The Price of Everything - Eduardo Porter [84]
In Israel, people who have donor cards are “paid” with priority treatment if they ever need a transplant. The Islamic Republic of Iran legalized payments for kidneys in 1988. Donors get a flat fee of about $1,200 and often negotiate extra compensation with the recipient. Iranian officials argue that the practice has reduced the average waiting time for a transplant to a few months.
But buying a kidney is illegal in most of the world. Kidney donors live just as long and are just as healthy as those with two, according to recent research. But many people—including those at the World Health Organization—oppose renal commerce. In an address to transplant surgeons in Rome in 2000, Pope John Paul II argued that “to use the body as an ‘object’ is to violate the dignity of the human person.”
Some critics fear that desperately poor people would sell a part of themselves to obtain money. They note that an illicit market in human flesh is emerging—with customers hailing from wealthy nations like Saudi Arabia and Taiwan, and sellers from poorer places, like China, Pakistan, and the Philippines. In the United States in 1983, Representative Al Gore of Tennessee, who would go on to become vice president, sponsored legislation to ban the practice, prohibiting donors from gaining anything of “valuable consideration” in exchange, including proper medical care. It became law in 1984.
Proponents of kidney sales note pointedly that those outraged by the idea that the poor could sell bits of their bodies are not so squeamish when it comes to allowing the poor to enlist in the armed forces, where they vastly increase their odds of a violent death in exchange for a wage. But the culture allows for a professional army—perhaps because the individual soldier puts his life at risk for the tribe. Kidney sales, by contrast, are between individuals. So the culture banned them.
DARWIN’S PRICE SYSTEM
Some people say culture is all about sex. The boy with the nose stud and the purple hair jumping up and down onstage is simply advertising his genetic material, a bit like the peacock with his huge tail. It is an instrument of courtship. This kind of socially sanctioned behavior survived across evolutionary time because it was successful at encouraging reproduction.
I would add that culture also allowed society to happen, helping humankind transcend its self-centered nature. Establishing borders of community, and setting the prices within it, culture helped pro-social attitudes emerge and evolve, improving groups’ ability to survive in competition over resources with others.
Some intrinsic notion of fairness and reciprocity must have been essential to survival among the earliest groups of hunter-gatherers 3 million years ago, when there were few legal institutions to enforce contracts. These early humans might have simply killed each other to get at one another’s food. Instead, they hunted collectively and traded. Culture helped groups become more cohesive, and thus more effective killers of the people on the other side of the cultural fence. There was one price system inside the enclosure in which stigma carried a cost and there were rewards to selflessness. Reciprocity—trading favors at “just” prices—prevailed.
These dynamics predate humanity. Chimpanzees groom each other and share food. Traveling through the forest, the able slow down to wait for the sick and injured. Wolves collaborate to bring down big prey. Capuchin monkeys have a keen sense of justice. Ordinarily, they are willing to work in exchange for little bits of cucumber. But just offer something nicer, like a grape, to the monkey in the next cage over and they will stop cooperating. The formerly desirable cucumber suddenly becomes unacceptable. The monkeys go on strike. It is costly for capuchin monkeys to reject the food, but by doing so they can ensure they’re not given a raw deal again.
And modern humans exhibit different behaviors on each side of the cultural fence. Outside the group—the race, the faith, or the village—we may be the most ruthless bargain hunters. But