I mentioned yesterday that there were two Drum posts I was interested in discussing, this is the second.
The debate around legalising the organ market is one of those for which I've never come down on one side or the other, but it's sort of been simmering around in the back of my mind for a while now, so this seems as good a time as any to get something down about it. The basic argument seems to be between "exploitation" versus "people dying". On this level, I am far more persuaded by Somin than I am by Drum (who is also undecided on the issue, in fairness, though his current stance seems to be on the other side of mine, such as it is, to Somin's). A lot of people against the idea argue there is a point of principle here, but a principle has to be pretty damn compelling and clear before it's worth sacrificing up to 80,000 lives, and forcing up to 80,000 other people to be poorer than they need to be . "Avoiding exploitation" is something I am entirely in favour of as a principle, but when compared to saving lives you need to be much, much more specific about where the problem lies,  especially in situations in which the exploited have a genuine choice, albeit one in which neither option is in any way desirable.
In this one respect, this debate has similarities with those over whether boxing should be banned, and whether prostitution should remain illegal. In both cases, those who argue for laws against the activity tend to point out that absent such laws people will be economically compelled to enter into them, despite the inherent risks, which is clearly A Bad Thing. The problem with this argument, though, is that if someone is economically compelled to get repeatedly punched in the face and/or sleep with strangers, preventing them from doing that must by definition have negative consequences on that person's life. If a woman has to choose between prostitution and starvation, then that's a horrible, horrible situation, but telling her she has to choose starvation is hardly helpful.
If this argument works for boxing and prostitution (and if anyone has any counters to it, I would be pleased to hear them), then it most certainly works in a situation in which someone else gets to live as part of the process. Certainly, if every time a boxer got knocked out a terminal illness was cured I'd be far more likely to watch Ricky Hatton do his thing.
On the other hand, I do see some validity in Drum's slippery slope argument (as he says, it's a terribly overused rhetorical trick, but it isn't entirely without worth). Here's the thing, though. Drum argues that if it's a kidney today, it's a cornea tomorrow. If it's a cornea tomorrow, it's a chunk of lung by Sunday. My question is this: why is a cornea worse than a kidney, or a piece of lung worse than either?
As far as I can see there are two options. Either body part X is no worse a thing to sell than body part Y, in which case Drum's argument doesn't apply, or body part X is worse, and therefore there is a concrete case to be made that we don't allow that part to be sold. I don't think either Drum or myself are in a position to sort those out from each other. Doctors would be, though, and hopefully legislators as well, assuming they bother listening to the experts. If it were done right, each individual body part would have risk assessments associated with them, and those risks would be clearly and thoroughly explained.
Following on from that, the two most compelling arguments against legalising the organ trade I can see are a) the risks involved are so complex and fiddly you couldn't reasonably expect the average person in the street to understand them, and b) the possibility that doctors will err on the side of collecting organs rather than ensuring donors are well briefed, and/or that the government will stack things in the favour of those requiring donations, since they have all the money. I'm not qualified to judge a) (though I don't find it tremendously difficult to credit as a possibility), and as far as b) goes, off the top of my head I would think the latter situation more likely (the occasional episode of House notwithstanding), but that's an argument against the specific wording of the legislation; I don't think it's strong enough on its own to justify a blanket ban.
Anyway, that's where I am right now. If anyone has anything to add, you know what to do.
PS: I should add that the title of this post comes from a conversation with Mad Richard, in which he told me his discovery that he had only one liver and two kidneys (rather than vice versa) had completely flummoxed his plan to drink like a teenager for his entire life, a revelation he likened to discovering Father Christmas wasn't real. Pointing out that the fictitious nature of Father Christmas was unlikely to have featured on the Y8 Science Syllabus back in school proved useless.
Update: Gooder suggests in comments that illegal fighting matches might be a more apt analogy than boxing, since the former is far more likely to be where anyone desperate enough to fight is going to end up. I've heard the argument used with explicit reference to boxing, but nonetheless I'm entirely happy to go with Gooder's suggestion instead.
 I freely admit that there is a problem with this formulation which is that once getting a kidney cut out becomes profitable, there will be far more people with only one kidney, which presumably will raise the number of people at risk of dying from kidney problems. The whole thing might descend into some bizarre game of musical chairs, only it's just the rich people who get to decide when the music stops.
 Drum is right to call this kind of formulation "baldly utilitarian", but then I'm a mathematician; I tend to be receptive to utilitarian arguments. Well, genuinely utilitarian arguments. One of the many reasons I distrust so many conservatives is their habit of choosing the course of action that maximises their utility, and then try to fudge some pseudo-explanation as to why that choice benefits everyone else (see also: "trickle down").