No Helmets for More Organs

Does life, or at least economics, imitate art?

Wearing a helmet while motorcycling in Texas is not mandatory. Indeed, Texas is one of six states that have repealed mandatory helmet laws since 1994. The consequences remind me of an old Faye Kellerman novel, Prayers for the Dead, about a transplant surgeon who is active in a motorcycle club because he wants to discourage helmet use in order to increase the supply of transplantable organs (motor vehicle deaths being a major source of organs).

A recent unpublished study links changes in state laws on mandatory helmet laws to the supply of transplantable organs, showing that where and when helmet wearing was no longer required, the supply of organs for transplants in the state increased.

I’m all in favor of increasing the supply of organs for transplant, as there is currently a substantial shortage of transplantable organs. Some economists have argued for a free market in organs that lets the market establish a price.

I find that repugnant; I don’t want people selling their kidneys, just as I find the Kellerman doctor’s behavior repugnant. Perhaps the best hope, or at least the most moral, may be the incentive that today’s shortages provide for innovation of trans-species or, better still, artificial organs for transplants.


I believe there is much more room to advance the efficiency of organ transplants (ie. kidney chain). Also, we could increase the supply by "nudging" our population to becoming kidney donors.

Differences in helmet laws is a zero-sum game. You are essentially shifting life away from (stupid) motorcyclist and giving it to the sick.

Chris MacDonald

"I don't want" isn't much of an argument.

Clearly there's reason to be worried about abuses in an unregulated market for solid organs, but a good case can be made that a well-regulated market would be beneficial for all concerned. (See James Stacey Taylor's book, "Stakes and Kidneys."


I ride a motorcycle. I wear a helmet.
The question: where is the line between individual freedom and the obligation of government to protect us?
I guess that since I choose to ride with a helmet, it is acceptable to me that others ride without. I may need an organ. But I would never push others to ride without protection. I always encourage everyone to wear a helmet and other protective gear. 'All the gear, all the time."

Jayson Virissimo

So, because you find organ markets distasteful you want the state to use the threat of violence to keep people from making voluntary agreements with what to do with their own body that make EVERYONE better off?

What makes you think you have a higher moral claim to other peoples' bodies than they themselves do?


"Perhaps the best hope, or at least the most moral, may be the incentive that today's shortages provide for innovation of trans-species...organs"

Artificial organs--maybe. Even better would be organs cloned from the patient's own tissue.

But how is the involuntary manipulation of a healthy, innocent animals to provide organs for sick animals more moral than getting them from willing donors who die from their own idiocy or willing donors who seek to improve their lot in life through a voluntary transaction?


But does removing helmets increase demand as well?


They aren't your kidneys to control. Freedom means accepting that others will make choices inconsistent with your own preferences.

The quickest, easiest way to increase the supply of some organs is to allow people to sell them, rather than making the ill wait years (or even die waiting) for innovation to save them.


To that point, I have wondered recently why the state of Texas makes such a strong push for all drivers and passengers to wear their seatbelts. They must spend millions on all the television, radio, and roadside advertisements. Along with that, I would expect as more people are made aware of the law, the state revenues from tickets to drivers not wearing seatbelts are decreasing. If you assume that more people wearing seatbelts leads to fewer traffic deaths, you would also lose this benefit of the supply of organs for transplant.

All of this begs the question: why? Is there a huge economic cost to the state caused by a high number of traffic deaths? if not, is there some other reason that the state would make such a strong push? Is its the state's repsonsibility to keep its passengers "safe"?

I would really appreciate your input on this.


This study is weakened a bit by using "number of fatalities per million persons" instead of "number of fatalities per million motorcyclists," or "number of fatalities per million miles traveled." During the time covered by the study, the number of motorcyclists in the United States increased by a large amount - there was about a 60% increase between 1998 and 2003, for example.

From 1994 to 2002, the number of fatalities per 10,000 motorcycle registrations went from 5.8 to 6.3 across all states, with a disproportionate increase in fatalities in the states without mandatory helmet laws - but the study doesn't mention that bit either. Since the typical motorcyclist also rode more per year, the number of fatalities per mile traveled on motorcycles seems to be fairly flat.

There's also some evidence that there was a greater overall increase in motorcycle registrations in the states that didn't require helmet use, which would further skew their use of "total deaths" and "total donations."

