Department of Philosophy, İnönü Bulvarı, TR–06351 Ankara 3Akdeniz University Faculty of Medicine,
Department of Medical Ethics, “Why Would Opt-Out System for Organ Procurement be Fairer?*”, PDF,
ZBurdette)
Now we would like to evaluate two systems by comparing their features, and determine their fairness by
taking into consideration the degree of serving the right to healthcare. First of all, one can easily claim
that opt-out would obviously provide more organs, and would expectedly save more lives than the
opt-in system. The main aim of any kind of procurement system is to increase the resources, and the optout system is more appropriate to that aim. As Hamm compiled, a growing body of evidence
supports this claim.15 A study in 2006 compared 22 countries over 10 years, and it took account of
the determinants that might affect donation rates, such as gross domestic product per capita, health
expenditure, religious beliefs, legislative system, and the number of deaths from traffic accidents and
cerebrovascular diseases. Authors concluded that when other determinants of donation rates are
ac-counted for, presumed consent countries have roughly 25– 30% higher dona-tion rates than
informed consent countries.16 A study in 2003 found similar results.17 The successful results observed in
Spain did not necessarily result from presumed consent, as the infrastructure and educational system in
Spain showed great improvements during the same period of time. However, presumed consent may
have played a role. Donation rates increased in Belgium, Singapore, and Austria after presumed consent
was initiated.18,19,20 These findings suggest that the adoption of opt-out would increase donation rates,
and, consequently, would fulfil the requirements of the right to healthcare more appropriately.
Presumed consent solves the illicit market – it’s only a question of supply
Glaser 5 – J.D. candidate at the Washington College of Law
Sheri R., “Formula to Stop the Illegal Organ Trade: Presumed Consent Laws and Mandatory Reporting
Requirements for Doctors” [http://www.wcl.american.edu/hrbrief/12/2glaser.pdf] //
Presumed consent, when the state strictly follows it, is the best- practice method of legally
obtaining organs. In countries with pre- sumed consent laws, there is a higher procurement rate for
organs than in countries without these laws. Many argue that if the demand for organs were met
legally, then people would have less incentive to illegally obtain organs and the black market would
eventually dimin- ish. On a more basic level, if there were more organs available for transplant,
then more people’s lives would be saved.
2NC DA
The aff necessarily creates a property right to the body---it’s the only way to
regulate and legitimize sale---that’s Siegel
The aff flips common jurisprudence towards a property right for the body---now’s
the brink
Heather Hausleben 13, J.D., Seton Hall University School of Law, “Property Rights in Organs – An
Argument for Commodification of the Body,” 1 May 2013,
http://scholarship.shu.edu/cgi/viewcontent.cgi?article=1350&context=student_scholarship
At common law, the ability to donate through a gift doctrine requires that the donor has “the necessary
disposing power,”31 which must intrinsically be linked to the power of property because one cannot
give something that one does not have.32 Despite the fact that courts have not openly recognized a
property interest in bodily tissue, the finding that a donation or gift can legally be made necessarily
implies a property interest of some sort in the body .
Courts are also beginning to recognize a property interest in deceased relative’s body parts .33 Although the
outcome of these types of litigation often rest on the practical difficulties of medical examiners sharing all concerns with next of kin,
the acceptance by courts of the idea of constitutionally protected34 property rights in the body of a
deceased relative displays the change of attitude recognizing that the body is the property of an
individual, or the in event of death, of the individual’s family.
The aff guarantees legislation to overturn the UAGA---these necessarily include
support of property rights for the body
Gregory S. Crespi 94, Assistant Professor, Southern Methodist University School of Law, J.D., Yale
University, 1985, Ph.D., University of Iowa, “Overcoming the Legal Obstacles to the Creation of a Futures
Market in Bodily Organs,” Winter 1994, 55 Ohio St. L.J. 1, Lexis
Let me set forth my reasoning in more detail. As previously discussed, the 1968 version of the UAGA -- still the basis for
current state law in most jurisdictions -- does not expressly address the matter of organ sales. This gives
the courts some room to exercise their discretion. Given the underlying policy of facilitating organ transplantation that was
central to the drafting and widespread adoption of the UAGA, n220 the forceful arguments that can be made that a
futures market could better achieve that objective than does the existing system, n221 and the lack of clear
evidence concerning the intent of the adopting legislatures , n222 it may be possible to convince judges
to construe those statutes that are based upon the 1968 UAGA to not preclude commercial organ [*56]
transactions. Such a construction could be accompanied by judicial endorsement of the concept of
property rights in body parts -- a concept now supported by a significant body of legal authority n223 -which in conjunction would remove at least the state law obstacles to the operation of a futures market in the
significant number of states that have statutory frameworks based upon the 1968 UAGA and that have not
adopted express prohibitions against commercial organ transactions. n224
2NC RISK
Throwing out scenarios is a terrible corrective—they replace probability neglect
with consequence neglect—the best middle ground is to balance magnitude with
probability
Friedman, PhD candidate in public policy, and Zeckhauser, professor of political economy – Kennedy
School @ Harvard, ‘12
(Jeffrey A. and Richard, “Assessing Uncertainty in Intelligence,” HKS Faculty Research Working Paper
Series RWP12-027)
To provide empirical support for its discussion, this article examines a broad range of National
Intelligence Estimates (NIEs). Though NIEs comprise only a small fraction of overall estimative
intelligence, their production is so highly scrutinized that it is reasonable to assume that their flaws would
characterize lower-profile estimates as well.8 In addition to examining more than a dozen specific
estimates, the following sections describe general patterns across a database of 379 declassified NIEs
that were written between 1964 and 1994 and that were released through the Central Intelligence
Agency’s Historical Review Program.9 Throughout the following sections, this combination of deductive
and inductive analysis helps to draw out the tensions between eliminating uncertainty and assessing
uncertainty in estimative intelligence.
Analyzing Alternatives
Intelligence analysts often wrestle with alternatives. To return to the example of an analyst studying Syria
in 2012, this analyst would have had to consider a wide range of possibilities. If al-Assad were to survive
the year, his domestic and international standing could presumably change in any number of ways. If alAssad left power, the transition might be stable but it might also descend into widespread violence, while
al-Assad’s eventual successors could be relatively friendly or hostile to the United States. There are many
relevant scenarios here. An intelligence analyst who seeks to eliminate uncertainty would argue that one
of them constitutes the ‘correct answer’, and that her ideal goal should be to identify what that answer is.
Intelligence tradecraft often encourages this kind of thinking when it comes to analyzing alternative
possibilities.
When estimates focus on a single possibility, it is called ‘single-outcome forecasting’. This practice has
been criticized for some time, because analysts often have insufficient information for making definitive
predictions, and because policymakers should be aware of a range of potential contingencies.10 Yet
even when analysts do consider multiple possibilities, several elements of standard practice reveal a
tendency to assume that one of those scenarios should be considered the most important or the most
correct.
For instance, most NIEs highlight a ‘Best Estimate’ or ‘Key Judgments’. In principle, calling some
estimates ‘Best’ does not exclude the idea that there are other possibilities. Meanwhile, the Key
Judgments section of an NIE is generally intended to serve the function of an executive summary, so it
does not inherently privilege one alternative over another. In practice, however, these sections often
highlight a subset of relevant possibilities and encourage consumers to give these possibilities special
attention. NIEs typically present their judgments in sequence, often with one or two possibilities receiving
the bulk of explanation and support. Many NIEs contain a distinct section enumerating ‘Alternatives’ that
often receive relatively limited discussion.
This treatment can suggest that certain alternative views are relatively insignificant , and the 2002 NIE
on Iraq’s Continuing Programs for W eapons of M ass Destruction serves as a prominent example. The
Key Judgments section of this NIE begins with 42 paragraphs supporting the assessment that Iraq ‘has
continued its weapons of mass destruction (WMD) programs’ and that ‘if left unchecked, it probably will
have a nuclear weapon during this decade’. That conclusion, as is now widely known, was based on
controversial information. Doubts about the NIE’s main judgment were raised in a two-paragraph text box
at the end of the opening section, arguing that the evidence does not ‘add up to a compelling case that
Iraq is currently pursuing… an integrated and comprehensive approach to acquire nuclear weapons’. It is
almost impossible to miss this objection – but it is equally difficult to miss the disparity in emphasis
between these very different points of view about Iraq’s nuclear program.
