I think one of the standard concerns is that this will lead to rationing of healthcare by ability to pay, and that such a system will not long survive.
1: Yeah -- a problem I can see is the possibility of well-off patients sucking up all the available organs, even those now available for free (that is, one assumes that many people who now donate organs for free would take money if it were offered).
What if an organ is a great match for a poor patient, and an okay match for a rich patient, and the rich patient buys it? I'm not categorically opposed to payments for organs, but I can see a lot of problems.
How about some kind of incentive/pool system, where the patient doesn't pay the donor *directly*, but donates to a pool that then pays donors? What would be really awesome is if the hospital, say, or the state, or whoever, rewarded donors with lifelong, irrevocable health insurance.
I am in favor of the cash payments. If we are lucky we will get lifelong, irrevocable health insurance like the rest of the civilized world soon enough.
I considered egg-selling at one point. I wouldn't have done it for 8,000, but I wondered if I could get one of the 25K deals they advertised in my college newspaper. I figured it was a way to do a program like the one I'm doing to get me into a PhD program without a lot of debt. But then I got a job that mostly pays for it.
Me too. A while back, there was one of those really, really specific egg donation solicitation ads all over the place that was unambiguously looking for Dr. Oops (that is, they wanted a blue-eyed six-foot serious athlete with SAT scores above a cutoff point as an egg donor) and was offering 50k. She never even considered it, and I have to say that I wouldn't either -- who would want their kid to be raised by people that screwy? Once the kid isn't related to you, why not adopt someone who needs a home?
For people who object to egg donation, do you see sperm donation the same way? It seems that people draw a strong distinction between them, if only because I never see ads offering $20K for sperm donors.
FSR I keep reading all these references to "egg selling" as "ego selling" and that has started me wondering what the world would be like if that were possible and accepted. Lots of formerly poor people living comfortable but self-less lives? The rich trading some of their wealth for a new way of looking at the world? Would you be able to keep your name and identifying characteristics if you sold your ego? What about government-issued id numbers? Those certainly seem to me to be attached to a body rather than a psyche but is that how it should be?
Well, sperm donation doesn't potentially risk your future fertility or health. Where I don't think we're really certain about what the long-term effects of massively boosting one's egg production is. Are.
True, which does mean there's some point to it from the recipient's point of view beyond adopting. I'm still uncomfortable with egg and sperm donation though -- I wouldn't do either, except maybe for close family. If you're going to bring a child into the world, I think you're responsible for its well-being, and I have a hard time considering that responsibility fulfilled by handing it over to someone who you know nothing about beyond their capacity to pay.
This isn't a well thought out position, it's more poorly analyzed discomfort.
My fascist liberal tendencies come out most strongly with organ donation. It's so vital to saving so many lives to have available organs, and the shortage is so acute, and voluntary measures so far have produced such inadequate results, that I'd like to see very strong consideration given to making the option on the back of your driver's license/ID (in most states that I'm aware of, at least) of opting-in to organ donation be switched to an opt-out.
I'm also well aware of the slippery slope arguments here (hey, I was a science fiction kid who read Larry Niven's "organlegging" stories when I was single-digit age, and don't want to go that far), but this is literally life and death for so many people, and so long as we emphasize that opt-out is a perfectly legitimate choice, I think the good to be done is worth the strongest consideration.
"Once the kid isn't related to you, why not adopt someone who needs a home?"
I tend to feel that way about people spending money (a fortune, by my standards, in many cases) on thoroughbred dogs, when there are a jillion mutts, or at least paperless dogs, being killed every year, and every day.
But, then, I did once spend the better part of a year working for Seattle Animal Control.
"It seems that people draw a strong distinction between them, if only because I never see ads offering $20K for sperm donors."
Setting aside the relative pain question (which should be more than a little obvious is a pretty effing large differential), there's the point of perfectly obvious supply and demand distinction.
It's a straight-forward case of classic market dynamics. But possibly you've not read anything on the topic.
This, absolutely. I think there's too much respect for people's squeamishness around organ donation, and opt-out and heavy education and publicity directed at the reasons for not opting out (they really won't kill you for your organs! You can have an open casket! You'll be saving lives! You were through with them anyway!) would both be a very good idea.
LB, children for the childless issues are near and dear to my heart, and I'm uncomfortable (in a poorly analyzed way) with your poorly analyzed discomfort -- feeling responsible as I do for the well-being of a child whom I had no part in bringing into the world.
Well, SCMTim, there are a number of things that make me unhappy about it.
Just to start with, we're one of the only Western countries to allow their sale. In Europe, egg-donors receive some compensation for their duress, but it is *illegal* to buy or sell eggs. That way, the people who donate eggs really want to, you know, donate eggs, whereas here, the people who "donate eggs" really want $10,000. I tend to see eggs as a little more human than sheer commodities (although, obviously, not human enough to merit Constitutional personhood).
The market here also strikes me as being somewhat exploitative. Every single college newspaper I've ever looked at has been crammed with ads solliciting egg donors, and the amount of money on offer varies wildly. Are there any governmental regulations on this? Any limit to how many times a single donor can donate? The hormonal treatments that donors undergo are not trivial--have there been any long-term studies on their effects?
Last, or at least last for now, I also think that the balance between the child's future need-to-know and the donor's desire for anonymity will shift dramatically in the future. The UN charter on the rights of children has language that suggests a children has a right to know his or her parents. The EU recently decided that a sperm donor was required to support "his" child, even though he and the lesbian couple he'd donated his sperm to had signed a pre-natal contract absolving him of financial responsibility. As research into genetics advances, people might have very good reasons to demand a right to know their parents' family histories. We'll see how this all shakes out in the future, but I strongly suspect that further down the road, egg donors are going to see those eggs coming back in the form of adult people with pointed questions. This last concern doesn't directly address the monetary exchange, but I do think that all of the money in the fertility business does obscure these questions, especially for the donors.
So who among us has a driver's license marked accordingly?
Mine has a miniature form you could fill out which refers to the Uniform Anatomical Gift Act, but also has a place for a Medical Information/Living Will Seal. ? I'll have to go look up the act to figure it out.
I actually feel the same poorly analylzed discomfort LB does--and I'm aware that this includes some discomfort with adoption, at least where *my* kid or potential kid might be concerned. I know someone who put a baby up for open adoption and then later the adoptive parents fled the country to evade prosecution for tax fraud or somesuch. If it had been my baby, I would find that wrenching. And of course there are occasional stories of abusive adoptive parents.
Now, of course I know that the *vast* majority of adoptive parents are fabulous, loving parents. And I'm totally not anti-adoption (or sperm or egg donation). But I have to admit, I don't think I could do it. I could adopt someone else's child, but I think I'd have a very hard time placing one of my own.
Years ago, a bioethics professor of mine--who also happened to be a complete moron--insisted that the main problem with payment for organ donation (given that inequity concerns could in fact largely be addressed with variations on the pooling suggestions made above) was that such a system would "cheapen the gift": that is, once payment for organs was on the table, it would make it more difficult for people to enjoy the opportunity to give selflessly, and thus diminish the world supply of genuine altruism.
This argument--and related ones, such as the notion that a "donated" organ is somehow more valuable than a "sold" organ--is raised with considerable frequency by opponents of donation incentives (the Institute of Medicine's objections mentioned in the op-ed are, I think, of this nature).
Mind-boggling, and, to me, nearly obscene: potential shortage of altruism was a bigger concern to this guy than actual shortage of life-saving organs for transplant. Opportunity to give selflessly more precious than opportunity to, um, stay alive. (To say nothing of the fallcy at the heart of it: allowing sale does not entail prohibiting donation.)
I think there is much to LizardBreath's concern expressed in 3, but in principle, why shouldn't we figure out a way to allow people to sell their organs, particularly if it appears that it does them no harm? We allow boxers to box, even though it clearly is not good for them. I assume that many on this thread support decriminalization of one of more currently-ilegal drugs, even though they are demostrably bad for you, so why not this? Is it better to tell someone that they have to do without something that is vitally important to them or their family because we are squeemish about their choices regarding how to get the money to pay for what they want?
Further--and I want to try to state this as a musing only, I am not trying to call anyone out for being inconsistent--it is interesting the reaction some are having to the notion that selling an egg is in some way selling a child and there are concerns about having your child raised by someone else. In discussions of abortion, it seems to be the accepted wisdom that an egg is nothing--indeed, it is a point of strong disagreement whether or when a fertilized egg is ever a child. So it surprises me that one would consider an unfertilized egg something to be squeemish about. I mean I'm pro-life, but I realize that unfertilized eggs are discharged every month by almost all women of child-bearing age. Why are we squeemish about this?
I'm relatively uncomfortable with egg-selling, but since I don't have any to sell, I've refrained from forming any set opinion on it. From what I've seen though, it seems that those transactions occur between relatively wealthy couples and still relatively well-off younger women. The women selling the eggs may not be wealthy, but they are generally white and college educated, like in LB and Tia's cases above (though, of course I don't know their race, but I'd wager most of the couples in the egg-market are white). This makes sense, since generally, these couples want a baby with a high likelihood of turning out like them, in terms of race, intelligence, health, etc.
