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There's an article on kidney donation in the New York Times Magazine today. The author is Sally Satel. She is a Scholar at the conservative think tank, the American Enterprise Institute.

Dr. Satel has written an essay on what it's like to be sick and need an organ transplant in the United States, where it remains illegal to pay for an organ.

Sally is a psychiatrist.

A couple of years ago, Sally was diagnosed with end stage renal disease. Sally was told she needed a kidney transplant.

In the essay in the New York Times Magazine, Sally describes in excruciating detail, how she got lucky and received a kidney.

Sally thinks our system for allocating organs isn't working. She believes there should be a "booming" market for organs.  Hey, we all have two and we only need one, right? If the system were working, she argues, organs would be readily available.  Sally believes if there were incentives, people would donate.

I'm going to tell you right in your face, what this woman is hinting at in this loathsome article. But like all of these cowards, she doesn't come right out and say what she really thinks.  Actually, I'm being far too polite, she's more than hinting.  

She thinks if we, as a nation, offer incentives, one of which she suggests should be "Medicare for life", people would line up to donate their organs.

This lady is talking about trading insurance and access to affordable and guaranteed healthcare for the 47 million uninsured, in exchange for their body parts.

Sally is free to write anything she damn well pleases. It's sad but not surprising that the New York Times would publish such garbage.  The intersection of conservative free market hucksterism, and how to allocate scarce and desperately needed organs, is especially perilous territory for someone like Dr. Satel with a lunatic agenda.

Sally's Solution to the Shortage of Organs:

Theoretically, kidneys should be in booming supply. Virtually everyone has two, and healthy individuals can give one away and still lead perfectly normal lives. Yet people aren’t exactly lining up to give. At the beginning of 2005, when I put my name on the list, there were about 60,000 people ahead of me; by the end of that year, only 1 in 9 had received one from a relative, spouse or friend. Today, just under 74,000 people are waiting for kidneys.

Donor's need to be motivated.  Offering donors, um, health coverage, what she calls "lifetime Medicare coverage", would motivate people to become organ donors.

Well, we certainly have an army of 47 million uninsured Americans, middle class, low-income many of whom might jump at the opportunity to donate an organ in order to get health coverage. If Sally and her ilk had their way, this is what could happen.

Do you want to vomit?

Altruism is a beautiful virtue, but it has fallen painfully short of its goal. We must be bold and experiment with offering prospective donors other incentives for giving, not necessarily payment but material reward of some kind — perhaps something as simple as offering donors lifelong Medicare coverage. Or maybe Congress should grant waivers so that states can implement their own creative ways of giving something to donors: tax credits, tuition vouchers or a contribution to a giver’s retirement account.

In short, we should reward individuals who relinquish an organ to save a life because doing so would encourage others to do the same. Yes, splendid people like Virginia will always be moved to rescue in the face of suffering, and I did get my kidney. But unless we stop thinking of transplantable kidneys solely as gifts, we will never have enough of them.

I have no doubt despite her access to the healthcare so many of her fellow citizens can only dream about, Dr. satel suffered throughout her ordeal.  But her heart, to say nothing of her medical training, certainly doesn't extend beyond her own personal drama. But this is the way these people behave. As Michael Moore said in SiCKO, as Americans we have a looming choice. Either our healthcare system is what Sally advocates, it's about me, or it's about all of us.

Sally has been writing about her health issues and her need for a kidney for some time. Most Americans who need organs, don't have multiple opportunites to write in the New York Times about their search for an organ donor as sally has.

But writing so much leaves Sally with a paper trail of hypocrisy.

Here's what she wrote in the New York Times in 2005.

At the time, she was appalled that an inmate would request payment for his kidney. And equally appalled that it's a felony to pay for an organ.

Most of the people who contacted me knew that they could receive no payment.

One exception was an inmate in a Kentucky penitentiary who wanted $900,000. In meticulous penmanship, he wrote: "What is life worth to you? If you do not have this kind of money, I am sorry. I cannot help you." It was as if he were holding his kidney hostage.

. . .I would also have gladly paid for a kidney, but that is a felony under the National Organ Transplantation Act of 1984.

Once Sally got her kidney--for free--from a libertarian-minded kindred spirit, she launched a new AEI sponsored campaign to make organ selling acceptable.

Here's what Sally wrote in an American Enterprise Institute publication after she received her kidney.

Organs for Sale

Don’t get me wrong. Altruism is a beautiful thing--it’s the reason I have a new kidney--but altruism alone cannot resolve the organ shortage. For that reason, more and more physicians, ethicists, economists, and legal scholars are urging the legalization of payments for organs in order to generate more kidneys for transplantation. One doesn’t need to be Milton Friedman to know that a price of zero for anything virtually guarantees its shortage.

Sally's solution is crafted, I would argue, right out of the AEI, George Bush, Mike Huckabee, Rudy Giuliani, Willard Romney play book. She's far more eloquent than me, these are her words.

The best answer is by creating a market arrangement to exist in parallel with altruistic giving. Within such a framework, any medical center or physician who objects to the practice of compensating donors can simply opt out of performing transplants that use such organs. Recipients on the list are free to turn down a paid-for organ and wait for one given altruistically. Choice for all--donors, recipients, and physicians--is enhanced. And it is choice in the greater service of diminishing sickness and death. Paradoxically, the current system based on altruism-or-else undermines the individual autonomy that is at the heart of the most widely held values in bioethics.

The rich can pay for their organs--supplied by the army of uninsured. The rest of us? Well, we can wait, and many of us will die.

This, of course, is how Republicans view access to healthcare. It's available to whomever can afford it, and the free market tax cuts will solve all the remaining pesky problems.

The reality for many Americans who need life-saving organ transplants is bleak indeed.

Need an Organ? It Helps to Be Rich:
While Anyone Can Donate an Organ, Not Everyone Can Join a Waiting List, Especially the Uninsured, Report Says

Brian Shane Regions is dying.

Medications sustain the 34-year-old for now, but a heart transplant is his only hope of a cure for his congestive heart failure -- as is the case for the thousands of others who suffer from irreversible heart damage.

But Regions lacks health insurance and receives inconsistent care for his condition. He said some of his doctors have casually suggested that he should be on the waiting list for a new heart, but not one has helped him pursue it.

"There's really nothing I can do," said Regions, a freelance photographer in Campti, La. "I don't have the insurance to do it right now. They are treating the symptoms. I'm managing, but I know I'm slowly getting worse and it's not going to get any better."

It's the harsh reality of the organ transplant field: Patients who are uninsured or unable to pay are sometimes denied lifesaving treatment because hospitals can't afford to foot the bill for the surgery or the extensive recovery.

I'm sure the American Enterprise Institute provides Sally and her fellow conservatives with very good health insurance. This grotesque story reminds me how the wingers support the war.  They love any war that requires no sacrifice--from them. They love any war that is fought by the less fortunate kid of their neighbor.

Imagine a winger selling donating an organ to get health insurance.

Originally posted to nyceve on Sun Dec 16, 2007 at 01:35 PM PST.

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Comment Preferences

  •  Really kind of takes your breath away (118+ / 0-)

    This is another reason why the lunatic right is so dangerous.

    •  This sounds like the start of a Swift essay... (41+ / 0-)

      Theoretically, kidneys should be in booming supply. Virtually everyone has two, and healthy individuals can give one away and still lead perfectly normal lives. Yet people aren’t exactly lining up to give.

      It always amazes me that with conservatives we keep going back to Dickensian England (and they don't realize it).

      "The revolution's just an ethical haircut away..." Billy Bragg

      by grannyhelen on Sun Dec 16, 2007 at 01:50:28 PM PST

      [ Parent ]

        •  Every year I trot out Scrooge quotes... (13+ / 0-)

          ...they always sound like they come out of GOoPer mouths.

          What else can I be, when I live in such a world of fools as this? Merry Christmas! Out upon merry Christmas! What's Christmas time to you but a time for paying bills without money; a time for finding yourself a year older, but not an hour richer; a time for balancing your books and having every item in 'em through a round dozen of months presented dead against you? If I could work my will, every idiot who goes about with 'Merry Christmas' on his lips, should be boiled with his own pudding, and buried with a stake of holly through his heart. He should!

          "At this festive season of the year, Mr. Scrooge," said the gentleman, taking up a pen, "it is more than usually desirable that we should make some slight provision for the Poor and destitute, who suffer greatly at the present time. Many thousands are in want of common necessaries; hundreds of thousands are in want of common comforts, sir."

          "Are there no prisons?" asked Scrooge.

          "Plenty of prisons," said the gentleman, laying down
          the pen again.

          "And the Union workhouses?" demanded Scrooge.
          "Are they still in operation?"

          "They are. Still," returned the gentleman, "I wish
          I could say they were not."

          "The Treadmill and the Poor Law are in full vigour,
          then?" said Scrooge.