The tendency to privilege particular judgments goes beyond the structure of intelligence estimates.
Ironically, it permeates many of the conceptual frameworks that are intended to encourage analysts to
consider multiple possibilities in the first place. For instance, one prominent text on analytic tradecraft
recommends that analysts approach complex questions by generating multiple hypotheses, evaluating
the ‘credibility’ of each hypothesis, sorting hypotheses ‘from most credible to least credible’, and then
‘select[ing] from the top of the list those hypotheses most deserving of attention’.11 Though its authors
intend for this method of ‘multiple hypothesis generation’ to ensure that important alternatives do not get
overlooked, the instruction to focus on the ‘most credible’ predictions indicates an assumption that
unlikely possibilities are less ‘deserving of attention’. Yet that is often untrue. The most consequential
events (such as major terrorist attacks, the outbreak of conventional wars, and the collapse of state
governments ) are often perceived as unlikely before they occur, yet they can have such enormous
impact that they deserve serious consideration. The overall significance of any event is a product of its
probability and its consequences, and so both of these factors must be considered when comparing
alternative scenarios.
To give another example, many intelligence analysts are trained in a practice called Analysis of
Competing Hypotheses (ACH). ACH seems to embrace the goal of assessing uncertainty. It instructs
analysts to form a matrix of potential hypotheses and available information that helps to show how much
evidence supports (or contradicts) each possibility. This practice combats first impressions and promotes
alternative thinking.12 Yet the word ‘Competing’ is important here. Competing for what? The original
description of ACH explains its goal as being to determine ‘Which of several possible explanations is the
correct one? Which of several possible outcomes is the most likely one?’13 A recent manual introduces
ACH as a tool for ‘selecting the hypothesis that best fits the evidence’.14 To this end, ACH instructs
analysts to ‘focus on disproving hypotheses’.15 This does not mean that ACH always generates singleoutcome estimates, and the method is designed to indicate places where the evidence sustains multiple
interpretations. When this occurs, ACH tells analysts to rank remaining possibilities from ‘weakest’ to
‘strongest’.
An analyst seeking to assess uncertainty would approach the issue differently. She would not see the
relevant possibilities as rival or competing. She would say that no possibility merits attention for being
‘correct’ and that focusing on disproving hypotheses places unnecessary emphasis on eliminating
relevant scenarios from consideration. Moreover, she would argue that it makes little sense to say that
any possibility is ‘weak’ or ‘strong’ so long as analysts accurately assess its likelihood. 16 This is not to
claim that all scenarios have equal significance. But to repeat, the significance of any possibility is the
product of its likelihood and its potential consequences. For that reason, ACH’s method of ranking
hypotheses based on probability exposes analysts to consequence neglect.
2NC SOLVENCY
Markets don’t solve
Caplan 13 – director of the Center for Bioethics @ the University of Pennsylvania
Arthur, “Opinion: Why selling kidneys still won't work” [http://www.nbcnews.com/health/healthnews/opinion-why-selling-kidneys-still-wont-work-f8C11459943] October 24 //
Nor is it clear that $10,000 would really be enough to prompt many people to have a kidney
removed. Kidney surgery is still major surgery, living with one kidney is a bit risky and there is a
very real danger of various complications. While they won’t kill you, the problems could keep you in
the hospital for days or weeks.¶ There is also the problem that markets only work for kidneys. We
have two kidneys, which is one more than most people need. But markets won’t help obtain more
hearts or livers or lungs. That means running one part of the transplant system with payments and
the other based on altruism. Those involved with kidney transplants want to give markets a try.
Those doing heart transplants don’t — they worry that a market will dry up the altruism they must
rely on to get those organs.¶ Lastly, putting $10,000 on the table to get people to sell a kidney
should not happen unless and until there are national standards for who can safely decide to sell
one. The sicker you are or the more mentally unstable you are, the harder it should be to let you
sell your kidney. But there are no agreed-upon criteria about either minimal health or mental
competency to sort out those moved only by money to sell.¶ The idea of trying markets to
increase the supply of kidneys is the whack-a-mole of transplant policy. Every other year
someone does a study, tosses out a model or just proclaims that a market will solve the kidney
shortage problem. But there is more than money involved when it comes to body parts, and until
proponents of payment can engage those concerns, it is not likely that we will see a shift from
academic talk to political action.
Not enough people will sell
Varjavand 13
[Reza Varjavand, Saint Xavier University associate professor of economics and finance at the Graham
School of management, 2013, Journal of Management Policy and Practice vol. 14(4), “Legalized Market
for Human Kidneys: A Wrong Solution to a Right Problem,” http://www.nabusinesspress.com/JMPP/VarjavandR_Web14_4_.pdf, accessed 8/1/14]
Shortage, in the U.S. is not caused by economic factors like lack of price; there is no concrete
evidence to prove that. People do not wish to donate a kidney in expectation of pecuniary gains
especially in affluent countries like the United States. Unlike the peasants living in the rural areas of
a less developed country who are the major source of kidneys that are for sale, I believe the poor in
the U.S. are not so depredate they would sell their body parts for money, even if it were legal. And,
if a few of them do, it is not going to change the prospect of the persistent shortage. In addition,
because people are well- informed about the possible health risks and the harm they may suffer
because of the possible side effects, they cannot be lured into selling a kidney against their
wishes. So I think an attempt to boost supply through monetary incentives may not be as effective
as it sounds. Likewise, people do not seek a kidney because it is cheap or expensive; they need it
because they suffer from an unfortunate medical condition and they hope that there is a matching
donor somewhere out there who can help save their life. Again, shortage is not a pricing
problem and should not be dealt with by finding a monetary solution.
Err neg – aff studies are flawed – too vague, support for legalization isn’t the
same as willingness to sell, and examples of other countries don’t apply to the
US
Rid et al 9 – Senior Lecturer in Bioethics in the Department of Social Science, Health & Medicine @ King’s College London
A., L. M. Bachmann, V. Wettstein, and N. Biller-Adorno, “Would you sell a kidney in a regulated kidney market? Results of an
exploratory study” Journal of Medical Ethics 35:558-564 //
This paper focuses on the first, empirical claim about a regulated kidney market—namely, that such a market would
increase the supply of kidneys. Market proponents claim that ‘‘surveys suggest that the public favours compensation
and that compensation
would increase donation’’. 6 However, the data they cite to support this
claim are insufficient . Studies investigating the impact of financial incentives in the deceased donation
context have limited significance for the context of live donation. 8–11 Moreover, surveys that do not
detail the conditions of a regulated kidney mar- ket 10 12 13 are too vague to assess how the population would respond to such a market, and the distinction between removing financial disincen- tives and providing
financial incentives is often unclear. 12 Attitudes about legalising live kidney sales 10 may not reflect one’s
willingness to sell an organ. Finally, data from Iran 14 —the only country that has implemented a regulated kidney
market today—are difficult to extrapolate, because the Iranian market allows for co-payments among
transplant recipients and living conditions in Iran are strikingly different from those in industrialised
countries.
2NC SHORTAGE
Bio-printing solves the shortage---multiple research rends, complex
developments, momentum mean the shortage will be resolved in the next 10
years---that’s DAEF---that’s faster than the aff---establishment of regulations, and
availability will be gradual due to shifting cultural norms.
Advances in bioprinting will solve organ shortages
Griggs 14
Brandon, “The next frontier in 3-D printing: Human organs”
[http://www.cnn.com/2014/04/03/tech/innovation/3-d-printing-human-organs/] April 3 //
Soon, however, 3-D printers may be spitting out something far more complex, and controversial:
human organs.¶ For years now, medical researchers have been reproducing human cells in
laboratories by hand to create blood vessels, urine tubes, skin tissue and other living body parts. But
engineering full organs, with their complicated cell structures, is much more difficult. ¶ Enter 3-D
printers, which because of their precise process can reproduce the vascular systems required to make
organs viable. Scientists are already using the machines to print tiny strips of organ tissue. And while
printing whole human organs for surgical transplants is still years away, the technology is rapidly
developing.¶ "The mechanical process isn't all that complicated. The tricky part is the materials, which
are biological in nature," said Mike Titsch, editor-in-chief of 3D Printer World, which covers the
industry. "It isn't like 3-D printing plastic or metal. Plastic doesn't die if you leave it sitting on an openair shelf at room temperature for too long."¶ The idea of printing a human kidney or liver in a lab may
seem incomprehensible, even creepy. But to many scientists in the field, bioprinting holds great
promise. Authentic printed organs could be used for drug or vaccine testing, freeing researchers from
less accurate methods such as tests on animals or on synthetic models.¶ Then there's the hope that 3D printers could someday produce much-needed organs for transplants. Americans are living longer,
and as we get deeper into old age our organs are failing more. Some 18 people die in the United
States each day waiting in vain for transplants because of a shortage of donated organs -- a problem
that Anthony Atala, director of the Wake Forest Institute for Regenerative Medicine and a pioneer in
bioprinting, calls "a major health crisis."¶ An 'exciting new area of medicine'¶ Bioprinting works like this:
Scientists harvest human cells from biopsies or stem cells, then allow them to multiply in a petri dish.