As far as I know though, one is pretty indifferent about who one gets their kidney from. Organ transplants are tricky for sure, but as far as I know, it's very possible to get a kidney from someone of a different race (I should look these factors up, really). This, to me, creates the potential for an organ-selling underclass, made up of poor minorities selling their kidneys to rich (and probably mostly whites).
This potential outcome makes me extremely uncomfortable.
In discussions of abortion, it seems to be the accepted wisdom that an egg is nothing--indeed, it is a point of strong disagreement whether or when a fertilized egg is ever a child
I think the mistake you're making is treating this as a classification problem with only two categories. I'm not sure what's improbably about a system with more categories: (a) nothing, (b) something other than a child, and (c) a child.
Because in the case of an abortion, there is, in the end, no child. Pro-lifers think the zygote or fetus that is destroyed has moral status equivalent to that of a child, and pro-choicers don't, which is why they disagree. From my point of view, when I had an abortion, no child came into existence, and so no responsibility to such a child was implicated by my actions. If I had donated an egg, on the other hand, if everything worked out as intended, a child would have come into existence, and as its mother I would have been responsible for its welfare, but I would have not been in a position to carry out that responsibilty.
I don't think my position is inconsistent or difficult to understand.
it's very possible to get a kidney from someone of a different race
Possible, but I think less likely -- my understanding that your odds of a tissue match go up with ethnic similarity, and of course up further with family relationship.
the child that *develops* from the egg to be a child.
OK, but why is that so important? Indeed, what makes it your child? You did not give birth to it. Is someone to whom you donate blood or a kidney part yours? The child is an independent person. It gestated in, and was given birth to by, another woman. And is being raised by another family, with no knowlege or connection between you other than the donation of a single, unfertilized cell.
I'm really not trying to criticize your intuitions here, it's just very interesting when you look at it analytically.
I sort of agree with Idealist about the egg-selling stuff. Seems that it doesn't make much sense to feel a moral or emotional tie to the child grown from your egg just because of the genetic relatedness. On the other hand, I can see how you could regret enabling the child to exist in the first place (regardless of relatedness) when the child ends up having terrible parents.
Also, child support from sperm donors? How incredibly crazy is that?
You did not give birth to it. Is someone to whom you donate blood or a kidney part yours? The child is an independent person. It gestated in, and was given birth to by, another woman.
It is conventional in our, and most (all right, I'm being sarcastic here. In freaking ALL) cultures to feel closeness to and responsibility for those with whom one has a genetic relationship, on some level regardless of the shared experiences normally necessary to create a strong emotional bond. Particularly strong (as in, what are you from MARS or something) is the genetic relationship colloquially referred to as the parent-child relationship.
For a thought experiment as to how this might play out, consider the possibility of a parent being erroneously told that their newborn had died at birth, when in fact the baby had been given to a different family in error. Even, say, five years later, perhaps after having had an additional, replacement child, it is my intuition that most parents would still feel interest in and concern for the welfare of the first child if they discovered its continued existence, despite the fact that it was being raised by another family.
You're all hereby forbidden from ever again criticizing the New York Times for being blinkered about class. When organ-selling becomes legal, people in desperate straits will often feel that they have no choice but to sell an organ to get through a rough patch, send a kid to college, raise money for an operation, etc. You end up with a society in which the underclass keeps the affluent in "good organ." That's morally gross. When things are so bad that the poverty vs. giving up an organ calculus starts to favor giving up organs, we're living in a sick world.
Re 12: It is to be hoped that an altruistic ego-donation pool would develop to succour the psychically dissatisfied but impoverished -- perhaps the donors to this pool would be wise men who had attained enlightenment and had no longer need of their egos? Or perhaps, this could be an opt-in form on the back of your driver's license -- if the EMS arrived at the scene of your accident before the spark of life had left your body but were able to determine that your prognosis were negative, they could harvest your ego -- no reason a healthy young ego should expire with the body. I am wondering what the donor-recipient match-up process would be like, and how long the queue would be. Would connections with those in power allow you to jump the queue?
No, blood and kidneys are not sentient human beings. A child is. Gestation and birth are indeed very important labor in the creation of a child, and I don't discount them. I don't, however, discount genetics, either.
I honestly don't see what's "interesting" about this, analytically speaking. An egg isn't a human being; nor is a zygote or a fetus. I'd be quite willing, putting aside incovenience and possible health risks, to donate eggs for the development of embryonic stem cells, for instance. A child, however, *is* a human being, and I would feel uncomfortable having a child that was related to me brought up by someone I didn't know. I'd feel the same way if one of my nieces were adopted out to a stranger; hell, it bothers me that my friend's baby was adopted by tax-dodging assholes who broke their open adoption agreement. And it's pretty well established that adoptive kids and children conceived via donor sperm often want to find their biological parents. I don't think it's weird to feel a biological connection, or at all inconsistent with the idea that an egg isn't a person.
Really, I'm having a hard time not finding the question kind of insulting. It seems kind of similar to the "if you don't value the life of an embryo, what's to keep you from infanticide" question.
But, more charitably: maybe the disconnect is that you're hearing me say I'm "against" egg donation. I'm not. What I said was that the *risks* of a donated egg->child, or adopted child, being raised by someone who's an asshole would keep me from being comfortable doing it. If the adoption/donation turned out just fine and the kid were happy and well-cared for and not a selfish jerk, then hey: flowers all around. The problem is, you don't know that that's going to be the case, and absent that knowledge, I would be uncomfortable creating, or helping create, a child.
Come to think of it, this is *entirely* consistent with being pro-choice. I don't want kids raised in shitty circumstances. I especially don't want *my* kids raised in shitty circumstances, and I figure most women probably feel the same way. So it makes sense to me that if the probability is that the kid is going to be raised in shitty circumstances, a responsible woman would prefer not to have one of *her* kids brought into the world.
"It's a straight-forward case of classic market dynamics. But possibly you've not read anything on the topic.
Geez, Gary, lighten up."
I was just hypothesizing. I wasn't condemning. There isn't any reason to assume any given person has looked into the issues and situations regarding sperm and egg donation, and every reason to presume they haven't. I'm unaware of anything pejorative about that, or why assuming kindly that someone hasn't looked into it is unkind. When I want to condem, I, you know, condemn.
Jeepers, in trouble already am I. Begins, the yoda-speak, does.
"Hey Gary, as long as you're on the thread: Do you know any good sf books exploring the idea of ego-selling?"
Well, I'm pretty out of touch with the field in the last ten-plus years. Not per se, off the top of my head. I can think of a variety of stories dealing with personality transfers, and personality/brain-add-ons, and with uploading minds, and the like, but not so much with the selling. But, as I said, I've really kept up with almost nothing in the past ten-plus years, so I'm not the ideal person to ask. I'd recommend posting a query to rec.arts.sf.written on Usenet (I think you can probably do this via Google Groups, if you don't have more convenient access, with a little trouble).
"In Europe, egg-donors receive some compensation for their duress, but it is *illegal* to buy or sell eggs. "
Last I looked, that's how it is here, too, actually. The fees are "compensation," not payment for eggs. Same for sperm. (And what I meant about supply and demand is that since sperm donation is pretty easy [yeah, go for it], and not exactly painful, most of the time [unless you like it that way], there's plentiful supply, and sperm banks are very picky about who they accept, because they can be.
Whereas egg donation is excruciatingly painful and complicated and puts you in the hospital, and so not so many volunteer, and so there's a large un-met demand absent compensation.
32: "We do, however, consider the child that *develops* from the egg to be a child."
your odds of a tissue match go up with ethnic similarity, and of course up further with family relationship.
Sure, I'll concede the differences in odds, but I don't know what the level of the odds are in various cases, so it's hard to say how likely we'd see inter-racial organ sales. Even conceding that it's unlikely, you still have a potential market where poor whites/blacks/etc sell their organs to rich white/blacks/etc., so you still have a kind of underclass occuring. (I'm assuming that sales will not be taking place b/w families members. If you have a feasible donor in the family, you wouldn't need to go on the market.)
From the summary in the link to Kieran's book: In the end, Healy suggests, successful systems rest on the fairness of the exchange, rather than the purity of a donor’s altruism or the size of a financial incentive.
I guess this is what I'm getting at... if we opened up a market for kidneys what would those on either side of the exchange look like, and what are the implications for the fairness and rights enforcement in that exchange? I'd be interested in what Kieran's take on that is
And a question for the women: which would you be more willing to sell: your kidneys or your ovaries?
Erm, it's a whole child. The egg isn't the only component of it -- there's sperm, and gestational nutrition and developmental support -- but parents generally feel responsibility for their whole children regardless of the fact that there are two parents involved.
42: Well, of course it's morally gross. OTOH, poverty is morally gross. I see clearly the argument in favor of not buying other people's bodies (or parts thereof). On the other hand, like prostitution, it seems to be something that happens anyway. Which raises the question (like prostitution) of whether there are ways to make it less morally gross, and to properly reward people who, let us imagine, make conscious decisions to do it for whatever reason--including thinking its better than starving. No?
42: so it's less morally gross to not let the would be doner have the money they decide they really need? I think we should structure the world so that everyone's needs are always cared for, too, but we're not living in it. I'm not sure that "that's gross" is considering the interests of the poor more than the discomfort of the rich.