The point still seems to stand, but the effect is apparently much smaller than the authors suggest.



Why not make helmet use optional, but with the condition that if you are in an accident without a helmet then you will be denied any sort of medical treatment unless you have proof of private insurance on your body or bike and, whether you have insurance or not, if you die all available organs will be harvested from you.

It seems to me this would eliminate all the externalities associated with this brand of foolish behavior, would encourage helmet use and yield a societal good of more transplantable organs.


Maybe governments truly are concerned for the well being of their citizenry and economics do not factor into their decision.


Why do you find the doctor's behavior repugnant? I think it's rather clever. Motorcyclists who don't wear helmets, as dumb a decision as that might be, still make an informed choice not to do so. I would be shocked to hear of a motorcyclist who says he/she has NEVER heard that wearing a helmet is safer than not wearing one. So they are informed. If they decide to make the dumber choice, why shouldn't my loved ones or myself benefit from their organs?


Lets make a bet.

I win we do away with helmet laws...but you are still an idiot if you ride without. You win we keep helmet laws except EVERYONE WEARS HELMETS, EVEN IN CARS!!. Deal?

Here is the bet...

I'll bet every argument that works to put helmets on M/C heads: Cost to society, concern for the rider, threatening to withhold care since the unhelmeted MC rider "costs" more.. will ALL work on car drivers as well.

So it is a slippery slope. You want me to wear a helmet on my bike? I want you to wear a helmet in your car...for all the exact same reasonss.

Still want to shove helmet laws down my throught? I can shove them right back. If ABATE was smart they would use the same tools pro helmet people use to try to pass pre helmet in CARS laws as there is no difference.

MESSAGE TO AMERICA....LEAVE US ALONE!!!!! Go build roads and get off our backs!!!

Joe D

caleb @6: You don't generally lose a kidney or liver in a motorcycle accident. Legs, yes; brains (which could be protected by the bucket), yes. I haven't heard of any brain transplants recently.

Eric M. Jones

I play this game two ways--

1) I Always wear a helmet on a motorcycle, and always wear a seatbelt. And I drive carefully in a Grand Cherokee.

2) I refuse to donate my organs. Doctors are not Gods and I do not want some doctor harvesting my organs for his friend, wife, relative, collegue, countryman, or golfing buddy. Don't think they are completely objective on this.

Instead, I want every possible means taken to preserve all of me alive and intact. When that is no longer possible, I'll gladly donate my whole body to science.


Hey TSG,

Why not make sterilization or use of condoms optional, but with the condition that if you pollute the world with your breeding, you will be denied any sort of medical treatment? All the breeding in Amerika costs the taxpayer much more than motorcycle accidents!


If you're riding your bike, with or without a helmet, aim directly for fascists like Hamermesh who wishes to deny you rights over your own body and the disposition of its organs!

Daniel Howard

Perhaps states without helmet laws can also go with the "implied consent" / "opt-out" style of rules for organ donations. If you want organs from irresponsible donors then it is good to make their consent easy to obtain.


Fred Anon

As Dan Ariely has clearly shown, all you need to do to provide an unlimited supply of organs is to change the default on the question from No to Yes. People still have the freedom to choose, they just have to opt-out if they don't want to be a donor.

Even better, all you have to do is force them to *make* a choice, and the donor rate goes up dramatically. People are too lazy to choose, and in a high % of drivers licenses they would have chosen to be a donor if forced to make a choice.


So.. how many of those dead riders would have had non-fatal but nevertheless serious and expensive injuries? I'd be very surprised if a head injury was the only one they had.

And as someone else said, absolute numbers in a period of rising or falling population are bogus.

If you say "no health care without a helmet" do you say the same for seatbelts? What about someone who has skin cancer? What about someone who had a measurable trace of alcohol and had any injury from a car crash or even falling over? Refuse health care for any possibly preventable injury of any kind?

That will definitely drop health care costs...

Stats in Australia (where seatbelts are compulstory) show that even in airbag equipped cars, head injuries are significantly lessened if the car occupants wear helmets. So given that, should car occupants be penalised for not wearing helmets? If not, why not?

(Bike helmets are a good thing. Blaming victims isn't)