This article from the Washington Post, citing FDA sources who would only speak anonymously, claimed that the agency is considering a program to reduce the salt content of all processed foods in America. A report from the Institute of Medicine and a press release from the FDA confirmed the rumor. The FDA’s press release emphasized that while the agency has not yet begun to regulate the amount of salt in foods, it will "thoroughly review the recommendations of the IOM report" and make plans to "work with other federal agencies, public health and consumer groups, and the food industry to support the reduction of sodium levels in the food supply."

The Institute of Medicine report revealed more about the mechanisms of how the policy would be implemented: "the goal is to slowly, over time, reduce the sodium content of the food supply in a way that goes unnoticed by most consumers." A few months earlier, this article in the New England Journal of Medicine had promoted the idea of using government regulations to achieve population-wide reductions in dietary salt intake, claiming that such regulations would prevent thousands of heart attacks and strokes, which are caused by hypertension (high blood pressure), and would save up to 92,000 lives per year in the US.

It almost seems surreal that a government agency would begin to scrutinize the list of ingredients in every single food product in America and then "work with" — that is, force — their manufacturers to ensure that incrementally less salt was added to the foods over time. (What would this agency be called, the Department of HomeBland Security?) Yet, this is the reality with which we are faced.

At the heart of my issue with the proposed salt regulations is the principle that each individual is the best one to decide how to live his or her own life. The logical extension of that principle is that each person should decide the contents of his plate — and that if we want to use our discretion to enjoy the occasional pastry, French fry, or foie gras, we must grant our neighbors that freedom as well, even if we don’t always agree with their decisions. It is an insult to basic human dignity for governments to declare that they are better off deciding what you and I eat, because we just can’t handle eating the right way by ourselves. After all, if you are what you eat, and someone else controls what you eat, what are you then?

Similarly, food companies should not be subjected to incrementally tightening regulations on how much salt they may add to their products. There are several good reasons why a producer would want to add salt to a food product — for instance, to act as a preservative, to enhance the flavor of the food, or to augment the texture. They have decided how much salt to add to their foods based on the signals that consumers send by voluntarily buying certain products. Government aims to contradict those market signals by force of law. Regulations on the salt content of foods will likely raise the price of all processed foods, make it more difficult for smaller, less entrenched companies to compete with large ones, and harm the quality and taste of the foods. Ultimately, the consumer will be the one who suffers.

The idea of a sweeping, government-mandated reduction in the amount of sodium in foods is sufficiently offensive to me on principle that I would oppose it. However, it is also predicated on blanket generalizations and lacks rigorous data to support the notion that it would save lives. I would urge those who might support this measure on pragmatic grounds to consider the following: if this population-wide measure is ostensibly being implemented to prevent complications of hypertension (strokes and heart attacks), it is important to ask whether it would actually accomplish that goal and whether it would create unintended adverse consequences.

It is not known whether FDA regulations on the amount of sodium in foods would actually reduce salt consumption among Americans. It is conceivable to imagine that people might simply add salt to foods that they perceived as bland, negating any effects of the regulations on the actual amounts of salt that they consumed.

Another important question is that of what food manufacturers would do to compensate for the mandatory reductions in salt content. Flavor enhancers like monosodium glutamate (MSG) and sugars may very well replace the salt that will be regulated out of processed foods. Although "low-fat" wasn’t enforced by law (but was endorsed and recommended by government officials), we can look to the low-fat heyday of the 1990′s for clues about what will happen when salt is restricted by the government. Did eating low-fat products cause people in the US to lose weight? No. Manufacturers replaced fat with corn syrup and other sugars to make up for changes in taste and texture. Average sugar consumption rose dramatically among Americans. Type 2 diabetes and obesity have continued to increase in prevalence since the government recommended that we eat less fat.

There already exists an array of low- or reduced-sodium products — cheeses, soups, sauces, nuts, etc. — on the shelves of every grocery store in America. These products exist because some consumers prefer them; food purveyors know this. However, despite the fact that they exist, reduced salt products are not nearly as popular as their full-salt counterparts. These observations indicate that 1) most people don’t want to restrict their intake of sodium; and, 2) the demands of the salt-conscious consumers are already being voluntarily met by food companies. There isn’t really a problem here, especially not one that should be "fixed" by government. If, as the lackluster sales of low-salt products suggest, most people don’t want to restrict their salt intake, it’s especially nefarious of the government to force everyone to do so.

Assuming the government was actually able to achieve a population-wide reduction in salt consumption by regulating the amount of salt in processed foods, how would it affect people’s blood pressure, risk for heart attacks and strokes, and other aspects of their health? The only way to know would be to conduct a large randomized, controlled trial. Such a trial has never been done, therefore, there is no hard evidence to indicate how universal salt restriction would affect Americans. A certain amount of dietary sodium is required for life; cutting dietary sodium could be unnecessary or even harmful in some individuals. As Dr. Alderman points out in this article in JAMA, governments and medical panels have made blanket recommendations in the past — low-fat foods, margarine vs. butter, and postmenopausal hormone replacement, to name a few — which were based on insufficient evidence and turned out not to be beneficial for all individuals. There is similarly little evidence to suggest that forcefully restricting everyone’s salt intake would be a boon for society.

While the effects of a population-wide reduction in dietary sodium consumption cannot be known in advance, several studies have been conducted on participants, both with and without hypertension, who voluntarily restricted their salt intake (for instance, Saks et al., 2001 and others). These studies have shown that some people have significant reductions in their blood pressure when following a low-salt diet. Particularly likely to be "salt-sensitive" are elderly, black, and hypertensive patients. However, some others, particularly non-hypertensive individuals, show almost no response to salt restriction (for more references, see Weinberger, 1996, Midgley et al., 1996, and others). In fact, the majority of people show very little variation in blood pressure in response to varied salt intakes. Therefore, blanket reductions in salt content of foods would subject the entire population to worse-tasting foods, possibly benefiting a relatively small segment of people while subjecting the rest to unknown effects.

In the NEJM analysis, researchers predicted the benefit that different subgroups of Americans would get from reducing their sodium intake by 3 g/day. Their predictions indicated that non-hypertensive, non-black individuals younger than 65 years would get virtually no benefit from cutting their salt intake. These individuals were predicted to get a reduction of approximately 2—3 mmHg in their systolic blood pressure (the "120" in "120/80") — and they would need to eliminate 3 g/day of salt from their diets (from an average of 10.4—7.3 g/day). To put this number in perspective, 2—3 mmHg is within the range of error of repeat blood pressure measurements, and would be considered clinically insignificant in terms of affecting risk for stroke and heart attack. It seems very unlikely to me that anyone would find this trade-off worthwhile. It goes without saying that the decision about how much salt they’d like to eat should be left to them.

The group that was predicted to benefit most from salt restriction, black people with hypertension, would purportedly get a 5—9 mmHg decrease in systolic blood pressure from cutting their salt intake by 3 grams a day. That may be a slightly more clinically significant reduction, but it doesn’t change the fact that these individuals are the best ones to decide how much salt they should consume. It should also be noted that dietary salt reduction is not the only way to reduce one’s blood pressure — exercise, stress-relieving activities such as meditation, and drugs can all act alone or in combination to achieve lower blood pressure in someone who is concerned about the negative effects of hypertension. Neither hypertensive patients nor anyone else should be forced to endure bland-tasting food because government officials deem that it’s for their own good.

Whether they are pushing for salt reductions in all processed foods, advocating for circumcision of all baby boys, promoting universal flu vaccination, banning trans-fats, or agitating for soda and candy taxes, those who want to control what you do with your body are incapable of seeing people as individuals. They view each person as part of a collective herd which must be forcefully made to behave for its own good. They see you as incapable of deciding for yourself the right way to live. Health professionals have a role in educating their patients about healthy lifestyles in a caring and compassionate way. As important as education and persuasion may be, however, it is not our role — nor is it the role of the state — to force patients to behave in a certain way.

I believe that many of those who would use the government to control your health decisions think they are doing good. After all, who wouldn’t want to save lives and prevent diseases? Unfortunately, authoritarian "public health" measures often fail to achieve their objectives of saving lives and improving health, and create negative unintended consequences. Even if they actually did save lives, at what cost would they do so? It would always be at the cost of restricting individuals’ freedom of choice, and that leaves a very bitter taste in my mouth.

Stephanie R. Murphy [send her mail] is an MD/PhD student living in New Hampshire.

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OK, you’ve caught me in a rare moment of sarcasm. Maybe I wasn’t really that surprised. After all, government bureaucrats attempt to control what types of substances you put into your body, what kind of work you do with your body, and even how you can legally dispose of your body after death; it makes perfect sense that they would also scramble for power over what parts of your body should remain attached. Yes, that’s right. The CDC is now considering a campaign for universal circumcision in the US.

The reason for pushing this one-size-fits-all policy stems from the results of several studies, all done in Africa, which have demonstrated the benefits of male circumcision for reducing the transmission of HIV.

The studies on circumcision and HIV transmission are very interesting. They are large, randomized, controlled trials; the methodology is solid. They show, on average, a 40—60% reduction in the risk of a circumcised, HIV negative man contracting the virus from an HIV positive woman, as compared to an uncircumcised man. The precise mechanism of circumcision’s protective effect is unknown. There are many potential explanations, none of which are mutually exclusive. First, the foreskin has a relatively high population of cells that are receptive to being infected by HIV. Second, it acts as a reservoir which may trap infected secretions. Third, the foreskin has a higher propensity to ulcerate (become scraped) and become infected with other sexually transmitted infections that cause open sores. It seems that removing the foreskin also removes several potential avenues for HIV entry into the body.

