Encourage free market in body organs by Bruce Korol‏

Procuring transplantable organs from donors in a country that is always facing a shortage is a constant challenge and it's clear the problem requires another way of thinking.

The Journal informed us about the just-announced $200,000 provincial grant that will establish a reimbursement program to cover the expenses of living donors.

Iran has ended their waiting list for kidneys by paying living donors, while Singapore has approved a plan that provides significant financial payment to donors. Israel gives living donors priority if ever they personally need a transplant.

Jurgen de Wispelaere, a medical ethics researcher from the Universite de Montreal, recently suggested that tax credits be used to encourage organ donation. In his paper, de Wispelaere proposed the government create an incentive by providing a tax benefit to a second consenter for signing up to be a living advocate.

Forget about this and other slim government incentives to coax potential donors and let's open up what many would reflexively find repulsive: a free market in body organs.

Right now it is illegal to buy and sell organs in Canada. Each province has its own act. Alberta's Human Tissue and Organ Donation Act states: "No person shall offer, give or receive any reward or benefit for any tissue, organ or body for use in transplantation, medical education or scientific research." Violating it could result in jail time and/or a hefty fine.

Though donations have actually increased and provinces have tried to improve organ donation by raising awareness and reimbursing living donors for expenses, shortages persist.

Canadians who need a kidney, for example, face lengthy wait times for a transplant. As a result, many wealthy Canadians take their chances and travel abroad to purchase their organs.

Faced with a lengthy waiting list, it's an understandable reaction for an ailing individual, even if this entails further health risks and an uncertain outcome.

A shortage and a resulting black market naturally develop when the government prohibits an activity. Economists will tell you the purchase and sale of organs will increase organ donations and alleviate shortages.

In an open market, explains economist Gary Becker, the prices of organs for transplants would settle at levels that would eliminate the excess demand for each type of organ.

Donald Boudreaux, economics professor at George Mason University, says, "If organ sales were liberalized, the availability of organs would rise and their prices would fall. Transplant surgery would become more affordable and, thus, more lives -- not only of the rich but of all classes -- would be improved and saved."

Boudreaux also points out that prohibiting a donor from receiving compensation artificially increases "the marginal value of transplantable organs ... prohibiting organ donors from personally profiting keeps the quantity supplied of such organs lower than it would be in a free market."

Living donors could contract with those who need a transplant or an individual could sell the right to harvest their organs after they have died. The altruistically-minded can still donate their organs for free whether they're alive or dead.

Of course, the proposed practice of buying and selling organs is laden with bio-ethical concerns and has a tawdry stigma attached to it.

Critics argue that it might lead to the impoverished selling their organs to wealthy patients, that it offends human dignity or that it violates our shared humanness.

However, if there's a voluntary exchange between a recipient and donor, why should you or the government care?

If there's a recipient who wants to pay for an organ and a living donor who is willing to sell their organ why prevent it? Is it ethical to play God and forcefully condemn donors to poverty and potential recipients to death?

A person's autonomy should be respected. It doesn't matter whether the donation is motivated by charity, financial desperation or unmitigated greed and whether the selling of organs offend the moral sensibilities of the religious, medical or Canadian community, organ donation is a personal choice.

So, let people work out the ethical implications of selling their body parts and increase the supply by allowing a free market in organs.

Bruce Korol is a Calgary lawyer.

© Copyright (c) The Edmonton Journal

Polygamy is a (al)right by Bruce Korol

In his article, "It's inevitable: The courts will legalize polygamy" (Ottawa Citizen, April 7), David Warren laments the foregone conclusion that courts will legalize polygamy, and rails against the constitutional climate that has made it possible.

But why is polygamy criminalized in the first place and why are conservatives like Warren so adamant in keeping it that way? A 2006 study by three law professors at Queen's University concluded that criminalizing polygamy serves no useful purpose; polygamy is rarely prosecuted, and anti-polygamy laws likely violate the guarantee of freedom of religion.

Polygamy also has a history that predates monogamy by thousands of years, yet polygamists remain unfairly persecuted in North America.

It is present in many cultures, and given its past religious importance there's no doubt it's a legitimate religious belief, Warren's misgivings notwithstanding.

If the arrangement is among consenting adults then the government has no legitimate authority in interfering in the relationship. It's extremely problematic for the state to wield its coercive power against polygamy without clear evidence of an actual crime.

The polygamists' claim for legal recognition is bolstered by same-sex marriage. Winston Blackmore will cite gay marriage laws in his defense, which is a scenario that was predicted by many critics -- such as David Warren -- when same-sex marriage was legalized.

If two men or two women wish to marry each other and it infringes on no one else's rights, then the government shouldn't stop them. Same thing goes for polygamy. Consensual adults should be free to marry whomever they please.

The contradictions are apparent and polygamists see it as an issue of unequal treatment under the law.

When the Utah ban on polygamy was challenged in 2004 (a challenge that was eventually dismissed), Dani Eyer, executive director of the ACLU of Utah, said the state will "have to step up to prove that a polygamous relationship is detrimental to society . . . There's no denying that thousands and thousands are doing that here and will maintain that it's healthy . . . The model of the nuclear family as we know it in the immediate past is unique, and may not be necessarily be the best model. Maybe it's time to have this discussion.''

The practice might be frowned on but one doesn't have to condone the practice to recognize the heavy-handed senselessness of criminalizing it.

The more important argument for polygamy is that government should stay out of marriage.

Polygamists have refused to acknowledge the state and its intrusion into their private affairs, and so they should. There's no legitimate reason for the government to dispense morality edicts on what is properly the private sphere.

The impending court battle allows pro-family advocates who were against same-sex marriage to bring up the same public-policy talking points, but someone's private marriage isn't a matter for public debate. This is something gays didn't comprehend when they begged the government to legally recognize their relationships and it's something the traditionalists miss when they want to be the only ones to have their marriages granted state legitimacy.

A legal marriage should be between those involved in a committed relationship without state interference. David Boaz, executive vice-president of the Cato Institute, had this to say in a 1997 article calling for the privatization of marriage: "If they wanted to contract for a traditional breadwinner/homemaker setup, with specified rules for property and alimony in the event of divorce, they could do so. Less traditional couples could keep their assets separate and agree to share specified expenses. Those with assets to protect could sign prenuptial agreements that courts would respect. Marriage contracts could be as individually tailored as other contracts are."

Consenting adults choose relationships that work for them whether they are monogamous or polyamorous.

Maybe Warren is wrong and the anti-polygamy law eventually will be considered valid because it protects women and children and promotes "Canadian values." British Columbia Attorney-General Wally Oppal might also be right when he claims that most Canadians find polygamy morally repugnant. But neither personal feelings nor constitutional parsing should dissuade us from this essential point: Government should stay out of the marriage business -- and that includes marital structures the majority disapprove of.