          "Both very busy, sir."

          "Oh! I was afraid, from what you said at first,
          that something had occurred to stop them in their
          useful course," said Scrooge. "I'm very glad to
          hear it."

          So, does that sound like your typical Republican or not? Certainly Scrooge would be 1,000% behind poor wretches donating their kidneys. Just so long as nobody came from his kidney.

          Thanks to 6+ years of Dubya, we are all suffering from "accelerated decrepitude."

          by Pris from LA on Sun Dec 16, 2007 at 02:49:32 PM PST

          [ Parent ]

          •  A Christmas Carol (0+ / 0-)

            In Dickensian fashion, last Thursday "W" quietly vetoed SCHIP a second time. Last night the Dems, unable to overide extended the current program a year. Yes, Scrooge Bush, anxious to please his suddenly fiscal conservative advisers (except when bleeding trillions of dollars with virtually no accounting for a war of choice in Iraq) so that we wouldn't allow anyone to slip away from the private system he advocates. That's the one where his good buddies, the CEO's and management, rape us with exhorbitant salaries and bonuses; where multiplicity exaggerates the administrative costs of insurance and complicates things with multiple sets of innane rules. It's the system which conspires to keep people really needing health insurance from obtaining it, and once one has it, denies everything humanly possible to maximize profits! A single payor system, while certainly not without problems, pays leadership rational salaries, cuts administrative costs, and allows premium dollars to mostly pay for benefits to insured. One could wish that we citizens could be the ghosts of Scrooge George a review of his misdeeds in Christmas past and present, and a good look at his unmourned funeral in Christmas future. But alas! This Scrooge and his cronies won't hear the message or reform their beliefs. They won't be buying turkey (or needed healthcare) for the poor.  Nor will they be running about doing good wishing everyone a Merry Christmas! Instead they'll gloat in their miserly ways. Sadly, many Tiny Tims will die from lack of access to adequate healthcare and or become chronically disabled by preventable diseases. Tiny Tims won't live to say "God bless us everyone!" But, after all, we won't be socialized! A Christmas Carol, indeed!

        •  Can I have more healthcare, sir? (9+ / 0-)


          okay - have to stop, this could get ugly :)

          "The revolution's just an ethical haircut away..." Billy Bragg

          by grannyhelen on Sun Dec 16, 2007 at 04:16:27 PM PST

          [ Parent ]

        •  Richard Posner advocates selling babies (6+ / 0-)

          If one should be able to sell humans, why shouldn't one be able to sell parts of humans?

          Come to think of it, I recall that they tried that selling humans approach in this country for a few hundred years.  The free market is a very open-minded concept.

          Some men see things as they are and ask why. I see things that never were and ask why not?

          by RFK Lives on Sun Dec 16, 2007 at 05:18:28 PM PST

          [ Parent ]

          •  WTF (1+ / 0-)
            Recommended by:

            is WRONG with these people?

          •  RFK, help me out here . . . (1+ / 0-)
            Recommended by:
            Black Max

            These people want fertility clinics to throw embryos in the garbage rather than use them for stem cells.

            They want poor and uninsured people to trade an organ for healthcare.

            Life begins at conception.

            But Bush vetoes healthcare for children.

            Democrats are baby killers.

            They are the culture of life.

            I'm confused, and I've left out plenty.

            •  You're not the least bit confused (3+ / 0-)
              Recommended by:
              nyceve, splashy, Black Max

              You're paying attention.  If we started talking about my profession, you'd get even more confused.

              For me, the emotional Rubicon was crossed when 5 Supremes stayed the FL count on 12/9/00.  The decision was nakedly political, and it stood legal logic utterly on its head.  W could suffer no irreparable legal harm by letting the count go forward, while stopping the count hurt Gore severely.

              3 days later, the same 5 Supremes held that there was no longer time for the count to proceed.  It was the grossest form of legal Catch-22 imaginable.  The Dems, however, meekly went along w/ it.

              Ever since then, I stopped looking for reason and logic in public affairs.  It's kind of weird since my profession is supposed to be grounded in a belief of reason and logic.  If, however, one no longer expects reason and logic, it makes the unacceptable at little more tolerable.

              Some men see things as they are and ask why. I see things that never were and ask why not?

              by RFK Lives on Sun Dec 16, 2007 at 06:17:08 PM PST

              [ Parent ]

      •  They Live in the past because it's cheaper nt (10+ / 0-)

        Be careful what you shoot at, most things in here don't react well to bullets-Sean Connery .... Captain Marko Ramius -Hunt For Red October

        by JML9999 on Sun Dec 16, 2007 at 01:52:37 PM PST

        [ Parent ]

    •  Ayn Rand would be proud (46+ / 0-)

      Why shouldn't rich people be able to buy poor peoples' kidneys?  And what's wrong with paying them off using government funds, rather than actually giving them the money their organ gained?  

      I'd love to hear her views on human cloning for transplantable organs: moral indignation comes so easily to these people, when it's convenient.

      Shame on this woman.  The American Psyciatric Association should censure her.

      Rudy Giuliani is a small man in search of a balcony. -- Jimmy Breslin

      by Dallasdoc on Sun Dec 16, 2007 at 01:52:11 PM PST

      [ Parent ]

    •  Thanks for this. (27+ / 0-)

      I was incensed to see that a "scholar" (and I use that term loosely) from the American Enterprise Institute authored the piece. I think it's extremely irresponsible for the so-called "paper of record" to run stuff from them. Honestly, the words "American Enterprise Institute" should ALWAYS be followed by the words "A Neo-Conservative Think Thank," to enable readers to put the author's ideas in context. i.e., that they are bat-shit crazy.

    •  And the answer is? (5+ / 0-)
      Recommended by:
      dburbach, nyceve, cathy b, Corwin Weber, Newzie

      Imagine that single payer has been instituted, how then do 74,000 persons receive kidney transplants?

      "Dear Jack: Don't buy a single vote more than necessary. I'll be damned if I'm going to pay for a landslide."

      by 1918 on Sun Dec 16, 2007 at 02:11:58 PM PST

      [ Parent ]

      •  Yes -- how DO we increase supply? (2+ / 0-)
        Recommended by:
        cathy b, Pluto

        Satel's arguments give me the creeps too, but the question does remain.  

        Even if we solve the payment side for people who need organ transplants, what does that do to solve the organ supply side?  

        I'm honestly curious what suggestions people have.  I don't like the pay-for-kidney approach, but the sad reality is the supply today is vastly smaller than the need, and I'm not sure how better coverage for the people who need the organs helps with the problem of finding the organs to be transplanted....

        •  double the murder rate (1+ / 0-)
          Recommended by:

          and harvest all the organs.

          (based on United States Crime Rates 1960 - 2006

          I'm sure a wingnut would be pleased to see every transplant matched by an accompanying murder... it's a free-enterprise solution.

          Looking for intelligent energy policy alternatives? Try here.

          by alizard on Sun Dec 16, 2007 at 04:34:08 PM PST

          [ Parent ]

        •  I will donate a kidney, (4+ / 0-)
          Recommended by:
          greeseyparrot, ER Doc, ilyana, phonegery

          when one of my children, parents, husband, sibling, sister or brother-in-law, nephews or nieces need one. I will do it then--gladly and without hesitation. And, since I am O-neg blood type, I understand that I am more likely than any other non-related donor to be a match. (Correct me if I am wrong, but I read that about the O-negs somewhere.)

          However, with the current supply problem, I would not be willing to donate to someone who wasn't a close family member. I feel a need to protect my own, selfish or not.

          Frankly, I think donating harvestable organs should be required for all in-hospital deaths. If we just started requiring it, and stopped making such a big weird deal about it, we wouldn't have a problem with supply.

        •  I am an organ donor, but (1+ / 0-)
          Recommended by:

          I have very mixed feelings about it, since I found out how organs are sold by the hospitals in bulk to be re-sold by commercial enterprises.

          I know that if I withdraw, the recipients would be punished. But it makes me sick that I'm trying to give my body parts to people who need them, and they're treated as business inventory for people I don't know to make a profit.

          I wish there were a way to specify that you want you parts used only if they're never sold.

      •  research (8+ / 0-)

        There's already been progress towards cloning organs. Remove the restrictions on stem cell research, give researchers a few billion dollars, and see what happens.

        Live Free or Do Whatever It Takes So I Don't Die

        by nasarius on Sun Dec 16, 2007 at 04:14:32 PM PST

        [ Parent ]

        •  National Institute of Health (3+ / 0-)
          Recommended by:
          xanthe, ER Doc, phonegery

          which we already pay for would probably need less than billions. Just a green light. You can bet drug companies won't fund it. That is a cure and a cure is a four letter word for a drug company. Can't get repeat customers for a cure.

