A Legal Market for Fetal Organs?
Jacob M. Appel is a bioethicist and fiction writer. He holds a B.A. and an M.A. from Brown University, an M.A. and an M.Phil. from Columbia University, an M.D. from Columbia University's College of Physicians and Surgeons, an M.F.A. in creative writing from New York University, and a J.D. from Harvard Law School. He has most recently taught at Brown University in Providence, Rhode Island, and at the Gotham Writers Workshop in New York City. He publishes in the field of bioethics and contributes to such publications as the Journal of Clinical Ethics, the Journal of Law, Medicine & Ethics, and the Bulletin of the History of Medicine. His essays have appeared in The New York Times, The New York Daily News, The Chicago Tribune, and other publications.
Appel has also published short fiction in more than one hundred literary journals. His short story, Shell Game With Organs, won the Boston Review Short Fiction Contest in 1998. His story about two census takers, "Counting," was shortlisted for the O. Henry Award in 2001. Other stories received "special mention" for the Pushcart Prize in 2006 and 2007.
He is admitted to the practice of law in New York State and Rhode Island, and is a licensed New York City sightseeing guide.
Appel contributed a Dangerous Idea to Big Think's "Month of Thinking Dangerously," advocating that we add trace amounts of lithium to our drinking water to help reduce the suicide rate.
Appel is a Big Think Delphi Fellow.
Question: Should buying and selling human organs be legal?
Jacob Appel: Sure. I've actually written about a legal market in fetal organs, which I think is somewhat different from a legal market in organs of post-born adults. And I would strongly favor legalizing the market in fetal organs because I don't feel that fetuses are people and therefore the risk of exploiting them is minimal and I feel that women are capable of making reproductive choices in relation to their fetuses particularly people who abort may want to save the lives of other individuals by making their organs available. And I think they should be able to profit from this.
In contrast, for adult organs, I think there should be a financial mechanism for allowing people to sell their organs. But I don't necessarily think there should be a market. I think a market opens itself up to abuse and will likely have the organs go to the highest bidder and make it most available to the wealthy.
In contrast, you want to create financial incentives so there are enough organs available for all 70,000 people who need kidneys, for example, in the United States. But then you don't want to distribute them based on economic opportunity, or economic -- based on assets, you want to distribute them based on need. So, I would have a system where the government bought up organs for people, let's say $10,000 for a kidney and then distributed them using the same system we have now, on a first-come, first-served, or need based approach. I think to tell people they can make other economic decisions in their lives, they can choose to be a laborer at $7.00 an hour for 40 hours a week, but they can't choose to avoid three months of work by selling a kidney is an unnecessary involvement, or an unnecessary intervention in the individual decision-making of people.
I will add, and I think this is often lost in the debate over organs. We focus excessively on the risk of exploitation of people who would sell their organs. We don't focus on the passion of people who die every year because they don't get organs. And if you are one of those individuals, or one of their relatives, you may see the question from a very different light.
Question: How difficult is it to obtain a life-saving organ in America today?
Jacob Appel: Oh, it's extraordinary difficult. I don't have the numbers in front of me, but there are approximately 115,000, 120,000 people on the waiting list for different life-saving organs in the country and with kidneys, we do have dialysis, so we can prolong the lives of these people a number of years. But the people who need heart transplants, or liver transplants, the majority of them, I believe die while waiting. Certainly a good plurality of them dies while waiting. Unlike kidneys where you can have a live donor make a donation, these people have to wait for cadavers. So the question arises, why not pay people who know they're going to die, or people to make their organs available in a pool if they are going to die to harvest their organs as soon as they do die, which would also reduce the risk of exploitation. These people are at death's door and are dying anyway.