The resulting mixture, a sort of biological ink, is fed into a 3-D printer, which is programmed to arrange
different cell types, along with other materials, into a precise three-dimensional shape. Doctors hope
that when placed in the body, these 3-D-printed cells will integrate with existing tissues.¶ The process
already is seeing some success. Last year a 2-year-old girl in Illinois, born without a trachea, received
a windpipe built with her own stem cells. The U.S. government has funded a university-led "body on a
chip" project that prints tissue samples that mimic the functions of the heart, liver, lungs and other
organs. The samples are placed on a microchip and connected with a blood substitute to keep the
cells alive, allowing doctors to test specific treatments and monitor their effectiveness.¶ "This is an
exciting new area of medicine. It has the potential for being a very important breakthrough," said Dr.
Jorge Rakela, a gastroenterologist at the Mayo Clinic in Phoenix and a member of the American Liver
Foundation's medical advisory committee.¶ "Three-D printing allows you to be closer to what is
happening in real life, where you have multiple layers of cells," he said. With current 2-D models, "if
you grow more than one or two layers, the cells at the bottom suffocate from lack of oxygen."¶ To
accelerate the development of bioprinted organs, a Virginia foundation that supports regenerative
medicine research announced in December it will award a $1 million prize for the first organization to
print a fully functioning liver.¶ One early contender for the prize is Organovo, a California start-up that
has been a leader in bioprinting human body parts for commercial purposes. Using cells from donated
tissue or stem cells, Organovo is developing what it hopes will be authentic models of human organs,
primarily livers, for drug testing.¶ The company has printed strips of human liver tissue in its labs,
although they are still very small: four by four by one millimeter, or about one-fourth the size of a dime.
Each strip takes about 45 minutes to print, and it takes another two days for the cells to grow and
mature, said Organovo CEO Keith Murphy. The models can then survive for about 40 days. ¶ Organovo
has also built models of human kidneys, bone, cartilage, muscle, blood vessels and lung tissue, he
said.
Momentum is building---accelerates the process.
Phillips 14 – senior contributor and editor at Inside3DP.com
Shanie, “Latest Development Brings Us One Step Closer to Bioprinting Organs”
[http://www.inside3dp.com/latest-development-brings-us-one-step-closer-bioprinting-organs/] August 6 //
Printing organs is certainly one of the coolest and most talked about capabilities of 3D printing. Even
though fully functional, implantation-safe organs have yet to be artificially created, many developments
have been made that lead in that direction. This past week, another revelation in bioprinting was made
that brings us one step closer to 3D printed organs.¶ A team of researchers from universities across
the US and China tested biological ‘inks’ with different concentrations of mouse fibroblasts and
hydrogel solutions, and found that adding more cells in the bioinks reduces both droplet size and the
rate at which the ink gets dispensed. This is a significant breakthrough in bioprinting, as no studies
have been done yet that really reveal how bioinks behave when dispensed through printer nozzles. ¶
“There are a few different biofabricating methods, but inkjet printing has emerged as a frontrunner. It
has been used to print live cells, from hamster ovary cells to human fibroblasts, which are a common
type of cell in the body,” the researchers reported in the American Chemical Society journal Langmuir,
which published the results.¶ Organ shortage is a serious issue. Currently over 120,000 people are on
waiting lists for donated organs, yet less than 10,000 received the transplants they needed between
January and April of this year. In addition to the shortage itself, available organs also run the risk of
being rejected by the patient’s body. With the new bioink information discovered this week,
researchers can now better conduct and tailor bioprinting studies, which could lead to quicker
development of functional 3D printed ‘self-made’ organs that can’t be rejected.¶ “The new results will
help scientists move forward with this promising technology,” said Yong Huang, one of the researchers
from the University of Florida in Gainesville. Other researchers in the team were from Clemson
University in South Carolina, Zheijiang University in China and the Medical University of South
Carolina.
We’re on the brink of being able to bioprint organs
Ungar 13
Laura, “Researchers closing in on printing 3-D hearts”
[http://www.usatoday.com/story/tech/2013/05/29/health-3d-printing-organ-transplant/2370079/] May 29 //
LOUISVILLE, Ky. — Researcher Stuart Williams is not talking about a far-off, science-fiction effort
when he describes how scientists here will create new, functioning human hearts — using cells and a
3-D printer.¶ The project is among the most ambitious in the growing field of three-dimensional printing
that some say could revolutionize medicine.¶ STORY: Doctors design custom implant for baby¶
STORY: 3-D printing revolutionizes development¶ "We think we can do it in 10 years — that we can
build, from a patient's own cells, a total 'bioficial' heart," said Williams, executive and scientific director
of the Cardiovascular Innovation Institute. The institute is a collaboration between the University of
Louisville and the Jewish Heritage Fund for Excellence.¶ Known for creating products as diverse as car
parts and action figures, 3-D printing also is being used to create models of human bones and organs,
medical devices, personalized prosthetics and now, human tissues. Williams describes the process as
taking a three-dimensional structure "and essentially cloning it, using a printer."¶ "Bioprinting is pretty
much done everywhere," said Dr. Anthony Atala, director of the Wake Forest Institute for Regenerative
Medicine in North Carolina where scientists recently won an award for innovations in bioprinting. "Our
ultimate goal is increasing the number of patients who get organs."¶ Earlier this month, officials
announced that a baby's life had been saved when a 3-D printed device from the University of
Michigan — a specially designed splint — restored his breathing. The case was recently featured in
the New England Journal of Medicine.¶ Here, Williams and his colleagues recently created and
implanted parts of hearts in mice as part of their heart-printing research. And University of Kentucky
scientists have used the technology to grow new ulna bones in rabbits and make numerous models of
human parts for teaching and surgery planning.¶ Eventually, scientists across the globe hope printing
tissues and organs from patients' cells can eliminate the danger of rejection and the persistent
shortage of transplant organs. Atala said that may be years away, and scientists face a number of
challenges, such as replicating the complexity of blood vessels. ¶ But Bill Gregory of the UK Center for
Visualization and Virtual Environments expressed the optimism of many scientists, saying that, in the
future, "You'll be able to custom-make parts and get them when you need them."¶ Work began in
1990s¶ While interest in 3-D printing has "all of a sudden exploded," Williams said that he and other
scientists have been studying medical applications of the technology since the 1990s. ¶ It involves
taking a three-dimensional digital image of a structure, then replicating the structure by depositing
material in layers. Materials can be plastic, liquid or cells in a biologically safe glue. Different
researchers use different custom-made glues and printers.¶ Williams, who worked at the University of
Arizona before coming to UofL in 2007, said his team there received money from the U.S. Department
of Defense to use 3-D printing to create a lymph node — with the idea it could be implanted in the
event of bioterrorism.¶ To create the node — which they did in 2001 — they built a 3-D printer called
the BioAssembly Tool, or BAT, for about $400,000. They started with a direct-write printer, adding
parts from the hardware store and from custom shops.¶ In 2003, Williams won an R&D 100 Award for
his work on the custom printer, which has resulted in $30 million worth of bioprinting work. ¶ Williams
has brought the BioAssembly Tool here, where his main interest is creating blood vessels, cardiac
structures and ultimately hearts to fight cardiovascular disease, which accounts for about 3 in 10
deaths in Kentucky.¶ "This was what killed my dad," he said. "My dad was in congestive heart failure." ¶
In 2007, the Cardiovascular Innovation Institute received a $2 million grant from the National Institutes
of Health to develop the printing technology, which researchers used at the time to organize tissue
grown in the lab to build networks of small blood vessels using mice and rats. Their work has
continued since.¶ Tissues are created using cells derived from an individual's fat and extracted with a