Also: regardless of what a biological parent may feel, the biological child, in my opinion, deserves to know what sort of person his or her parents are.
Knowing, for example, that both biological parents were raging drunks who died at 35 of liver failure would most likely change the child's attitude towards alcohol--which would therefore probably prolong the child's life.
And that's only the easiest example. My sister is a genetic counseler; I've got lots more.
By pointing out a possible explanation for a fact, where the explanation is not obvious, but the principles guiding the explanation are considered to be common knowledge among the audince (supply/demand), suggesting that the reason the explanation didn't occur is that the audience wasn't aware of the common knowledge, instead of the more likely explanation that the relevance of that knowledge hadn't occurred to them, is rightly taken to be patronizing.
Now, if the principle of supply and demand was blindingly obvious in the formulation of the question, your reaction would be more appropriate, but still snippy.
Kieran: fabulous cover image. The book looks great, too--I don't mean to sound all "wow, great cake, especially the [canned] frosting!" (does anyone remember that commercial?)--but I'm always interested in how much control authors have over their covers and the other design elements of the book, and I presume that one was entirely yours.
42, 51, 52: The thing is, I can't see any way it could be enough money. Someone who's poor enough to sell a kidney for $10K? They're still going to be poor after they get the $10K, they just won't have a kidney. At that point, I am more horrified by the class implications than reassured by the fact that they're getting the money they need.
More people should probably also donate spare super-egos to others.
Well I could see the benefit to the recipient, but who wants to become conscienceless? I think the net benefit to society would be a wash. I mean say some good soul donates his/her conscience to Dick Cheney -- the total number of psychopaths remains constant.
Tia, I don't know about citations, but I'd make the same assumption Carl makes, based solely on the ads I've seen for egg donations. And the presumption that people with access to that kind of money (or health insurance that good) are likely to be white and college educated, and that most people tend to place a high value on things that reflect their own values. If that makes sense.
"You end up with a society in which the underclass keeps the affluent in "good organ." That's morally gross. When things are so bad that the poverty vs. giving up an organ calculus starts to favor giving up organs, we're living in a sick world."
We live in a sick world. A world in which people often can't sell organs, and die, or suffer, or their family suffers, because they don't have that fillip of additional income at a crucial time.
Which is not a disagreement with you, but the flip side of the point.
It would be nice to think that, eventually, stem cell and other r & d will lead to the ability to regenerate organs whether organically, or externally and grafted, and thus no eventual need for transplants from a living person, by the way, and sooner or later that will inevitably be the case, though no one can say precisely when that will be possible, let alone wide-spread. But within fifty years seems a very safe bet. Probably within thirty, I suspect.
(I wrote a post about you the other day, by the way; I'd like to fancy that you saw it since you can't bear to miss my posts, but I kinda doubt that's actually true in this universe.)
I was envisioning a mandated sum of something more like 100K. I assume that dialysis and everything associated with the operation would cost easily that much, so it can't be that inconceivable to double the cost.
And really, I think, if anything, it's the perspective of the rich to think, no, it would just be too unsavory to pay for this, so considering the possibility is not being blinkered with regards to class.
So, legalizing an organ market would worsen the class divide, but help more people to live.
Which is worse? And is it relevant whether other actions are being taken or planned to independently lessen the class divide?
If we go on the moral principle that a social policy should increase the quality of life of those whose quality of life is worst, that leads us to try to decide whose life is worse--a poor healthy person, or a middle-to-upper class ill person without a needed organ donor. If we decide it's the poor person who's worse off, we need to decide whether their life would actually be improved by letting them sell an organ.
61: I don't know about that. Let's say $25K, and hypothesize an international market. $25K is enough to make a difference between destitution and comfort, or even wealth, in some places. I mean, think about the immigration discussion: if people are willing to risk their lives and not see their families for decades, possibly forever, for a job that pays $150/week and keeps their kids in school, $25k (or even $10k) is a huge, huge amount of money. I think that if I were given the choice between emigrating from Honduras to Los Angeles and abandoning my kids in order to provide for them, or donating a kidney, I'd take choice B.
Re 62: I guess you can make an argument that Dick Cheney is powerful where the freshly-minted psychopath is not -- but my hunch is that the newly-ensouled would fall quickly from power and the newly-conscienceless would rise like bubbles of swamp gas. Maybe we could work out some kind of system (assuming the superego-transfer process were quick and painless) where the two would exchange superegos whenever the one posessing the conscience fell too far below the median power status -- this seems like it would require a pervasive and intrusive bureaucracy to monitor and keep going but I suppose that's not such a huge flaw.
Do you have a cite for this, Carl? I'm not so sure.
No, I've been looking around, but I think it'd be hard to find proper stats, since these kind of private market exchanges are really quite private. Nonetheless, you see a tremendous amount of these ads in college newpapers, so you get a gist of the target audience here. My reasoning is just that, the buyers probably want ovaries from someone as much like them as possible (otherwise, why not just adopt?). This makes the exchange a lot more equitable, in a socio-economic sense. This is just supposition -- I'd be glad to get pwned by the facts, if I'm wrong.
Kieran: fabulous cover image. The book looks great, too--I don't mean to sound all "wow, great cake, especially the [canned] frosting!" (does anyone remember that commercial?)--but I'm always interested in how much control authors have over their covers and the other design elements of the book, and I presume that one was entirely yours.
Hey, thanks -- I believe you can judge a book by its cover, or at least that's what people do. So I wanted a good one. Presses -- maybe even editors -- vary a lot in their policies about covers. Some let you pick your own within broad limits, others have a house-style you can't avoid -- especially if the book's is in a series. Chicago allowed me to suggest a few images (of which the final cover was one) but made it clear that their designers would be doing the designing, not me. With this topic, the bog-standard is Gray's Anatomy style cutaway shots of torsos, or alternatively some anonymous bit of medical equipment like a blood-filed pipette or an organ cooler or whatever. So I looked pretty hard to find some non-cliche images. I was lucky to discover some good ones. Then I waited anxiously and was very happy when they picked one of them for the cover.
"the top Google hit for "ego-swapping" looks promising, as does the last one."
Well, swapping isn't selling. Remember, I'm a bit literal-minded. (And, also, I was a bit unclear what you had in mind as regards "ego," since it's just a Freudian metaphor.)
"It's a straight-forward case of respecting conversational norms. But possibly you've not read anything on the topic."
A moderate amount. Suzette Haden Elgin and Deborah Tannen, and a few others.
"There's no such thing as "half a child.""
See, now it's not me being the only literal one. I was simply making a kidding point about an egg not developing from an egg alone, as you later acknowledged.
"At that point, I am more horrified by the class implications than reassured by the fact that they're getting the money they need."
Sure. But the primary issue here is worldwide poverty, not organ donation policy. Cure worldwide poverty, and that problem disappears.
I'm sure the Underpants Gnomes are worth consulting on this.
64, 66, 67, 68: Man. It's not that I don't see the point, I just really, really don't want to accept it. Any advocacy for a policy that follows the form: Of course it's nightmarish, but in our horrific society, it's better than the available alternatives, seems wrong to me. Once you're looking at an argument like that, stop making an effort to institute the nightmarish policy, and work on fixing the horrific society.
"I mean say some good soul donates his/her conscience to Dick Cheney -- the total number of psychopaths remains constant."
Oh, and perhaps this reveals a bias towards the elite, but I'd rather the ultra-powerful Veep had a conscience than an ordinary schlub had it go missing, if it came down to it. Less overall harm from a lower-class psychopath than a ruling psychopath, generally speaking, as I believe we've seen proven by control experiment now.
But LB, that's easy to say, but the horrific society isn't going to be fixed any time soon. In the mean time, you have actual poor people who might benefit. One one hand you have poverty (hazardous to your health), and kidney donation (probably not as much so). I think someone could rationally choose the latter for a variety of reasons, and I'm not sure it's fair to let our sense of squick be the deciding factor.
"Once you're looking at an argument like that, stop making an effort to institute the nightmarish policy, and work on fixing the horrific society."
In a situation where a solution headed in the right direction (such as, say, universal healthcare) is politically infeasible, and where a stopgap solution that wouldn't have any relevance in a better society *is* politically feasible, is it appropriate to push for the stopgap solution?
On the other hand, I'm not sure even in a well off society that there would not be a shortage of organs. Is there some specific factor in the US causing the shortage that can be solved without a market? And if it can be solved, would that solution be a stopgap, and not worth implementing on its own? For instance, making organ donation opt-out would be appropriate even in a society without gross class inequities, not a stop-gap solution at all. An organ market, on the other hand, is quite different.
In the mean time, you have actual poor people who might benefit. One one hand you have poverty (hazardous to your health), and kidney donation (probably not as much so).
But surely you folks are setting up a false dichotomy. There are tons of policies we could enact to help alleviate poverty. Letting people sell their organs is probably the worst one.
And as far as solving the organ-shortage problem...donation consent rates are at less than 50%. Encouraging more people to consent to have their organs donated would be a better policy than setting up a kidney-market.
There are better ways to solve both the problems of poverty and organ-shortage.