As for kidneys, while dialysis is life prolonging, dialysis is not always life saving. It also substantially reduces the quality of life of individuals involved. In contrast, not having a kidney has no impact if you have one kidney of your own on the life quality or life expectancy of the individuals that give a kidney, on a virtually zero risk. Extremely low risk procedure. The real question that arises is, do we have an ethical obligation as healthy individual with two kidneys to give one to a stranger? And it's a challenging question. Maybe we do. We don't have the mechanism in place to make that happen. In fact, in the rare cases where people have tried to do that in this country, hospital ethics committees have often stepped in and questioned the capacity, or sanity of the individual who is seeking to. Which to my way of thinking is somewhat perverse. If someone is willing to, not sacrifice their life, or quality of life, but make a great altruistic **** for a stranger and we say this person must be crazy.
Recorded on March 1, 2010
Interviewed by Austin Allen
The bioethicist believes it's an idea whose time has come. But how could such a market be regulated to prevent abuses?
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What is human dignity? Here's a primer, told through 200 years of great essays, lectures, and novels.
- Human dignity means that each of our lives have an unimpeachable value simply because we are human, and therefore we are deserving of a baseline level of respect.
- That baseline requires more than the absence of violence, discrimination, and authoritarianism. It means giving individuals the freedom to pursue their own happiness and purpose.
- We look at incredible writings from the last 200 years that illustrate the push for human dignity in regards to slavery, equality, communism, free speech and education.
The inherent worth of all human beings<p>Human dignity is the inherent worth of each individual human being. Recognizing human dignity means respecting human beings' special value—value that sets us apart from other animals; value that is intrinsic and cannot be lost.</p> <p>Liberalism—the broad political philosophy that organizes society around liberty, justice, and equality—is rooted in the idea of human dignity. Liberalism assumes each of our lives, plans, and preferences have some unimpeachable value, not because of any objective evaluation or contribution to a greater good, but simply because they belong to a human being. We are human, and therefore deserving of a baseline level of respect. </p> <p>Because so many of us take human dignity for granted—just a fact of our humanness—it's usually only when someone's dignity is ignored or violated that we feel compelled to talk about it. </p> <p>But human dignity means more than the absence of violence, discrimination, and authoritarianism. It means giving individuals the freedom to pursue their own happiness and purpose—a freedom that can be hampered by restrictive social institutions or the tyranny of the majority. The liberal ideal of the good society is not just peaceful but also pluralistic: It is a society in which we respect others' right to think and live differently than we do.</p>
From the 19th century to today<p>With <a href="https://books.google.com/ngrams/graph?year_start=1800&year_end=2019&content=human+dignity&corpus=26&smoothing=3&direct_url=t1%3B%2Chuman%20dignity%3B%2Cc0" target="_blank" rel="noopener noreferrer">Google Books Ngram Viewer</a>, we can chart mentions of human dignity from 1800-2019.</p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDg0ODU0My9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTY1MTUwMzE4MX0.bu0D_0uQuyNLyJjfRESNhu7twkJ5nxu8pQtfa1w3hZs/img.png?width=980" id="7ef38" class="rm-shortcode" data-rm-shortcode-id="9974c7bef3812fcb36858f325889e3c6" data-rm-shortcode-name="rebelmouse-image" />
American novelist, writer, playwright, poet, essayist and civil rights activist James Baldwin at his home in Saint-Paul-de-Vence, southern France, on November 6, 1979.
Credit: Ralph Gatti/AFP via Getty Images
The future of dignity<p>Around the world, people are still working toward the full and equal recognition of human dignity. Every year, new speeches and writings help us understand what dignity is—not only what it looks like when dignity is violated but also what it looks like when dignity is honored. In his posthumous essay, Congressman Lewis wrote, "When historians pick up their pens to write the story of the 21st century, let them say that it was your generation who laid down the heavy burdens of hate at last and that peace finally triumphed over violence, aggression and war."</p> <p>The more we talk about human dignity, the better we understand it. And the sooner we can make progress toward a shared vision of peace, freedom, and mutual respect for all. </p>
Is Bitcoin akin to 'digital gold'?
