In praise of an Iranian government policy

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One thing that I didn't know about Iran is that, when organs are donated, they pay the person making the donation for their submission. That doesn't sound like a bad idea at all when you consider the chronic shortage of organs in the UK (and the attempts of prodnosed authoritarian 'experts' to bully people into giving up their organs):

I'm sorry, but I don't feel that I 'owe' anyone anything. My body parts are my own and do not belong to the NHS or other people. I am using my body and all its environs for their intended purpose, or as I see fit. If, when I die, there is still something that is of use to others, then I may kindly offer up whatever is left to other people. We are not all simply a collection of spare parts - we are all human beings, and deserve to be treated as such in regards to organ donation (or any other kind of donation) and not bullied into it by publicly-funded, obnoxious healthist wowsers.

Iran doesn't have the chronic shortage of organs that we do because their people have the freedom to be paid for their organs being taken and used elsewhere. That doesn't sound like a bad idea to me. Everyone goes away happy.

I agree. That's a better idea than having a black market around organ trade. There's a pretty big black market on the organ trade in India, specifically kidneys. It's pretty scary.

The standard economic model is wrong in saying that different motives are independent. There is some work in behavioural economics finding that if people do something voluntarily, the numbers can drop off if you also offer money. The proportion of people giving blood in the UK, where they don't get paid, is higher than in the US, where they do get paid, but it's difficult to know whether other factors might account for that. I think there was a survey in Switzerland, in which people were less willing to have a nuclear waste dump in their community if they would get paid for it. The most quoted example is an Israeli kindergarten that imposed fines for people being late to pick up their kids. Punctuality got worse, and didn't recover to the previous level when the fines were abandoned again. Lots of people are willing to do much to be considerate. As soon as you bring money into it, people treat this as a commercial transactions, and often the financial incentive has to be quite high to match what people would do just to be nice.

Being nice to strangers isn't a social norm in all societies, so relying on that may not work everywhere:
Costly punishment across human societies
Homo ecomonicus in 15 societies

An alternative policy would be to change the default. Instead of having to opt in to be an organ donour, change the law to presume consent unless people opt out. Make opting out easy. The people who don't care enough to make a choice are added to the pool of organ donours, those who object are not made to participate.

Shifting to an opt-out system (which, IMO, has serious philosophical issues re. property rights - you're presupposing that the government has the right to someone's body which has to be claimed back) would only hold back the problem for a short while. You're still relying on enough people to die each year with transplantable organs to meet the demand each year for said organs: as the population gets older, the latter will increase while (hopefully) the former will decrease.

No, we need more focus on bionics, xenotransplantation, and stem cells.

I wonder if we could colonise a xenotransplant with the patients own cells, and over time replace the transplanted cells with the patients ones...? Especially in men, who have a ready supply of pluripotent cells, which are usually used to produce sperm... I doubt many many would have a trouble with sacrificing one of their testicles to generate stem cells to save their life. Even more interesting, there's a good chance that we could use such cells to build up a stem cell bank which can match everyone, and which will be acceptable to everyone but a few fringe cults and sects.

what good is payment when you're dead?

The only important organ i think of that i can donate and live to tell the tale is a kidney, but i don't need to go to Iran to sell one.

You can pass the money on as an inheritance, maybe even getting enough to ensure there is no tax on your estate?

Agreed.

I think it only presupposes that you are willing to help out others once you no longer have a use for your body. The opt out system still lets you decide, so I don't see how it affects property rights.

There are jurisdictions in which what you throw into the rubbish bin and put out still is your property, and jurisdictions in which you don't own the stuff any longer once you have put it out to be picked up, meaning evidence collected from a suspect's rubbish by Canadian police officer was admissible in court because going through the rubbish was not theft. Those laws make differences to your property rights because you have no say except in so far as you may vote for someone who pushes the position you like. The opt in vs opt out leaves it up to you to decide, it only differs in what is assumed if you can't be bothered to decide.

It might interest you that you don't own your body under English law, according to the BBC Radio 4 programme Law in Action of 23rd June 2009. I think the legal position is that bodies can't be owned, although body parts stolen from a UK medical institution were determined to be property. A court in California decided that the person from whom a cell line was derived that made a lot of profit did not own the cells, and therefore had no right to a share in the profits.

Here is a thought experiment for you, presupposing that you own your body and all its products: if a man and woman have sex without protection and the man doesn't want to pay alimony for the resulting child, could he claim the woman violated his property rights and stole his sperm to use it in a way he did not consent to?

And another: someone tells you that you smell. Has that person violated your property rights by appropriating the products of your body, which might be your body odour or your halitosis?

I'm not saying that owning your body is a silly proposition. I just want to see what happens if you want to be consistent about it. How do you have to define property rights over your body so that they are not silly?

Because the 'opt-out' system inherently supposes that the government has the first right over your body, rather than you the citizen.