However, when considering the benefits of circumcision, there are some significant caveats. For one, circumcision is not a panacea; it does not completely prevent transmission of HIV, it just lowers the probability that a man will contract the virus during any given sexual encounter with an HIV positive woman. It should be noted that these studies only examined the effect of circumcision on transmission of the virus from an HIV positive woman to an HIV negative man. While this is a relatively common scenario in Sub-Saharan Africa, HIV epidemiology in the US is different. Overall rates of infection are lower. Also, HIV in the US is relatively more common among men who have sex with men (MSM). There is no evidence that circumcision protects against HIV acquisition in MSM. Circumcision also does nothing to protect anyone against acquiring HIV via bloodborne routes, such as sharing needles with an HIV positive person. It should go without saying that men can protect themselves from acquiring HIV in other ways besides getting circumcised, such as practicing safe(r) sex and avoiding intravenous drug use. These methods are much more reliable than the 40 — 60% risk reduction conferred by circumcision.

Circumcision also has risks and demerits. My personal philosophy on medicine leads me to look skeptically at any procedure that removes a part of the body which is not causing harm, pain, or annoyance to the patient; in other words, don’t mess with success. As with any surgical procedure, infections and pain after circumcision are both possibilities that should not be ignored. Medical errors should be considered as a legitimate risk during circumcision, too. There are rare case reports of penile amputation that have occurred during botched circumcisions. There are also many more reports of less extreme, but still real, consequences resulting from circumcision mishaps.

Of course, the question on the minds of many who are considering circumcision is that of whether the procedure impacts sexual enjoyment and satisfaction. That question is, in my opinion, impossible to answer accurately. To distill the immense debate surrounding this issue to its barest essence, choice seems to play a significant role in how men view their foreskins (or lack thereof). Men who choose to get circumcised tend to be happy that they did so; those who did not have a choice in the matter because they were circumcised at birth are more likely to lament it.

That brings me to my main point in writing about the prospect of universal circumcision: the issue of choice. If my patient asked me about circumcision, I would discuss with him the information above. I would also encourage him to do his own research about the procedure if he felt interested. He would make his own decision about whether he wanted to have the surgery.

By contrast, the CDC’s attitude demonstrates a lack of consideration for patient autonomy and consent, two essential elements in all medical decisions. The CDC would like every baby boy born in America to be circumcised, no matter the opinion of his parents and, more importantly, without the boy’s consent. If circumcision were a medically necessary and life-saving procedure with no possible ill effects, things might be different. In reality, it is a surgical procedure that is not essential for the health of a normal man; furthermore, it has both risks and benefits. The relative importance of those risks and benefits is subjective. Every man may value them differently. For that reason, it’s essential that each individual be afforded the choice about what to do with his own foreskin.

To be perfectly blunt, I do not see any justification for removing a part of a baby boy’s body without his consent. Men can always get circumcised as adults if they wish; by contrast, once the foreskin is gone, it’s gone forever. Most people will concede that the procedure is painful even for babies, but they insist that the pain is justified because the baby will not remember it. I wince at the thought of causing pain to a newborn boy. I say that even if he does not remember the physical pain as an adult, he may still suffer from the psychological sting of having had a body part removed without his permission.

Another argument from the advocates of universal circumcision is that it makes good hygiene easier. This is a typical government one-size-fits-all solution: parents are too stupid, in the minds of government agents, to teach their sons good hygiene, so instead we should just circumcise everyone. People are also too stupid to practice safe sex, so we should circumcise them all because they will gain a marginal reduction in the overall risk of contracting HIV. I’ve also heard arguments for circumcision based in religious tradition and cultural norms. Sure, circumcision is common — and a very old tradition in some religions and cultures. But does that make it right? I don’t think that’s for us to decide. I think that each individual, the owner of his own body, should make the call about whether or not circumcision is appropriate for him.

It’s difficult for me to assume the mindset of statists who advocate for this kind of thing, so I raised the issue of universal circumcision in conversation with a few people whose opinions I thought would be unencumbered by that pesky philosophy of leaving others alone and letting them make their own decisions. In addition to the religious and culturally based arguments that several people trotted out, one colleague had an interesting comment. He thought that universal circumcision was a good idea, envisioning a world where no more would awkward teens have to worry about getting teased in the locker room, because “everyone would look the same.” Oh really? The last time I checked, people came in all shapes, colors, and sizes, and that was a good thing! I guess that if everyone looked alike, wore the same clothes, and had the same hairstyles, nobody would ever have to worry about not fitting in. Would this egalitarian also propose to redistribute the wealth from the best-endowed men to those who are not quite as blessed by Mother Nature? Ridiculous.

I certainly cannot agree with the CDC’s move toward making a blanket recommendation that all boys should undergo a medical procedure at birth, without their consent. I want each man to have the opportunity to make his own decision about what to do with his foreskin when he reaches an age at which he is capable of doing so, based on his understanding of the risks and benefits, and how much he personally values each. The bloated, overreaching federal government apparently does not want the same.

Stephanie R. Murphy [send her mail] is an MD/PhD student living in New Hampshire.

Stephanie R. Murphy Archives

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Once again, my hometown is raising the bar for nanny statism. Hopkinton, Massachusetts, home of the starting line for the Boston Marathon, apparently is very concerned about what its residents are throwing away.

Hopkinton made headlines in 2001, when the principal of my high school attempted to implement a tough new anti-smoking policy. It would have given teachers the power to suspend students for smoking — without catching them in the act — simply by testifying that the students smelled of smoke.

I hope that I needn’t explain why this is a bad idea. I can just imagine a non-smoking kid getting on the bad side of a teacher; is that a hint of cigarette smoke the teacher just detected on her pupil’s jacket? How about a non-smoking student with parents or siblings who smoke, whose clothes have all been permeated with smoke in his home environment? He, too, could be suspended under this policy.

Hey, the Supreme Court had it all wrong in Tinker v. Des Moines. Students do leave their constitutional rights at the door when they enter the school house, at least in Hopkinton!

Even though I was a student at Hopkinton High School at the time, I found out about this new smoking crackdown when a friend from Louisiana called to inform me that Rush Limbaugh had somehow found out about it, and was proceeding to have a field day making fun of my hometown.

(I’m not really a fan of Rush, but I do have him to thank for nipping this draconian smoking policy in the bud when I was in high school. After he called my school principal a Nazi on his nationally syndicated radio show, she decided it was time to get a different job.)

Now, upon arriving home for the holidays, I was greeted with the news that Hopkinton now employs an Official Trash Bureaucrat! That’s right, the Hopkinton Board of Selectpeople is very concerned. Hopkinton has mandatory curbside recycling. But the town government still worries that you might be throwing away things that you should be placing into that oh-so-earth-friendly green bin. So to address this pressing issue, they have commissioned the Hopkinton Recycling Officer to pick through your trash, just to make sure you’re on the straight and narrow. What’s the problem with that? You don’t have anything to hide, now do you?

A little bit of history: originally, the recycling program in Hopkinton was a voluntary one. Residents voted to make curbside recycling services available along with their trash pickup, and were told it would only cost each household an extra $1 per year. "Great idea!" they exclaimed, and enthusiastically adopted the new service. Little did they know that the program would eventually become mandatory, with its own enforcer to give the ordinance some teeth!

According to a police report I found online:

Thursday, August 24, 2006

7:19 am A caller from B Street reported that an older white male was going through her trash and when he was questioned he stated that he was the town recycling inspector and then left in a maroon Jeep Liberty. Officer Patrick O’Brien stopped the vehicle on Cedar Street and he was the town recycling monitor.

I’m left with some burning questions. How exactly did this ordinance get passed? Were people just oblivious as to what their town government was doing, or was it approved by Hopkinton’s governors at some closed-door, midnight session, as congress is so fond of doing? Do those who appointed the recycling enforcer get their trash scrutinized, too? How much does it cost the townspeople in property taxes (putting aside, for a moment, the cost in personal liberty) to employ the trash police? And if this is a volunteer position, who would seek out this type of job? I think the B Street resident above was rightly worried about privacy, especially given the prevalence of identity theft.

It seems that Hopkinton wants to keep its trashpicking bureaucrat hush-hush. Looking through this eleven-page list of town officials, I can’t find a listing for Chief Trashpicker.

Something smells rotten about this whole situation, but please, refrain from looking in any trash cans to find the source of the odor. Maybe you should instead turn your attention toward the Hopkinton town hall.

Stephanie R. Murphy [send her mail] is an MD/PhD student living in New Hampshire. The baseball says, “Anything is possible in life.”

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My main career goal is to help people suffering from obesity and type-2 diabetes. Personally, I’ve made a conscious decision over the past five years to avoid eating trans fats. So what do I think of New York city’s recent ban on trans fats, and the proposed statewide trans fat prohibition in Massachusetts, which is all but assured to pass unanimously? Read on. I’ll let you decide for yourself.

When it became apparent several years ago that trans fats are relatively nasty, health-wise, the news traveled quickly. Many consumers began buying butter instead of margarine, and scanning the labels on food to make sure it didn’t contain hydrogenated oils. Food producers realized that people were buying less of products made with trans fats. They reformulated their products to reduce or eliminate the sinister oils. They changed their labels to be sure that people knew ("Trans fat free, made with heart-healthy Omega-3′s!"). Even restaurants began to boast of trans fat-free offerings. This occurred as quickly as news that large amounts of trans fats are unhealthy began to emerge: a powerful demonstration of how consumer demand is the most powerful regulator of the marketplace. Now there are many more options available to consumers than there ever were before.

Trans fats didn’t disappear, of course. There are still products which contain trans fats on the market. Trans fats have their advantages. They extend the shelf-life of foods; they are relatively inexpensive to use; some people think that they taste good. Some people still consume them in large amounts, to be sure. But many health-conscious consumers have reduced their trans fat intake or eliminated the oils completely from their diets. If you are one of them, I congratulate you! I think you are not only taking steps to educate yourself about good nutrition, but also choosing to take good care of your body. I would encourage everyone to avoid eating trans fats.