          However, It's unfortunate that we would fund Stem Cell Research, pay for the Cures, and then the drug companies would get them for free. Make a lot of noise about the cost of testing for FDA approval and would be given a patent on the formula. Thats when an insurance company would be saying no to a $200,000 shot.

          If we want affordable health care, the first long step is to take away the patent (obscene drug profit protection racket) system for life saving drugs and cures acquired by federal funded or state funded research. Until that happens, I have no doubt stem cell research would produce cures. But it wouldn't do anything for people except the very rich with the current system.

          We can't make improvements in health care in isolation. We have to consider who benefits besides the patient and who will take advantage of it. Lots of moving parts and all have to be considered when coming up with solutions to various problems.

          Support Col Hackworth's watchdog group for the troops with money or a sign

          by Dburn on Sun Dec 16, 2007 at 05:05:25 PM PST

          [ Parent ]

      •  Stem cell research. (4+ / 0-)
        Recommended by:
        splashy, cathy b, 1864 House, brentmack

        We're not too far away from being able to grow organs.

        We'd be closer if the Rethugs hadn't gutted funding for the research.

      •  Good question (0+ / 0-)

        This is no substitute for solving the lack of universal health care.   I can just see George "they can go to the emergency room" Bush changing his name to George "they can donate a kidney" Bush.   Of course, there aren't enough people in need of organ transplants to give everyone who needs insurance a chance to take part.    And why do poor people have to resort to that and rich people not?

        Still, the idea does have some merit if you limit yourself to the present context.   Unlike the traditional sale of organs, where someone desparate puts themselves at great risk for a temporary financial fix, this is different.
        Right now, if you don't have health insurance, this might not only save the life of the recipient but also the donor.
        The problem is, that it makes sense only in the context of a broken system.   It is a win win situation in a rigged game.

        And lets not forget that lack of universal health care itself may dramatically reduce the supply of organs.    Sure I have a spare kidney.   But I wouldn't drive down the highway without a spare tire.   Its only a backup until the primary fails.  Lacking health insurance, I could not afford to give one to anyone.   If I had not only health insurance now but a long term guarantee of health insurance (i.e. universal care), it changes the equation a lot by reducing the risk side.    Provide universal health care and you increase the number of available donors by a third.
        For both the poor and the rich.   Maybe more for the poor, since rich people's friends and family are less likely to be influenced by lack of health care.

        This whole thing raises consent issues.   To what extent can you consent when you are under that much financial/medical duress?

        I have one other suggestion as to how to increase the supply, with or without universal health care.   One that doesn't pit self interest against altruism but instead realigns self interest to conform with altruism.   Anyone who donates an organ goes to the top of the list when they in turn need one (any organ).   I am no expert on kidney failure but it sure seems like there are a lot of people out there that had a spare kidney that wasn't sufficient.   Apparently, whatever destroys kidney #1 seems to frequently take out kidney #2 as well.    So, maybe having a hot spare isn't as good as having a kidney in the bank.   And while you might have a "spare" kidney, you don't have a spare heart.    Of course, having one in the bank doesn't help if you can't afford to have it installed, so again universal health care comes into play.

        Another thing can happen when you increase supply by the previous two methods.     People can become less worried about inappropriate harvesting.  So more people sign their donor cards.    

        There could be a registry of people who make not just a commitment to donate on death but to make a living donation.
        You can only go on the list before you have any indication of kidney problems.    And the commitment is only binding if the recipient is on the list, and there are exceptions if you develop other health problems.   Since, presumably, the chance of a kidney donation saving a life is higher than the risk of it taking one, it would be to ones advantage to join.  

        While a system designed by laissez faire capitalists is likely to turn out as poorly as everything else they touch,
        incorporating some socially responsible capitalism is worthy of consideration.   If kidneys can be sold at a reasonable price to a universal health care system for anyone who needs them, that is fine with me.

        Lots of people would probably be willing to donate a kidney in exchange for lifetime health coverage or a college education in our current broken system.    Of course, people whose knuckles don't drag the ground figured out a long time ago that it is in societies best interest to provide these services in the first place.   But there are a number of other ways where similar levels of compensation could give the donor a leg up in life, if used wisely.

        There seems to be a lot of knee jerk or off the cuff comments on this diary without much serious talk of risks and benefits to both donor and recipient or background statistics.    Here is a modest contribution in the lies, damn lies, and statistics department:

        In 2007, there were 6731 living donors ( and 6053 deceased donors.   The average wait is over a year (hmm, where did that number go?), or the rest of your life, whichever comes first.   According to the immediate (perioperative) risk of mortality for the donor is 1 in 3000.  However, many had complications.   Perhaps 75%.
        Long term mortality of donors over 20 years was significantly lower (30% lower for females and 50% lower for males) than the population at large.  However, donors are generally healthier than the population at large.   So, that doesn't tell us what the relative risk to the individual donating is but apparently people who are accepted for donation have a better mortality and quality of life than the population as a whole.   It appears that the risk due to donation is so small it is difficult to measure.    However:
         - you undergo the pain of surgery
         - 12 weeks of unpaid time off in addition to what is covered by employer
          - 11% get anti-depressants, and 5% are treated for hypertension
          - 38% had complications with 7.6% serious enough
            to require hospitalization or surgery

          - medical expenses are normally paid by the insurance of the recipient
          - 4% had trouble with future insurance
          - 3-4 days in the hospital.

        So, there are some significant costs.

        90-95% of live donated kidneys work well after 1 year vs 85-90% of kidneys from deceased donors.

        From The Nasty Side of Organ donation:
        "Dialysis can cost governments $50,000 annually for 30 years.  A kidney transplant costs $70,000 with $10,000 annually for anit-rejection drugs"
        This source also says that kidney donations rarely save lives but save costs.   No supporting evidence offered for that or the dollar costs (though the dollar costs seem about right).   Well, they also save spending the rest of one's life going to a dialysis center and Wikipedia says you live ten to fifteen longers with a transplant than with dialysis and even a 75 year old will live 4 years longer.   The longer the delay, the shorter the time the kidney will last.

        47% of kidneys now come from living donors

        I just skimmed on dialysis:
        Dialysis for 4 hours three times a week seems to be typical but studies show more frequent and longer dialysis are better.  There is increasing use of home dialysis all night, every night while you sleep.

        The federal government pays 80% of a patients dialysis cost:

        Cost of adminstering dialysis to seriously ill hospitalized patients, rather than pulling the plug, was $128K per year, ranging from $62K to 274K per quality adjusted life year with an average duration of survival of 32 days and 27% survival to 6 months.

        This last source suggested that $50,000 per quality-ajusted life year was a common threshold for "cost-effective care"

        Some will surely object to putting a dollar value on human life, but look at it this way: if you have a finite amount of money for health care, which is likely to always be the case, it makes sense to allocate that money such that it provides the greatest social benefit.   The more we are willing to spend on health coverage, and the less we spend on insurance companies, the higher the threshold will be.
        And if you are paying the costs out of your own pocket, you make a $/QALY assement at some level.

        The cost of dialysis, at $50,000 per QALY, seems to have established the threshold:
        That article points out the pitfalls of using QALY estimates for a rich country in a poor one.

        -6.25, -6.36 Worst. President. Dictator. Ever.

        by whitis on Sun Dec 16, 2007 at 09:16:21 PM PST

        [ Parent ]

    •  'they' have a motto lovely American (9+ / 0-)

      sociopaths auhhh neocons.... LIVE AND LET DIE

      Apparently a criminal with unlimited funds is a genius these days. - Larisa Alexandrovna

      by pollwatch on Sun Dec 16, 2007 at 02:23:29 PM PST

      [ Parent ]

    •  Thank you for raising this issue.. (15+ / 0-)

      Organ donation has particular meaning for me at this time.  This Monday it will be four weeks since my 17 year old nephew diedafter being in terrible car accident.  He sustained massive head injuries. His wishes, expressed on his driver's license, were to be an organ donor. His liver and kidneys saved the lives of three people.  

      There are not enough organs to immediately give a transplant to everyone that needs them, but there needs to be clear protocols that protect the donor from premature harvesting. In the case of my nephew, it was decided that he would be withdrawn from life support less than 24 hours from the time of the accident. My sister and brother in law didn't even get a chance to "sleep on it". They made the decision in a state of shock.  We were all in shock.

       I was with him when he died. I still do not know the exact extent of his injuries, but when they removed the breathing tube, he did breath on his own, till they started injecting him.  I can't seem to escape the terrible feeling that he was euthenized for quick access to his organs. I won't discuss it with my sister, unless she brings it up and wants to talk.. I'm in a kind of limbo.

      In many ways I think we are in a headlong downhill race in terms of how possible terminal patients are treated.  We can't make decisions based on balancing one life against all those would be recipients of body parts.  The voluntary multiple donor should be dead, and not made to die.      