Carl, I don't think anyone's suggesting that we alleviate poverty with an organ market. They're suggesting that the presence of poverty shouldn't overly affect our considerations of the effects of an organ market, because it's a separate problem that can be solved with separate measures.
One one hand you have poverty (hazardous to your health), and kidney donation (probably not as much so).
See, I suspect that those two things intersect. Question: Does the poverty of the donor mean an increased likelihood of developing serious illness later on?
I have no hard data whatsoever, but I can easily imagine a case in which a poor person donates an organ, gets $25K, finds a great one-time use for the money and doesn't have any healthier a life afterwards...and a few years down the line develops FITB chronic/serious illness and is now much more likely to die from it. Am I crazy?
(I'm assuming that a disproportionate number of current organ donors are middle-class and above, what with the whole affording-to-take-time-off-from-work and so forth. Maybe this is completely wrong.)
We're not setting up a false dichotomy; I think, rather, that you are, by suggesting that one must choose between universal health care, better job training, etc., and compensation for organ donotion. I'm just recognizing that the amount of social work to be done before there's no more poverty is considerable enough, and there's enough resistance even to a consensus that we should give a shit about poverty, that it won't be eliminated for a while. Given that, I'd err towards allowing people to choose something which, all things considered, might perversely in the end be better for their health.
Also, I really don't support an "organ market" if that means competition, etc. I'd support mandated, high cash payments, and healthcare for life if we don't get to universal health care by other means
85: This. I have a very easy time believing that organ donation is not hazardous to the health of current donors, because they are self-selected to be healthy and with access to good care. Once it's a market, I would be unsurprised to find that a lot of kidney sellers found themselves on dialysis down the road.
85, 89: That's a good point. I wonder, though, if that risk would be diminished by giving every donor health insurance. Also, donors would be screened for their underlying health.
Maybe I am from Mars, because I really have a different intuition here. For sure, there is a notion (unjustified in my view, but it obviously is there), that there is a bond between parent and child which we value even if the parent did not raise the child--for example, children who are adopted often feel a need to find their birth parents.
But it seems to me that this notion of their being a strong connection is based on more then mere genetics. It is based on the notion that the mother carried the child and gave birth to him or her. Does this idea really make sense in the case when the only contribution to the child is an unfertilized egg (or sperm, for that matter). Indeed, would we have the same intutions if we were talking about the connection between a child and a sperm donor? Sure, we might also feel a connection to brothers, sisters, aunts, uncles etc., who we have never met, but isn't that about their role in the family we do know rather than the mere fact that you share genetic material?
Carl, I don't think anyone's suggesting that we alleviate poverty with an organ market. They're suggesting that the presence of poverty shouldn't overly affect our considerations of the effects of an organ market, because it's a separate problem that can be solved with separate measures.
I didn't mean to oversimplify your points, but, I really can't see how you can imagine opening up a market for organs without the effects of class and income having a huge impact on the nature of that market, and likely in a way that's going to be detrimental to the poorest and most desparate.
OTOH, there's a case to be made that creating an organ-donation market pretty much adds one more serious conflict-of-interest problem w/r/t alleviating poverty, no?
We could have The Running Man and similar scenarios. Or appearing on the "Torture Queen For A Day Show."
Buck once had a National Lampoon? comedy record with an episode of Catch It, And You Keep It: "Look, Mrs Johnson is maneuvering to catch those gold bars... Ooo, that had to hurt. There goes Mr. Brown with, ow, what is that, a set of steak knives? And here comes a brand new washer-dryer set!"
But it seems to me that this notion of their being a strong connection is based on more then mere genetics. It is based on the notion that the mother carried the child and gave birth to him or her.
Um, so in my thought experiment above, would you expect the mother but not the father to feel a connection to the lost newborn refound at the age of five? Because that strikes me as peculiar.
OTOH, there's a case to be made that creating an organ-donation market pretty much adds one more serious conflict-of-interest problem w/r/t alleviating poverty, no?
You betcha. See those Larry Niven stories Gary cited above -- they start out with forced organ donation as a non-wasteful means of execution for death penalty crimes, and end up with the death penalty covering every offense down to parking tickets.
You write about this as if it's a hypothetical. It's not. People in India do sell kidneys. And according to a study published in the Journal of the American Medical Association, (1) they do it to get out debt (2) they fail to get out of debt and are economically worse off afterwards than before and (3) their health declines.
Economic and Health Consequences of Selling a Kidney in India, Madhav Goyal, MD, MPH; Ravindra L. Mehta, MBBS, MD; Lawrence J. Schneiderman, MD; Ashwini R. Sehgal, MD; JAMA. 2002;288:1589-1593. Abstract at http://jama.ama-assn.org/cgi/content/abstract/288/13/1589
there is a notion (unjustified in my view, but it obviously is there), that there is a bond between parent and child which we value even if the parent did not raise the child--for example, children who are adopted often feel a need to find their birth parents.
Arg. What do you mean, "mere genetics"? And "unjustified"? It's not at all unjustified to wonder about one's biological parents, or biological offspring--it's the most fundamental bond living things *have*. It would be insane, probably literally, to be indifferent to it. And if your sense of the emotional attachment between mothers and children is entirely based on carrying and giving birth, then what's the case for fathers? Or the case against abortion? Or is the caes against abortion predicated on a belief that women *are* completely indifferent to anything except an actual living baby, and that this makes them unreliable, morally? But then your position vis-a-vis egg donation seems to be that people *shouldn't* feel any connection to the child that results from it, so why is there a moral problem with not feeling anything about a fetus?
It seems to me that there's this underlying assumption you're making that if something is a *feeling* its illogical. But the mind/body thing isn't, in fact, a dichotomy. Responsibility towards children generally and one's own children specifically is about as important, and logical, a feeling as we could possibly have, I should think.
91: "Sure, we might also feel a connection to brothers, sisters, aunts, uncles etc., who we have never met, but isn't that about their role in the family we do know rather than the mere fact that you share genetic material?
Maybe I'm just weird, but I do not see it"
I think you're not seeing it. Interest in your genetic children/parents/siblings absent any other connection is pretty understandable to me. Consider the number of adopted children who want to seek out their genetic parents, and the certain number of mothers who gave up children to adoption who similarly wind up seeking or being open to finding their genetic child.
Hi ogged.
Hi Gary.
Nice to see guys around here. Hope everything is going all right with your respective health situations (I almost wrote "healths").
Rest of the thread: so far the empirical evidence on blood donation versus payment is, afaik, that you get at least as much blood and of a much higher quality when you disallow payments. I can't find a good link for this, I read about it (and the economics debate about which would be better) somewhere in the Dukeminier and Krier property casebook.
Also, whoo! Facts! But again I'll revert to my prostitution analogy--is it *inevitable* that organ selling will turn out this way, or might it be run in a way that could have better results for the seller? That said, however, I'll then revert to my feminist philosophy, which is that what actually happens is more important than what might happen in theory, and say "hm, that's a really good argument against organ selling. Now what's to be done about the organ selling that's already happening?"
Anyway, if empirical evidence suggests that compensation donation makes donors' lives worse, I obviously wouldn't support it. That it works that way in India is an important piece of evidence, though not the end of the story. I just really disagree with the notion of valuing a kind of squeamishness over what kind of relationship the rich should have with the poor over the poor people's actual well-being. I might do a post about this.
I've finished my little research project on the Anatomical Gift Act. As of the first of this year my state, Illinois, has gone over to a first-person consent system. Those miniature witness lines on my driver's license are now obsolete. I'll be able to donate by registering online, and I'll probably sign my dl just for good measure. Under the old system, apparently, next-of-kin were often pestered to approve at the worst possible time. My n/o/k will be informed but not consulted.
Since we're not open casketeers anyway, I don't expect any problems. I'll do it today. Even if my bike is hit and I'm sent sailing, I've always got my wallet with me on the bike. The life I save might be Ogg's!
I just really disagree with the notion of valuing a kind of squeamishness over what kind of relationship the rich should have with the poor over the poor people's actual well-being. I might do a post about this.
It's funny, I'm generally as right-brained logical as they get, but on moral issues I think you ignore squeamishness at your own risk. I believe that moral intuition tends to incorporate subliminal knowlege about how things work out in practice that is very easy to overlook when we simplify situations to their 'essential' elements.
Also, whoo! Facts! But again I'll revert to my prostitution analogy--is it *inevitable* that organ selling will turn out this way, or might it be run in a way that could have better results for the seller?
I think the prostitution analogy is apt. One might want prostitution were legalized, and then regulated and, say, unionized so that women could enter into the industry with a large degree of autonomy. The exchanges in the market (between the prostitute and her employer, between her and her client) were on relatively equitable footing.
Similarly, if you could insure that those selling kidneys were guaranteed health care and a fair income afterwards, there'd be less objection to it.
But this is reality -- a world in which we could guarantee those things would be a world were people wouldn't HAVE to sell their friggin' kidneys to get out of debt.
For IDP's poll: I've always checked off the organ donor box on my driver's license. Or, rather, put the pink sticker on the license and carried the signed consent form behind it. Pretty much everyone in my immediate family has done the same, and my father has specifically indicated that he'd like his body to go to Science, if possible. We don't really do funerals.
