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“To determine whether kidneys should or shouldn’t be up for sale,” Michael Sandel writes, “we have to engage in a moral inquiry.” Quite so. Here’s what my investigation turns up.
Every day, eighteen people die in the United States while waiting in vain for a kidney transplant, according to the National Kidney Foundation. The Department of Health & Human Services reports that nearly 92,000 patients were on the kidney waiting list as of April 6 (up from 66,000 six years ago), but that only 16,812 transplants were made in 2011. That deadly math is part of the reason that, according to the National Institutes of Health, more than 380,000 Americans are on dialysis, a punitively expensive and physically grueling death-postponement procedure. The imbalance cannot be meaningfully addressed via cadaver-harvesting alone. As the writer (and kidney donor) Virginia Postrel observed in 2009:
If every single person who died the right way became an organ donor, an optimistic estimate would be that 7,000 more kidneys a year would be available for transplant. Since the [waiting] list is now increasing by 6,000 a year, that would be enough to end it—in 80 years.
So we know that maintaining prohibition—letting the law be guided by our moral revulsion toward placing price tags on human organs—will certainly increase the body count. We know that boosting the number of kidney donations from the living is the only real way to whittle the waiting list down. And we also know, from such procedures as egg donation, that legalizing monetary rewards is a guaranteed method for expanding the pool of living donors. Your morality may vary, but mine says that sentencing more than 6,000 people a year to an avoidable death falls well short of the Golden Rule. My inquest therefore concludes that the burden of argumentative proof on the legality of kidney sales should fall squarely on those who back the lethal status quo.
But Sandel doesn’t really care about preventable renal failure; for him the more urgent national crisis is the allegedly pervasive encroachment of “markets” into our most personal spaces. Instead of grappling with whether sick people should die for his prejudices, Sandel changes the subject to: Do we want a society where everything is for sale?
Because Sandel disagrees with people’s choices, he wants to take those choices away.
So let’s address the unrelated question. No, I don’t want a society where everything is for sale, and thankfully we’ll never live in one as long humans retain both choice and prosperity. You cannot buy my friendship, my political loyalty, or my musical tastes. I choose not to buy sex, or wedding toasts, or (in most cases, anyway) gift cards. These are hardly outlier notions among my fellow libertarians.
So what do free marketers and Michael Sandel disagree about? This: he expresses no apparent concern about enshrining his market-aversions into law, fully backed by government force. Because he disagrees with people’s choices, he wants to take those choices away.
How do you get so far afield from the life-and-death issue of kidney transplants? The answer lies in Sandel’s depressive opening paragraph: “Markets have come to govern our lives as never before.” As a logical notion, this ranks right down there with “phone books are governing my telecommunications as never before.”
Before we assign omnipotence to the M-word, let’s remember for a second what markets originally were: locations where farmers could sell their wares. Customers no longer had to waste time trekking to each individual farm, with its limited choice and noncompetitive pricing. Markets saved people time and money and increased their choice, while producers benefited from gathering customers in one place and focusing more on the areas where they were most competent.
It’s precisely because of markets, and the choice and prosperity they bring, that I don’t have my life governed by either markets or financial considerations (separate concepts that Sandel conflates). I have turned down job offers with substantial raises, chosen to live in extremely high-tax cities, and donated money to nonprofits, including the one I work for. People who live in market-averse societies, like my wife’s native France, invariably have fewer choices.
Are markets somehow “crowding out” morality? If so, surely there must be better evidence than a two-decade-old referendum in Switzerland that had nothing to do with markets. (Repeat after me: financial incentives are not markets.) That a famously civic-minded and rules-oriented country rejected a government bribe is interesting, and if anything it suggests the opposite of what Sandel concludes. Sounds to me like the morals crowded out the financial incentives. Though I suspect you’d get a much different result in Romania.
This is not some academic exercise. People are dying right now because we have let our revulsion at markets create serial prohibitions of consensual behavior, whether it’s buying and selling marijuana, sex, or kidneys. How many more people are we willing to let perish for this mistake?
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