machine. They go into the BioAssembly Tool, and the living cells are mixed with a glue that eventually
dissolves inside the body like surgical sutures.¶ STORY: 3-D printing shows promise in prosthetics¶
VIDEO: 3-D printer could make live body parts¶ The printer rebuilds the structure, which then can be
implanted. Williams said they are still working on whether the fat-derived cells will be coaxed into
becoming cardiovascular cells in the lab or inside the body.¶ He said building a heart involves creating
five parts — valves, coronary vessels, microcirculation, contractile cells and the organ's electrical
system. Six months ago, researchers created and implanted a portion of a heart and blood vessels in
mice.¶ The ultimate goal is to extract a patient's fat through liposuction, isolate cells with a machine,
mix them with the glue and "print" a heart — all within an hour.¶ Williams said the total bioficial heart
could cost about $100,000 in today's dollars, not counting $150,000 or so in hospital and surgery
costs. That's less than the typical heart transplant and doesn't require ongoing costs for anti-rejection
drugs.¶ If the bioficial heart were proven and federally approved, insurance most likely would cover it if
it were considered medically necessary for the patient, he said.¶ Williams said some of his peers laugh
at his 10-year timetable, but he's not discouraged.¶ "I love it when they laugh," he said. "It provides me
with a challenge."¶ Beyond Louisville¶ Scientists in Lexington also are tapping into the possibilities of 3D printing.¶ Gregory said his UK center printed ulnas for rabbits around 2005, using "bone-seeding"
material that coaxed new bone to grow within rabbits.¶ A more common application of 3-D printing at
UK is to create surgical models from CT or MRI images, using liquid, small beads or powder, Gregory
said.¶ Models allow surgeons to practice on a person's precise anatomy before an operation — or
teach medical students or residents — using printed replicas of structures such as jaws, eye sockets
or cheekbones. Gregory said doctors also develop custom implants for reconstruction. ¶ Dr. Larry
Cunningham, chief of oral maxillofacial surgery at the University of Kentucky, said models give doctors
"something you can hold in your hand," instead of trying to visualize a structure from a twodimensional image.¶ "The advantage to the patient is I'm better prepared," Cunningham said. "I can be
faster with less down time, which is important because OR time can cost $100 a minute."¶ The cost of
3-D printers has come down. Gregory said people can buy decent "hobby printers" for a couple
thousand dollars, and sophisticated lab versions cost around $20,000 with custom-made printers
costing much more.¶ The increasingly accessible technology has spawned new companies and
products.¶ San Francisco-based Bespoke Innovations creates custom prosthetics, saying on its
website: "The advent of 3-D printing has allowed us to build something based on the unique shape of
a particular user, modify it with our designs, and turn it into something physical that can be worn." ¶
Human parts¶ Meanwhile, scientists across the world are working on the next step, creating an array of
real human parts.¶ In February, doctors at Weill Cornell Medical College and biomedical engineers at
Cornell University in New York announced they had used 3-D printing and injectable gels made of
cells to build a facsimile of a human ear that looks and acts like a real one.¶ And in the case of the
baby in Michigan, university officials said the splint was created from a CT scan of the patient's
trachea and bronchus, integrating a computer model with 3-D printing. The baby, who stopped
breathing every day when his collapsed bronchus blocked the flow of air, was off a ventilator three
weeks after the surgery, and officials say he hasn't had breathing trouble since. ¶ Wake Forest
scientists, like their peers in Louisville, are working on organs. Officials at Wake Forest say their
scientists were the first in the world to engineer a lab-grown organ, and they hope to scale up the
process by printing organs with a custom printer. Institute scientists there have also designed a
bioprinter to print skin cells onto burn wounds.
2NC MARKET
Geographic containment is impossible – domestic donor pool will inevitably dry
up and market forces means donors from underprivileged countries will travel to
the US to sell their organs
Jha and Chugh 6 – professors of nephrology @ Nephrology at the Postgraduate Institute of Medical
Education and Research, Chandigarh, India.
Vivekanand and Kirpal S., “The case against a regulated system of living kidney sales”
[http://abcnews.go.com/images/WNT/The%20case%20against%20a%20regulated%20system.pdf] //
Schemes for setting up government-funded and regulated paid kidney donation programs that give
equal opportunity to rich and poor people, and guarantee health care to the donors, have been
proposed. Getting such programs to work, however, would be a major challenge. Even the
proponents of regulated sales concede that such models can apply only to Western countries that
have well-established systems of implementation and monitoring to ensure fair and equitable
distribution through existing domestic networks. Inherent in such schemes is the assumption that
strict geographical containment is possible.¶ Once the initial rush of domestic donors is exhausted,
the globalization of organ trade, whereby donors would come in large numbers from the developing
world to supply organs to the industrialized world, is inevitable. The accep- tance of even a limited
domestic organ market in the advanced nations will act as the proverbial thin end of the wedge and
encourage adoption of commercial donation in the developing world. This view was endorsed by
the National Kidney Foundation in a testimony to the US Congress where Dr Francis Delmonico
argued that “...a US congressional endorsement for payment would propel other countries to
sanction unethical and unjust standards...”.¶ Paid transplantations negatively affect living related
and cadaveric transplantation in devel- oping countries. 13 When cheap organs are avail- able,
people often opt to buy one rather than subject a loved one to the risk of donation. There are other
strategies apart from organ sales that can increase donation rates, such as public awareness
campaigns, a ‘presumed consent’ law, use of marginal donors and performing ABO- incompatible
or paired-exchange transplanta- tions. An element of reciprocity could also be injected into the
system, so that—for example— people can choose to donate organs only to those who have in
turn indicated their willingness for the same.¶ The arguments supporting a regulated organ
market are extremely simplistic, and ignore the ground realities. Allowing such an activity in
any corner of the world would open the doors for rampant exploitation of the underprivileged in
areas that are already plagued by vast economic inequalities. It is important that the transplant
community approaches this issue with a sense of responsibility towards society that is equal to the
compassion it shows towards its patients.
Iran proves a legal market doesn’t solve
Corwin 6
Julie, “World: The Risks, Benefits Of A Free Market In Organs”
[http://www.rferl.org/content/article/1068445.html] May 16 //
But Scheper-Hughes says there are no guarantees that legalizing kidney sales would end all the
abuses now associated with the black market. She says that in Iran legal sales have not corrected
a problem of the black market: the exploitation of poor people as organ suppliers for middle- and
upper-class recipients.¶ "We know from research, including research conducted by a postdoctoral
fellow of mine who was working in Iran, that the donors are often recruited from marginal
populations that include, in addition to very poor people and people in debt, also include
populations of young people who are disaffected from their families -- some of whom are spending
a great deal of their time in the street and some of whom are drug-using people and so forth,"
Scheper-Hughes says.
Laundry list of other countries for organ brokers to shift too
Sack 14
[Kevin Sack, New York Times, 8/17/14, “Transplant Brokers in Israel Lure Desperate Kidney Patients to
Costa Rica,” http://www.nytimes.com/2014/08/17/world/middleeast/transplant-brokers-in-israel-luredesperate-kidney-patients-to-costa-rica.html?_r=0, accessed 8/21/14]
Experts list China, Egypt, India, Pakistan, Sri Lanka, Turkey, Eastern Europe and the former Soviet
republics as hot spots for organ trafficking. But illicit transplants usually go undetected unless there
is a surgical mistake or a payment dispute. Prosecutions are thwarted by false affidavits, toothless
laws and lack of international cooperation, particularly regarding extradition.¶ Over the last decade,
the authorities have pursued only a handful of cases worldwide. Few have sidelined the brokers,
who seem bolder than ever. Some, like Mr. Volfman, who leases office space atop a mirrored
skyscraper in Ramat Gan, have moved out of the shadows. They brazenly ply their trade even
while under police scrutiny, posting Facebook photos of the luxury cars and five-star hotel rooms
they rent on the road.