108: Well, women *and* men. But yeah, more and more I suspect that the real reason prostitution is such a shitty thing, ultimately, isn't about lack of regulation but because of the idea that women, in the end, are basically the sex class.
LB, thanks for 107. I think that's an awesome articulation of the importance of moral *feeling.*
Seems I saw a documentary on prostitution being legal and autonomous in the Australian Outback. Mature woman kept house, received visitors as if she were a hair stylist or some other kind of home worker, all on the up-and-up.
Your feelings of squeamishness might be a useful guide, an indicator of a problem, but you really have to figure out what's causing it and figure out an overt justification for your problem. Because people feel squeamish for bullshit reasons, about things there's no reason to feel squeamish about. Lots of people feel squeamish about gay adoption. Another cause of squeamishness is just wanting to avoid contact with something gross or uncomfortable.
For IDP's poll, I have a sticker on my driver's license and my best friend is my health care proxy, and she knows I consent to be carved up as much as anyone likes.
And has anyone else noticed that NYS driver's licenses are glossy to the point that ballpoint smears right off? I had checked the little box and signed it, but when I looked at it (whichI hadn't for years) there was the merest smudge left. So I just re-signed.
The class/exploitation objections people are voicing here seem to be focused on markets in live kidney donations. What about markets (of some sort or another) in cadaver organs? Still likely to appeal disproportionately to the underclass, but concerns about poverty compelling people to risk their health by ripping out a kidney wouldn't be a factor. Would the possibility that poverty might compel some to put aside their notions about proper treatment of a corpse be as objectionable/exploitative?
(There might be a concern that payment to survivors would provide a perverse incentive to die/let an ailing relative die, but structuring the payment to, e.g., cover funeral expenses would avoid that possibility. Pennsylvania was planning something like that in the late '90s, but I can't find any info on whether they went ahead with the plan, and, if so, what effect it had.)
Your feelings of squeamishness might be a useful guide, an indicator of a problem, but you really have to figure out what's causing it and figure out an overt justification for your problem.
That strikes me as wrong. I don't know that we ever definitively settle why we're creeped out by things like Derbyshire talking about 15 year-olds. At most we convince a sizeable number of people and then enforce our will.
Moreover, part of the problem is going to be determining in what sort of society the poor are so disadvantaged that part farming is OK. Then there are the associated problems. For example, are really poor people going to increase the number of kids they have specifically to guarantee income down the line?
Also, watch out for this. The first-person consent is now permissible because my state has adopted the revised Uniform Act. But the registry under the old act will not automatically roll over into the new; you'll have to re-register now. Your Sec'y of State probably has a web page about it.
Well, women *and* men.
Fair enough. I tended bar a place that was swimming in male prostitutes, so I should know better!
It's a hard argument for me, as an economist, to make to folks who I think have more of a sociology-type background, but I think it's really problematic to let people treat certain things as "assets" to buy and sell because of the social environment such selling would occur in. Everyone buys and sells cars, homes, old records, etc. Only the most desparate amongst generally sell our bodies (sexually), our organs or our children. That, I think, *should* make us squeamish.
105: I just really disagree with the notion of valuing a kind of squeamishness over what kind of relationship the rich should have with the poor over the poor people's actual well-being.
Maybe this is just more squeamishness, but I have a hard time squaring "poor people should donate organs for money!" with concern for the well-being of the poor. I don't see how it's possible to structure a "money-for-poor-people's-kidneys" program that isn't susceptible to massive exploitation and abuse.
I think we can generally agree that it would take significant financial straits before any of us would be willing to undergo a potentially life-threatening surgery, just for the money. Given that, I think our squeamishness is on to something. If our actual goal is to get the poor out of poverty, why not just give them some money? Or a good paying job? Or the health insurance? Why dangle those things at the end of a scalpel?
Would the possibility that poverty might compel some to put aside their notions about proper treatment of a corpse be as objectionable/exploitative?
To me, not at all. I have no problem whatsoever with payment for cadaver organs. (Well, not true. I have a problem with a survivor who has an objection to donating cadaver organs that can be overcome by payment -- I think they're awful. But I don't see any ill effects from catering to awful people in this regard.)
Tia: Your feelings of squeamishness might be a useful guide, an indicator of a problem, but you really have to figure out what's causing it and figure out an overt justification for your problem.
SCMT: That strikes me as wrong. I don't know that we ever definitively settle why we're creeped out by things like Derbyshire talking about 15 year-olds. At most we convince a sizeable number of people and then enforce our will.
I can say why I'm creeped out by Derbyshire talking about 15-year-olds. At length if need be. How do you "convince a sizable number of people" if you're not going to work on consensus forming? Is consensus forming saying "that just doesn't sit right" and someone else saying "I think so too"? I think you (ideally) form consensus by reasoning out your opinion, articulating the values you think the society should share, and figuring out empirically what actions lead to best outcomes ("best" according to your values).
How the hell does one make those hyperlinks anyway?
Becker makes one point w/r/t the poor as organ growers effect that I haven't seen in these comments, but is interesting:
Although this is not an exact analogy, predictions that a voluntary army would be filled mainly with poor persons have turned out to be wrong. Many of the poor do not have the education and other qualifications to be acceptable to the armed forces. In the same way, many poor persons in the US would have organs that would not be acceptable in a market system because of organ damage due to drug use or various diseases.
But that aside, the slums-as-the-fields-where-organs-do-grow argument seems misplaced. In our system, the rich can afford better health-care period. Health and wealth are already related. The rich will be able to purchase organs where the poor will often not, much as the rich are able currently to purchase a variety of health-enhancing products that the poor are not. In other words, I don't see how allowing organ purchases adds to the inequality problem, which is caused by the structure of the health-care system and not by the availability to purchase a particular product.
I think you (ideally) form consensus by reasoning out your opinion, articulating the values you think the society should share, and figuring out empirically what actions lead to best outcomes ("best" according to your values).
Right. But ultimately, your values are going to sit on a set of moral intuitions that aren't much more than "that creeps me out." Or so I believe.
The rich will be able to purchase organs where the poor will often not, much as the rich are able currently to purchase a variety of health-enhancing products that the poor are not.
Yeah, but, for us, that's a bug not a feature. See #1.
SCMT, there are plenty of people who hold to values that, in general, match their moral intuitions, but that violate those intuitions in certain circumstances, and often those people are willing to ignore those intuitions for the sake of their explicit values. There are probably many more people who directly rely on their intuitions, however.
This is refuted by your use of <em> and </em> and < and > in the same post. Generally the best way of reproducing some bit of HTML is to find an instance of it and "view source" -- this is generally an option on your browser's "view" or "file" menu -- and copy the source.
Maybe this is just more squeamishness, but I have a hard time squaring "poor people should donate organs for money!" with concern for the well-being of the poor. I don't see how it's possible to structure a "money-for-poor-people's-kidneys" program that isn't susceptible to massive exploitation and abuse.
That's a totally legitimate argument. If there's no way the program could work in the real world without descending into something that would just create incentives to damage your health and for no real benefit, then it's obviously a bad idea. But that's different from elevating a principle against commodifying a body part
The line about what kind of thing it's okay to pay for is also far from clear, and that's part of what I was going to talk about in my post, but I guess I'll just say it in comments here. There was a Daily Show segment a few years ago about a student-run dorm room cleaning service at Harvard, and a lot of students wanted it eliminated because it created class differences among the students. I thought this was the height of absurdity, since the class differences obviously existed, and it was good for the students running the service to have the income. Relatedly, Barbara Ehrenreich won't have anyone clean her house because she doesn't want to have that kind of relationship with another person. Obviously, B.E. has lots of anti-poverty cred, but I think that's kind of silly? What kind of relationship with another person? The kind where people have less money than she does, and for want of money they do something they'd rather not that she benefits from? The kind of relationship all of us have with millions of people in the world? I think this attitude is confused.
I think we can generally agree that it would take significant financial straits before any of us would be willing to undergo a potentially life-threatening surgery, just for the money. Given that, I think our squeamishness is on to something. If our actual goal is to get the poor out of poverty, why not just give them some money? Or a good paying job? Or the health insurance? Why dangle those things at the end of a scalpel?
No one thinks that the primary goal of organ donation compensation is to end poverty, or that it should be allowed to the exclusion of other anti-poverty measures. I think that given the premise that generous compensation would have better outcomes for the donor than keeping their kidney, a sense of the proper relationship among the classes should not inhibit allowing the donor to be compensated. It's totally possible that premise is false, though.
I think Becker's point is a bit misleading -- you don't need organ sellers to come from the waaay bottom of the income/class distribution for the inequality to be troubling. No, I don't think we'd end up in a situation where homeless heroin addicts are selling kidneys. But there are enough families who are working class low imcome families facing desperate enough situations who would be viable organ sellers. So yes, the very poorest amongst us may not, but for sure no one above a certain income level is going to be selling their organs.
Similarly with the volunteer army issue. The army is solidly lower-middle class. And there are few very poor people in the army for the reasons Becker cites. But there are also very very few rich people in the army. And furthermore, the army's middle class status frankly is buoyed by the fact that until the Iraq war, the military has been able to be relatively selective in who it takes. We're seeing evidence that recruiters are becoming much less selective lately -- something that will surely bring down the median income stats of those enlisted.
