@ #3 - There is a way to save more lives that isn't dignified. Utilitarianism comes to mind due to the tyranny of the majority. If you follow it, it would save more lives; the big question is how to do it in a dignified manner.

This is religion here, not Mill or Bentham we're talking about.

Ken Rabin

The statement on organ doantion by the current Pope is essentially the same as one his predecessor issued in the early 1990s.

While I completely agree with the Freakonomists contention that the US could use a European style ("opt-out") organ donor policy, I think that it is morally shaky to go much further than that.

As long as we have a world with great extremes of poverty and wealth, and great extremes in the valuation put on human life, we run a great risk of encouraging a situation in which organs are snatched from unwitting or unwilling donors by unscrupulous governments or profiteers.

In short, we must do everything we can to promote, honor and facilitate voluntary donation (and yes that could include government funding of funeral costs etc), which is really what Pope John Paul and Pope Benedict are talking about, and everything we can to stop organ trafficking from places like China.



In the case of large resource disparity (very poor vs. very rich) this is a terrible idea.

I, as a relatively well off person, would never sell my organs. Only poorer people would ever sell their organs.

If the time came and a family member needed a kidney, the poor would be less likely to have them available for the relative, and the family member would likely not be able to afford a kidney.

I guess its a way to kill off poor people, if that's what you're into. :( If there were a legal protection guaranteeing x% of the rich receiver's money for the next 10 years or something, maybe.

What your life isn't worth 10% of your salary for 10 years or 10% of your current assets (whichever is greater)? That's too bad for you!


Re: unintended consequences mentioned in #10

The default state for any market is freedom. The unintended consequence of the regulation of the organ market is that too many people who need organs are dying in the name of protecting would-be donors from their own free decisions.


RE: matt

You're operating under the premise that everyone is equally likely to need a transplant and equally likely to be chosen for a transplant. Chacnes are, everyone who signs up will have a pretty good idea which end they'll be on.

This would also probably prevent anyone who hasn't signed up from ever getting a transplant, even when they need it.

Lot's of people are also rejected as organ donors due to health problems, this would prevent these people from signing up, and thus prevent them from receieving a transplant later, which they would probably be more likely to need. This would leave a donor pool of all healthy people who would have a marginal chance of ever needing a transplant.

Like I said before, there's a way to give donors preference, but it's going to take more than the three rules you presented.


I'll admit that I did not read everything within this post and linked to it, but I have an idea that may or may not have been mentioned earlier:

Rather than a completely free market, where organs go to the highest bidder, why not offer a flat payment for donation, taking into account the cost of the procedure, potential reduction in quality of life, and appropriate compensation? Anyone willing to donate would receive X amount (it could vary based on the organ itself or the complications of the specific procedure, but otherwise would be fixed) and the organs would go into the general pool just like the ones donated for free are now. Obviously, there is the question of where the money would come from, but ideally with an improved health care system, it is something that could somehow be a function of that.

Another interesting point that I had never heard articulated before but I thought was something worth considering:

I recently heard of a service where people who were willing to donate could post their relevant information with a particular group, who would then cross-check it with any known patients who would be a match. Therefore, rather than scrambling to find an appropriate match, there is a database containing all people who are willing to donate that can be tapped. I thought this was intriguing, but had someone point out to me that while I may feel noble donating an unused kidney to a stranger now, how will I feel in 5 years when a loved one needs a kidney and I am all out of spares? I realize this isn't the most "economic" argument, but I am sure some people do not donate based on a similar logic.



Re E:

Another way to explain why I disagree with your statement: my idea is equivalent to stating that those who didn't sign up lost all rights to getting an organ. Perhaps that makes it more clear that nothing is lost to you unless you aren't willing to donate your own organs.


Re E:

Really? I don't see it. Sure, all the unhealthy people could sign up, but there would be a large incentive for all the healthy people to sign up too, as then they'd be back on an even footing when it came to getting a donation and ahead of all those that didn't sign up. I'd sign up, even though I don't expect to need anything for 50-odd years, because I might need something. The difference between this idea and health insurance is that I'm not actually paying anything.


Response to #3: What makes you think the Pope is particularly religious? The Catholic Church is an institution of great worldly power and wealth, and the Pope is its head. Someone who was extremely religious would probably lack the political clout to become Pope.


#3: See Thomas Aquinas.


He seems to believe the unintended consequences are a cost to high to accept. I'm not religious but do find the religious bashing folks the epitome of what they seem to hate - simple mindedness.

Knowing humans and their tendencies, without religion we'll get something like nationalism, which has killed way more people.

Catholic Economist


Check out Larry Iannaccone's articles "Introduction to the Economics of Religion" or "A Formal Model of Church and State."