Economic incentives outweigh regulatory safeguards – brokers will continue
operating sales in the illicit market b/c it’s more profitable
Mendoza 11
[Roger Lee Mendoza, Professor, Wilmington University/University of Pennsylvania, J Public Health (2011)
33 (1), “Price deflation and the underground organ economy in the Philippines,”
http://jpubhealth.oxfordjournals.org/content/33/1/101.full#ref-10, accessed 8/22/14]
The dividing line between the underground and legal transplant systems becomes razor-thin when
several participants (matching agencies, foundations, hospitals, doctors and law-enforcers) in one
system consciously or unconsciously perform the same roles or functions in the other with relative
ease. Kidney patients pay huge sums for new kidneys, but most of them go to brokers, including
some doctors/medical facilities, for locating and transporting poor donors. Without brokers
operating in a relatively unrestrained market, it is doubtful if many poor vendors will find kidney
buyers. Without incentives (e.g. cash rewards) to report these brokers and their vast networks, and
swift government action, the underground kidney trade will continue to flourish , entrench
market inequalities based on asymmetric information and dent government reform efforts. ¶ The
Philippine experience thus yields valuable public health policy insights that are transferable to other
countries, particularly in the developing world: (i) grassroots-based educational and health
promotion strategies are vital considering vendors' socio-demographic profile and limited
awareness of legal prohibitions and health risks; (ii) a carefully designed mix of supply-side and
demand-side incentives complements law-enforcement (e.g. cash incentives to report buy-and-sell
transactions and swift government action with on-the-spot media coverage); (iii) criminal deterrence
is insufficient and costly in the absence of creative policing and prosecution strategies to cope with
ever-changing trading environments (e.g. online, sham marriages between foreign patients and
Filipino vendors) and rules (e.g. sub-contracting); (iv) donor post-operative care and long-term
health deserve equal attention (e.g. making organ recipients partly responsible for donors' health
care promotes a more equitable transplantation model); and (v) policy debate should not be
confined to legitimacy issues (e.g. prohibition and punishment of compensated donations), but
should address other relevant aspects of transplantation, including better renal care programs,
promotion of cadaveric (brain-death and cardiac-death) organ donations, the health hazards of illicit
organ-selling and sources of information asymmetries.¶ Collectively, these policy implications
underscore the need to evaluate government action in terms of its net effect on participants in the
underground organ commerce. A carefully designed mix of effective regulation and lawenforcement and public education should raise the costs and lower the benefits of brokered organ
trading. It should also encourage the exchange of useful and symmetric information concerning
organ donation and transplantation. Otherwise, organ traders will likely find it economically
inefficient to distinguish between what is legal and prohibited in organ donation and
transplantation.
Illegal brokers circumvent the plan – they’ll just move to a new country
Sack 14
[Kevin Sack, New York Times, 8/17/14, “Transplant Brokers in Israel Lure Desperate Kidney Patients to
Costa Rica,” http://www.nytimes.com/2014/08/17/world/middleeast/transplant-brokers-in-israel-luredesperate-kidney-patients-to-costa-rica.html?_r=0, accessed 8/21/14]
A broker who trades in human organs might seem a difficult thing to find. But Ms. Dorin’s mother
began making inquiries around the hospital where she worked, and in short order the family came
up with three names: Avigad Sandler, a former insurance agent long suspected of trafficking; Boris
Volfman, a young Ukrainian émigré and Sandler protégé; and Yaacov Dayan, a wily businessman
with interests in real estate and marketing.¶ The men were, The New York Times learned during an
investigation of the global organ trade, among the central operators in Israel’s irrepressible
underground kidney market. For years, they have pocketed enormous sums for arranging overseas
transplants for patients who are paired with foreign donors, court filings and government
documents show.¶ The brokers maintain they operate legally and do not directly help clients buy
organs. Dodging international condemnation and tightening enforcement, they have nimbly
shifted operations across the globe when any one destination closes its doors. ¶ The supply
of transplantable organs is estimated by the World Health Organization to meet no more than a
tenth of the need. Although there is no reliable data, experts say thousands of patients most likely
receive illicit transplants abroad each year. Almost always, the sellers are poor and ill-informed
about the medical risks.¶ The vast marketplace includes the United States, where federal
prosecutors in New Jersey won the first conviction for illegal brokering in 2011. ¶ But a Times
analysis of major trafficking cases since 2000 suggests that Israelis have played a disproportionate
role. That is in part because of religious strictures regarding death and desecration that have kept
deceased donation rates so low that some patients feel they must turn elsewhere. ¶ “When
someone needs an organ transplant, they’ll do everything in their power,” said Meir Broder, a top
legal adviser to Israel’s Ministry of Health.
Legalization doesn’t increase the quality of organs – creates an incentive for
donors to lie about preexisting conditions
*DDOC = deceased donor organ commercialism
Epstein et al 11 – senior Lecturer in Medical Ethics and Law @ Barts and The London School of
Medicine and Dentistry,
Miran, Dominique Martin, and Gabriel Danovitch, “Caution: deceased donor organ commercialism!”
Transplant International Volume 24, Issue 9, pages 958–964, September 2011 //
DDOC also risks impairing the safety of organ transplantation. Commercial organ donation, both
from the living and deceased, is accompanied by an increased risk of infection [67]. Although such
complications may be related to the quality of transplantation services, in particular the screening of
organ vendors and the hazards of maintaining continuity of patient care in the setting of transplant
tourism, DDOC may nevertheless contribute to increased risks. For example, prospective organ
providers or their relatives may be reluctant to reveal information about the provider’s health that
might jeopardize the chance of sale,
such as the presence of risk factors for infection or disease. Medical staff may also conceal such
information to profit from organ recovery or transplantation. In this regard it is worth noting that in
the U.S., paid blood donation was discontinued precisely because of the increased infection risk.
The larger the amount of money at stake the greater may be the propensity to conceal critical
information [68].
Antibiotic use doesn’t spike resistance
THOMAS, M.E., et al., 08
virus into poultry farms during the
("Risk factors for the introduction of high pathogenicity Avian Influenza
epidemic in the Netherlands in 2003." Preventive veterinary medicine 69, (10 June 2005): 1-11. Agricola.
EBSCO. [1 Aug. 2008,
http://search.ebscohost.com/login.aspx?direct=true&db=agr&AN=IND43716042&site=ehost-live]
With the exception of ciprofloxacin resistance, there
is a paucity of scientific evidence to document the association
of antimicrobial agents used in veterinary medicine with increases in antimicrobial-resistant pathogens
(Phillips et al., 2004). For example, it has been suggested that the increased prevalenc e of extended-spectrum
cephalosporin-resistant strains is in part related to the use in food animals of ceftiofur, which is an extended-spectrum
cephalosporin approved for use in veterinary medicine (White et al., 2001); however, scientific evidence is lacking.
Antimicrobial agents used for intensive calf rearing in the 1970–1980s have also been speculated to contribute to the emergence of
multiple-antibiotic resistant Salmonella Typhimurium DT104 strains. Genes included in the antibiotic resistance gene cluster of
Salmonella Typhimurium DT104 confer resistance to four of the five antimicrobials used during that time to treat veal calves,
therefore co-selection of the entire cluster could have arisen from the use of any one of those drugs (Velge, Cloeckaert, & Barrow,
2005). While there is no definitive evidence for this scenario, several reviews have been published presenting contrasting views
regarding the role of veterinary usage of antimicrobials in the emergence of antibiotic-resistant foodborne pathogens. In support of a
causal relationship are reviews by Angulo et al., 2004 and Mølbak, 2004, whereas reviews by Phillips et al., 2004 and Wassenaar,
2005 advocate that veterinary usage of antimicrobial agents are inaccurately incriminated as being a major
contributor to antibiotic-resistant pathogens in humans. Debate on this topic will continue but should consider the
additional routes which lead to resistant bacterial populations, that antimicrobial usage in animals is required for animal health and
well-being, and that not every antimicrobial-resistant pathogen has human health consequences. On this latter point, clearly not all
infections caused by resistant pathogens fail to respond to treatment. For example, in a study of 23 diarrhea cases in Thailand,
nearly all were infected with ciprofloxacin-resistant Campylobacter, yet 58% of patients receiving ciprofloxaxin treatment were cured.
This response implies that treatment with ciprofloxacin could still be effective in many cases (Sanders et al., 2002). Another
consideration is that acquisition of drug resistance could entail a biological cost to the pathogen resulting in reduced fitness and
competitiveness in the absence of antibiotic selection pressure. For example, most data on E. coli suggest that increased antibiotic
resistance results in decreased fitness (Wassenaar, 2005). Alternatively, for some foodborne pathogens such as fluoroquinoloneresistant C. jejuni, resistance can be neutral or even beneficial in terms of fitness (Luo et al., 2005). When coinoculated into
chickens, fluoroquinolone-resistant Campylobacter isolates either outcompeted or were outcompeted by most of the
fluoroquinolone-susceptible strains, with the outcome being dependent on the genetic background of the recipient strain. These
variable results highlight the complex nature of antibiotic resistance and the large data gaps that exist in
making informed scientific decisions on use of antimicrobials in animals used for food.