      "Let us not be conservative with compassion. Be generous with compassion."

      by ilyana on Sun Dec 16, 2007 at 02:59:40 PM PST

      [ Parent ]

      •  oh my God, ilyans, I am so very sorry . . . (8+ / 0-)

        for your terrible loss.

        I suspect some doctors, know when a person is irretrievably lost, amd may take certain actions to hasten death.  

        I am saying this from intuition--not knowledge, maybe so of our wonderful Kossack doctors, like dallasdoc will weigh on on this.

        I am so so sorry. We all are.

        •  Thank you, nyceve. (0+ / 0-)

          I suspect that it is difficult to determine with any certainty that someone is lost without giving the patient time for stabilization and reorganization to begin.  The tests to determine level of brain injury are supposed to be done close to the time of the injury, and then again 24 hours later.  They pulled Shaun's breathing tube 17 hours after the accident.

          If anyone wants to comment on this situation please do.  

          "Let us not be conservative with compassion. Be generous with compassion."

          by ilyana on Sun Dec 16, 2007 at 05:59:47 PM PST

          [ Parent ]

      •  So very sorry, Ilyana, (3+ / 0-)
        Recommended by:
        ER Doc, ilyana, 1864 House

        Losing a young person is such a horrendous thing to go through. A group called the Compassionate Friends has been a big help to someone close to me who had a similar loss, if your sister and family need a connection to other families with lost children.

        I've read that an otherwise healthy person is often able to breathe on their own, often for many, many hours, even when brain dead. You might want to talk about this with someone who knows how such things work--to ease your terrible feelings. Waiting until his breathing failed might have made it too late for the organ donations, even though it could never have brought him back, and might have even increased his body's suffering. There are so many things we don't know. I wish you and your family peace of mind.

        •  I appreciate the information, cathyb (1+ / 0-)
          Recommended by:
          cathy b

          I will pass it on to my sister.  
          I understand there is a narrow window for the viability of organs,  once they pull a breathing tube,  if the patient's lungs and heart are not functioning well.

          I don't judge the decision that was made to let him die, if he was going to.  But I don't think he was given enough time.  

          "Let us not be conservative with compassion. Be generous with compassion."

          by ilyana on Sun Dec 16, 2007 at 06:08:53 PM PST

          [ Parent ]

    •  and once a "free market" in monetized organs (7+ / 0-)


      • better count your organs before and after going into surgery
      • expect people to be found bleeding to death in alleys missing various organs after meeting one of Sally's "entrepreneurs"
      • expect people to simply disappear - broken up for spare parts in a "chop shop" by organized groups of Sally's "entrepreneurs".

      Note: if this becomes legal, for the entrepreneurial types around here, the AEI would be an excellent source of ... slightly used spare parts.

      Looking for intelligent energy policy alternatives? Try here.

      by alizard on Sun Dec 16, 2007 at 04:28:21 PM PST

      [ Parent ]

  •  How much is she charging for her left ovary? (19+ / 0-)

    She doesn't need two of them.

    I assume she's putting it on the market.

  •  And there was a sci-fi story by Larry Niven (19+ / 0-)

    many years back that had criminals (such as repeat traffic offenders) being sentenced to death as a source of easily obtainable organs.

    This is worse.

    "I'm not gonna waste the perfect comeback on you now. But don't think I don't have it. Oh yes, it's time will come!" -- Xander, BTVS

    by prodigal on Sun Dec 16, 2007 at 01:39:39 PM PST

  •  Sending this diary link toThe Yes Men (13+ / 0-)

    The Yes Men should pay her a visit with a plan to raise children especially for organ harvesting.

    That's the next step, isn't it?

    In TX-32, track the voting record of Pete Sessions at SessionsWatch.

    by CoolOnion on Sun Dec 16, 2007 at 01:48:32 PM PST

    •  My email (8+ / 0-)

      Here's the email I just sent to The Yes Men:

      The Yes Men need to pay a visit to Sally Satel, of the American Enterprise Institute.

      "Sally thinks our system for allocating organs isn't working. She believes there should be a "booming" market for organs.  Hey, we all have two and we only need one, right? If the system were working, she argues, organs would be readily available.  Sally believes if there were incentives, people would donate."

      The Yes Men should propose raising children for the purpose of organ harvesting, just to see how far she's willing to go in the name of free market economics.

      In TX-32, track the voting record of Pete Sessions at SessionsWatch.

      by CoolOnion on Sun Dec 16, 2007 at 01:53:48 PM PST

      [ Parent ]

  •  I support organ selling 100% (4+ / 0-)

    ....can you imagine how many college kids would sell kidneys to pay off student loans? I sure as hell would. Most of the people my age I know, Dems and Republicans would too. In fact I was waiting on the phone when MPR did a story on this just before Thanksgiving to say as much (parked on  the damn highway about 20 minutes from reaching home) but they ran out of time before my call.

    The problem lies in a few things:
    1)Preventing a black market for organ donations/exploitation

    2)Making sure people who got organs and gave them had access to proper health care to deal with the aftermath of losing/gaining an organ

    3)That the organs are distributed on the first come/first served basis that we use now (i.e. the list) and not on who can pay.

    Come up with a system that deals with those thing acceptably--and I think we can--and we are go for selling. I still fail to see how this is intrinsically bad when it will give more people organs.

    There's something attractive about invincible ignorance... for the first 5 seconds.

    by MNPundit on Sun Dec 16, 2007 at 01:48:45 PM PST

    •  Interesting View (1+ / 0-)
      Recommended by:

      And very practical, given your conditional requirements.

      I suppose it's a step beyond selling bone marrow.

      The payer is the Federal Government, right?

      Fascism ought to more properly be called Corporatism since it is the merger of state and corporate power. - Mussolini

      by Pluto on Sun Dec 16, 2007 at 01:53:39 PM PST

      [ Parent ]

      •  I was just Reading about this the Other Day (5+ / 0-)

        I was working on an article about medical tourism.

        The Philippines is the hot spot for kidneys. Everyone is selling them --and folks are traveling there and getting them cheap.

        This links to some of current news about this:

        The cash-for-kidney trade is flourishing worldwide. But it thrives the most in countries like the Philippines, where abject poverty and unclear laws combine to make the country a kidney market.

        A loophole in the law allows foreigners to make a "voluntary gift" to a "donor" as an expression of gratitude, rather than a payment. In the eyes of the law, there is no trade.

        Predictably, the loophole has been exploited by various "agents" and hospitals doing a thriving business - and, many argue, by the desperate foreign recipients buying kidneys and exploiting the poor.

        Mark Schofield, a 43-year-old father of two from Wales, waited more than four years for a kidney transplant before, desperate and frustrated, he flew to the Philippines with $81,000 in savings to buy an organ from a living donor.

        "I'm not prepared to lie down and play dead," the former surfing champ said. "I know the moral argument about buying and selling organs, but I also know I have two young children whom I want to see grow up."

        It's an ethical dilemma. But it should be discussed.

        Would you buy a kidney on the world market to save your child's life?

        Fascism ought to more properly be called Corporatism since it is the merger of state and corporate power. - Mussolini

        by Pluto on Sun Dec 16, 2007 at 02:06:26 PM PST

        [ Parent ]

        •  I am reminded (0+ / 0-)

          of a side point in some of Anne McCaffrey's books, in which "organ farms" existed; where orphan children live a fairly good life...until someone with their blood type and other factors needs a heart, a liver, a pancreas...

          It's an obvious place to go in fantasy, but not where I want to see us go in real life.

          •  The Island... (0+ / 0-)

   a pretty good example of this actually. I mean the last half of the movie was terrible, but the first part, exploring the society and until they found out, was pretty interesting.

            There's something attractive about invincible ignorance... for the first 5 seconds.

            by MNPundit on Sun Dec 16, 2007 at 08:40:15 PM PST

            [ Parent ]

        •  No. (0+ / 0-)

          I already made that decision for myself. I will not go overseas and buy a kidney to save my own life. I will die on dialysis first.

          I am faced with that decision right now. This is not hypothetical, not a thought-exercise. I have made my decision.

          Anybody want to donate a type B or type O kidney to a fellow progressive?

          "George Bush remains about as popular as a germ at a medical conference." - The Economist, June 23, 2005

          by Kitsap River on Mon Dec 17, 2007 at 05:11:40 PM PST

          [ Parent ]

    •  The argument against: (3+ / 0-)
      Recommended by:
      mattman, ER Doc, Boreal Ecologist

      The argument for is simple enough: it's my body, and I should be able to do whatever the hell I want with it.  The argument for devolves on the social effects: the supply of organs will come from the poor, and it's a little creepy to have a world in which the poor are selling their organs.  So it comes down to personal autonomy versus social effect.

      •  you didn't consider all the social effects (1+ / 0-)
        Recommended by:
        ER Doc

        What if I decide it's "your body", and that I can bash you over the head and sell you to a black-market chop-shop anyway.