Essentially, churches can not maximize their number of followers (assume that's the goal, even unconstrained) by telling people what they want to hear. Religion is a public good, and participants' utility from religion is increasing in the participation of the others around you. That is, church services are more enjoyable when surrounded by people who are really into it, and you wouldn't enjoy it as much if you were surrounded by apathetic people. The church's membership can drop, then, if its leadership announces a loosening of the rules because it draws in more free-riders. By keeping prohibitions (e.g. dance, sex, etc.) the church raises the cost of participating so that only people that are really into participate - which creates a more sustainable church.

Iannaccone shows that strict churches grow, and when they liberalize they tend to lose membership.


denis bider

If Freakonomics doesn't mind a little offending of its religious readers, I think a great issue to pursue would be the economics of religion.

We know that many religious leaders do not actually believe what they preach, but they preach what's going to be well received by their audience. In this sense, religions are a bit like mainstream media. We don't hear about "Oprah's Mystery Man" because Murdoch thinks that everyone should know, we hear about it because they think it drives ratings.

In a similar parallel, it would be interesting to investigate how much religious policies are ratings-driven. How well would a Pope be received if he told everyone "I reconsidered, it is okay to use condoms"? Or if he said that "a regulated market in human organs would be okay"?

Already, the Catholic Church is more tolerant and more science-friendly in its views than many Christians in the U.S. If the purpose of a religion is to maximize its number of followers, what happens if a religious leader endorses views with which its followers do not agree? Is the purpose of religion really leadership, or is it just to make people feel good about their existing views?

In other words - is it the dog (the Pope) that wags the tail (the believers); or is it the tail that wags the dog?


denis bider

Charles (#10): Believing that the unintended consequences of a market in organs are too great to accept is unreasonable, unless you also believe that the people who will die without a kidney are going to die according to God's will. But if that is what you believe, then, why of course - deviating from God's will is an abomination.


RE: Bobby G

By utilitarian he is referring to the practicing of harvesting organs from those without social utility for the sake of those with lots of it, e.g. there is little provided to society by a prisoner having two functioning kidneys, but much is taken from society when a policeman (or whoever) dies from kidney failure.

RE: matt

Terrible idea. We'll have all the world's alcoholics, drug users, etc sign up to be donors, then in five years they'll all cash in and the suuply of healthy organs will be gone. Your idea is somewhat similar to health insurance, where healthy people subsidize the care of unhealthy people. There's a way to make preferential care a good option, but not as you present it.


I'm not sure I agree with the proposition that the Pope is not a "clear thinker," or even that he could not have read your paper on the subject.

Whatever the Pope's faults may be -- and I don't deny he has some! -- Benedict XVI is NOT an intellectual lightweight. Anyone who can quote Manuel II Palaiologos in a tangential manner (and inadvertently ignite a furor in the process) is no idiot.

He has merely arrived at a different conclusion on the matter based on his own value judgements, as determined by his chosen philosophy. He operates by a package of axioms and assumptions -- in his case mainly determined by Roman Catholicism -- and evaluates whatever he reads accordingly. Most people live by packages of axioms and assumptions -- some the same as his, others a bit different, some VERY different -- so this is not unusual.

To convince the Pope to reach a different conclusion, one would first have to pierce the wall of axioms that surround him. That's a tall order, especially given that he makes his living asserting the veracity of those axioms! For the opposite to happen, i.e. for the Pope to convince you of HIS conclusions, he likewise would have to pierce the axioms that a professor of economics lives by -- some of which support YOUR own livelihood.

I doubt either of you would be able to change the other's mind. In the language of economics, neither of you has any "incentive" to concede the possibility of fault in any of your axioms. Quite the opposite, actually.



I'd think that some churches have organs donated to them and others pay for them. What's the big deal?


Would there be any religious, moral, or economic objection to this plan:

1)organ donation is opt-in, and once the decision is made to donate, this decision is binding no matter what your heirs say

2)people who have made this binding decision to donate have absolute priority over all other people when it comes to receiving organs, no matter what

3)a minor correction to (2): to prevent someone making this decision to donate the day that they suddenly realize that they need an organ, you have to have made this binding decision a certain amount of time before you need an organ. This time being the minimum of: 5 years, the time since the above policy enters effect, and the time since you reached an age at which you could sign a binding contract.

Seems like it gives people an incentive to donate, and people who think it's wrong to donate organs should also think it's wrong to receive them.



Erin, on the contrary, the mental acrobatics required to reconcile Catholic theology with the real world are really pretty astounding.

Bobby G

According to the blog post, the pope said that "the adoption of discriminatory or utilitarian criteria... is morally unacceptable." What? Utilitarianism is founded on the principles of individual choice and freedoms (hence free market). How can consent and consensus on a decision made by two adults with (hypothetically) complete information transparency be considered immoral? If both people want to do it and it will not negatively affect any outside party, I do not understand how there can be any basis for restriction (although I am well aware how many precedents there are already that violate this line of thinking).

If anyone is the "moral police" I guess it would be the Pope, but I am always against restrictions in markets where there is no apparent pre-existing externality (besides, at the risk of sounding like a complete jerk, external parties' "feelings").