- In October, PayPal announced that it would begin allowing users to buy, sell, and hold cryptocurrencies.
- Other major fintech companies—Square, Fidelity, SoFi—have also recently begun investing heavily in cryptocurrencies.
- While prices are volatile, many investors believe cryptocurrencies are a relatively safe bet because blockchain technology will prove itself over the long term.
Presentation slide from Sanja Kon's presentation on the evolution of money at 2020 Web Summit
Credit: Sanja Kon<p>The move came shortly after the payments company Square invested $50 million into Bitcoin, and after Fidelity announced that it was opening a Bitcoin fund into which qualified purchasers could invest <a href="https://www.bloomberg.com/news/articles/2020-08-26/fidelity-launches-inaugural-bitcoin-fund-for-wealthy-investors" target="_blank">(minimum investment: $100,000)</a>. Together, this institutional backing might have something to do with Bitcoin's recent surge back to near its 2017 price peak of $19,783. (Bitcoin is listed at 19,384.30 as of Dec. 3.)<br></p>
Presentation slide from Sanja Kon's presentation on the evolution of money at 2020 Web Summit
Credit: Sanja Kon<p>But more importantly, it suggests cryptocurrencies might soon have the opportunity to prove themselves in real-world use cases. After all, skeptics have long doubted the ability of cryptocurrencies to go mainstream as a form of everyday payment. But people seem increasingly comfortable with digital payment systems.</p><p style="margin-left: 20px;">"The entire world is going to come into digital first," Schulman said at Web Summit, adding that PayPal's services already go hand-in-hand with cryptocurrencies. "As we thought about it, digital wallets are a natural complement to digital currencies. We've got over 360 million digital wallets and we need to embrace cryptocurrencies."</p><p>Sanja Kon, vice president of global partnerships at the cryptocurrency payments processor company UTRUST, also spoke at Web Summit about the increasing adoption of digital payments:</p><p style="margin-left: 20px;">"Physical cash is becoming more and more obsolete. And the next step in the evolution is digital currency."</p><p>Kon noted some of the inherent advantages of cryptocurrencies, namely ownership. </p><p style="margin-left: 20px;">"For many people, this is really the main benefit of cryptocurrency: Users owning cryptocurrencies are able to control how they spend their money without dealing with any intermediary authority like a bank or a government, for example," Kon said, adding that there are no bank fees associated with cryptocurrencies, and that international transaction fees are significantly lower than wire transfers of fiat currency.</p><p>Kon said cryptocurrencies have unique growth opportunities in areas where people aren't integrated into modern banking systems:</p><p style="margin-left: 20px;">"With cryptocurrencies and blockchain, with the use of just a smartphone and access to internet, Bitcoin and cryptocurrencies can be available to populations of people and users without access to the traditional banking system."</p>
Bitcoin as 'digital gold'<p>Still, it could take years for people to start using cryptocurrencies for everyday purchases on a large scale. Despite this, many cryptocurrency advocates see digital currencies, particularly Bitcoin, as a way to store value—digital gold, essentially.</p><p style="margin-left: 20px;">"I don't think Bitcoin is going to be used as a transactional currency anytime in the next five years," billionaire investor Mike Novogratz recently told <a href="https://www.bloomberg.com/news/articles/2020-10-23/novogratz-says-bitcoin-is-digital-gold-not-a-currency-for-now?srnd=markets-vp" target="_blank">Bloomberg</a>. "Bitcoin is being used as a store of value. [...] "Bitcoin as a gold, as digital gold, is just going to keep going higher. More and more people are going to want it as some portion of their portfolio."</p><p>There are obvious parallels between gold and Bitcoin: Both are mined, do not degrade over time, are finite in supply, and aren't directly tied to the value of fiat currency, making them <a href="https://www.reuters.com/article/us-gold-inflation/gold-as-an-inflation-hedge-well-sort-of-idUSKCN1GD516" target="_blank" rel="noopener noreferrer">relatively invulnerable to inflation</a>. The obvious objection is that the price of Bitcoin, and cryptocurrencies in general, is far more volatile than gold.</p><p>But for investors who believe the inherent value of cryptocurrency technology will prove itself over the long term, these price fluctuations are just bumps on the long road to the future of currency. </p><p style="margin-left: 20px;">"It's no longer a debate if crypto is a thing, if Bitcoin is an asset, if the blockchain is going to be part of the financial infrastructure," Novogratz said. "It's not if, it's when, and so every single company has to have a plan now."</p>
Singapore has approved the sale of a lab-grown meat product in an effort to secure its food supplies against disease and climate change.
