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Efficiency and the futures market in organs

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Abstract

There has been considerable debate over regulated organ markets. Especially current markets, where people sell one of their kidneys while still alive, have received increased attention. Futures markets remain an interesting and under-discussed alternative specification of a market-based solution to the organ shortage. Futures markets pertain to the sale of the right to procure people’s organs after they die. There is a wide range of possible specifications of the futures market. There are, however, some major unaddressed efficiency concerns. This article presents this class of concerns and discusses the implication for organ futures markets. It identifies a number of inefficiency sources pertaining to crowding out, bad organs, costs and missed opportunities, family refusals, moral hazard and strength of the provided incentive. However, a complete assessment of futures market requires better knowledge regarding the potential reaction from donors, families and health professionals.

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Notes

  1. We can imagine a futures market for living organs, where a person is paid to part with an organ at a (significantly) later point in time. The theoretical possibility of designing a futures market for the sale of a kidney or a liver lobe at some point in the future will not be debated further.

  2. Many of the references given here are to arguments made regarding current markets, but the proposals apply to futures markets as well.

  3. I am grateful to an anonymous reviewer for this suggestions.

  4. For the general debate over the permissibility of the veto, see (Albertsen 2020a; Zambrano 2017; De Wispelaere and Stirton 2010; Wilkinson 2005; 2007; Johnston 2017; Shaw et al. 2017; Cay 2019).

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Acknowledgements

The idea for this article was presented at the Markets and Justice Conference, at Aarhus University in 2019. I am grateful to James Stacey-Taylor, Simon Rippon and Lasse Nielsen for helpful comments. I am also grateful to Jørn Sønderholm and Jens Damgaard Thaysen for our many mutual discussions on this topic.

Funding

Carlsberg Foundation (Grant number: CF14-0896). Danmarks Frie Forskningsfond 9037-00007B. Danmarks Frie Forsknings fond DFF—2033-00203B. Danish National Research Foundation: DNRF114 (CEPDISC).

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    Andreas Albertsen

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Albertsen, A. Efficiency and the futures market in organs. Monash Bioeth. Rev. 41 (Suppl 1), 66–81 (2023). https://doi.org/10.1007/s40592-023-00180-0

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