Say a machine is invented that allows one individual to transfer years-of-life to another individual. Should people be allowed to buy and sell their years-of-life or should these exchanges be outlawed?
If your answer is yes, picture the cults that would arise with the sole purpose of breeding and brainwashing people so that they give life-years to their now immortal Leader.
If you’re answer is no, then does the morality of kidney exchanges hinge on the evidence that donating a kidney doesn’t lower life expectancy? As far as I know randomized studies on this have never been done, and the selection bias and unobservables here seems potentially insurmountable. If these results were overturned by a randomized trial, how many kidney exchange supporters switch positions?
I do support kidney exchanges, but I also don’t have good answers to these questions.
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Wednesday ~ September 15th, 2010 at 8:20 am
jazzbumpa
What is the connection of your hypothetical machine to the reality of kidney exchange?
Giving some individual access to an infinite number of kidneys is not going to make her immoral.
Donating a kidney is a way of preventing a premature (and I assume quite miserable) death.
Are you saying that there is no specific knowledge about the effect of kidney donation on the donor?
What about comparing life duration after donation to expectancy of a similar demographic? Not perfect, but should be able to detect large differences.
Other than the risk of not having a back-up, should the remaining kidney fail, why would a donor’s life expectancy be compromised?
Cheers (and may your kidneys live long and prosper)
JzB
Wednesday ~ September 15th, 2010 at 8:44 am
Adam Ozimek
The machine assigns to the giver:
E(life pre-trade) = E(life pre-trade) – E(x)
And to the taker:
E(life pre-trade) = E(life pre-trade) + E(y)
Where E(x) > 0, and E(y) > 0. (you could but need not assume E(x) = E(y))
The kidney exchange does the same exchange, except E(x) = 0, and E(y) > 0.
And while I agree our best guess is E(x) = 0, our knowledge is limited due to selection bias and unobservables. Given that, I’d say it’s a probabilistically non-trivial possibility that in reality E(x) > 0, even if only slightly.
Well that makes the kidney exchange the same kind of trade as the machine.
You’re right though that kidneys lack the immortality dimension, and one could draw a moral line between the two based on that. But I suspect opposition to the life exchange would come more from what the giver loses than the taker gets.
Friday ~ September 17th, 2010 at 2:54 am
Pat Cahalan
> Well that makes the kidney exchange the same kind of
> trade as the machine.
No, it doesn’t, because you’re conflating a probabilistic exchange with a deterministic one, which is the problem with analogies like this.
Let us reframe the question so that the analogy is actually apt. The magic life machine exists, however, there are some caveats.
Namely, a percentage of people who use the machine (both the donators and the receivers) are going to die during the process, you’re not definitely giving a year of life from one player to another. Instead, you’re exchanging a year of life expectancy for some tidy sum of filthy lucre.
Well, money also increases life expectancy, so for Joe Gazillionaire, for whom $250,000 means nothing, trading for a year of life *expectancy* seems like a good deal. For John Poorhouse, that $250,000 might actually *give* him five years of life expectancy. Hey, everybody wins. Well, assuming they don’t draw the black queen and croak from the process.
Suddenly, the morality of the exchange seems a tad different.
If you’re going to compare a deterministic exchange to a probabilistic one without noting the difference, you’re going to get a skewed analysis.
Wednesday ~ September 15th, 2010 at 9:32 am
jazzbumpa
What this illustrates is the conceptual hazard of reducing human interactions to a mathematical equation, no matter how compelling or elegant the model might seem to be.
In the machine example, donors have in some way had more than their life time and utility reduced. They have either been victimized directly, or indirectly through brain-washing or some other Jim Jones-style psychological ploy.
A kidney donor can reap intangible benefits that significantly increase her utility.
Models are a poor representation of actual behavior.
Cheers!
JzB
Wednesday ~ September 15th, 2010 at 9:46 am
Adam Ozimek
You’re mistaken. I have not attempted to model the utility, but simply the impacts on life expectancy.
Also, note that yours is a model as well, it’s just verbal, and I could write the utility functions exactly as you describe them in mathematically equations without any loss of generality from your verbal description.
Wednesday ~ September 15th, 2010 at 11:25 am
jazzbumpa
I do realize you are only modeling life span. Mentioning utility was an elaboration outside your model. Sorry for the confusion.
BTW – I didn’t model anything. I’m speaking of and in generalities that I posit defy modeling.
Frex: intangible benefits. You can’t model them. In fact, you can’t even define them with any degree of certainty, because they are subjective, and could vary greatly among potential donors. I know people who have donated blood for cash to buy beer.