Are you one who hasn’t heard much about trans fats? If so, I encourage you to find out more about them. Have you heard about trans fats and chosen to consume products containing them? If so, good for you — you are making an informed decision. Perhaps you eat a doughnut once a month, or a piece of cake with store-bought frosting on your birthday. Maybe you prefer buying foods that contain trans fats because they cost less money. Maybe you just prefer the taste and are not concerned about possible future detriments to your health. Or maybe you don’t believe that trans fats are bad for you.

There could be a myriad of reasons why you’ve made the decisions you’ve made. Who am I to try and use the government to force you not to eat certain foods? You’ve made a decision about what to put in your body, and I respect it. I would never tell you that you are too stupid to decide what to eat.

But that’s what New York City and Massachusetts want to do: tell you that you are too much of an idiot to decide what to put in your own body. Despite the recent trend in the food industry toward offering products with fewer or no trans fats in response to consumer demand, politicians have jumped in front of the anti-trans fat parade that was already marching steadily down Main Street.

What’s next, mandatory exercise? If some "obesity experts" and doctors had their way, we would be subsidizing fruits and vegetables and taxing cookies. They’ve already succeeded, in many venues, at gutting school vending machines of soda and candy and replacing them with yogurt and fruit juice (which, incidentally, are often loaded with just as much sugar as the treats they were intended to replace).

I think this is unrealistic. Just because candy is unavailable from a school vending machine doesn’t mean it’s unavailable. For example, I’ve heard tell of enterprising young students bringing "black market" candy into school and selling it at a profit to their friends! I think young people who are forming eating habits should learn how to make choices — that is, see a given food, think about whether or not they want to put it in their bodies, and decide to do so or not to do so. This is what happens in the real world, outside the realm of an elementary school; learning how to make the right choices for you when confronted with a cornucopia of foods each day is a skill that must be learned.

Of course, my hope is that students would choose to snack on vegetables or mixed nuts instead of popping M&M’s. I would tell them about the unpleasantness of diabetes and heart disease, and encourage them to make food choices that would sustain their energy throughout the day and their health throughout their lives. I understand that many of them would still choose soda over bottled water. But I also understand that I cannot force them to make the choices I hope that they would make.

We’ve seen just how well it works when we try to tell young people that they can’t drink alcohol, or people of all ages that they aren’t allowed to smoke marijuana. Whose brilliant idea was it to try telling a bunch of adults they aren’t allowed to eat doughnuts and cupcakes made with trans fats? I’m just curious how long it will take before a black market in trans fat laden goodies emerges on the streets of New York. I picture a plump man standing on the corner in a large trench coat, whispering to passers-by, "pssst, want to buy a doughnut? I got the good stuff…"

When will legislators learn that they have a fat chance of changing human behavior simply by writing down a law on a piece of paper?

Stephanie R. Murphy [send her mail] is an MD/PhD student living in New Hampshire. The baseball says, “Anything is possible in life.”

The term “regifting” was coined on the TV sitcom Seinfeld in an episode where Jerry received a gift from his dentist. The gift (a label maker) was the same gift that Elaine gave to the dentist just a few days earlier. Elaine became furious that the dentist had “regifted” her present to Jerry, thus the new name for this common phenomenon was immortalized in popular culture.

Regifting happens when someone receives a gift he doesn’t like enough to keep. Instead of throwing it away, he gives it to someone else. The timing of Christmas parties and year-end get-togethers often creates an ideal environment for regifting. I have taken advantage of the opportunity to regift quite a few times.

But despite its popularity, regifting carries a social stigma. Many gift-givers, like Elaine on Seinfeld, become indignant if they learn that their present has been regifted. Some would call regifting distasteful. Perhaps — but if you ask me, it’s not wrong.

The cynic may view holiday gift exchanges as simply an inefficient transfer of wealth. The fact is this: I have no way of truly knowing what someone else wants unless he tells me directly. Unfortunately, most people refuse to specify gift preferences because “it ruins the surprise.” If somebody asks me what I’d like for a gift, I always tell them specifically. I’d rather get something that I honestly want than a “surprise.”

During the holiday season, when the expectations of gift exchange are typically in full force, this creates an interesting situation. People feel obligated to buy gifts for family, friends, co-workers, and acquaintances. But few people actually know what the recipients would like to get. So they guess. Sometimes they don’t quite hit the mark. It is naturally impossible to know someone else’s wants better than he knows them himself. Wealth-transfer by gift-giving could never be as efficient as a market, where prices and preferences choreograph the exchange of goods.

The recipient of an inefficiently chosen gift feels obligated to pretend that he likes it (in front of the gift giver). Most people act this way out of a desire to protect the gift giver’s feelings. They also do not wish to appear ungrateful or rude. After the gift giver leaves, some people put the gift on a shelf and use it for dust-collecting purposes. Others re-wrap the gift and give it to someone else. Others know the old adage, "one man’s trash is another man’s treasure;" they sell their bad gifts on eBay.

Once you receive a gift, it becomes your property; you own that object and you are free to use it however you wish. If you think you’d have more happiness by selling your gift and using the proceeds for another purpose, how could the person who gave you that gift object to your doing so? The gift giver presumably gave the present in order to make you happy. As long as you own the gift, you are free to choose how you make use of it. Most likely the “victim” of regifting is just balking because you have sent him a message that he chooses presents for you inefficiently.

The choice to get rid of an unwanted gift is a choice like any other. What does it cost you to regift a gift? Well, you won’t own the thing anymore. You’ll probably need to wrap it and deliver it. And there is always the risk of offending the original gift giver. Also, you must consider how much you care about the recipient. Are you giving him a gift merely out of a social obligation, or do you genuinely think he would enjoy it?

What does it cost to give a new gift? There are money, time, and perhaps materials involved in buying or making a new gift. You’ll still need to wrap it and deliver it. There is no risk of offending a third party here, but there is always the risk — even in the case of a regift — that the recipient will not want your gift. If you won’t be hurt or offended in that case, the above risk is minimal for you.

You may choose to regift. You may choose to sell your gift. You may donate the gift to your favorite charity. It makes sense in a variety of circumstances! It doesn’t make sense to keep something that you will never use or enjoy.

Gifts with greater liquidity are regifted with the least frequency. A gift certificate allows its recipient to choose his own items. The company issuing the gift certificate earns revenue just by selling a piece of plastic, a sheet of paper, or a code. There is always the chance that nobody will redeem the gift certificate, or that the recipient will buy something that exceeds the gift card’s value. Even if the gift giver has no idea what type of store the recipient would like to shop at, there are gift cards from credit card companies that can be redeemed virtually anywhere — and of course, there is always cold, hard cash. Who could ask for more?

Really, though, the obsession over holiday gift giving gets pretty ridiculous. I prefer to think of a gift simply as something given to show affection or appreciation. I don’t think that a gift should be an obligation, nor a chore, nor an expectation, nor some kind of cryptic indicator of one’s true feelings for another person. Unfortunately, it isn’t always that simple. People give gifts for a variety of reasons — sometimes motivated by various social pressures more than a desire to express affection for the gift recipient.

So regifters, hold your heads high and proudly put those unwanted presents to better use! Your detractors are missing the point.

Stephanie R. Murphy [send her mail] studies Biochemistry at the University of Massachusetts at Amherst. She is a member of LifeSharers Organ Donation Network.

Commercials interrupt television programs — always at the best parts. Overly emphatic announcers hawk their products in cheesy, fake voices. Catchy, repetitive theme music, which is often louder than the volume of the interrupted program, worms its way into the recesses of our brains. We catch ourselves humming, "ba da ba ba ba, I’m lovin’ it!" on the drive to work, and then wonder, "how did that get in my head, anyway?" Worst of all, so much advertising lately is hackneyed and unoriginal.

Even if we choose to mute the TV or change the channel during a commercial, it’s admittedly a bit of a hassle to have to do so (television viewing is the epitome of laziness — who wants to reach for the remote?). The success of programs like TiVo reveals just how passionately people dislike viewing commercials.

Anti-capitalists use the irritating properties of many commercials to support their claims that advertising "brainwashes" consumers into buying products they don’t really want. Furthermore, they say, it maliciously preys on children.

In my opinion, the idea that commercial viewers are mindless automatons who can be influenced against their will to buy valueless products is ludicrous. Additionally, I believe that parents are responsible for setting guidelines as to what (if anything) their children watch on television. I can, however, understand how some people come to embrace these anti-advertising diatribes. The rants of "consumer advocates" are unfortunate catalysts; they transform the negative feelings that many people get from watching vapid, obnoxious, and unremarkable commercials into a hatred of capitalism itself.

We make our own choices about what to buy. Ads are just supposed to provide us with information about products that might interest us. If it weren’t for advertising, very few people would even know that many of their favorite products exist. We can choose to tune in or to tune out; we can choose to buy or not to buy. Admittedly, though, commercials can be unpleasant.

But occasionally a great commercial comes along that provides a glimmer of hope. I refer particularly to a well-done series of advertisements for United Airlines.

The ads employ fresh styles of animation, presenting inspirational stories set to classic musical themes. My favorite is "Interview," animated by Wendy Tilby and Amanda Forbis. It depicts a businessman character who is about to go on an important job interview. He apprehensively gets dressed, hops a plane to a far off city and then takes a ride in a taxi. Arriving at a tall building, he rides up the elevator with a mixed expression of nervousness and hope. Then, he looks down at his shoes, only to realize that they don’t match. He completes the interview. Afterward, we see the businessman walking down the street, sporting a look of complete despair and staring wistfully at his mismatched shoes. Suddenly, his cell phone rings — he has gotten the job, and his woebegone expression changes to one of glee as he excitedly jumps up in the air. "Where you go in life," a voice-over (Robert Redford) gently says — the only words in the entire commercial — "Is up to you. There’s one airline that can take you there. United — it’s time to fly."

