One of the main promises of driverless cars is that they’ll save tens of thousands of lives that would otherwise die in car crashes caused by poor human driving. But could those saved lives actually mean more people die? While the roads will be safer without distracted humans behind car wheels, organ-donor waiting lists might grow as the supply of organs from auto-crash victims dries up.
According to figures sourced by Slate‘s Ian Adams and Anne Hobson, liver and kidney disease are bigger killers than breast or prostrate cancer. Over 10,000 people are removed from donor waiting lists each year either because they get too sick or they die, and the waiting list for transplants has doubled since 1999, it now stands at around 123,000 people.
One of the largest sources of organs for transplant is people killed in auto accidents. One-fifth of organ donations come from the 35,000 people who die on U.S. roads each year. These people would usually keep on living a healthy life, so their organs are perfect for re-use. When autonomous cars really take off, there will be far fewer organs available. One estimate says that autonomous cars could save 300,000 lives over a decade. If that sounds dramatic, consider the effect of airbags and seatbelts. Since seat belts were made mandatory in the 1970s, road traffic deaths halved from 60,000 to just over 30,000.
One possible solution, Adams and Hobson argue, is to make the human organ market legal. A kidney transplant costs around $150,000. The average 4.5-year waiting period costs $350,000 for dialysis alone. That allows a lot of room, money-wise, to pay people to donate their organs. Economists Gary Becker and Julio Elias argue that paying people around $15,000 per kidney should be enough to get the market moving. And those are live prices. You’d be paid to have one of your kidneys taken out, not just to donate it after you’re dead.
We already allow the sale of sperm, eggs, and blood, although none of those leaves the donor lacking a body part they may need to survive. There are already some countries that are moving in this direction. Israel, say Adams and Hobson, not only compensates donors with wage reimbursement and other benefits, it also puts the donor and their family on a priority list if they should require a donation in the future–a kind of pay-it-forward scheme that seems a lot more attractive, ethically, than straight-up cash-for-organs payments.
Would this lead to exploitation of the poor, in favor of the rich? Well, the rich already game the system anyway.
A wealthier liver-transplant candidate, for example, can afford to undergo analysis at numerous liver centers and, in doing so, get put on multiple transplant lists. Richer patients can also afford to travel to countries with more prevalent black markets for organs (which, unregulated, may have meant darker outcomes for their original owners).
The dilemma here is clearly an ethical one, because, financially, paid donations make so much sense if you want to improve supply. It’s hard to conceive of anyone rich selling off an organ for that kind of money, so the majority of donors will surely be poor. This means that we need alternatives. The best option is medical advances: to prevent the need for organ transplants in the first place.