You Say Repugnant, I Say … Let’s Do It!: What happens when the most disturbing ideas are also the best?
Photo: Magnus D
Some ideas are downright repugnant. Like … paying for human organs.
On the other hand, is it any less repugnant to let thousands of people die every year for want of a kidney that a lot of people might be willing to give up if they were able to be compensated?
Our new podcast ventures into the realm of repugnant ideas. (You can download/subscribe at iTunes, get the RSS feed or listen live via the link in box at right.) The fact is that the repugnance border shifts over time. Selling eggs or sperm, “renting” a womb — not long ago, all of this was considered way out of bounds. So was birth control and adoption. Go back a bit further in history: currency speculation, charging interest on loans, even selling life insurance — these practices, too, were almost universally felt to be repugnant.
Will the border shift for human organs as well? Should there be a legal market for organs? (At the moment, only Iran has one.) And if not, what should we be doing to help alleviate the massive world demand for transplantable organs, especially as the increase in diseases like diabetes continue to drive kidney failure?
Steve Levitt kicks off our journey through the repugnant by describing why economists can be useful in such conversations:
Economists are pretty much immune to repugnance. Either by birth or by training, economists have their mind open, or skewed in just such a way that instead of thinking about something in terms whether something it’s right or wrong, they think about it in terms of whether it’s efficient whether it makes sense…and many times the things that are most repugnant are the things that are quite efficient — but for other reasons, subtle reasons sometimes, are completely and utterly unacceptable.
The star of the podcast is Harvard economist Al Roth (the dean of repugnant ideas), who has thought a great deal about the organ problem. But more than that, he has actually done his part to help, helping to found the New England Program for Kidney Exchange. Here, from SuperFreakonomics Illustrated, is a look at how it works:
But Roth knows that, given the scope of the problem, a program like his doesn’t help all that much. Here’s how he puts it in the podcast:
There’s an enormous social cost that people pay personally when they’re ill, that we pay as a society to have them ill and dying, and that cost weighs very heavily on me as I see it. When I started thinking about kidney exchange, the waiting list was on the order of 50,000 people and now it’s getting near 90,000 people. So kidney exchange is a small but fast growing source of live donors, but it’s like trying to hold back the tide with a broom.
You’ll also hear from two doctors — one an Israeli transplant surgeon, the other a New York emergency-medicine specialist — who stare the existing organ-donor protocols in the face and spit on them. Because sometimes the best way to fight repugnance is with a little repugnance of your own.
Brilliant? Repugnant? Maybe … both?
Hope you enjoy the program.