The UAL commercials stand out for several reasons. They are very different from most commercials out there — pleasant music; very few words; no loud, jarring voices or blaring colors. They manage to get the point across in a subtle and engaging way. They tell a story. To communicate their point quickly, most other commercials rely on stereotypes or try to cram in as many words and images as possible. The UAL commercials convey their messages subtly, but with amazing clarity. We are drawn into the story. We relate to the characters. We actually want to watch.

These spots are not just commercials for UAL — they promote capitalism itself. All of the stories presented in the ads embrace the common theme that UAL services make it possible to do business, spend time with family, and travel easily to anywhere one chooses. The ability to do these things grants us the power to greatly improve our lives. The UAL commercials emphasize the interrelated network of products and services that empower people to accomplish their goals and dreams.

If you’ll pardon the pun, I find these ads quite uplifting.

Stephanie R. Murphy [send her mail] studies Biochemistry at the University of Massachusetts at Amherst. She is a member of LifeSharers Organ Donation Network.

Halfway through the film, you realize you are not enjoying yourself. Not only is it a terrible flick, but your shoes have been soaked. A patron sitting one row behind you has spilled his high-fructose corn syrup-laden beverage, and now you feel a gooey sensation between your toes.

Yet, if you are like most people, you don’t leave the movie theater. You sit through the rest of the awful flick, and perhaps you even gripe about it later on. You rationalize, "Since I already paid for it, I should just stay for the whole thing. I might as well get my money’s worth."

People engage in this type of behavior all the time. Deep down, we know it’s irrational; we even poke fun at it. Remember the episode of Seinfeld where Elaine eats sandwiches from a terrible sub shop? She only does so because she has already eaten one, and she has gotten a promotional card that will let her have her 24th sandwich for free.

There is only one logical thing for the moviegoer in my scenario to do: leave as soon as he realizes he isn’t enjoying the movie — unless there is nothing else he could possibly do instead that he would enjoy even a tiny bit more. Regardless of whether he leaves or stays, he will not get his money back from the theater (the owner of the movie theater cannot resell the seat at full price once the movie has already started). Since the moviegoer has no chance of a refund, the best outcome he can hope for that evening is a chance to do something more fun or productive than watching the bad movie.

It makes good sense. But barely anyone ever follows this reasoning.

Once a person makes an initial investment in something, however small, he usually feels compelled to follow through on it with a larger investment. Sales people know that if they can get a prospect to agree to see a live demo or use a trial version of a product, the prospect is very likely to become a customer. Companies know this, too — that’s why so many of them offer new customers discounts or rewards that can only be redeemed after buying the product a certain number of subsequent times.

There are many other examples of this phenomenon. Political organizations try desperately to get people to sign up for their email lists, because subscribers are more likely to donate or volunteer. People often make one-time charity contributions, but once they begin to receive the charity organization’s reports and mailings, the one-time pledge turns into an annual contribution. Some people even make a point to buy more expensive gym memberships just so that they will feel more motivated to exercise.

After an initial investment of time, energy, or money, people typically follow through. The old expression rings true: if you’re in for a dime, you’re in for a dollar.

It’s important to be aware of this pattern of behavior. In some cases, such as the examples of the charity donation and the health club that I mentioned earlier, it can have positive consequences. However, the fellow who sits through a bad movie is not doing himself any favors. His welfare would be improved if he left the movie theater and did something more fun or productive instead. He cannot get his money back from the movie theater, but at least he can put his time to better use. It is pointless to stay simply because he has already paid. But some strange facet of human nature prevails, and the initial investment compels him to sit and endure the bad film.

The tendency of most people to follow through on a small investment has some interesting political implications. For instance, there are a lot of people who recognize that social security is an inherently bad idea — a pyramid scam, an inefficient method of investing, and a compulsory program that undermines an individual’s choice to save or spend as he thinks best. "But," they reason, "since we have already started paying into it, we simply can’t change it — and heaven forbid we abolish it altogether!"

Some people display a similar attitude toward other social services. I’ve heard parents say that their decision to send their children to public school was largely influenced by the fact that they’ve "already paid for it, anyway" in taxes.

I’ve also heard people say, in reference to the "free" bus system that runs around UMass, "well, we’ve already paid for it through student fees and taxes, so we all should ride the bus as much as possible to get our money’s worth." Sometimes students even make these comments in situations where taking a car may be faster, or on beautiful days when walking or bicycling might be more enjoyable. No matter. They paid for the bus system, darnit, and they’re gonna use it!

Bureaucrats exhibit the same pattern of behavior. They also take it one step further — they know how to manipulate this nonsensical aspect of human nature to justify expansion of disastrous government programs. This is just one of many reasons that government is self-perpetuating. For example, Amtrak has displayed an abysmal track record (pardon the pun) since its inception more than three decades ago. The "government corporation" constantly faces derailments, mechanical failures, and financial problems. But politicians cry out, "Amtrak is essential, and we’ve already worked so hard to build such a wonderful train system! Its problems are only because it doesn’t have enough funding! We can’t just start denying it much-needed finances now!" Then people nod their heads in agreement.

Like the patron of the bad film, we’re all invested in various government programs. For the overwhelming majority of us, it isn’t by our own choosing (due to the compulsory nature of taxes). But the fact remains. We should, however, be aware of the tendency to let an initial investment cloud our reasonable judgment about when to throw in the towel. Especially when it comes to government programs, we need to learn when to cut our losses and walk away. If you’re in for a dime, don’t go in for a dollar — get out!

Stephanie R. Murphy [send her mail] studies Biochemistry at the University of Massachusetts at Amherst. She is a member of LifeSharers Organ Donation Network.

Peterson's
sentencing brings up a debate that has all but evaporated from public
discourse in the recent past. Is the death penalty a moral impropriety,
or is it justified for violent criminals?

There
are five methods of execution currently used in the United States:
hanging, firing squad, electrocution, gas chamber, and lethal injection.
Lethal injection is by far the most common; it is used in 37 of
the 38 states which administer the death penalty (Nebraska uses
electrocution as its sole method of execution). Most people also
consider lethal injection the most humane method of execution.

A
prisoner killed by lethal injection is strapped to a gurney by executioners
and fitted with two needles in usable veins (one of the needles
serves as a backup). The prisoner is also fitted with heart monitors
to allow doctors to assess his condition. However, since ethical
concerns prevent doctors from participating directly in the prisoner's
killing, other members of the execution team insert the needles.
A prisoner's history of intravenous drug use may also cause difficulty
in finding a usable vein. Failure to find usable veins can result
in delays while executioners try inserting the needles in different
locations. Sometimes, inexperienced members of an execution team
may position the needles in such a way that they become clogged
or empty into muscles, causing the prisoner pain.

The
needles connect to an intravenous drip behind a wall, from which
initially flows a benign saline solution. Eventually, the warden
signals a curtain to be raised, exposing the prisoner to witnesses
in a separate room. Then the inmate is anesthetized with sodium
thiopental to induce loss of consciousness. Shortly thereafter,
pancuronium bromide begins to drip and stops the prisoner's breathing
through muscle paralysis. To complete the execution, potassium chloride
is added to stop the prisoner's heart. A doctor must then pronounce
the prisoner dead.

In
an electrocution, executioners strap the prisoner into a chair and
fit him with a metal electrode across his head. The executioners
also blindfold the prisoner, and attach another electrode to a shaved
portion of his leg. On the warden's signal, one of the executioners
throws a switch to deliver an electric shock which can reach up
to 2000 volts and lasts approximately half a minute.

At
this point, witnesses may observe the prisoner experiencing violent
convulsions, which sometimes result in broken and dislocated limbs.
Smoke is emitted; witnesses may smell burnt flesh as the electrical
current brings the prisoner's skin and internal organs to high temperatures.
The prisoner may catch fire. Witnesses may also observe the prisoner
defecating, vomiting, drooling, and urinating during the shock.
In his dissenting opinion in the case of Glass vs. Louisiana (1985),
U.S. Supreme Court Justice William Brennan observes
that during an execution, "the prisoner's eyeballs sometimes
pop out and rest on [his] cheeks… witnesses hear a loud and sustained
sound like bacon frying."

After
the initial electric shock, doctors must then wait for the body
to cool and determine if the prisoner's heart is still beating.
If they can detect a heartbeat, the execution team delivers additional
shocks until doctors can pronounce the prisoner dead.

Executions
by hanging,
firing
squad, and gas
chamber are now far less common, but still employed in some
states — as recently as 1996, a hanging took place in Delaware and
an execution by firing squad occurred in Utah. A German national
was executed by gas chamber in Arizona in 1999.

Some
anti-death penalty advocates complain that the US is the only country
in the developed world that employs capital punishment. Interestingly,
the attitude of many Americans toward the death penalty seems to
reflect a curious contradiction in terms.

Consider
the following hypothetical scenarios:

1. Felix
   randomly, unremorsefully murders Joe's family, and there is
   ample, undeniable evidence to show that Felix did so. Joe murders
   Felix in revenge. Joe gets arrested, tried, convicted of murder,
   and sent to prison.
2. Felix
   randomly, unremorsefully murders Joe's family, and there is
   ample, undeniable evidence to show that Felix did so. Joe takes
   no retaliatory action against Felix, except to alert the police
   to what has happened. Felix gets arrested, tried, and convicted
   of murder. A judge sentences Felix to death, and he is later
   executed.

In
both of these situations, Felix murders Joe's family. In the first
scenario, however, Joe retaliates against Felix by killing him.
Joe faces legal consequences. In the second situation, Joe does
not retaliate against Felix, and Felix dies at the hand of the State.
The State faces no consequences.

We
condemn murders committed by individuals, but when the State takes
a life, we view it as an appropriate vindication.

Can
we absolve ourselves of the moral responsibility for annihilating
another human life by transferring that responsibility onto the
hands of an entity or an institution? Perhaps some may argue that
the act of execution is mollified by virtue of the fact that it
is carried out by the State and not by an individual.