I understand that it's a bug and not a feature SCMT, but my point is that allowing organ sales doesn't make the structural problem any worse. The same type of unfairness exists when we allow organ sales, but fewer people will die if we allow organ sales. Ideally, we would reform the health-care system so that health does not depend on wealth, but since that solution isn't possible at the moment, we should opt for second-best solutions that still result in an improvement over the status quo.
Ah hah, thank you LB. My knowledge of HTML has just doubled! :)
Handy HTML tags. Collect the set! (I only know two handfuls, myself, but I consult as needed when not in a hurry.)
To link to something, aside from following above instructions, but if you want to find in future, scroll ">here to "link something."
Don't leave your online keyboard without it. (Someday I may figure out divisions and tables, and then CSS, but I've gotten by for about 11 years online without it.)
I'm wary of squeamishness as a touchstone; I'm reminded of Leon Kass and his "wisdom of repugnance." It's not always the angels who have icky feelings about things.
I agree with you. But I don't think that Becker's point is entirely irrelevant. There still might be some inequality with respect to class representation in the military, but because those in the most desperate financial situations are not overrepresented, we can say that there may not be any troublingly coercive effect deriving from the combination of a capitalist system and a volunteer military. Ditto w/r/t organ sales. If there is no coercive effect in giving persons the option to sell their organs, then it makes more sense to think of their decision to sell as rational and considered, and in their interests, than as an irrational decision coerced by an institutionalized desperation. And if that is the case, then we're not doing ANYONE any favors by denying an option to sell organs.
133: Yeah, this might be one of those principle vs practice things. I'm not certain whether my revulsion to the idea of organ sales is rooted in principle or in certainty that it would fail to be beneficial. Since that's not an exclusive or, I'm content to argue against it on practical grounds.
Take supply-side economics. Or neoconservatism. I'm not an economist or international relationsist, so I can't tell you why it's a bad idea in principle, but I can tell you why it's a bad idea in practice.
I'll leave the decision as to whether compensating organ donors is, in principle, good or bad to the philosophers here.
135: The same type of unfairness exists when we allow organ sales, but fewer people will die if we allow organ sales. Ideally, we would reform the health-care system so that health does not depend on wealth, but since that solution isn't possible at the moment, we should opt for second-best solutions that still result in an improvement over the status quo.
I think there are at least two unsupported and tendencious claims in there.
Handy HTML tags. Collect the set! (I only know two handfuls, myself, but I consult as needed when not in a hurry.)
To link to something, aside from following above instructions, but if you want to find in future, scroll ">here to "link something."
Don't leave your online keyboard without it. (Someday I may figure out divisions and tables, and then CSS, but I've gotten by for about 11 years online without it.)
Tia:The kind where people have less money than she does, and for want of money they do something they'd rather not that she benefits from? The kind of relationship all of us have with millions of people in the world? I think this attitude is confused.
I think you're right, this kind of attitude can border on the absurd and/or patronizing. A lot of us have a certain squeamishness about people hiring nannies or housekeepers who are lower income immigrants (legal or not). But it's not that we object to the exchange in theory. If you're poor, you have your labor, if you're rich you've got some money -- exchanging one for the other is fair enough. As long as the employee has reasonable autonomy (ie, to quit, to object bad working conditions, etc.). *But* even you must see there's a difference between these kinds of exchanges, and things like working in the sex trades. Some exchanges because of the society we live in, are simply going to be grossly inequitable. I think we're arguing that an organ trade would be something more like that. That there's a difference between selling your kidney, and selling your labor.
I thought this was the height of absurdity, since the class differences obviously existed, and it was good for the students running the service to have the income.
Except that we don't care about class differences except that they're made manifest. It seems reasonable to me, for example, to believe that if your co-worker was also your maid, you might not treat them as equals. Would that be wrong of you? Yeah, but also pretty typical.
This thread is making me very sympathetic to the idea that there are better ways to combat organ shortage that don't have problems with market perversities. If we fully explore and even implement some of these, and the problem remains, a market solution might be the next best thing.
"Barbara Ehrenreich won't have anyone clean her house because she doesn't want to have that kind of relationship with another person. Obviously, B.E. has lots of anti-poverty cred, but I think that's kind of silly?"
Perhaps silly, but I can certainly understand how one would want to avoid seeing oneself as upper-class, and domestic help is usually associated with the upper and upper middle class.
Feh. That comment (143) appeared a second time not because I hit "post" again, but because since I got the familiar "misconfigured" page, I just hit F5 to reload the page. I won't do that again.
Handy HTML tags. Collect the set! (I only know two handfuls, myself, but I consult as needed when not in a hurry.)
To link to something, aside from following above instructions, but if you want to find in future, scroll ">here to "link something."
Don't leave your online keyboard without it. (Someday I may figure out divisions and tables, and then CSS, but I've gotten by for about 11 years online without it.)
Right. There is a practical difference between things that a reasonable number of people do, even in the absence of desperation, because they seem to be in their own best interest (such as cleaning houses -- if I were out of work, I'd clean for money. You'd have to be an idiot to hire me, but I'd do it if I couldn't find anything higher paying) and things that, as a matter of practice, it seems that people just don't do unless really desperate or fucked up somehow (prostitution, paid organ donation). I really want to treat those two categories differently -- not as if they were on the same continuum of slightly less desirable money-making opportunities.
That is so appalling I do not even know where to begin.
How so? Idiosyncratic maybe -- appalling? What is the problem, that she is violating noblesse oblige? Should she have to hire somebody to clean her house? This seems to me like a perfectly acceptable area to allow her freedom of choice.
Andrew: then it makes more sense to think of their decision to sell as rational and considered, and in their interests, than as an irrational decision coerced by an institutionalized desperation.
In theory, I'd agree, giving the poor property rights to make rational decisions sell their "assets" should be a thing to be encouraged and far be it from me to impose some ill-defined moral stance on them. *But* I think the study from India cited above (at 100 I think) is illustrated. In the abstract the authors claimed that most of those who sold their kidneys did so under the duress of debt, and in retrospect would not have done it, or advise people the know to do it. That does NOT sound like a rational, non-coerced decision to me.
I don't know about appalling, but definitely weird. Choosing not to hire a cleaning person? Totally reasonable. Seeing something fundamentally wrong with the relationship between employer and employee? A bit off.
The housecleaner thing is interesting, because I kind of sympathize with it emotionally. On the other hand, I pay someone to stay in my house and mind my children for me, and that doesn't bother me. But it doesn't bother me largely because the interpersonal dynamics work out well -- Nancy is very professional, and relates to us like co-workers, and Buck works at home and has become good friends with her.
But I could completely see having a nanny-relationship that would creep me out or make me feel guilty.
There is a humanitarian crisis in Somalia; no food, warlords, etc. Life expectations are less than three years from however old one is now. I am Berb, and I like really young girls. I go to Somalia and say to a very young girl, "I'll pay you a lot of money and take you out of here if you'll act as my sex toy for five years. I can guarantee that you'll have an longer expected lifetime, even if you exclude the five years you'll be working for me." It looks like there's at least a colorable argument that the young girl is better off, but I really don't want Berb to be able to make that offer.
Carl at 151: *But* I think the study from India cited above (at 100 I think) is illustrated. In the abstract the authors claimed that most of those who sold their kidneys did so under the duress of debt, and in retrospect would not have done it, or advise people the know to do it. That does NOT sound like a rational, non-coerced decision to me.
I agree. OTOH, the US is not India, and India---outsourcing hysteria aside---is not yet the US. Since the very poor here are apparently not coerced into joining the military, perhaps there's good reason to suppose that they also wouldn't be coerced into donating a kidney.
How so? Idiosyncratic maybe -- appalling? What is the problem, that she is violating noblesse oblige? Should she have to hire somebody to clean her house? This seems to me like a perfectly acceptable area to allow her freedom of choice.
I am in no way questioning her right to choose not to hire someone to clean her house, whether because she does not want to spend the money or because it makes her feel more self-reliant, and not part of the pampered class.
What is highly obnoxious is the notion that there is something unseemly about having to sell your labor by cleaning houses. Does she think that whatever she does makes her morally superior in some way to a person who cleans toilets or cooks french fries or digs ditches. Is it embarassing to her to participate in a direct manner in the employment of a person who does meanial tasks like clean houses? Is being poor or having to work with your hands something demeaning which a good person should be embarassed to witness? I mean, wtf?
I agree. OTOH, the US is not India, and India---outsourcing hysteria aside---is not yet the US. Since the very poor here are apparently not coerced into joining the military, perhaps there's good reason to suppose that they also wouldn't be coerced into donating a kidney.
Why in Gawd's name would you limit it? There are already people who fly to outside countries for various healthcare work; why wouldn't people fly to India to get cheaper kidney work? It would make it more affordable to the American middle-class.
Does she think that whatever she does makes her morally superior in some way to a person who cleans toilets or cooks french fries or digs ditches.
I think you're misreading where her concern lies. She doesn't want home labor, I assume, because she believes she'll change, and not for the better, if she does.