Sis Y -
Why might life-years be specially protected, unlike labor-hours or money or land?
I know economics is a cold and amoral field of thought. But, just as an example, someone who loses labor-hours or land might have an opportunity to recoup. Loss of life is final and reduces utility to zero.
Though Adam might have a different view on the utility of the no-longer-existent.
Further, brainwashing that leads to loss of life is in quite a different moral dimension than brainwashing that leads to loss of financial assets. Sometimes you just have to think like a human being, rather than an economist.
Having to point this out disturbs me more than any other experience I have had in this forum. And that is saying a lot.
Now, I must go hug a squid.
JzB
Wednesday ~ September 15th, 2010 at 10:02 am
Johnnie Linn
The market for kidneys would appear to be a lump-of-labor market.
Wednesday ~ September 15th, 2010 at 10:48 am
Sister Y
Your brainwashing concerns are present with any voluntary transaction. Why might life-years be specially protected, unlike labor-hours or money or land?
Essentially, I think the question is whether we should be allowed to adjust our own life spans in order to further our values. It MIGHT be a contest between welfare and autonomy, as some freedoms may make us worse off (as Velleman has argued, against an institutional right to die).
However, whether welfare is promoted by restricting this choice (really, relegating it to black markets thereby transferring gains from donors to middlemen) is an empirical question that had not been seriously investigated, to my knowledge. I think that despite any welfare gains from a prohibition on transfer, one’s lifespan is an issue so central and personal that autonomy must trump.
Based on current numbers, allowing suicides to donate our organs would solve the organ shortage instantly.
We often trade life years for our values – smoking, being miner, riding motorcycles. Why no direct trades?
Wednesday ~ September 15th, 2010 at 12:06 pm
Sister Y
I know economics is a cold and amoral field of thought. But, just as an example, someone who loses labor-hours or land might have an opportunity to recoup. Loss of life is final and reduces utility to zero.
The idea here – a market in life-years – is that you wouldn’t necessarily trade your life away instantly, but would trade a few years (in the future) for increased utility now. You WOULD recoup the losses, by concentrating your utility in the immediate future, rather than having a long, crappy future.
For many of us, expected future utility is negative anyway – we would rationally prefer to have zero utility than to suffer.
I understand that this is disturbing – it should be. But being moral and focusing on human values does not necessarily mean going with our “gut feeling.” It must involve subjecting our intuitions to rational analysis and testing them against the intuitions of others.
Wednesday ~ September 15th, 2010 at 12:06 pm
jazzbumpa
We often trade life years for our values – smoking, being miner, riding motorcycles. Why no direct trades?
What an absurd proposition. None of these is a value trade-off supported by a rational decision-making process.
Smokers are either addicted, in denial, or both.
Miners owe their soul to the company sto’ and have a severely limited option set.
If you think motor cyclists make a value judgement based on peer approval and the thrill of wind in their hair and bugs in their teeth vis-a-vis slicing decades off their life and or winding up a quad, take a survey the next time you’re at a Hell’s Angels convention and see how many blank stares you get.
This is a fundamental problem with economic reasoning. It purports to be a science of human interaction, but makes assumptions about human behavior that are startlingly at variance with reality. People are not logical econo-automata. Consider how amusingly alien Mr. Spock is. Instead, they muddle through life in various degrees of fog, are constrained by their comfort zones and my-god-what-will-the-neighbors-think, force of habit, ritual, denial, intellectual laziness and perfidy, gullibility, and sub-clinical psychoses.
You don’t make a series of complicated utility-maximizing decisions between waking and sitting down to breakfast. You just do what you do.
JzB
Wednesday ~ September 15th, 2010 at 12:08 pm
jazzbumpa
Oh, phooey. My /rant symbol turned invisible.
Rats!
JzB
Wednesday ~ September 15th, 2010 at 12:14 pm
Sister Y
Should we have no choice at all, then, given that we are not perfectly rational?
I ride a motorcycle, knowing that it might kill me. The pleasure of riding is worth more to me than the expected losses from getting smeared on the pavement. Velleman argues in a related paper (A Right of Self-Termination?) something like your position – that we can’t rationally trade life years for our values and pleasures. I think that’s bullshit and argue so here.
By the way, here’s the Velleman paper (gated, sorry) against an institutional right to die based on the idea that choices can harm us. And this is my response.
Wednesday ~ September 15th, 2010 at 5:05 pm
jazzbumpa
Should we have no choice at all, then, given that we are not perfectly rational?