Still,
somebody must do the killing. Concrete actions must be carried out
by individuals. The State, while it may sometimes seem omnipotent,
cannot physically undertake the action of ending a life. That action
requires an agent, or several agents, in order to be performed.

A
prosecutor argues that a criminal defendant has committed a horrible
crime. A jury convicts the defendant. A judge applies the death
sentence. Police take the convicted person to a facility where he
awaits death. Finally, an execution team ends the prisoner's life.
All of these people are the agents of killing — enabled and encouraged
by the State.

Most
specifically, executioners physically carry out the act of slaying
the prisoner. The other agents implicated in the process of State
execution can begin the process, but the execution team fills an
essential role. Execution cannot take place unless someone physically
carries it out. This leads us to ask: what kind of person seeks
employment as an executioner? Is it appropriate for the State to
endow these people — or to endow any person — with the power to
kill?

Some
liken the death penalty to killing in self-defense, since, they
argue, violent criminals have both the capacity to repeat their
crimes and the potential to escape from or be released from prison.
Therefore, they pose a threat to society, and must be eliminated.
It may be morally legitimate for Bob to kill Ed in the event that
Ed directly and immediately threatens Bob's life. However, violent
criminals who are executed are not directly threatening anyone when
they are put to death. Execution and self-defense are different
situations. Moreover, the very fact that the execution is carried
out on behalf of the State makes it illegitimate — because the State
is not a person, no one can threaten its life, and therefore it
does not have a reason to kill in self-defense.

Many
states which employ the death penalty also have laws which prohibit
physician-assisted suicide. The morality of suicide, physician assisted
or self-inflicted, raises an entirely new debate. Regardless, the
existence of these contradictory laws essentially declares it permissible
for the State to slay an individual while maintaining that an individual
may not choose to end his own life. This transfers an individual's
very life into the State's exclusive jurisdiction, eroding self-ownership
and free will.

The
death penalty deifies the State. Many religions explicitly denounce
killing as one of the worst possible human behaviors, a pronouncement
which is said to originate directly from God. However, the State
may engage in murder without consequence; furthermore, many people
tolerate State sanctioned killing as moral, necessary, and even
humane — thus, the State is implicated as the supreme moral authority
and power. Killing a criminal implies that his life has less value
than the lives of non-criminals, or of criminals who are "not
as bad." But many religions also place an equal value on every
human life, and caution that the only true judge is God.

Death
penalty proponents cite several benefits of capital punishment.
They argue that it acts
as a deterrent to violent criminals. They consider it the only
just punishment for murderers; they also maintain that it delivers
retribution and closure to the families of victims. They deny that
sentencing is discriminatory
or that the execution
may be painful to offenders.

While
they may concede that innocents have received death sentences in
the past, death penalty proponents increasingly cite DNA
evidence as an absolute method of linking violent criminals
with their crimes — ensuring that innocent people no longer receive
death sentences. Many believe that violent criminals cannot be rehabilitated,
and that they have a chance to escape and hurt others as long as
they are left alive. Some death penalty proponents also argue that
the high monetary cost of the long appeals process necessary before
a prisoner can be executed is well justified because of this potential
for criminals to escape and cause harm.

Opponents
counter that the death penalty doesn't
really deter violent criminals. Furthermore, one cannot assume
that every family of a violent crime victim would feel closure or
relief if a perpetrator were executed. Some consider the death penalty
unacceptable retribution. For instance, Coretta Scott King said
in a 1981 address to the National Coalition to Abolish the Death
Penalty, “An evil deed is not redeemed by an evil deed of retaliation.
Justice is never advanced in the taking of a human life. Morality
is never upheld by a legalized murder.” Some families of victims
may even wish to forgive criminals as part of the healing process.

It
is a matter of debate
whether violent criminals can ever be rehabilitated or reintegrated
with society. The argument about the potential for criminals to
escape, however, only addresses prisons' degree of success at keeping
criminals under lockdown. It contributes little to a moral justification
for State endorsed killing.

Additionally,
death penalty opponents say that the possibility of sentencing innocent
people to death precludes it from ever being morally acceptable.
Unfortunately, the application of the death penalty is irreversible
and cannot be rectified if applied in error. Additionally, opponents
make the egalitarian argument
that certain groups of people — especially those with inferior (i.e.,
state-assigned) legal council — disproportionately receive death
sentences.

None
of these arguments, however, truly address the contradiction which
lies at the heart of capital punishment: why do we consider it unacceptable
for an individual to kill, while simultaneously viewing State killing
as both appropriate and necessary?

Central
to the issue of State-sanctioned killing is power and autonomy.
Granting the State a literal license to kill places every individual's
life within the grip of the State executioner's icy hand. Though
it may be improbable, it is certainly possible for anyone who lives
in a place which practices capital punishment to be wrongly accused,
sentenced to death, and executed. That possibility grants the State
enormous power — the power to end any individual's life, potentially
including innocents. When one stops to consider it fully, this is
an egregious concept.

The
term "death penalty" is simply a euphemism for the act
of State sanctioned murder, ironically carried out under the pretense
of justice.

This
is not to imply that violent criminals should go unpunished;
however, their punishment need not involve the cession of a very
dangerous power — the power to inconsequentially end a human life
— to the bungling, bloodthirsty, Leviathan State.

March
21, 2005

Stephanie
R. Murphy [send her
mail] studies Biochemistry at the University of Massachusetts
at Amherst. She is a member of LifeSharers
Organ Donation Network.

Language
is based on words; words are symbols for things, entities, and concepts.
Look at any text in its original form from more than 100 years ago
— it's quite easy to observe that language is extremely mutable.
Words can morph and change. Gradually, they assume different meanings
over time. They adapt like chameleons to the context of the writer
or speaker. The capricious nature of words is not in and of itself
a good or bad thing. It is, however, a characteristic of language
which holds enormous power. As Orwell establishes, words are directly
tied to thoughts.

A
19th century "liberal"
was ideologically very different than the liberals of today. It
used to be that a liberal was someone who espoused ideals which
we now refer to as "libertarian": free trade, few or no
taxes, ownership of one's body, and so on. But gradually, ideologues
who embraced government intervention when it came to property rights,
gun rights, taxes, social programs, and regulation of business co-opted
the term. Modern liberals claimed for decades to value civil liberties
as well. However, that aspect of the word's definition is becoming
increasingly hazy as modern liberals
champion such legislation as the Patriot Act and national ID cards.

Meanwhile,
in the dialogue among modern libertarians, "liberal" in
its former sense has been replaced by "classical
liberal." The coinage of this phrase serves two purposes:
first, it clarifies that the word "liberal" has changed
in meaning since its inception; second, it defines and separates
the political beliefs of libertarians from those of present day
liberals.

A
similar change occurred with the word "conservative."
Just decades ago, "conservatives" believed (or at least
claimed to believe) in smaller government, low taxes, and more personal
responsibility. The term is now synonymous
with a government expansion, unfathomable debt, and the waging of
imperialistic wars around the globe. It's amazing that Neocons have
managed to so drastically change the meaning of conservatism within
such a short period of time.

"Conservative"
was, and still is, an adjective often used to describe libertarians.
But clearly under the present definition, that is not an accurate
depiction. Many libertarians have tried to circumvent this by referring
to themselves as "fiscally
conservative, socially liberal." Unfortunately, the warping
of both terms — "liberal" and "conservative"
— makes this description unacceptable as well.

Some
libertarians may have found these changes in jargon tolerable, or
they may not have cared. But I must call attention to two more words
which are currently being skewed by the maniacs in Washington. You
might have guessed them already: they are "freedom" and
"liberty."

Bush's
inaugural
speech was a dastardly example of the latest trend in corrupting
these words. In his address, Bush repeats the word "freedom"
27 times and the word "liberty" 15 times. The subtle corruption
of these two words is demonstrated by the context in which he places
them.

"There
is only one force of history that can break the reign of hatred
and resentment, and expose the pretensions of tyrants, and reward
the hopes of the decent and tolerant, and that is the force of human
freedom." Herein lays the association of freedom with force,
two concepts that were always contrasted before. Bush uses the two
as if they go hand in hand. The "force of freedom" rightly
sounds awkward to most listeners. But in reality, it's more than
just awkward phrasing — it's an association of two concepts which
hardly belong together.

"The
survival of liberty in our land increasingly depends on the success
of liberty in other lands. The best hope for peace in our world
is the expansion of freedom in all the world." Here, Bush rallies
the troops by informing the listener that his own "freedom"
is in jeopardy. Only by spreading the Bush brand of "freedom"
can that threat be ameliorated. Implicitly, Bush states that we
must protect our own interests by stopping at nothing to "expand
freedom" around the globe — if this involves unbridled militarism
and imperialism, so be it!

"Freedom,
by its nature, must be chosen, and defended by citizens, and sustained
by the rule of law and the protection of minorities." Here,
Bush defines freedom as something the State must ensure, while simultaneously
his "defended by citizens" line pegs freedom as a concept
which can justly incite wars. The "protection of minorities"
portion reinforces the victim status that governments often attribute
to minorities of any sort, bolstering their dependence on the State.

Within
the first 500 words of his speech, Bush has already contaminated
the word "freedom" by associating it with force, imperialism,
the State, and war. The remaining mentions of it reveal similar
references.

"In
America’s ideal of freedom, citizens find the dignity and security
of economic independence, instead of laboring on the edge of subsistence.
This is the broader definition of liberty that motivated the Homestead
Act, the Social Security Act, and the G.I. Bill of Rights."
Economic independence apparently now means State programs. They,
evidently, are "America's ideal of freedom."

Surely
another freedom-laden speech will follow the elections to be held
in Iraq. An additional curious aspect of Bush's definition of freedom
seems to be the simple ability to vote.

My
own observations lead me to conclude that in general, people are
not fond of statist ideas — at least when the ideas are presented
honestly. The only people who really favor the tighter grip of government
on every aspect of our lives are those who compose it. Power is
universally enjoyed, though it can only be held by a few. And as
Lord Acton explained, it corrupts absolutely.

