There aren't many areas where America lags behind Iran. Unfortunately, there is one: tackling the problem of organ shortages.
In the United States today, 83,000 people are on the official kidney-transplant waiting list. In 2008, only 16,500 people in the country received kidneys, and almost 5,000 people died while waiting for one. In Iran, while data are less reliable, the best available information indicates that the organ shortage in that county has been significantly eased by means of a simple mechanism: paying people, through the government, to donate organs -- something the U.S. government not only refuses to do but prohibits private individuals or organizations from doing as well.
Why are most people so squeamish about allowing payments for organs?
Although deceased donors are necessary for some types of donations (heart, for instance), live donors could help close the gap when it comes to kidneys. And yet, though most people have a surplus kidney -- for which many kidney-disease patients would pay handsomely -- we thwart a transaction in which both parties would consider themselves better off. This is basically because many of us find the idea of paying for organs, well, icky.
Social norms versus market norms
Why, exactly, do we feel this way? It's impossible to say with scientific certainty, but it's possible to think systematically about it. We know, for instance, that people have different standards for how they treat financial transactions as opposed to nonfinancial ones.In his book "Predictably Irrational," behavioral economist Dan Ariely looked at how people behave under social norms versus market norms.
This, perhaps, is part of the shift that goes on in our brains when we consider a person receiving payment to donate an organ. Donating organs is something you do for your brother, sister, son, daughter, spouse or other relative. And it's something you do out of the goodness of your heart. Doing it for a stranger, for $30,000, is another matter entirely.
Of course, these norms are not based on a rational weighing of pros and cons. A person donating a kidney is taking a risk with his or her health, to be sure. But we allow people to take comparable risks for money all the time. For instance: working in a coal mine. Or, perhaps an even better analog to organ donation: renting out their wombs. Some pregnancies can be roughly as risky as kidney donations, but social norms have evolved over the past few decades to where the practice -- typically done for money -- hardly causes the batting of an eyelash.
How could we overcome these hang-ups to ease or eliminate organ shortages? Is part of the problem that people don't want to become organ donors?
No. The truth is, people aren't all that reluctant to sign up. The United States just makes it too difficult.
But there's a simple fix for this, which New York state Assemblyman Richard Brodsky is looking to implement. Instead of making people jump through hoops to opt in to being an organ donor, Brodsky wants a "presumed consent" system for New York, in which people would have to opt out of organ donation if they did not wish to donate.