I think often the problem some of us feel about the housekeeper issue is not the class differences -- clearly the person hiring the housekeeper/nanny is going to be higher up the class/income ladder than the employee. And I think if the housekeeping/nanny trade had a more, ehm, ethnically diverse make-up, I don't think I'd feel there's anything off about the situation. But I think that the idea that a large number of domestic workers (in a lot of areas) are minorities/immigrants with limited english and cultural capital, makes us feel that the employer-employee relationship may not be as on-the-level as one where the housekeeper is a native. Not just from a legal standpoint, e.g. scrub the windows or I'll call immigration, but also, I think, the cultural difference is more likely to make the employers have that "oh, it's 'the Help'", attitude.
Again, I don't have a major issue with this -- I wouldn't condemn anyone else for hiring domestic help unless they were assholes otherwise. But it is the source of my personal discomfort.
160 -- Have you read any Ehrenreich? Her body of work speaks very strongly against her feeling herself morally superior to a person who cleans toilets or cooks french fries or digs dishes, or being embarrassed to witness being poor or having to work with your hands. Very strongly.
What is highly obnoxious is the notion that there is something unseemly about having to sell your labor by cleaning houses. Does she think that whatever she does makes her morally superior in some way to a person who cleans toilets or cooks french fries or digs ditches. Is it embarassing to her to participate in a direct manner in the employment of a person who does meanial tasks like clean houses? Is being poor or having to work with your hands something demeaning which a good person should be embarassed to witness? I mean, wtf?
What would trouble me is the prospect of being treated as a social superior by a housecleaner. Again, the reason I don't have a problem with hiring a nanny is because she considers herself my social equal -- we both work for a living outside the home. I see nanny-boss relationships that fall much more into a social master-servant category, and I find that unseemly and unpleasant -- if I couldn't hire a nanny without having that sort of relationship, I would do a lot to avoid it.
161: As far as I know, Americans can already fly to India to purchase kidneys and have them transplanted there. Maybe we're talking past each other though. My point is that the situation for organ-sellers in America and for organ-sellers in India might be materially different w/r/t the question of coercion. So far as the purchasers of organs are concerned, I agree that there might be very little difference between the two countries.
My wife and I pay someone to clean our house twice a month. We had some initial moral discomfort, but we got over that by paying her generously and treating her like a person.
she believes she'll change, and not for the better, if she does.
How? Why? Has she never gone out to eat? Paid a mechanic to change the oil in her car? Paid an accountant to do her taxes? She likely is all the time paying someone to do things for her which whe could do for herself.
163: Belle Waring had an interesting series of posts on a similar issue. I've never lived in Singapore, where BW lives, but in Hong Kong, the middle and upper classes *all* have maids, nearly all of whom are Filipina. The economy of the region (created in no small part by colonialism in which the U.S. participated) is such that if you are from the Philippines, leaving your home, family, and your own children, to take care of someone else's kids in another country, is your best option. It's fucked up, and I think it's perfectly sensible to have serious misgivings about participating in such a system.
Andrew:
Re. the difference b/w the US and India. I'd hope you're right. Part of me finds it hard to believe though -- perhaps I'm more cynical than the evidence justifies. And since there are so many better solutions to both poverty and organ shortages, I don't think it's worth the risk to find out which of us is right.
I think that selling a kidney is different from selling labor. I'm as much of a fascist liberal as anyone and I'm not sympathetic to the idea that poor people should have the freedom to choose to sell their kidney if it's not in their best interest. But I think their best interest should be the ruling consideration, not a principled avoidance of the commodification of body parts (that was the sentence I neglected to finish). And actually, I only agree with SCMT insofar as it has the same problem with creating incentives for exploitation, which maybe the organ thing does too, and that the thing he's talking about is actually probably more damaging than giving up a kidney. As an individual, there's some degree of horrible abuse I'd want to be able to trade for my life.
It would make me feel weird to hire such domestic help. In an ideal world, there would not be enough inequality for domestic work to be a worthwhile job (at pay below, say, 15.00 an hour). By hiring someone below that wage, you're taking advantage of that gross inequality, and I can see how that would make someone feel weird. Would Ehrenreich be opposed to paying someone 15.00/hr for her domestic work?
As far as I know, Americans can already fly to India to purchase kidneys and have them transplanted there.
I think that's illegal. I couldn't swear to it. My larger point is that if there is demand here, there will be supply in India (or China or wherever), and we have some evidence that the market in India creates bad outcomes.
How? Why? Has she never gone out to eat? Paid a mechanic to change the oil in her car? Paid an accountant to do her taxes? She likely is all the time paying someone to do things for her which whe could do for herself.
Again, none of those are conventionally master-servant relationships. It may be (all right, I'm sure that it is) possible to hire someone to clean your house in a way that doesn't fall into that social pattern, but it's not irrational to distinguish between housecleaning and auto mechanics on the basis of wanting to avoid the pattern.
My honey's apartment-mate has hired a cleaning lady who comes in twice a month to clean everywhere but my honey's room. She's a nice person, and she's clearly totally empowered in the labor-for-cash exchange, but even as a bystander, pretty much, I feel strange about it. I'm sleeping in on a lazy Sunday morning, and somebody is cleaning up Saturday's dishes in the kitchen. And it does create perverse incentives. The apartment-mate will say things like: "Oh, just leave that; the cleaning lady is coming tomorrow." I don't know that feeling weird about it is a moral impulse on my part, though.
My inept googling hasn't turned up any hits, but I recall reading somewhere about a theory that Americans preferred self checkout lines and such because they are very uncomfortable about class differences, particularly in the context of service relationships. There was an article in the NY Times a couple of weeks ago along similar lines involving wealth inequality between friends.
I understand Ehrenreich's aversion to hiring domestic help, and share it to some extent; I think part of the issue is that by hiring a full-time maid you become The Boss, which is an uncomfortable position for a lot of liberals. Hiring an occasional cleaning service or whatever just makes you a client, without the feeling of an asymmetrical employment relationship that causes discomfort. (I may not be accurately judging this; I'm also uncomfortable with the situations Ideal mentioned for similar reasons, so my explanation could well be off-base.)
you become The Boss, which is an uncomfortable position for a lot of liberals. Hiring an occasional cleaning service or whatever just makes you a client, without the feeling of an asymmetrical employment relationship that causes discomfort.
I understand (even though I do not share) the concern you voice. But this is a bit like eating meat, but trying to ignore that someone had to kill the animal. Your avoidance of being an employer means that instead of getting to work for you--someone who will be a kind and considerate boss and who will pay the best wage you can afford--someone has to go get a job cleaning grease traps at McDonalds for less money and have a total dick for a boss. And you eat at that McDonalds (or substitute work as a dishwasher as that cool restaurant the just got a great review in the Times--McDonalds probably treats its workers better than the people who wash the dishes in a lot of the places most of us eat).
So you are avoiding being a boss because you feel uncomfortable about it, but you sure are not making life any better off for the person who did not get a job because of your reservations. And you are still enjoying the results of their labor, it's just that you do not have to look in the kitchen.
I'm not trying to be a dick--the concerns voiced here about hiring people to work for you are I am sure motivated by the best of good will and intentions--but such motivations do not IMHO help the persons toward who you trying to show concern.
Finally, I will note that you may be overanalyzing the employer-employee relationship. Someone may be your domestic servant, and they may even act subservient (which is maybe what freaks out some people), but people who do shitty jobs are people just like you and me, and if it makes you feel any better, they know that it's just a job--maybe a shitty job--but likely the best they can get. Few people are actively happy about having a shitty job, but they peobably are not nearly as emotionally invested in working for you as you are about having them work for you. It's just a job. Money on the table. If a better one comes along, they will take it. If you are a nice boss, they will appreciate it. Just like you.
I used to feel a bit like Idealist--in part I read you as finding people inconsistent, Ideal--but now I think people have heuristics that we often don't realize. I don't have a problem with someone cleaning my place once every other week. I might have a problem with something more frequent. And my best guess as to the difference? The people I know with lots of help are generally dicks. I'm not crazy about the name Susan for roughly the same reason.
I just think there should be a distinction between the rich (or just relatively priveleged) people's feelings about their moral status with respect to the poor and poor people's actual interests. The former is only the rich people's concern, and is not that important relative to the latter. If Barbara Ehrenreich wants a clean house (and by her own telling her house is really messy and her children grew up to keep extra clean house and told her it was a reaction to her), but she won't hire a housekeeper because it feels uncomfortable to her, she hasn't helped anyone, and in fact, if she probably would have helped someone if she'd paid some housekeeper a good wage. Similarly, what's important in figuring out whether compensation for organ donation is what the actual outcomes would be for all parties, including everyone who might be affected by any perverse incentives it created, not rich or priveleged people's feelings about their moral status.
Similarly, what's important in figuring out whether compensation for organ donation is what the actual outcomes would be for all parties, including everyone who might be affected by any perverse incentives it created, not rich or priveleged people's feelings about their moral status.
If you invent the magical future-telling machine, I totally want to invest.
I certainly don't think you're being a dick, Ideal; I understand the issues you're raising and I've been pondering them all day. I think a lot of the problem is how personal it becomes when you're actively being The Boss--when you go to a restaurant or whatever you can just ignore it (although as I mentioned above going to restaurants bothers me in the same way), but when it's in your house and you have to decide what to pay the person etc. it hits home in a way you can't avoid. It doesn't really matter on an intuitive level if the person is just doing a job and would be doing a different one if you hadn't hired them, althought that is of course true.