Therefore,
the only real way for statists to sell their ideas is to dress them
up, like a wolf in sheep's clothing. Calling statism by a different
name doesn't fool those who truly recognize it. But to the average
person, branding such things as war, interventionism, and bureaucracy
as "freedom" and "liberty" makes them much easier
to swallow. What if Bush had not said, "we're going to bring
freedom to the Iraqi people," but instead, "we're going
to squander lives, livelihoods, money, and time destroying Iraq
in the name of ambiguous rhetoric and falsehoods?" Who would
have gone along for the ride?

Political
orations tend to be well documented. Accordingly, they easily integrate
with historical records, especially written ones. A particularly
abstract and ideological speech such as Bush's second inaugural
address, therefore, possesses great potential to influence the future
definitions of words such as "freedom" and "liberty."
The address clearly focuses on defining these two words; they shape
its central themes and are repeated an excessive amount of times.

Apparently,
it's not enough for the political elite to steal our peace of mind
by fomenting hatred of Americans with inane foreign policy; our
health and happiness through excessive regulation of our own bodies;
our money through taxation. It seems that they wish to steal our
words, too.

Don't
relinquish liberty and freedom — literally or literarily.

January
29, 2005

Stephanie
R. Murphy [send her
mail] studies Biochemistry at the University of Massachusetts
at Amherst. She is a member of LifeSharers
Organ Donation Network.

It
seems like all I ever hear are reports of governments committing
atrocities against autonomy and free will. It's just like a car
wreck. I don't want to look, but there it is — and I simply can't
tear myself away.

The
United States government is growing more ugly and militaristic
than I ever dreamed possible. I suppose one should never underestimate
a democratic regime.
We are entangled in a pointless killing spree in Iraq, based on
falsehoods and ambiguous rhetoric. I am sickened by the blasé
newscasts of unfathomable death and destruction, and by the irony
of the pundits and spinsters babbling about how "they hate
us because we're free." Worse yet is the knowledge that it
won't end anytime soon, and that the carnage of this war doesn't
even compare to that of wars previously fought. It's hard to think
of words to describe the way these things make me feel.

These
ventures must be paid for, and not just in casualties
and collateral
damage. Politicians are saddling us with the debts
incurred by irresponsible government spending. "Us" refers
to the elderly, the middle-aged, the young, those not yet old enough
to vote, and even those yet unborn. No thanks to the Leviathan welfare-warfare
state, it is now possible for an American child to enter this world
already "owing" thousands of dollars in debt that is not
even his own.

Ah,
dollars.
Our economy is a house of cards which threatens to collapse the
minute foreign lenders realize that our money is paper and backed
by nothing but empty promises and imperialistic whims. It may not
happen today or tomorrow, but when it does we will feel it as surely
as a ton of bricks.

We
must worry about being felt
up at airports and carted off to Gitmo
if we object. Those of us who carry weapons for self-defense are
branded by state law enforcers, academics,
and the media
as dangerous lunatics.

Nanny-statists
wish to legislate and regulate what we may put into our bodies:
foods, medicines, and substances such as tobacco, alcohol, and other
drugs. We pay for expensive and futile government propaganda
meant to instruct us which foods and substances are healthy
and which are doubleplusungood.

Everything
and everyone are to be feared. Terrorists are everywhere. A crisis
looms around every corner. Government is, of course, the only solution.

Such
news fills me with an overpowering sense of despair. I like to consider
myself an activist. I discuss issues which I consider important
with my peers. I write. I invest time and money in causes that I
believe may help preserve shreds of my liberty and that of others.
But I am not naïve enough to think that my actions alone can
bring about any appreciable change. I know others who share my concerns.
But those of us who understand and deeply value freedom in its truest
sense — and are willing to fight for its advancement — seem altogether
few and far between.

Alone
with these thoughts, I feel demoralized and helpless. But I have
reached an important realization:

Even
libertarians sometimes succumb to the "sky is falling"
mentality that we readily denounce in others. In the face of those
who would rob us of the very liberties which make us human, we must
bear in mind all of the astounding things which freely acting people
have done and made.

For
one, the life
expectancy in developed countries like the US keeps rising.
This statistic is usually cited as an example of prosperity and
developing medical technologies, but I would also argue that people
are not just living longer but better lives. New pharmaceuticals,
diagnostics, medical devices and treatments are allowing us to combat
diseases earlier and more effectively. Our quality of life constantly
improves as medicine innovates. Scientists are exploring physics,
chemistry, biology, mathematics, astronomy, geology, and a host
of other disciplines to make mind-boggling discoveries
about our world.

Transportation
is affordable and ubiquitous. Most people in America own cars and
use them daily to commute to jobs they might otherwise be unable
to access. We can fuel them relatively cheaply, and fuel efficiency
continually improves. Corporations are introducing vehicles which
can run on a plethora
of fuel sources, from gasoline and diesel to vegetable oil, natural
gas, electric power, and hydrogen fuel cells. We ride airplanes
which can bring us across the globe in a matter of hours at an affordable
cost. We have high-speed
trains. We have all kinds of maritime vehicles from cruise ships
to sailboats. Soon, we will probably be able to take leisure
trips into space.

And
as for leisure, we have more free time than ever before. Devices
that organize our schedules and complete tasks for us afford us
more time. We can increase productivity and spend more time on leisure
activities. Time
is money, as we all know. The prevalence of entertainment such
as video games, television, movies, music, art in American society
demonstrates that we no longer must devote all of our energies to
mere subsistence. We can live a little.

We
are also growing – rather, our waistlines are growing. While the
government seizes every available opportunity to rail against the
obesity epidemic (and to introduce more
anti-fat legislation), the fact is that we are fat because we have
an abundance of food choices, and we can afford to endulge.
For most of us, our weightiest concern is trying to stay slim and
not where to find our next meal. Many see this as a positive
thing.

It's
easier than ever for us to communicate with each other. Many Americans
choose to carry cell phones and PDA's, a wide range of which are
available. We can access the Internet wirelessly. Global trade is
aided by the vast communications
network, and it's possible to effortlessly keep
in touch with family and friends across huge expanses of physical
distance. We instantaneously fire off emails — for some of us, hundreds
a day — to recipients scattered around the world. People from every
corner of the earth are growing increasingly literate. Knowing several
languages has become tantamount to success in international business.
The Internet allows communities
of people to come together and discuss topics of common interest,
to meet, and to network.
Combined with shipping technologies, it allows people from all over
the world to trade with each
other. It shatters
physical and cultural barriers.

These
marvels and dozens more are the product of simply allowing humans
to act as they naturally desire — to pursue their own interests
and to engage in voluntary transactions.

My
intent is by no means to ignore or downplay the egregious attempts
of the political classes to erode our property rights, free speech,
free choices, and free will. I simply wish to remember a fact which
is often overlooked. Despite the actions of the despots, we still
have a cornucopia of achievements to appreciate and to enjoy. If
I'm reiterating what others have said,
so be it. Capitalism's bounties can't be touted enough.

Above
all, there is something you and I possess that no government can
corrupt: a primal human spirit that embraces liberty. This essence
is vital for combating the world's cruelties and injustices. Positive
things and experiences in life merely impel us to continue discussing,
dissenting, and advocating for liberty in the most fundamental sense
of the word.

We
must remember to maintain a sense of perspective, despite the Chicken
Littles of the media and the chicken hawks of the government. Sometimes
we may struggle with a sense of imminent doom. But ugliness in the
world begs us to be mindful of beauty. Freedom has yielded remarkable
things — and they simply provide more reasons for champions of liberty
to keep fighting.

January
21, 2005

Stephanie
R. Murphy [send her
mail] studies Biochemistry at the University of Massachusetts
at Amherst. She is a member of LifeSharers
Organ Donation Network.

Williams
says he "believes in" the program. He only accepted the
stolen loot because he supported NCLB anyway. He would have promoted
it voluntarily.

The
DOE apparently paid Williams to promote NCLB as part of an "outreach"
program. In other words, government officials hired a black person
to talk up a program they know many black Americans are skeptical
about — and rightly so. Part of Williams' contract was also to encourage
other prominent black journalists and pundits in America's
Black Forum to promote NCLB as well. Does anyone else find this
insulting?

The
media have regurgitated this story with a detached indifference,
just as they cover all government idiocy. News reports on celebrity
gossip evoke more passion in journalists. Admittedly, the Armstrong
Williams scandal isn't a life or death issue. I was sickened to
hear, however, the nonchalant reports this weekend of US forces
in Iraq mistakenly dropping a 500-pound bomb
on a residence in Iraq. We killed 14 innocent people. Oops.

Even
those who are incensed by the pundit's payoff seem assuaged by the
fact that it has spurred an investigation. Reaction to government
failures typically follows a formulaic course: an official reports
that one or another fat bureaucracy has "formed a committee"
which is "looking into" the debacle. This only happens
if and when coverage of the goof creates enough public murmuring.

Why
are people so placated by investigations? The government is investigating
— with your money — a scandal in which it illegally paid someone
— using your money — to spew propaganda for another of its disastrous
programs — which you are paying for both in monetary terms and in
terms of the program's unintended consequences. It's happened hundreds
of times with hundreds of other government disappointments in the
exact same way. Not to worry. "They're looking into it."

Where's
the rage? Has everyone suddenly become a pacifist? I think it's
safe to assume that we have not.
So why do I feel like the only person who gets fired up about anything
done by the mob of organized criminals running amok in Washington,
DC?

Surprisingly,
the answer to this question came to me via a commentator on my favorite
War Network.

The
Leviathan state has become so bloated that it intrudes into virtually
every area of our daily lives. Naturally, this makes for a lot of
news. The hawkish commentator explained it quite eloquently: for
journalists to get news information from any government source,
they have to "make nice." They must gain a reputation
for asking the right questions — i.e., ones that don't rock the
boat — and for spinning stories to cast politicians and government
programs in a favorable light. Only then will officials talk. It
increasingly appears that we have a free press in name only.