        Even if I get caught, it isn't going to do you a hell of a lot of good even if parts of you go on living attached to a couple of dozen other people.

        Looking for intelligent energy policy alternatives? Try here.

        by alizard on Sun Dec 16, 2007 at 04:43:56 PM PST

        [ Parent ]

        •  Found the MPR Program (0+ / 0-)

          It's the MidMorning radio show from November 21st. I had just actually had a conversation about the subject only a few days before and that was going to be my comment. As I told the screener "When I discussed this with my friends, our major concern was black market organ farming, and I wanted the guests to discuss what proposed safeguards there would be..."

          They actually did get to it a bit, and one solution is that hospitals aren't allowed to accept anonymous sales. The person who's organ it is, must be the one to actually give to the hospital, you can't just hire a company to say, ship you 100 livers, you have to do an individual-to-hospital business. Without any profit incentive why bother dragging in homeless people or foster kids and chopping them up for organs?

          That's not to say I favor this INSTEAD of socialized health insurance, but in addition to or as a stop gap UNTIL such a thing.

          There's something attractive about invincible ignorance... for the first 5 seconds.

          by MNPundit on Sun Dec 16, 2007 at 05:33:18 PM PST

          [ Parent ]

    •  you're joking, right? (7+ / 0-)

      If you're that desperate, why not sell yourself into slavery. The same bogus arguments would cover that case as well.

      Don't be insisting that we remove the last shreds of moral restraint on the market worshipers in order to solve your personal problems, as if they had no other solution.

      People like me find organ markets intrinsically bad because we think some things should not be bought and sold. End of fcking story. Secondarily because markets can not in fact be regulated fairly, it would the rest of in residual peril.

      You'll pay me the 8s I won of you a-betting?

      by Boreal Ecologist on Sun Dec 16, 2007 at 02:13:52 PM PST

      [ Parent ]

    •  Any readers of Larry Niven out there? (9+ / 0-)

      First we pay people for organs.

      Then when there aren't enough, we take organs from people who will be executed, after all they aren't using them...

      Then when demand gets high, many would vote to make more crimes capital, after all, the organs are needed..

      They had fangs...they were drinking blood....They had this look in their eyes, totally animal. I think they were young Republicans. (Buffy the Vampire Slayer)

      by wrights on Sun Dec 16, 2007 at 02:54:05 PM PST

      [ Parent ]

    •  Wouldn't you rather (1+ / 0-)
      Recommended by:
      Anne Hawley

      reduced the cost of higher education?

  •  "imagine a winger selling an organ to get health (13+ / 0-)

    ..... insurance" you ask us.

    Why not. She already sold her soul to the devil.

    The side effects of immunosuppressant drugs could be blamed here... I wonder what other deep, dark ideas are going to bubble to the surface of her brain.
    Odd. Many people who have a life altering experience become more charitable towards the human race.

  •  Hey Sally, here's an idea (23+ / 0-)

    Since Bush keeps denying health care to needy children, maybe we could work out a deal. Parents who donate a kidney could be rewarded with health insurance for their children. Just think how the organ donations would on a parent's desperation to get proper medical care for their children.

    Republicans are disgusting anyway, but Sally's ideas are way beyond disgusting.

    Thanks, Eve, for this excellent diary.

    Torture is not American. It's Republican.

    by Ekaterin on Sun Dec 16, 2007 at 01:49:54 PM PST

  •  Maybe Satel (14+ / 0-)

    should sell her heart. Obviously, she's not using it.

    Al Qeada is a faith-based initiative.

    by drewfromct on Sun Dec 16, 2007 at 01:53:24 PM PST

  •  isnt that an oxymoron??? (6+ / 0-)

    a Scholar at the conservative think tank-AEI???

  •  Let's not forget Sally's anti-PTSD (16+ / 0-)


    It's all in their heads, ya see.

    Why they put her articles in the NY Times, I can't imagine.

    Oh yes I can.

    They published Judy Judy Judy Miller, too, did they not.

  •  Just horrifying--imagine what this country (9+ / 0-)

    will look like if we go farther down the road to Laissez-fairy land.

  •  On the radio (6+ / 0-)

    I heard some young jerk dj's yukking it up with a woman who had just been released from the hospital. She had been unconscious during exploratory surgery when she was given some type of medical procedure that resulted in a very large hospital bill.  On the radio she was offering to sell a kidney to pay the bill.  She was serious, but their limited minds could not imagine her or what she was saying.  They thought it was a very funny joke.

  •  Sure you'd be able to buy an organ but it (9+ / 0-)

    would cost you an arm and a leg.

  •  Let them eat cake. (1+ / 0-)
    Recommended by:
  •  Sally = the real face of Compassionate (16+ / 0-)

    Conservativism: line up, little people, line up.

    Come get your nice, comprehensive health insurance right here. It'll only cost you a kidney that you don't need anyway.

    Liberty once lost is lost forever. Samuel Adams

    by 4Freedom on Sun Dec 16, 2007 at 02:08:46 PM PST

  •  well, (5+ / 0-)

    people with ESRD are on Medicare, typically.

    How much does three times a week dialysis cost?

    Enterpriser; Hard core Libertarian: +6.63 / -4.41

    by jimsaco on Sun Dec 16, 2007 at 02:09:16 PM PST

  •  These people are appalling, just appalling (6+ / 0-)

    and the worst part of it is that they really don't see anything wrong with what they propose---they have no problem at all with the idea of the poor selling their body parts to the rich.  Disgusting.

    "Going to church does not make us Christians any more than stepping into our garage makes us a car." --Rev R. Neville

    by catleigh on Sun Dec 16, 2007 at 02:14:09 PM PST

    •  it's just blithe optimism (1+ / 0-)
      Recommended by:

      that the bad effects won't touch them. When their own kids go missing and bits and pieces of them are discovered inside various members of the Richistani. . . some may figure out that this is A Bad Idea. And they'll be shouted down by others in the group of batshit "free-enterprise" crazies amongst which they used to be numbered.

      Looking for intelligent energy policy alternatives? Try here.

      by alizard on Sun Dec 16, 2007 at 04:56:00 PM PST

      [ Parent ]

  •  The real reason it won't happen that way... (11+ / 0-) simply that lifetime medicare is much too high a price to pay for a mere organ.  Several thousand dollars should be sufficient to motivate the poor; and it is certainly not in the interest of good, taxpaying americans to subsidize the care of people who were too careless and sloppy to hang on to their organs in the first place!  

    No, what we need is a simple online organ auction, appropriately taxed, so as to pay for the necessary defence of the united states.  

    It would also be helpful, of course, if people like myself -- who have rendered themselves unemployable, become entirely surplus -- could make a wholesale donation, allowing the use of all of their organs by those more fortunate.  The surplus could be returned to the treasury, where it would in some measure offset those monies we have already squandered with our waster lifestyles.

    This also seems like a potentially excellent way to empty the prisons, which have grown entirely too populous.


  •  She's Got a Point? (1+ / 0-)
    Recommended by:

    In principle, I don't think selling organs is so bad.  Sure, we like to exaggerate and say that the price of human life is infinite, etc, but really, yeah, if someone paid me enough money, I'd give my kidney.  The problem is that the system it sets up is awful, and if you can get large sums of money by selling your organs, you probably won't want to do it for free.

    What she really should be advocating is embryonic stem cell research.  Instead of creating a market to make things perhaps more efficient but much less equitable, she should be talking about growing her own organs in a lab.  It won't be long, hopefully, before organs can be manufactured for general consumption.

    •  Kidneys Will be Vat Grown (7+ / 0-)

      Probably within our lifetimes.

      But ethical issues in medicine will continue to grow.

      Fascism ought to more properly be called Corporatism since it is the merger of state and corporate power. - Mussolini

      by Pluto on Sun Dec 16, 2007 at 02:23:45 PM PST

      [ Parent ]

    •  Would you donate a kidney (10+ / 0-)

      for nothing? I did, and I find it amazing that anyone would try to put a price on an organ.

      •  I wouldn't, but I respect you for it. (0+ / 0-)

        You're obviously a much better person than I am.  To tell you the truth, I wouldn't donate a kidney even for large sums of money because I'm diabetic and chances are I'll need them both, but assuming I were healthy enough to do it (which I was assuming in my comment above), I still wouldn't do it for nothing.  I'm just not that selfless.  I really do respect that you have done it, and it's because of people like you that some people get another chance at life.

        However, I have to disagree with your revulsion to putting a price on it.  Everything has a "price", and it's misleading to say otherwise.  We all run cost-benefit analyses for everything we do, even if not consciously, as you must have when you decided to donate an organ.  I don't know what your thought process was, but by definition you didn't do it for "nothing", exactly -- maybe you did it because it feels good to do good deeds, or because you loved someone and wanted that person alive, or for whatever reason, but it's clear that you got some sort of positive thing or feeling in return, or at least expected to, because otherwise you wouldn't have made that choice by definition.  If your thinking hadn't ended up with a net positive somehow, you would have decided against it, and this is true for EVERYTHING you have ever done, from choosing your clothes this morning to your choice of college and career.