Approve for your dining pleasure<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="dd3f57f8baf14e654812d30a309d1f17"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/307gysA18_E?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p><a href="https://www.ju.st/en-us" target="_blank" rel="noopener noreferrer">Eat Just</a>, a company that produces animal-alternative food products, announced the news earlier this week. In what the company is calling a world first, Singapore has given it permission for a small-scale commercial launch of their GOOD Meat brand product line. For the initial run, the cultured chicken meat will be sold as an ingredient in "chicken bites."</p><p>"Singapore has long been a leader in innovation of all kinds, from information technology to biologics to now leading the world in building a healthier, safer food system. I'm sure that our regulatory approval for cultured meat will be the first of many in Singapore and in countries around the globe," Josh Tetrick, co-founder and CEO of Eat Just, <a href="https://www.businesswire.com/news/home/20201201006251/en/Eat-Just-Granted-World%E2%80%99s-First-Regulatory-Approval-for-Cultured-Meat" target="_blank" rel="noopener noreferrer">said in a release</a>.</p><p>According to the release, Eat Just underwent an extensive safety review by the Singapore Food Agency. It provided officials "details on the purity, identity and stability of chicken cells during the manufacturing process, as well as a detailed description of the manufacturing process which demonstrated that harvested cultured chicken met quality controls and a rigorous food safety monitoring system." It also demonstrated the consistency of its production by running more than 20 cycles in its 1,200-liter bioreactors.</p><p>While Eat Just did not offer details on its propriety process, it likely follows <a href="https://www.newscientist.com/article/mg24032080-400-accelerating-the-cultured-meat-revolution/" target="_blank" rel="noopener noreferrer">one similar to other lab-grown meats</a>. It starts with muscle cell samples drawn from a living animal. Technicians then isolate stem cells from the sample and culture them <em>in vitro</em>. These cultured stem cells are then placed in a bioreactor, essentially a fermenter for fleshy cells. The bioreactor contains scaffolding materials to keep the growing tissue from falling apart as well as a growth material—the sugars, salts, and other nutrients the tissue needs to grow. As the cells grow, they begin to differentiate into the muscle, fat, and other cells of meat tissue. Once grown, the tissues are formed into a meat product to be shipped to restaurants and supermarkets.</p>
An abattoir abatement?<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDg2Mjg5OS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyODg1NDI3N30.AYmFJfWQbPjK-o1IatyFHL-OLjcfXBMmQKYyvz4oT3s/img.jpg?width=980" id="8a82d" class="rm-shortcode" data-rm-shortcode-id="93f824fe4c6f397ab2b65e4665847e71" data-rm-shortcode-name="rebelmouse-image" />
A graph showing the number of animals slaughtered in the United States per year from 1961–2018.