As
Harry Browne points
out, most journalists have strong political views. Liberal or
conservative, people in the press see themselves as reformers who
can broadcast their views to others and elicit change. And they
unquestioningly see the government as the arbiter of such change.

Mainstream
news reports have another interesting feature as well: they are
reductive. Stories are condensed to a few key details in the interest
of holding short viewer attention spans and covering as many stories
as possible in a finite period of time. Unfortunately this practice
often leads to vast oversimplification of complex issues. It's common
for people exposed to oversimplified reporting to assume that hearing
a few shallow points makes them experts on the issue. An often-suggested
panacea for any complex problem is more government intervention,
and usually the newly ordained experts only serve to rally "public
support" for it.

The
media are notorious for fear mongering and sensationalism. Shocking
headlines sell; any crisis — real or invented — is a boon to journalists.
Government thrives on crisis. Whatever problem the media hypes ad
infinitum is a perfect opportunity for some politician to swoop
in and save the day with another useless program. Later, the unintended
consequences of that program will create yet another crisis, which
the media will again oversimplify and exaggerate. More intervention
will result.

Worse
yet, the exceedingly pro-government media continually claim objectivity.
When people consider the news they hear unbiased, they more likely
neglect to take it with the proverbial grain of salt. Unfortunately,
even the "most trusted" and the most "fair and balanced"
news requires a large saltshaker for the viewer or reader. Both
the ubiquity of news pertaining to the government and the self-proclaimed
objectiveness of the media contribute to the notions that many Americans
share about government: government is intrinsic to our lives; government
is a natural and benign entity; government is a "necessary
evil."

Some
consumers of information have increasingly begun to sense deception
on the part of the "objective" media, however. This is
one reason for the increasing popularity of Internet news sources
and weblogs over television, newspaper, and AM/FM radio broadcasts.
"Alternative" news sources usually make no bones about
displaying their biases directly and clearly. Guests of LewRockwell.com,
for example, know exactly what they're reading — and it's anti-state,
anti-war, and pro-market.

My
conclusion? Well, since my own biases are fairly transparent, you
may have already guessed it. The Department of Miseducation which
paid Armstrong Williams to espouse crazy government schemes might
as well have saved its — oops, I mean our — money. DC has Big Media
wrapped around its grubby little finger.

January
10, 2005

Stephanie
R. Murphy [send her
mail] studies Biochemistry at the University of Massachusetts
at Amherst. She is a member of LifeSharers
Organ Donation Network.

I
am convinced that the best way to approach organ allocation is simply
to allow a free market in human organs. I want to convince you,
too.

I
must tell you that proponents of an organ market have been making
their case for years; some of these basic arguments are not my own
but part of a discourse on the subject. If you are interested in
reading about practical considerations and ethics in organs markets,
I have listed some intriguing resources at the end of this article.

Now,
for the objections.

1. Some organs
   — such as kidneys — can be removed and sold while the donor
   is still alive, but who would want to sell organs which kill
   the donor when removed?

This is
usually the first objection raised after anyone broaches the
subject of making organs into commodities. You cannot benefit
from the sale of your organs if you are not alive. This problem
is best addressed by allowing a futures market in organs. In
a futures market, individuals could sell the right to harvest
their organs after they die. Benefits would become part of the
individual's estate, and would be paid to their next of kin.
Alternatively, sellers could be paid a small amount of money
during their lifetime for the rights to harvest their organs;
the sum paid out would reflect the probability of the seller
dying in a manner suitable for organ harvesting.

The organ
seller would enter into a contract with a firm — it could be
a lifetime contract or an annual one. This
is an interesting essay which details how the author envisions
practical futures markets in organs.

Of course,
organs like kidneys and lobes of the liver can be removed without
killing the donor. These types of organs could still be sold
in a futures market. They would probably be more commonly sold
in the manner of most other goods. Sellers would have a choice
between making a large, immediate profit from the sale of non-vital
organs or selling vital organs on a futures market.

2. An organ
   market would encourage organ thieves. It also encourages the
   killing of comatose and brain dead patients to harvest their
   organs and make a profit.

Everyone
has heard the urban legend about the guy who goes to a bar,
has a few too many drinks, and wakes up the next day in a bathtub
full of ice with one of his kidneys missing. It's just that
— an urban legend.

Practical
considerations prevent organ theft from becoming a real threat.
Any organ transaction requires that several immunological factors,
such as blood type, match between the donor and the recipient.
The possibility of finding a match for a specific recipient
in a random victim of organ theft is practically zero. It would
not be profitable for organ thieves to randomly attack victims;
nor would it be feasible for them to search and target a specific
match for the recipient.

Additionally,
organs must be harvested surgically and handled in a very specific
manner in order to be viable for transplant. Organ thieves would
have to hire a qualified surgeon to do the job. Many qualified
surgeons make so much money that they have no incentive to get
involved with shady organ thieves. The potential costs of being
caught would be immense enough to deter participation in organ
thievery even for those surgeons in training or in financial
trouble.

Another
factor that makes organ stealing implausible is physical distance
between the donor and the recipient. A live victim would have
to be sedated and transported to a location near the recipient
before he knew he was being robbed of an organ. If the victim
was murdered in another location, his organs probably would
not be viable once they reached the recipient anyway. However,
a significant market in the development of new technology instrumental
to the preservation and transport of organs exists. Companies
such as Organ
Recovery Systems are making it possible to harvest and transport
organs from donors whose hearts have stopped beating. (Thanks
to Dr. Ron Klatz for
drawing my attention to this technology.)

Some
people also worry that doctors will encourage their families
to "pull the plug" if they end up on life support
and their organs are viable. For many people this is a very
real concern. But an organ market would increase the supply
of organs so much that it would lessen the impetus for doctors
to pressure families of brain dead or comatose patients. A patient
truly concerned about this should make it clear to his family
that he does not wish to be an organ donor, or that he does
not want to be an organ donor unless he is already completely
dead — i.e. his heart has stopped of its own accord. Anyone
who wishes to be an organ donor can stipulate to his family
which specific organs he wants to donate, and to whom he wants
them to go.

Remember
that organ donation is completely voluntary, as would be organ
sale.

Some
people complain that under the current system, doctors and transplant
surgeons pressure families to remove their loved ones from life
support in order to profit from harvesting their organs. If
the family were allowed to reap some of this profit, money from
organ sales could even help to offset the enormous hospital
costs associated with keeping a loved one on life support. I
refuse to believe that any family would decide to remove a loved
one from life support just to make money from the sale of his
organs.

3. An organ
   market would supply poor quality organs — those who would be
   most likely to sell their organs have organs that are of the
   worst quality.

This
is not true, but even if it were: aren't organs of poor quality
preferable to no organs at all? Right now, the supply of organs
is so short that nobody has a choice about which organs they
receive. A market in organs would increase the supply so much
that recipients would probably be able to choose among several
matching organs.

Legitimate
organ brokerage firms would emerge. They, or insurance companies,
would do diagnostic testing to ensure donor-recipient match.
They would screen potential donors for diseases and probably establish
a rating system for the quality of donor organs. The organ's
price would take into account several factors: organ type, organ
quality, current supply and demand, surgical costs, transportation
costs, diagnostic testing costs, and a finder's fee. I'm sure
that broker firms would have an incentive to screen donors carefully
— imagine the lawsuits which would result if a recipient contracted
a disease from a donated organ. Over time, these firms would
build reputations for safety and quality. Consumers could choose
among them just as we choose among competing companies for any
other product.

4. An organ
   market exploits the poor. They do not get paid enough for their
   organs. They will sell their organs for drugs.

Although
poor people would probably be the most likely to sell their
organs, an organ market would not be exploitative — in fact,
it would help poor people by increasing the amount of options
they have for money making.

Realistically,
the most common organ transaction would probably be that of
kidneys. According to UNOS,
there are more people currently waiting for kidneys than any
other type of organ. A kidney can be harvested without killing
the donor, and the donor can lead a relatively normal life with
just one kidney after the transaction.

I
won't claim that recovering from having a kidney removed is
easy or fun. I don't want to downplay the fact that the donor's
quality of life will probably suffer. However, allowing the
sale of organs affords people a choice that they don't have
under the current system.

We
make economic choices every day — if I buy a cup of tea at Starbucks,
I have shown that I prefer having a cup of tea to having a few
bucks in my pocket. If I sell my kidney for $20,000, I have
shown that I prefer $20,000 in my bank account to a kidney in
my gut.

People
choose whether or not to sell their organs. Choice represents
economic power. The option to sell organs is one opportunity
for poor people to lift themselves out of poverty. Nobody can
force a person to sell his organs. But if he makes an informed
decision to sell, more power to him.

If
a person sells an organ in exchange for drug money — well, that's
also his choice. My guess is that one of two things will happen
if drug addicts decide to start selling their organs: either
the addict will run out of non-vital organs to sell, or the
addict will not be able to market his or her organs because
they will be distressed from drug use and possibly infected
with diseases. Of course, the reason drugs are so dangerous
and expensive is precisely because of the "War on Drugs."
That, however, is another subject for another column.

5. Selling
   organs is dangerous, even for those organs which can be removed
   without killing the donor.

Isn't
it more dangerous to have black market organ transactions?

Black
market organ removals must be done in secret. Often this means
they take place under poor or dangerous conditions. Sellers
of organs on the black market take enormous risks because they
essentially have no legal recourse if they don't get paid, or
if they suffer complications from the surgery. Sellers may not
be able to afford treatment for those complications, which could
result in death. A legitimate market in organs would allow donors
to choose a firm to broker their organ transactions, and to
enter a contract where the specifics of the transaction were
clearly delineated. Violating the contract would warrant legal
action. Competing organ brokerage firms would have an incentive
to gain a reputation for being the safest, the cleanest, and
the highest paying (for the donor) or the most economical (for
the recipient).