1NR KEYSTONE
Runaway warming leads to extinction – precautionary principle means you
should vote neg if there’s any risk they don’t lead to extinction
Roberts 13—citing the World Bank Review’s compilation of climate studies
- 4 degree projected warming, can’t adapt
- heat wave related deaths, forest fires, crop production, water wars, ocean acidity, sea level rise, climate
migrants, biodiversity loss
David, “If you aren’t alarmed about climate, you aren’t paying attention” [http://grist.org/climateenergy/climate-alarmism-the-idea-is-surreal/] January 10
We know we’ve raised global average temperatures around 0.8 degrees C so far. We know that 2
degrees C is where most scientists predict catastrophic and irreversible impacts. And we know that we
are currently on a trajectory that will push temperatures up 4 degrees or more by the end of the century.
What would 4 degrees look like? A recent World Bank review of the science reminds us. First, it’ll get hot:
Projections for a 4°C world show a dramatic increase in the intensity and frequency of high-temperature
extremes. Recent extreme heat waves such as in Russia in 2010 are likely to become the new normal
summer in a 4°C world. Tropical South America, central Africa, and all tropical islands in the Pacific are
likely to regularly experience heat waves of unprecedented magnitude and duration. In this new hightemperature climate regime, the coolest months are likely to be substantially warmer than the warmest
months at the end of the 20th century. In regions such as the Mediterranean, North Africa, the Middle
East, and the Tibetan plateau, almost all summer months are likely to be warmer than the most extreme
heat waves presently experienced. For example, the warmest July in the Mediterranean region could be
9°C warmer than today’s warmest July. Extreme heat waves in recent years have had severe impacts,
causing heat-related deaths, forest fires, and harvest losses. The impacts of the extreme heat waves
projected for a 4°C world have not been evaluated, but they could be expected to vastly exceed the
consequences experienced to date and potentially exceed the adaptive capacities of many societies and
natural systems. [my emphasis] Warming to 4 degrees would also lead to “an increase of about 150
percent in acidity of the ocean,” leading to levels of acidity “unparalleled in Earth’s history.” That’s bad
news for, say, coral reefs: The combination of thermally induced bleaching events, ocean acidification,
and sea-level rise threatens large fractions of coral reefs even at 1.5°C global warming. The regional
extinction of entire coral reef ecosystems, which could occur well before 4°C is reached, would have
profound consequences for their dependent species and for the people who depend on them for food,
income, tourism, and shoreline protection. It will also “likely lead to a sea-level rise of 0.5 to 1 meter, and
possibly more, by 2100, with several meters more to be realized in the coming centuries.” That rise won’t
be spread evenly, even within regions and countries — regions close to the equator will see even higher
seas. There are also indications that it would “significantly exacerbate existing water scarcity in many
regions, particularly northern and eastern Africa, the Middle East, and South Asia, while additional
countries in Africa would be newly confronted with water scarcity on a national scale due to population
growth.” Also, more extreme weather events: Ecosystems will be affected by more frequent extreme
weather events, such as forest loss due to droughts and wildfire exacerbated by land use and agricultural
expansion. In Amazonia, forest fires could as much as double by 2050 with warming of approximately
1.5°C to 2°C above preindustrial levels. Changes would be expected to be even more severe in a 4°C
world. Also loss of biodiversity and ecosystem services: In a 4°C world, climate change seems likely to
become the dominant driver of ecosystem shifts, surpassing habitat destruction as the greatest threat to
biodiversity. Recent research suggests that large-scale loss of biodiversity is likely to occur in a 4°C
world, with climate change and high CO2 concentration driving a transition of the Earth’s ecosystems into
a state unknown in human experience. Ecosystem damage would be expected to dramatically reduce the
provision of ecosystem services on which society depends (for example, fisheries and protection of
coastline afforded by coral reefs and mangroves.) New research also indicates a “rapidly rising risk of
crop yield reductions as the world warms.” So food will be tough. All this will add up to “large-scale
displacement of populations and have adverse consequences for human security and economic and
trade systems.” Given the uncertainties and long-tail risks involved, “ there is no certainty that
adaptation to a 4°C world is possible.” There’s a small but non-trivial chance of advanced
civilization breaking down entirely. Now ponder the fact that some scenarios show us going up to 6
degrees by the end of the century, a level of devastation we have not studied and barely know how to
conceive. Ponder the fact that somewhere along the line, though we don’t know exactly where, enough
self-reinforcing feedback loops will be running to make climate change unstoppable and irreversible for
centuries to come. That would mean handing our grandchildren and their grandchildren not only a
burned, chaotic, denuded world, but a world that is inexorably more inhospitable with every passing
decade.
The plan destroys Obama’s political standing
Martin Gunnarson, PhD student in Ethnology at the Centre for Studies in Practical Knowledge,
Södertörn University, and at the Department of Arts and Cultural Sciences, Lund University, 2012, The
body as gift, resource, and commodity, http://sh.divaportal.org/smash/get/diva2:510121/FULLTEXT01.pdf
But is a gift that is presumed really a gift? And if one’s dead body is such a valuable resource for helping
others in grave need, should it still be considered an object that one is entitled to control the ways of even
when one is dead? Perhaps the right thing to do would be to once and for all let go of the gift metaphor
and officially start referring to the brain-dead body as a resource. In the wake of such a rhetorical shift, a
political space might open up allowing the implementation of policies aimed at increasing the number of
organs available for transplantation. But as we all know, leaders who propose changes of such nature
would almost certainly risk committing political suicide.
The problems of implementing strategies aimed at increasing the number of organs for transplantation
are many and hard to solve, everybody involved knows this. In this context, not only politicians risk
losing the trust of people, health care practitioners do, too. Whether we are talking about making
consent as a necessary requirement for do- nation weaker, or about making the donor pool larger by
moving from total brain death to a criteria based on that the parts of the brain necessary for being
conscious and feeling pain are forever gone, mistrust may easily arise and spread if patients in some
situations move from being a subject of concern in their own right to being a resource for the concern of
others. Emergency care to keep organs fresh for transplantation, rather than trying to save the life of the
person that the organs presently belong to, are hard to handle, for health care personnel, as well as for
relatives. Every prognosis in medicine has a certain percentage of uncertainty to it, and if we move from
total brain death to less strict criteria (either directly or by the way of DCD) the chances (even if still very
close to zero) will rise that somebody diagnosed as dead will come back to life (meaning coming back to
consciousness). And even if this does not happen in a case which has been strictly controlled, it might
happen, or, at least, be said to have happened, in other cases which involve coma not being sufficiently
diagnosed to determine if it is irreversible or not.
Political death sentence
Hippen 8 [Benjamin E. Hippen (Associate editor of the American Journal of Transplantation, transplant
nephrologist in private practice with Metrolina Nephrology Associates and the Carolinas Medical Center,
at-large member of the United Network for Organ Sharing/Organ Procurement and Transplant Network
Ethics Committee); March 20, 2008; “Organ Sales and Moral Travails: Lessons from the Living Kidney
Vendor Program in Iran”; Policy Analysis, No. 614]
A straightforward repeal of Section 301 of the National Organ Transplant Act, 71 which proscribes the
exchange of “valuable consideration” for organs, would be the most effective first step toward establishing
a comprehensive system of organ vending in the United States. A more feasible but politically difficult
first step would be for Congress to allow exemptions from Section 301 of NOTA to permit pilot programs
in organ vending. However, whether or not such programs proved successful could depend on many
variables. For example, a pilot program might increase the number of organs without fulfilling other
obligations to organ vendors, invit ing unflattering comparisons to underground organ trafficking. Or
a program might be successful in one community but ineffective (or inappropriate) in other
communities. An incentive program that works in Chicago might not be nearly as effective in
Poughkeepsie. By extension, a single program which fails to increase the number of organs should not
lead to the conclusion that all incentive proposals are certain to fail. For these reasons, a straightforward
repeal of Section 301 would be preferable.