        Maybe you have incorruptible morals, but there are many things I'd willingly trade for a tremendously higher quality of life.  Would I hurt someone for money?  Perhaps I would?  Unless I think that a higher quality of life wouldn't compensate my ruined conscience.  Or if I'd rather have a lower quality of life for some spiritual or other reason.  We can't assign a price to everything easily, and the value of money may not be monotonically increasing or unbounded, which means that the value of something might be higher than the supremum of the possible values of money, but then again it might be.  There's very little difference between the value of a trillion dollars and of infinite dollars!  But it's important, I think, to not believe the romantic crap about things being infinite or superlative -- "There is no woman more beautiful than you!" -- or putting infinite equivalent monetary values on things.  I hope this makes sense?  And again, I salute you for your service to humankind; alas, I do not have the moral fiber to do something similar.

  •  I see poor, Black folks on years of dialysis (19+ / 0-)

    every day. Exactly what makes Ms. Satel believe that she deserved a kidney more than they? That she could afford health insurance? I invite her to go to any inner city hospital and say that to their faces.

  •  Sally could be an example to us and drop (1+ / 0-)
    Recommended by:

    dead for the greater good. Harvesting her body parts for others.

    have we hit bottom yet?

    by eddienic on Sun Dec 16, 2007 at 02:26:18 PM PST

    •  I wouldn't recommend (0+ / 0-)

      making use of her brain even after it is properly cooked.

      Prions laugh at our notions of "proper cooking".

      I also suspect that nobody would want her liver, cooked or otherwise.

      Otherwise, I have no particular objection to seeing her sold as spare parts.

      Looking for intelligent energy policy alternatives? Try here.

      by alizard on Sun Dec 16, 2007 at 04:59:17 PM PST

      [ Parent ]

  •  wow..that is creepy (3+ / 0-)
    Recommended by:
    CoolOnion, jessical, Pris from LA

    while one part of me wishes I could sell one of my kidneys for a few thousand dollars or more (because it is mine, and I can sell other parts of myself for money if i want), the other part of me sees exactly how this will get abused.

  •  Let's Make A Deal (9+ / 0-)

    If Sally Satel gets her way, you'll be able to trade a kidney for health insurance

    I trade both of George Bush's kidneys for health insurance for my wife and me.

    "The skeleton in the closet is coming home to roost!" Tom Stoppard

    by Apotropoxy on Sun Dec 16, 2007 at 02:27:13 PM PST

  •  Craigslist? Get ready.... (8+ / 0-)

    Amazing what contortions merchants will put themselves through when it come to healthcare. You probably already saw this but it blew my mind:

    Pittsburgh-based insurer Highmark says it has made giving the gift of good health possible with the introduction of its Healthcare Gift Card. While hospitals and some practices already are in the gift-card market, analysts consider Highmark's entry a watershed moment for the health care and gift card industries. Highmark is believed to be the first to issue a gift card that can be used nationally while also intended mostly for everyday health expenses.

  •  It's a stupid,stupid idea (6+ / 0-)

    Allowing people to sell their organs for money does not benefit anyone but the seller. If someone decides their organs are worth more than the "market value" that Ms.Satel would come up with, it would price out the the less fortunate, just like health care does nowadays. There's no benefit except for those who have the means (read: $$$$) to save their lives.

    No thanks. No more silly capitalist ideas. No one benefits from capitalism unless they are already rich.

  •  I just finished reading it (11+ / 0-)

    Apparently, selling out is okay on all levels with her.

    She would not disclose her conservative views/affiliations on the donor site and in discussions with potential donors because she didn't want someone backing out because they disagreed with her conservative stance.

    So now we know the price tag for her integrity. One kidney.

    They always say time changes things, but you actually have to change them yourself. - Andy Warhol

    by 1864 House on Sun Dec 16, 2007 at 02:34:03 PM PST

    •  To spite my interest in fairness... (8+ / 0-)

      ...I couldn't bring myself to read it.

      When I was about 35, I had three strokes and ended up in a big hospital.  Though I'm HIV negative, because I'm trans they put me in the AIDS ward, and my roomie was a young black woman who was undergoing the final stages of complete renal failure.  Neither of us felt real good, but we had some time to get to know each other.  The way she cried when they finally took her away to the ICU will be with me always; and in that position, if I loved my life at all...I would not buy one from a prisoner in China, but I'd lie to anyone at all, I really would.  And if she'd asked me to help her lie, if it would have helped, I'd be there with a top hat and tails.  Even if she was a right wing baptist and thought I should be taken out and shot.  No problem.  Just tell me what to say...

      •  Why not tell the truth? (1+ / 0-)
        Recommended by:

        If you were brave enough to be a trans, then certainly you could be brave enough to tell potential donors the truth about yourself.  (if you were in Patel's position)

        What's that old saw - Live Free or Die?  If you sold out your principles simply to save your life once, would you not do it over and over again?  

        No more lies - IMPEACH!

        by Fabian on Sun Dec 16, 2007 at 04:30:38 PM PST

        [ Parent ]

        •  disagree... (1+ / 0-)
          Recommended by:

          ...I don't link compassion and politics quite that strongly.  I don't care what crap comes out of someone's mouth, or how they vote, if they need help.  And I would vigorously defend the right of someone -- left or right -- to keep that as far from the equation as possible.

          If the idea that everyone has value carries any merit at all, it needs to apply to everyone.  Even right wing f**kwads :}

          •  Yes, but... (3+ / 0-)
            Recommended by:
            splashy, Fabian, AmericanRiverCanyon

            she concealed her conservative affiliation because she thought that the type of person - compassionate, caring - who would offer a kidney to a stranger, might find her politics of selfishness offensive. She linked compassion with politics.

            You and I might not stop to think about how someone voted before we attended to the bleeding, but apparently, she would. I have to wonder - since the thought crossed her mind when she was the one in need - whether she would have denied an organ to someone if she disagreed with THEIR politics.

            They always say time changes things, but you actually have to change them yourself. - Andy Warhol

            by 1864 House on Sun Dec 16, 2007 at 05:07:28 PM PST

            [ Parent ]

            •  Probably, but it doesn't matter... (1+ / 0-)
              Recommended by:

              Acts of generosity aren't about the person you're doing them for, they're for yourself, because of who you are.  If I were her donor I would have some choice and very public words about her current stance, but I wouldn't regret the donation.

              What's that great John Gardener quote?  One's principles aren't worth the life of a single sick old man.  I know most don't share that view, but consider it absolutely basic.  

              And, many moral choices are unseen, like icebergs.  Presumably people love her.  Perhaps her private and public lives are very different.  Perhaps she will become someone different in time, because she is alive to do so.  

              •  She looked in the mirror (0+ / 0-)

                and asked herself "What would I do?".

                Well, first of all, Dr Patel probably wouldn't donate a kidney to stranger.  She might donate one to a friend or relative, maybe.  After all, she's the epitome of "I got mine!".  If she was going to donate a kidney to a someone she knew, she'd make sure that it was someone who deserved it.  Looking at her philosophy, it would probably mean someone very much like her.

                So when she created her false face for organ donation purposes, she probably presented herself as needy and worthy as possible - and omitted things like privilege, class and politics.  It didn't occur to her that a truly generous person would consider every life equally worth saving - because she doesn't.  She knows all about prejudging people and bigotry and biases.

                No more lies - IMPEACH!

                by Fabian on Mon Dec 17, 2007 at 01:52:39 AM PST

                [ Parent ]

  •  I'm not wasting my beautiful mind, (3+ / 0-)
    Recommended by:
    mattman, nyceve, Pris from LA

    nor my beautiful kidneys, even considering Ms. Satel.

    Once in a while, they show us just exactly how stupid and amoral they really are.  

  •  I wonder if that organ donor's proud... (0+ / 0-)

    ...of donating a kidney to Ms. Satel.  

  •  Truly disgusting. (1+ / 0-)
    Recommended by:

    Especially since I just watched Sympathy for Mr. Vengeance the other day, this is just disgusting.

    I love your writing, nyceve, even if it does make my blood pressure rise...

    Question Authority - Now, more than ever.

    by Zaq on Sun Dec 16, 2007 at 02:50:04 PM PST

  •  From a living kidney donor: (4+ / 0-)

    This brings so many horrors to my mind.  We as human beings cannot allow this to happen. Makes me think of the stories I have read about bodies being found, and nothing "wrong" with them but that the body was lacking a kidney or two.

    So very, very wrong.  A living nightmare.