6. An organ
   market is unfair. Only the wealthiest people could afford to
   buy organs.

Wealthy
people on the UNOS waiting list already do buy organs on the
black market. They also get preferential treatment if they are
"important" enough. The current "fair" system
is actually massively unfair.

If
the market were legitimized the price of organs would plummet.  Many
more people would be able to afford them, because the supply
would increase. Besides, having an organ market would in no
way prevent people from donating their organs for free – either
in death or while they are still alive.

Regardless
of a patient's financial status, a condition which requires
having an organ transplant is bound to incur huge costs. The
financial cost of staying in the hospital or getting treatment
(such as dialysis) while waiting for an organ may surpass the
price of buying an organ on a legitimate market. Consider, too,
the opportunity costs of losing wages, missing time with family
and friends, and enduring years of poor quality of living.

7. Isn't
   it more ethical to use xenografting? What about other techniques?

No,
xenografting
is not more ethical. A market in organs facilitates voluntary
exchange between the donor and recipient; the donor consents
to sell his or her organs. Animals cannot give consent. And
as far as we can tell, they do not experience altruism. An animal
would not receive any benefit from having its organs involuntarily
removed. We can reasonably assume that no animal would consent
to having its organs removed, were it even able to give consent.
Therefore, xenografting is not ethical.

It
also poses additional problems.
First, having a xenotransplant probably would be less cost-effective
than buying an organ on a free organ market, at least with the
present technology. There are also concerns about viruses which
naturally occur in some species intermingling with human ones.
Some scientists believe that this could potentially create a
new pathogen which might be very dangerous. And perhaps the
most significant problem with xenotransplantation is the issue
of rejection by the recipient's body. Some companies
are working to develop technologies that address these issues.

As
far as other methods, a cost-efficient way of cloning single
organs or body parts or a way of synthesizing organs would be
an ideal solution to this problem, provided the parts were made
available on an unfettered market. I don't doubt that these
things may one day be possible with the continuing incentives
for innovation that capitalism provides. However they are not
available right now, so they can't be considered as a practical
solution to the organ shortage at this point in time. (An interesting
footnote: synthetic
blood is already emerging as a possible solution to the
ever-prevalent blood shortage.)

8. Some religions
   prohibit organ donation as body mutilation.

Organ
donation is voluntary. Organ sale would be voluntary, if it
were legal. You decide what do with your body. On the same token
we should all respect other people's wishes to do as they please
with their own bodies. Ultimately, a market in organs boils
down to one key concept: autonomy.

In
1999, someone
attempted to sell a "fully functional human kidney"
on eBay. Some debated whether
or not the auction was a hoax. But bids apparently rose to $5.7
million before eBay decided to shut down the auction. Jeffrey Tucker
tells me that the Mises Institute had to put out this
notice. Why? A Mises
daily article which extolled the virtues of a human organ market
prompted numerous emails and phone calls from people asking to buy
or sell organs.

These
situations merely demonstrate the high demand for organs.

It's
time to start thinking seriously about letting the market do what
it does best — allocate scarce resources efficiently — with human
organs.

Interesting
Resources

• http://www.independent.org/pdf/tir/tir_05_3_barnett.pdf
• http://www.cato.org/pubs/journal/cj17n2-3.html
• http://www.pitt.edu/~htk/
• http://www.organkeeper.com/
• http://www.amazon.com/exec/obidos/tg/detail/-/0754641104/lewrockwell/
• http://www.amazon.com/exec/obidos/ASIN/084474171X/lewrockwell//
• http://www.mises.org/fullstory.aspx?control=1414
• http://www.mises.org/freemarket_detail.asp?control=29&sortorder=articledate
• http://www.mises.org/fullstory.aspx?control=898&fs=let+the+market+save+lives

January
3, 2005

Stephanie
R. Murphy [send her
mail] studies Biochemistry at the University of Massachusetts
at Amherst. She is a member of LifeSharers
Organ Donation Network.

Each
day, this is what dozens of ailing people hear. The United
Network for Organ Sharing (UNOS) is a government agency which
handles allocation of organs from donors to patients. According
to UNOS, there are more than 87,000 Americans waiting to receive
viable organs right now.

To
reiterate, a government agency is allocating resources, and the
result is — drum roll, please — a shortage.

According
to its website, UNOS matches
organ donors with waitlisted recipients by taking into consideration
several factors both biological and logistical. They include the
following: blood types and immunological characteristics of the
donor and recipient, size of the organs to be transplanted, time
spent on the UNOS waiting list, physical distance between the donor
and the recipient, age of the recipient, and the ever controversial
"medical need."

The
allocation process may seem quite complicated, but never fear. UNOS
has policies
and bylaws
to help them decide who should get organs and who should not.

Government
regulations explicitly prohibit the sale of human organs. In other
words, the price of organs is fixed at zero. The demand for viable
organs is enormous compared with the supply. It doesn't take an
economist to know that this is a recipe for a shortage.

As
with all forms of government meddling, the market in organs is distorted
— that's the simple reason why thousands of people will die waiting
for an organ transplant this year.

And
also, as with all forms of government meddling, the system of organ
allocation in the US creates some interesting unintended consequences.
Perhaps the most obvious is a lack of incentive to donate organs.
Doctors and UNOS experts must determine that altruism is the only
motivating factor in any organ transaction between a living donor
and a recipient.

Any
shortage or long waiting list encourages people to try and get around
it. Patients often plead with their physicians to report their medical
need for organs as greater than the physician may feel comfortable
doing. Sometimes, under threat of lawsuits, or simply to save their
patients, doctors comply.

There
is also the question of whether the UNOS system leads to special
treatment for prominent VIP's in need of organs. Many people cried
foul when Mickey Mantle received a liver transplant after practically
no wait time; he died shortly after receiving the new liver.

And
as with any commodity which is illegal to sell but carries a high
demand, there is a black market in organs. Wikipedia
puts the price of a fresh kidney at about $125,000 US dollars. A
small portion covers transportation costs; the rest is split between
the donor, a private hospital, and the broker. The broker reaps
about $55,000 in profit on each of such transactions. It is difficult
to find reliable data on how often black market organ transactions
occur in America, but the organ trade is certainly alive not only
in the US but all over the world.

Those
who end up on the UNOS waiting list face a good possibility that
they will die waiting for an organ. There is, however, a silver
lining. Even in the face of a seemingly insurmountable system of
government intervention and central planning, the market is finding
solutions to the problem of organ scarcity.

A
young man named Todd Krampitz was recently diagnosed with severe
liver cancer. He underwent 6 weeks of chemotherapy. Then, doctors
removed three-fourths of his liver. What was left of it was later
found to contain more cancer, so Todd was informed that he would
need a liver transplant in order to survive — he was put on the
UNOS wait list. Todd didn't take the news lying down. He and his
loved ones set up a website,
which received a flood of media coverage, and used it to network
with potential donors. Todd received a liver within weeks, and lived
to tell his tale.

LifeSharers
is another fascinating alternative to the virtual death sentence
of the UNOS waiting list — a community which seeks to ameliorate
the shortage of organs. Members of the voluntary association receive
preferential access to the organs of other LifeSharers members,
should they become available. LifeSharers participants are promised
first access to the organs of others in the group regardless of
their status on the UNOS list. If a suitable match for LifeSharers
donor's organs cannot be found in a LifeSharers recipient, the organs
can go to someone on the UNOS list. There is no fee to join. The
only requirement for membership is that all members must agree to
themselves be organ donors.

You
can imagine the complaints from critics of this system: it gives
members an unfair advantage; it allocates organs to those who might
not have the greatest "need." I can't understand how LifeSharers
is any different than an organ donor who specifies that his organs
should go to his family members or friends before others. After
all, they're your organs. You grew them yourself.

You
own your body — and you should decide if, when, and how you want
to give of it.

You
own your body. What a powerful concept. Yet nowadays more and more
we are being bombarded with legislation and propaganda that implies
just the opposite.

Still,
vestiges of autonomy remain which continue to be thought of as socially
acceptable. Professional athletes, models, actors, movers, security
guards, and surrogate mothers all make a living from the use of
their bodies. It is common for Americans to sell their eggs and
sperm, which have the potential to create new human life. But to
sell our organs and to prolong or improve an existing life — from
this we are prohibited.

Why
shouldn't we sell our organs? This idea is nothing new; still I
feel compelled to bring it up. Despite the dismissal of organ sales
as exploitative, coercive, damaging to the quality of organs, and
dangerous, the proof is in the pudding. Areas of the world such
as Iran (where it is legal to sell kidneys) and India (where kidney
sales are technically illegal but a de facto market exists) are
the only places which do not face shortages. I learned of this from
James Stacy Taylor, who has written a book
on the subject, which will be available this spring. I saw him speak
at a conference last spring, where he addressed the four most common
objections to a market in human organs. I found his arguments delightfully
difficult to refute.

A
final caveat: If you sport an orange sticker on your government
issued driver's license (which, incidentally, is slated to become
a de facto
national ID), you may think yourself an organ donor. Actually,
most people are unaware that the orange sticker is only half the
battle. The most important step in becoming an organ donor is a
conversation with your family about your final wishes. If you happen
to expire and your organs are usable, you certainly won't be around
to give your consent to harvest them, no matter how much you wished
to donate during your life. If you're the orange sticker type who
hasn't yet expressed your desire to be a donor to your loved ones,
I implore you to do so.

And
please, for life and for liberty, start a discussion with your friends
about market-oriented approaches to the allocation of scarce health
resources. You could open minds. You could also save lives.

January
1, 2005

Stephanie
R. Murphy [send her
mail] studies Biochemistry at the University of Massachusetts
at Amherst. She is a member of LifeSharers
Organ Donation Network.