I’m short on time, but I calling false choice on you.
Maybe you have gone through this rational cost-benefit analysis and determined that a low probability of disaster justifies the risk. In failure mode analysis we multiply the severity by the event probability.
The reason the pleasure is greater is that you consider the expected loss probability to be slight.
Call bullshit all you like. This is not the way most humans operate most of the time.
Cheers!
JzB
Wednesday ~ September 15th, 2010 at 7:35 pm
Sister Y
There is a spectrum between having no choice and having complete freedom. What criteria shall we use to decide which choices to allow and which to restrict?
You correctly describe the mathematics of rational decision making – but you assume I am incorrect in my balancing of magnitude and likelihood of disaster. It is not that I ascribe an especially low probability to disaster (though I doubt my two-stroke will ever break 60 MPH), but that my expected utility without the motorcycle (or any of my other potentially life-shortening vices) is extremely low to begin with.
Similarly, in the case of lifespan/organ sales, some people simply may not want to live out their natural lifespans as much as they want to achieve certain goals that are only obtainable with money – like feeding or educating their families. (Or hiring lots of expensive hookers.) Forbidding them to sell their organs or lifespan “protects” them from something you might think is an incorrect choice, but forcing this option on them causes them to be less happy and fulfilled, and carries the dignitary insult of paternalism.
People are suffering now. Why not let them pursue their happiness?
Wednesday ~ September 15th, 2010 at 9:53 pm
jazzbumpa
Actually, I’ve made the same mistake I always make here, in letting myself get bogged down in minutia that is actually irrelevant to the point I’m trying to make.
If you want to trade life units for whatever makes you happy today, I’m not going to stand in your way (especially if you’re on your bike.) I have no objection to whatever decision you wish to make with any asset or aspect of your existence. That is simply your business.
My points are:
1) Economists love models, but models are poor representations of reality. They are poor because the underlying assumptions are not valid. But the conclusions of reasoning based on these poor models become the basis for policy recommendations.
2) Thinking like an economist leads you to ignore the moral dimensions of human interactions. This might be fine in the abstract, and within (perhaps undefinable) limits. The danger is that it can lead down paths to what one might call “final solutions.”
Cheers!
JzB
Saturday ~ September 18th, 2010 at 6:50 pm
octopus
what is it with people and these nonsense hypotheticals?
no, these exchanges shouldn’t be outlawed, and it’s shameful that organ exchanges are outlawed. thousands of people die every year so that the hand-wringers can feel good about abstract notions of sanctity and purity of whatever.
but let me address the question directly: I want to BE that immortal leader! that sounds awesome!
more seriously (maybe), how is that hypothetical any different from saying “if we make giving birth legal, picture the cults that would arise with the sole purpose of women birthing young children for the unsavory pleasures of the cult leader”… not an every-corner-kind-of-problem, is it? don’t see a lot of that going on, do you? so, do you think that’s because of LAWS AGAINST IT? or maybe, just maybe, because it’s completely insane and runs completely contrary to the actual desires of actual people?
when did it become universally accepted that if a law doesn’t exist to ban something, then OMG OMG EVERYONE WILL DO IT WHAT THEN WHAT THEN??????????? since when do laws stop people from doing what they want to do? how’s the “war on drugs” going these days?
think about how hard it is to get people to buy into something fairly basic like evolutionary theory (don’t even worry about arguing over group selection or whatever else, just the idea that this is the right framework, not magical creation by the invisible space unicorn) or the earth revolving around the sun or whatever else you prefer… yet these hypotheticals always rely on these p = 0.000001 assumptions where scary brainwashings of crowds of people are taken seriously as central arguments.
I think scary nonsense hypotheticals can be constructed regarding virtually every imaginable human interaction, because human interaction is complicated. thinking instead in probabilities, the probability of saving more lives than are saved today seems fairly certain, and the probability of people buying kidneys (or life force or whatever) to graft onto their faces like horrible monsters (!!!!!!!!!!!!!!) is very nearly zero.
by the way, to the dude constructing the “models aren’t reality” straw man and then burning it down with conviction: well done. I simply can’t count how many times I’ve heard economists, physicists, biologists, botanists, and proctologists say, “human love and yearning is fully captured by my system of partial differential equations, and before proposing to my wife, I first estimated the eigenvalues of her random matrices.” I am so, so thankful that someone is finally bringing the bright light of sense to these discussions. and the allusion to nazi germany at the end, via “final solution” in scare quotes, is top notch. you are the champion.
Friday ~ October 7th, 2011 at 8:00 am
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