Empirics prove the link
Laura Meckler, WSJ, 2007, Kidney Shortage Inspires A Radical Idea: Organ Sales,
online.wsj.com/news/articles/SB119490273908090431?mg=reno64wsj&url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB119490273908090431.html
Despite their differences over organ sales, Drs. Matas and Delmonico have much in common. Both have
been kidney-transplant surgeons since the late-1970s, when the field was young and all the leading
surgeons knew one another. Dr. Matas's wife sent gifts when Dr. Delmonico's grandchildren were born.
Dr. Delmonico was quick with recommendations for the best Italian food in Boston's North End when Dr.
Matas came to town to visit.
Dr. Delmonico has used his influence to help kill efforts on the kidney-selling front. In 2003, several
medical groups, including the American Medical Association and the United Network for Organ Sharing,
endorsed legislation to allow pilot studies of payments to families that donate a loved one's organs after
death.
Dissent was strong, including from Dr. Delmonico, who testified before Congress on behalf of the
National Kidney Foundation. "The sale of bodies or body parts would undermine the fundamental values
of our society," he told the House Energy and Commerce Committee. The bill went nowhere.
PC key to holding dems in line
Simendinger 12/29
Alexis, “Obama's 2014: Buffeted Yet Buoyed by Late-Year Uptick”
[http://www.realclearpolitics.com/articles/2014/12/29/obamas_2014_buffeted_yet_buoyed_by_lateyear_uptick_125061.html] //
Obama, as was true of his predecessors, will need to hold his party to protect his vetoes from
being overridden by required two-thirds majorities in each chamber. Overriding vetoes is not
easy, as history has shown.¶ Vetoes are a powerful constitutional shield to block legislation during
divided government, and can be used as weapons to force legislative compromises. Having
wielded his veto powers just twice to date, Obama is poised to get more practice. During President
Clinton’s final two years in office, Chuck Brain was the White House legislative director during a
contentious period with Republicans in Congress. Brain envisions a series of Obama vetoes that
he believes should be strategically worked out with members of the president’s party, and yet be
unpredictable enough to keep Republicans guessing.¶ “We’re going to see in the last two years of
this presidency, in this next Congress, the high art of veto politics,” Brain told RCP during a Dec. 11
panel discussion held at American University.¶ Obama says he’ll make strides using his unilateral
powers in the next two years. That means he has new calculations to make after losing the Senate
four years after losing Democratic control of the House.¶ “The numbers that matter to the president
are 34 and 146,” Schiliro added. “If the president focuses on that, then he has the ability to
have a disproportionate influence on the process. Those are the numbers he needs to sustain
a veto.”
PC key to sustain vetos
Douglas Bloomfield, 12/31/14, Washington Watch: Democrats in disarray ,
www.jpost.com/Opinion/Washington-Watch-Democrats-in-disarray-386301
In recognition of the rising influence of the liberal wing and Warren’s own national stature, Reid created a
leadership post for her as a strategic advisor. Obama expects to be using his veto pen quite a bit over the
next two years, and he will need Democrats to help sustain those decisions. Some, however, may be
reluctant to go to the barricades for a lame-duck president who many feel has taken them for granted and
could drag them down. Pelosi’s and Warren’s opposition to the year-end spending compromise between
the White House and Republicans told the president not to try to bypass them to cut deals with the
opposition because he will need them in the showdowns .
Obama’s working to maintain veto support—that’s key
Charles Babington, AP, 12/7/14, Obama, Congress Brace For Veto Showdowns,
www.huffingtonpost.com/2014/12/07/obama-congress-veto_n_6283688.html
Veto brinkmanship between congressional Republicans and President Barack Obama was virtually
absent in his first six years in office, but it's about to unleash itself on Washington. Until now, controversial
Republican-backed legislation rarely reached the president's desk because Senate Democrats blocked it.
Starting in January, however, Republicans will control both the House and Senate, and Obama may have
to decide more often whether to sign or veto GOP-crafted bills. Obama gave lawmakers an early taste of
veto politics recently when he forced congressional leaders to drop a proposed package of tax breaks
that were popular with many Republican constituents. Some Democrats did support the plan, but liberals
and the White House said it tilted too heavily toward corporations, not lower-income workers. The White
House also has promised to veto any bills restricting the president's major changes to immigration
policies, setting up likely showdowns early next year. Obama's threats present the type of bind that
Republicans may face repeatedly in the next two years. They can agree to many or all of the changes he
demands in legislation, or they can let him use his veto and hope Americans will blame him more than
them. It's a gamble, especially with critical spending bills Congress soon must address. Some
Republicans want to amend these must-pass bills to thwart Obama's bid to protect millions of immigrants,
now in the country illegally, from deportation. Assuming Obama keeps his veto promise, Republican
lawmakers would have to decide whether to drop their demands or let parts of the federal government
close for lack of money. GOP leaders say there will be no shutdowns, but they have yet to explain how
they can force Obama to back off on immigration. The 2013 partial government shutdown occurred under
similar partisan circumstances. Polls show the public blamed congressional Republicans more than the
Democratic president. It's unclear how often Obama will face a veto decision. Even in the minority,
Democratic senators can use the filibuster, the name for unlimited debate, to block many measures that
break strictly along party lines. But some proposals, such as building the Keystone XL pipeline, enjoy
significant bipartisan support. They might attract enough Democratic backing to reach 60 Senate votes,
overcoming a filibuster and sending the measure to Obama. White House senior adviser Dan Pfeiffer said
if Congress assembles legislation that Obama opposes, the White House will threaten vetoes and "if
Congress decides to pass them anyway, then we'll veto them." "We're not going to go out looking for
them, but we're not going to run from them either," he said. Should Obama veto a proposal such as the
Keystone project, the question would be whether two-thirds of the Senate and two-thirds of the House
would vote to defy him. That's the constitutional threshold for overriding a veto. It will be critical for
Republicans to put together veto-proof majorities in the House and Senate. Because any bill would
require 60 Senate votes to overcome filibusters, the Senate vote would always be bipartisan and closer to
the two-thirds majority needed to override a veto.
Defense under-estimates—Keystone key
Susan Casey-Lefkowitz, NRDC Switchboard, 1/17/13, New Analysis Shows Simple Math: Keystone
XL Pipeline = Tar Sands Expansion = Accelerated Climate Change, thinkprogress.org/tag/keystone-xl/
New research confirms what we have heard time and again from the industry itself: the proposed
Keystone XL tar sands pipeline will be a direct cause of an increase in tar sands oil development. More
tar sands oil taken out of the ground means more dangerous pollution that hurts our climate and health.
And, this new research also shows that tar sands will cause even more climate pollution than we
previously thought due to the impacts of the high carbon byproduct petroleum coke.
This is especially important in a time where our communities are feeling the damage of climate change in
violent storms, wildfires, droughts and floods. Just recently a federal advisory panel—established by
Congress in 1990 to analyze climate research—released the draft of its third National Climatic
Assessment. The report confirmed there is “unambiguous evidence” that the earth is warming.
The Pembina Institute’s analysis, “The climate implications of the proposed Keystone XL pipeline”, shows
that pipelines are a key determinant of tar sands expansion, and argues that the increase in greenhouse
gas emissions associated with supplying the Keystone XL pipeline with tar sands bitumen represents a
significant barrier to Canada meeting its domestic and international climate commitments.
Oil Change International’s new report “Petroleum Coke: The Coal Hiding in the Tar Sands” reveals that
current analyses of the impacts of tar sands fail to account for a high-carbon byproduct of the refining
process: petroleum coke. Because it is considered a refinery byproduct, petcoke emissions are not
included in most assessments of the climate impact of tar sands. Thus, the climate impact of oil
production is being consistently undercounted.
This analysis is making headway in Washington. Energy and Commerce Committee Ranking Member
Henry A. Waxman noted: “The new reports show that TransCanada’s Keystone XL pipeline is the key
that will unlock the tar sands. If the pipeline is approved, the world will face millions more tons of
carbon pollution each year for decades to come. After Hurricane Sandy, devastating drought,
unprecedented wildfires, and the warmest year on record in the United States, we know that climate
change is happening now, we have to fight it now, and we must say no to this pollution pipeline now.”