  •  This just frosts me... (5+ / 0-)

    First, when it comes to kidneys, yes Dr. Satel most of us are born with two, but if I give you one of mine and something were to happen to my spare, well where does that leave me?

    Second, what was this woman doing that she lost use of both kidneys. Sounds a little irresponsible to me. She should have been keeping better track of what her organs were doing.

    Yes, Virginia there is a Snarka Claus. I cannot think of a single honest bioethicist who would honestly sign on to this, for most of the reasons the diarist cites: Uninsured under a higher "market" pressure to donate, thus possible quality of organ may actually be diminished; Insured receiving better benefit since they'll be best equipped to access new supply; Hospitals under less pressure to perform altruistic transplants themselves.

    All the way around it is distateful, it is a shiny red poisonous apple that Snow White's stepmother held out to her, nice at first glance, death upon biting it.

  •  I first noticed Satel's RW brand of sociopathy (10+ / 0-)

    when she wrote an op-ed claiming that PTSD was a vastly overclaimed, overdiagnosed and overtreated disorder that was being exploited by military and other malingerers who simply want to cheat the system to get free health care and avoid having to serve out their terms, go back to Iraq or have to work for a living. This is in line with the same tired old far-right claims that the poor (code word for blacks) are poor because they're lazy and stupid, that gay rights promotes the conversion of children to become gay, that government can't solve problems and actually IS the problem, etc. Whether or not RW shills like Satel actually believe this tripe (I imagine that some of them do, and some are just in it for the money and career boost), it is tripe, and needs to be treated as such (with apologies for people who like eating tripe).

    However much some of these shills believe in this crap, this is clearly, at bottom, about money and privilege. Namely, about corporations and their top executives and shareholders being able to make as much money as possible, at the expense of the rest of us, and about their also being able to have as much privileged access to whatever our world has to offer that they might desire (be it oil, cheap labor, or body parts), also to the exclusion of the rest of us. And shills like Satel, whether true believers or not, are sent out regularly to basically misrepresent this to the public and give it the appearance of being respectable and desirable. Not unlike all those slick Rx ads we've been bombarded with for the past 10 years that try to convince us that we needs drugs that we don't actually need. Or dishonest hard sell subprime mortgage pitches. Or cigarette ads subliminally targeted at children. And so on. You get the idea.

    Satel's having a medical degree and working for a legitimate-sounding organization like AEI (which, I will admit, does have a few decent people, most notable Norm Ornstein, but which for the most part is a shill for the corporate world, as its name implies) allows her to fool some people, which is precisely why she was picked to sell this crap. But it doesn't make her any more honest, or any less of a sociopathic creep for promoting the idea that poor people can sell their body parts to pay the bills. We should call this "organ sharecropping", which is what it basically is. And sociopathic shills like Satel should be exposed for what they clearly are.

    0101011101100101 010101000110100001100101 010100000110010101101111011100000110110001100101

    by kovie on Sun Dec 16, 2007 at 02:52:37 PM PST

  •  I'll Bid Ten Dollars for Her Heart (4+ / 0-)

    Oops! She doesn't have one.

    I think Sen. Clinton would make a very good president.

    by bink on Sun Dec 16, 2007 at 02:59:50 PM PST

  •  Yeah this is kind of sickening (2+ / 0-)
    Recommended by:
    nyceve, 1864 House

    So even if I were to sell my kidney, what guarantee would there be for it to be a match? And what happens if the donor's body rejects my kidney? Does that mean that I do not get paid?

  •  Perhaps this idea has merit (3+ / 0-)
    Recommended by:
    nyceve, JuliaAnn, greeseyparrot

    After all, you could sell off body parts as needed - like say, you're a bit strapped for Xmas shopping this year. Sell a retina, a kidney, or half a lung and get your loved one a bigscreen TV.

    The pious could generously choose to donate their parts to charity and gift the cash proceeds to their own churches! The most holy of congregationalists would be in wheelchairs, their arms and legs gone, noses removed, ears clipped.

    People could compete to see who can sell the most and still life. Like a weight-loss competition. The "winner" might get down to like, 66 pounds, maybe, with all the non-essentials trimmed away and sold to the wealthy.

    Oh, this is going to be great. The wonders we shall see!

    Every day's another chance to stick it to The Man. - dls.

    by The Raven on Sun Dec 16, 2007 at 03:09:53 PM PST

  •  Just read the whole essay (8+ / 0-)

    What a spoiled, immature, self-centered, selfish bitch.  Among other things, she gets mad at her friend for not giving her a kidney, can you believe that?

    The exchange set off a spiral of anxiety in Dr. Yale’s mind — What if my brother or kids need my kidney? What if I had complications from surgery? I’m sorry, she said matter-of-factly, and that was that.

    I understood that my friend wanted to spend her kidney wisely. What mystifies me still is how she got so spooked...

    Uh, maybe surgical complications, blood relatives that might need it.

    The tone of the article is disgusting and immature, more suitable for a prom queen's quest for the perfect dress than a serious article about organ donation.

    What a selfish bitch.

    In TX-32, track the voting record of Pete Sessions at SessionsWatch.

    by CoolOnion on Sun Dec 16, 2007 at 03:24:16 PM PST

    •  I'd have no problem with giving an organ (1+ / 0-)
      Recommended by:

      to Dr Patel - after I'm dead.  That's when the rest of my usable organs will be harvested.  I'm sure not one will be wasted either.  But instead of congratulating me on my altruism(I was going to say "generosity" but really, it does not apply.) she would snipe at me for not giving my kidney to her, right now.

      It almost sounds like she preferred a nice, fresh kidney, taken from a warm, healthy body than a harvested organ, placed on ice and rushed to her OR.  

      You think showering with the same gender could be creepy?  Try someone who is lusting after other people's organs!

      No more lies - IMPEACH!

      by Fabian on Sun Dec 16, 2007 at 04:37:46 PM PST

      [ Parent ]

  •  if allowed it would become cannabolization (6+ / 0-)

    December 9, 2007 -- Jeffery Avila looks nervous. At 16, he's preparing to "donate" his kidney to a wealthy foreigner.

    "I am a bit worried," he admits, clutching his blood-type card, "but I haven't got a job, and I want to help my family."

    Avila lives in a barrio in the South Port area of Manila called Baseco. The slum in the Philippines has a few nicknames - among them "The Kidney Market" and "One Kidney Island" - because so many of the men who live in the slum's flimsy houses and around its open sewers have sold their kidneys to escape the dire poverty

    The rich would force the poor into doing it. And the price would go down and down.

    fact does not require fiction for balance

    by mollyd on Sun Dec 16, 2007 at 03:32:21 PM PST

  •  It makes me sick... (8+ / 0-) think that people who were supposed to take the Hippocratic Oath (which basically comes down to "First, do no harm") would actually believe this enough to write it down - and that someone would publish it.
     Satel makes me sick.  Makes me ashamed of my profession.
     Has she, perhaps sold part of herself - say, her soul - to the Devil?

    In a time of universal deceit, telling the truth becomes a revolutionary act. - George Orwell

    by drchelo on Sun Dec 16, 2007 at 03:35:20 PM PST

  •  The natural order of things (7+ / 0-)

    As has been noted elsewhere, conservatives view themselves as an aristocracy. Their virtue is not to be questioned; their superiority is a given. That others should put themselves at risk to serve them ... is only their due. The vast miserable, dirty, squalid mass of humanity exists only as a background against which their inherent refulgence can be better appreciated. As a pithy expression puts it, "They believe their shit doesn't stink."

    One now sees why the memos codifying the meaning of torture (literally defining deviancy down) were concerned about organ failure. Damaging the merchandise is not acceptable. Locking people up without right to counsel or even knowing the charges for an indefinite time - well we already have blood banks, right?

    I wonder how long before someone proposes that illegal aliens might be granted citizenship in exchange for an organ or two? We already have an accelerated citizenship process for legal aliens who enlist in the military.

    Let's not forget the American Enterprise Institute has pushed policies for years which benefit the rich, attack the middle class, and brutalize the poor. What better way to shape the marketplace so that there's a steady supply of people desperate enough to want to sell their organs?

    "No special skill, no standard attitude, no technology, and no organization - no matter how valuable - can safely replace thought itself."

    by xaxnar on Sun Dec 16, 2007 at 03:42:53 PM PST

  •  You cannot make up people like that (1+ / 0-)
    Recommended by:

    -- though a number of writers in science fiction have tried and Ayn Rand of course celebrated them all. These people make Nazis look sensible and humane.

    We have only just begun and none too soon.

    by global citizen on Sun Dec 16, 2007 at 03:45:48 PM PST

  •  It'll be a sad day... (2+ / 0-)
    Recommended by:
    nyceve, denise b

    When death ceases to be the great equalizer.