Credit: Our World in Data<p>Singapore's approval is an important step in support for clean meats—so-called because they don't require animal slaughter and would likely leave a reduced carbon footprint—but hurdles remain before widespread adoption is possible.</p><p>The most glaring is the price. The first lab-grown hamburger was eaten in London in 2013. <a href="https://www.bbc.com/news/science-environment-23576143" target="_blank" rel="noopener noreferrer">It cost roughly $330,000</a>. As with any new technology, investment, iteration, and improved manufacturing will see the price drop substantially and quickly. For comparison, Eat Just's chicken will be priced equivalent to premium chicken.</p><p>Other hurdles include up-scaling production, <a href="https://www.nature.com/articles/d41586-019-00373-w" target="_blank" rel="noopener noreferrer">the need for further research</a>, and developing techniques to reliably produce in-demand meats such as fish and beef. Finally, not all countries may be as receptive as Singapore. Countries with large, entrenched meat industries may protect this legacy industry through a protracted and difficult regulatory process. Though, the meat industry itself is investing in lab-grown meat. Tyson Foods, for example, has <a href="https://euromeatnews.com/Article-Tyson-Foods-announces-investment-in-clean-meat/697" target="_blank" rel="noopener noreferrer">invested in the food-tech startup Memphis Meats</a>, the company that debuted the world's first beef meatball.</p><p>"I would imagine what will happen is the U.S., Western Europe and others will see what Singapore has been able to do, the rigours of the framework that they put together. And I would imagine that they will try to use it as a template to put their own framework together," <a href="https://www.reuters.com/article/us-eat-just-singapore/singapore-approves-sale-of-lab-grown-meat-in-world-first-idUSKBN28C06Z" target="_blank" rel="noopener noreferrer">Tetrick told Reuter's during an interview</a>.</p><p>Regardless of the challenges, the demand for meat substitutes is present and growing. In 2020, plant-based substitutes like Beyond Meat and Impossible foods <a href="https://bigthink.com/coronavirus/plant-based-meat" target="_self">gained a significant foothold in supermarkets</a> as meat-packing factories became coronavirus hotspots. The looming threat of climate change has also turned people away from meat as animal products. Livestock production is environmentally taxing and leaves <a href="http://css.umich.edu/factsheets/carbon-footprint-factsheet" target="_blank" rel="noopener noreferrer">a much larger carbon footprint</a> than grain and vegetable production. </p><p>Then there's the moral concern of animal cruelty. In 2018 alone, 302 million cows, 656 million turkeys, 1.48 billion pigs, and a gob-smacking 68 billion chickens were <a href="https://ourworldindata.org/grapher/animals-slaughtered-for-meat" target="_blank" rel="noopener noreferrer">slaughtered for meat worldwide</a>. And those figures do not include chickens killed in dairy or egg production.</p><p>If brought to scale and widely available, clean meats could become serious competitors to traditional meat. <a href="https://bigthink.com/technology-innovation/meat-alternatives" target="_self">One report has even predicted</a> that 60 percent of the meat people eat by 2040 won't come from slaughtered animals. It could be just the thing for people looking for a meat substitute but who find tofurkey as distasteful as, well tofurkey.</p>
Scientists find that bursts of gamma rays may exceed the speed of light and cause time-reversibility.
- Astrophysicists propose that gamma-ray bursts may exceed the speed of light.
- The superluminal jets may also be responsible for time-reversibility.
- The finding doesn't go against Einstein's theory because this effect happens in the jet medium not a vacuum.
Jet bursting out of a blazar. Black-hole-powered galaxies called blazars are the most common sources detected by NASA's Fermi Gamma-ray Space Telescope.
Cosmic death beams: Understanding gamma ray bursts<div class="rm-shortcode" data-media_id="cu2knVEk" data-player_id="FvQKszTI" data-rm-shortcode-id="c6cfd20fdf31c82cb206ade8ce21ba3f"> <div id="botr_cu2knVEk_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/cu2knVEk-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/cu2knVEk-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/cu2knVEk-FvQKszTI.js"></script> </div>
A new study finds that some people just want privacy.
- Despite its reputation as a tool for criminals, only a small percentage of Tor users were actually going to the dark web.
- The rate was higher in free countries and lower in countries with censored internet access.
- The findings are controversial, and may be limited by their methodology to be general assumptions.