Tar sands have no viable alternatives to keystone
Sarah Laskow , TNR, 2/19/14, Keystone Opponents Have Nothing to Apologize For: Stopping the
Pipeline Will Slow Climate Change , www.newrepublic.com/article/116644/blocking-keystone-xl-reallywould-help-slow-climate-change
On one side of this debate are leaders of major environmental groups and prominent activists who want
President Obama to block the pipeline’s development. Their argument, which you may know by now,
goes like this: Without that crucial piece of infrastructure to carry oil from the tar sands to coastal
refineries and the supertankers that ferry it across the world, companies won’t have an easy time moving
the oil they extract. The industry will have to slow down extraction efforts dramatically—or, better still, give
up on them altogether.
On the other side are energy policy wonks who wonder whether fighting this one, seemingly obscure
project is worthwhile—and whether blocking it would really do much to reduce emissions. For a while, the
dissent was pretty quiet. You’d only hear murmurs, usually from people working on the drier side of
climate policy—like advocates for improving public transit infrastructure or energy efficiency. But then, in
October, Jonathan Chait came right out and said it in New York magazine: “Picking a fight over Keystone
XL,” he wrote, “was a bad idea.”
Late last month, the State Department finally weighed in on Keystone XL's climate impacts, by issuing a
report that more or less sides with the skeptics. According to the report, the tar sands industry has other
options for transporting, refining and (eventually) burning the oil it's pulling from the ground. As a result,
the report said, blocking the pipeline was “not likely” to affect the amount of oil companies took from the
tar sands. Here in the pages of the New Republic, Ted Nordhaus and Michael Shellenberger—who, like
Chait, have seen Keystone XL as a distraction for environmentalists—summarized the logic behind the
State Department’s conclusion: “If new pipelines aren’t available, rail cars or supertankers can be easily
substituted with little technological or economic difficulty.”
But is that really so clear? There is a reason that Keystone XL is the oil industry's first choice for
transporting tar sands oil. Generally speaking, pipelines are the cheapest, safest way to transport oil.
That’s a big reason why the vast majority—more than 94 percent—of oil into U.S. refineries goes that
way.
Not so long ago, the discussion of Keystone XL alternatives focused on the possibility of alternative
pipelines heading east or west through Canada and to the coasts. But those pipeline projects have run
into the same kind of political opposition (from the same sorts of groups and people) as Keystone XL has
generated. As for trucks or barges, the State Department concluded that they are not a viable alternative
to the pipeline. Transporting that much oil would take too many trucks, the State Department report said,
and there's not an inland waterway big enough to accommodate such heavy barge traffic.
That leaves rail. This is where the ambiguity comes in. It's technologically possible to transport large
volumes of oil by rail, and TransCanada, the company that wants to build Keystone XL, has considered
the possibility. But it would take extra investment both to add tank cars, spur lines, and oil storage
facilities to the existing infrastructure and to comply with safety regulations. Shipping oil by rail already
costs more than shipping by pipeline: estimates about the difference range from as low as five dollars
extra to closer to $25, or more. And the price of increasing a single terminal's oil-loading capacity comes
in at a magnitude of hundreds of millions; the system-wide improvements it will take to replace Keystone
XL's carry capacity will cost billions.
With rail, the industry also increases its chance of spilling a lot of oil, which means losing some of the
supply and dealing with the consequences—legal, financial, and political. And it may not even be much of
a chance: as train traffic from the U.S.'s Bakken oil fields has increased, so have spills. (If you're
interested in the details of tank car safety regulations, and the implications for the Keystone debate, Elena
Schor has a good write-up.)
The bottom line? Companies like TransCanada will probably keep developing the tar sands even if they
don’t get Keystone XL. But they probably won’t be able to do it as quickly—or successfully.
Approving the pipeline, in other words, is likely to ease the flow of oil to Gulf Coast refineries. Whether
that makes the Keystone XL fight worthwhile, obviously, is another matter entirely.
Tar sands not inevitable
David Roberts, Grist, 2/6/13, Debunking Nature’s arguments for Keystone, grist.org/politics/debunkingnatures-arguments-for-keystone/
This is the most familiar argument on behalf of Keystone, though “we can’t prevent this horrible thing so
let’s embrace it” is a peculiar form of endorsement.
I don’t get it. The world is not a spreadsheet. It contains friction, physical and temporal limitations, politics
and competing interests. Nothing is inevitable.
If activists can block Keystone, yeah, there are other possible routes to get the tar-sands oil out. So …
activists will fight those, too. Tar-sands producers want to ship the stuff west? Well, there’s the small
matter of a wall of First Nations opposition (and in Canada, unlike the U.S., indigenous tribes have real
political power). They want to ship the tar sands east? Well, there’s a coalition of enviro groups fighting
that too, pulling together some impressively large rallies. They want to ship the tar sands by train, to avoid
all these pipeline protests? Well, that’s more expensive and more dangerous and there isn’t nearly
enough rail capacity right now to handle it.
“Without Keystone XL, oil sands face choke point,” says the Globe & Mail. In this collection of quotes
[PDF] pulled together by 350.org, oil industry analysts and executives acknowledge that without
Keystone, tar-sands oil could be stranded, or at least severely constrained.
Evidence bad- its not conclusive
Even if Nebraska rules against Keystone, it only delays construction at worst
Colman 12/19
Zack, “No Keystone XL decision out of Nebraska” [http://www.washingtonexaminer.com/no-keystone-xldecision-out-of-nebraska/article/2557636] //
If the court decides the law is constitutional, the Obama administration will continue an inter-agency
review of the pipeline that will be used to determine whether building it is in the national interest. If
the court rejects the law, TransCanada would need to get the Nebraska Public Service
Commission to green light the route, which could take up to one year.
Warming causes a methane burp – means extinction
Lynas ‘7
[Mark, writer for The Guardian and author of Six degrees: our future on a hotter planet, “Six steps to hell,”
http://books.guardian.co.uk/departments/scienceandnature/story/0,,2063401,00.html, April 23]
The Eocene greenhouse event fascinates scientists not just because of its effects, which also saw a
major mass extinction in the seas, but also because of its likely cause: methane hydrates. This unlikely
substance, a sort of ice-like combination of methane and water that is only stable at low temperatures and
high pressure, may have burst into the atmosphere from the seabed in an immense "ocean burp",
sparking a surge in global temperatures (methane is even more powerful as a greenhouse gas than
carbon dioxide). Today vast amounts of these same methane hydrates still sit on subsea continental
shelves. As the oceans warm, they could be released once more in a terrifying echo of that methane
belch of 55 million years ago. In the process, moreover, the seafloor could slump as the gas is released,
sparking massive tsunamis that would further devastate the coasts. Again, no one knows how likely this
apocalyptic scenario is to unfold in today's world. The good news is that it could take centuries for warmer
water to penetrate down to the bottom of the oceans and release the stored methane. The bad news is
that it could happen much sooner in shallower seas that see a stronger heating effect (and contain lots of
methane hydrate) such as in the Arctic. It is also important to realise that the early Eocene greenhouse
took at least 10,000 years to come about. Today we could accomplish the same feat in less than a
century. If there is one episode in the Earth's history that we should try above all not to repeat, it is surely
the catastrophe that befell the planet at the end of the Permian period, 251 million years ago. By the end
of this calamity, up to 95% of species were extinct. The end-Permian wipeout is the nearest this planet
has ever come to becoming just another lifeless rock drifting through space. The precise cause remains
unclear, but what is undeniable is that the end-Permian mass extinction was associated with a supergreenhouse event. Oxygen isotopes in rocks dating from the time suggest that temperatures rose by six
degrees, perhaps because of an even bigger methane belch than happened 200 million years later in the
Eocene. Sedimentary layers show that most of the world's plant cover was removed in a catastrophic
bout of soil erosion. Rocks also show a "fungal spike" as plants and animals rotted in situ. Still more
corpses were washed into the oceans, helping to turn them stagnant and anoxic. Deserts invaded central
Europe, and may even have reached close to the Arctic Circle. One scientific paper investigating "kill
mechanisms" during the end-Permian suggests that methane hydrate explosions "could destroy
terrestrial life almost entirely". Acting much like today's fuel-air explosives (or "vacuum bombs"), major
oceanic methane eruptions could release energy equivalent to 10,000 times the world's stockpile of
nuclear weapons. Whatever happened back then to wipe out 95% of life on Earth must have been pretty
serious. And while it would be wrong to imagine that history will ever straightforwardly repeat itself, we
should certainly try and learn the lessons of the distant past. If they tell us one thing above all, it is this:
that we mess with the climatic thermostat of this planet at our extreme - and growing - peril.