    Their can be no market for human organs whithout a repricing of everything else. If everyone could be well off by selling one spare organ then no one would have to ever work again. The immediate result would be inflation in the price of everything to the point that selling your spare parts would become necessary to compete with the nouveau riche. It would just be one more thing that some people would profit from.

  •  Two things... (3+ / 0-)
    Recommended by:
    nyceve, alizard, SaraBeth

    First, we need to stop talking about health insurance and start talking about health care. By calling it insurance, we acknowledge that it is something we need in case we get sick - insurance against sickness, like car insurance is insurance in case of accident.
    Health care on the other hand, connotes an idea of caring for people no matter what their health needs. it encompasses preventative as well as crisis needs.
    Second, while I don't believe there should be a market for organs, I would like to see some compensation to families. My best friend recently lost her husband suddenly to a heart attack. Even before his body was cold they called to ask for some of his parts. And the thing is, we all knew that her hubby would have been generous to give of himself (literally). We also thought, why not do some good? A burn victim will benefit from his skin. His bones will go to someone needing a graft. And two people will see because of his eyes.
    But the thing is, my friend is suddenly left with the expense of a service, no insurance from hubby (he cashed it out 6 years ago so they could survive when he was out of work due to bypass surgery), as well as having to now depend on one income.
    I just think it would be nice for a stipend for people who give their organs. It doesn't need to be huge - a few hundred bucks would suffice. But we all know that someone is getting money from the process. Why shouldn't the survivor, who is grieving and dealing with the cost of arrangements, get a little something to help them in a time of need?
    And don't get me wrong, I can imagine how difficult it is for the folks who have to call to ask those difficult questions. But maybe their job would be easier if people knew there was something for them when it was over, something to tide them over for  a few days in difficult times (and no, it wouldn't be a per piece compensation - just one lump sum no matter how much or how little you donate from the deceased). Heck, it might even get more people to donate!

    "The truth shall set you free, but first it will piss you off!" - Gloria Steinem

    by MA Liberal on Sun Dec 16, 2007 at 04:01:03 PM PST

  •  Soylent Green is....PEOPLE!!! (3+ / 0-)
    Recommended by:
    nyceve, alizard, Cassandra Waites

    Would someone please explain to these conservatives that movies of this nature were science fiction (and not always the best science fiction), not essays on public health administration.

  •  The "free market" and healthcare... (1+ / 0-)
    Recommended by:

    What a combo!
    So, we have a healthcare system which is, supposedly, mostly driven by the free market.  And now, a prostitute for a free-market 'think tank' complains that the healthcare system isn't working (for her).  And what's her solution?
    The f**king free market!
    I'll gladly give up a kidney if I can swing a 2x6 at this idiot's head.

    Don't be a DON'T-DO... Be a DO-DO!

    by godwhataklutz on Sun Dec 16, 2007 at 04:25:16 PM PST

  •  Nearly 150 years ago (5+ / 0-)

    we outlawed the buying and selling of whole humans.  Why would anyone think that the buying and selling of parts of humans are any more acceptable?  The mere suggestion is unethical and morally reprehensible.

    "We are all born ignorant, but one must work hard to remain stupid." -Benjamin Franklin

    by Zorba the Greek on Sun Dec 16, 2007 at 04:35:46 PM PST

  •  Hannity - barter accounting services4 health care (1+ / 0-)
    Recommended by:

    I kid you not, the wingnut actually suggested to a caller that "in capitalism" that if he wants health care insurance he should think of some service he could give the health insurance company in exchange for the health care and used accounting and bookkeeping as his example.

    He then cited his so called own experience where he agreed to cut his landlord's lawn in exchange for a reduction in rent.

    We can imagine it now, Health care 500 dollars a month but you can spend 50 hours scrubbing toilets to work off the payment.

    I shall not rest until right wing conservatives are 4th party gadflies limited to offering minor corrections on legislation once or twice a year.

    by davefromqueens on Sun Dec 16, 2007 at 04:41:21 PM PST

  •  I'd be curious to see how many uninsured (2+ / 0-)
    Recommended by:
    nyceve, Cassandra Waites

    voted for Bush and this kind of thinking. I know of a few here. But the GOP managed to get the Reagan Democrats which many belong to the Values crowd who vote against the their own interests.

    I wonder if they would continue to vote the way they do if they understood that they were thought of as a viable source for body parts as long as they stayed healthy on their own.

    "See you have to earn your Health insurance instead of just get it if you can't get rich on your own which is better than socialized commie medicine".

    I can hear them saying it until the Doc gives a physical to the potential donor and says "Oh hey sorry, I can't put you down as a donor. You  contracted xxx which is a real organ value destroyer. Geez if you only had seen a Doctor. All you would have needed is to take a shot. Sorry...NEXT...oh yeah, you can't sell or give blood either- Have a nice day"

    Support Col Hackworth's watchdog group for the troops with money or a sign

    by Dburn on Sun Dec 16, 2007 at 04:48:20 PM PST

  •  I'd like to ask Sally (6+ / 0-)

    if she had signed up as a donor organ before her health problems started.  

    Also, calling the American Enterprise Institute a "think tank" gives real think tanks a bad name.  Perhaps calling it a Neo-Conservative Propaganda Farm would be a better description of its real function and purpose.

    People do not need religion. They need effective coping mechanisms to deal with existential anxieties. Patricia Guzikowsk

    by a lien on everything on Sun Dec 16, 2007 at 05:00:12 PM PST

  •  if exchange of any kind is allowed (2+ / 0-)
    Recommended by:
    nyceve, Cassandra Waites

    Then would be a very short time until debtors would be able to demand body parts. Bankrupsy, can only be imagined.

    fact does not require fiction for balance

    by mollyd on Sun Dec 16, 2007 at 05:06:56 PM PST

  •  It's the age-old meme: Money talks. (1+ / 0-)
    Recommended by:
  •  Is insanity (2+ / 0-)
    Recommended by:
    nyceve, gooderservice

    a requirement to belong to the republican Party? And, why in the name of all things decent, would anyone print such crazy shit?

    Common Sense is not Common

    by RustyBrown on Sun Dec 16, 2007 at 05:30:57 PM PST

  •  I agree with Sally... (2+ / 0-)
    Recommended by:
    nyceve, xanthe

    only one caveat:  That anyone who sells their organs must have a net worth over a million dollars.  (Okay, if you want to, you can change it to five million dollars.)

    Let's just start with that and see how it goes.

    "We The Lobbyists (and the rich)"

    by gooderservice on Sun Dec 16, 2007 at 05:34:27 PM PST

  •  Those guys are all the same (1+ / 0-)
    Recommended by:

    When it comes down to "me, me, me" they all of a sudden change their minds about their morals.  

    I wonder if she consciously wrote about her healthcare as a way to keep her insurance company from denying her service.   I could see that as an effective tool.  If they denied her any care, she has a bully pulpit and could really take it to them.  

    Reject these feverish legal theories- S. Whitehouse

    by otto on Sun Dec 16, 2007 at 05:35:15 PM PST

  •  Actually, her system makes sense (1+ / 0-)
    Recommended by:

    In talking to my wife, the Clinical Pathology Resident at Brigham and Women's (I'm so proud of my brilliant wife), compensating people for blood leads to a high percentage of blood tainted with HIV and HepC (which is thrown out of course).

    So, if we have a system in which donors can either be screened and give their organs free, or sell them without screening ... I'm more than happy to allow the AEI fellows to buy their organs.

    Just kidding, of course.

  •  Yes (1+ / 0-)
    Recommended by:

    It DOES make me want to vomit.

  •  national healthcare (2+ / 0-)
    Recommended by:
    nyceve, splashy

    There is a study which indicates that End Stage Renal Disease is 15% higher in the US than in Europe, and 33% higher in the US than in Japan.  

    Perhaps a decent, national healthcare program should be the first place we look for a way to reduce the problem.  

    Reject these feverish legal theories- S. Whitehouse

    by otto on Sun Dec 16, 2007 at 05:48:34 PM PST

  •  as I sit here (0+ / 0-)

    someone's got a TV on in the living room, the "good guys" are investigating somebody who was breaking up corpses for spare parts. . . in this case, contaminated spare parts that went into several different people.

    The kind of ethics which would permit someone to break up a living human body for parts for sale without her permission would also persuade that person it's perfectly all right if they open the body up and find that person was suffering from infectious diseases or various organ disorders.

    Some things shouldn't be in the "free market".

    Looking for intelligent energy policy alternatives? Try here.

    by alizard on Sun Dec 16, 2007 at 10:59:52 PM PST

  •  To Conservatives.... (1+ / 0-)
    Recommended by:
    Black Max

    humans are just expendable commodities...

  •  Larry Niven calls it 'organlegging' (0+ / 0-)

    Wonder how he feels about this, considering he is a rather staunch conservative who found the concept of "organlegging" morally repugnant?

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