Also, as Tim points out, another part of the problem is that people with servants tend to be unpleasant, and hiring servants makes you uncomfortably similar to them. This may be a more salient issue in practice.
186: Just that, as described, I think you would find very few people to disagree with you. The problem is that our ability to model anything complicated is terrible. People end up making decision based on their faith in the market, etc. And, as the people most likely to be effected are poor, we have relatively little reason to make sure things are working out as expected. The other option is to go with our moral intuitions until someone changes our mind. I feel, at least in some areas, that the latter method of decision is usually better.
Really, we should just make Kieran tell us the answer, as (per his link) he probably has a fair bit of insight into this.
189: I think people have disagreed with that position as stated in this thread. And I continue to think that "would be unlikely to work out as planned"; "there wouldn't be sufficient safeguards" etc. are better arguments than "we should just go with our moral intuitions." When people's moral intuitions are leading them not to pay someone to clean their house, it seems to me that people feel bad about somehow dirtying their hands as often as they do about injustice per se, and those feelings can be interesting guides and indicators, but are not a good way to organize society. No one knows for certain how anything is going to work out whenever you propose any kind of change to social policy. You just have to make arguments from evidence about the best likely outcome and reverse course if things aren't going well.
Do you guys remember that nanny-blogger story? The one where the boss became totally obsessed with the nanny's blog, fired the nanny for weirdly overwraught emotional reasons, and then wrote it all up for one of those ghastly NYT "Modern Love" columns?
I remember that the consensus that emerged from the blogs--okay, the opinion I thought most compelling--was basically that the woman didn't know how to interact with servants. Or, put more nicely: she didn't know how to maintain professional boundaries and forgot that it was structurally impossible to be coequal friends with someone in an economically subservient position.
I guess I found that explanation compelling because maintaining professional boundaries at home would be really difficult for me too. I can maintain all those boundaries and be hardnosed and openeyed in the outside world, but at home I tend to embrace naive illusions.
193: I was also thinking of that story in connection with this discussion. I think not knowing how to interact with servants is probably a common problem among people in her position. I certainly wouldn't have a clue.
No one knows for certain how anything is going to work out whenever you propose any kind of change to social policy.
Right. But sooner or later (in the best of all possible worlds) you're going to get to a model that says something like, "There is X chance of ill Y happening." In evaluating whether to go forward, you're going to have to try and evaluate how bad an ill Y (say, body farms) is, and your evaluation of Y is going to be based, I think, on your moral intuitions. You can, of course, model Y, but then you'll just have Z to decide on.
You just have to make arguments from evidence about the best likely outcome
I think I flip your argument. Discussions, models, and the offering of justifications are good and fine, but primarily because they flesh out the contours of the moral intuitions that are actually the deciding factors.
and reverse course if things aren't going well.
Yeah, I have no faith in our willingness to review programs and reverse course if it's primarily the poor getting fucked. Not because the non-poor are bad people; I just don't think we do it that often.
But really, Kieran's just being a dick. He should tell us the answer.
What about selling embryos? I happen to have a couple kids that, from a market standpoint, are pure Aryan goodness. Seriously. What if there was an offer to my wife and I for 50K? 100K? I can't say I wouldn't be tempted to sell an embryo.
Whenever I see a picture of someone I "know" from the internets I realize I don't actually have an imaginary picture of them in my head. You are all just floaty electronic text to me.
Very nice, albeit disembodied, floaty electronic text, that is.
192, 196: You're both (half-)right! It's the magic of reflective equilibrium. Which is the iterative process of going back and forth between broad moral principles and concrete moral reactions to specific situations, trying to alter, or even unconsciously altering whichever one needs to be, just a little bit, each time. I accept feedback from the professionals and really anyone else who has an idea about what I might be getting wrong.
Davies' post about his picture. I was also surprised.
Ok, I have to get caught up (good god, people. The comments go down so I go out to dinner and I come back and now I have *homework*). But a couple things from a ways back:
1. are really poor people going to increase the number of kids they have specifically to guarantee income down the line? Well, historically poor people have increased the number of kids to guarantee income, yes--for farm labor, for support in old age, whatever.
2. predictions that a voluntary army would be filled mainly with poor persons have turned out to be wrong. They have? The officer class isn't primarily poor folks--although given that ROTC scholarships can pay for a college education, I'd be surprised if the bulk of the officer class weren't primarily from the middle and lower-middle class, rather than the children of doctors and lawyers. But aren't the enlisted folks, in fact, pretty much largely from blue-collar backgrounds? Not truly destitute, perhaps, but pretty poor. And aren't there also, in fact, a much higher proportion of immigrants and Indians in the military than in the population as a whole, precisely because it's a route to benefits and security (including citizenship) that's not available in other ways?
Finally, does anyone want to opine on whether the following is an ok time, place, and manner restriction? I only pretend to know some con law.
The following:
The regulations of the Port Authority of New York & New Jersey for this location prohibit:
distribution of printed material within 25 feet of the viewing fence and in prohibited areas
...
Coordinated continuous expressive activity as part of a group of 25 or more persons in the absence of a permit by the Port Authority of New York & New Jersey
210: I think in context "poor" was taken to mean truly destitute (homeless people and such), and it is therefore true that the military doesn't have too many of those types (requiring a HS diploma does a lot of this). I believe the military was actually found to skew rural, and probably Southern too. I'm sure the Hispanic (not just immigrant) and Indian percentages are way out of proportion as well.
I don't know squat about con law, but I do know that I loathe the democratically unaccountable, corrupt, and authoritarian institution that is the Port Authority.
I would guess that the first person to make a good faith guess (or someone might just know and not have toguess) as to where that sign appears will be correct in their guess.
I do think it's kind of obnoxious to object to Barbara Ehrenreich's refusal to hire a nanny, if one knows what her objection is; otherwise, of course, it's simply ignorance. The problem, from her point of view--and it is a very good one--is summed up by Jackmormon in 179 and 193. Basically, the equation Idealist is making between hiring someone to change the oil in your car and hiring someone to clean your home is a false equation: one form of labor is done outside your home, in the "public sphere" of the work place, and in part because of this the worker is both protected by labor laws and on a more or less equal footing with the customer--"we reserve the right to refuse service." On the other hand, domestic labor happens in the home: domestic laborers are *far* more subject to exploitation and dealing with "employers" who don't know the first thing about employment law than workers in most other fields. Domestic workers also have no control over their workplace environment whatsoever, nor is their workplace environment subject to any kind of legislation or oversight. They don't get fifteen-minute breaks. Because we think of the domestic space as "private," we think of the relationships between individuals and "their" nannies/housekeepers as private arrangements, which makes them ripe for exploitation and confusing the professional and the personal. Hence the cliche that "our nanny/housekeeper is just like one of the family."
It's a similar problem to the problem of women's domestic labor, which is largely unpaid, invisible, and devalued.
So I don't think Ehrenreich's position is because she's worried about her *own* moral agency, or because she thinks of herself as better than nannies, or because she's uncomfortable with being "the boss." It's because she thinks of herself as *not* being better than nannies, and she sees the domestic workplace--rightly, I think--as one that's inherently exploitative.
I say this as someone who has, in fact, hired nannies and housekeepers. Like the other folks in the thread who've done that, I got myself past feeling weird about it by paying well, giving them paid vacations and raises, blah blah blah. But the point is, that was something I *chose* to do--I could just as easily have chosen not to. It wasn't something the workers were in a position to negotiate or expect.
It's because she thinks of herself as *not* being better than nannies, and she sees the domestic workplace--rightly, I think--as one that's inherently exploitative.
I would guess that Idealist's objection--certainly mine--is that the solution is not to be a dick to whomever works in your home. But money is better than no money, and an offer from a non-exploitive house is better than one from an exploitive house. All she has done is remove a relatively good job from the list of potential jobs available to domestic workers. So I was totally wrong; that sounds exactly like what Tia objected to in other places.
219: Well, no, that isn't the solution. Because the problem isn't a private one, hence it isn't solvable by your own personal private non-dickishness.
"All she has done" is to make a career out of analyzing these things and promoting better labor conditions and farier labor law. It seems to me that passing judgment on her for not giving one housecleaner a "good" job is extremely silly. Excuse the hyperbole, but isn't it a bit like criticizing an abolitionist for refusing to own slaves, thereby providing "good" servitude to a few?
Well, there imight be a best of both worlds solution: don't hire someone and give the same amount of money, or almost as much, to a charitable organization that targets people who match the one's you would have hired. Possibly even one that gives out weekly sums around the amount of a paycheck.
I'm not suggesting that this feasible for the vast majority of people.
I did not read that it was a nanny B.E. refused, first of all, but a house cleaner. Second of all, if domestic workers aren't protected by labor laws, then they should be, but that is not an inherent feature of domestic employment, and it is not for that reason any more inherently exploitative than any other. Third, workers in the house can leave the house--that's the equivalent of refusing service. It's more problematic if they're living there, but that's not what B.E. was objecting to, since she wouldn't have a cleaning service come to her home. Is anyone who travels outside a confined workspace automatically exploited? The cable guy? social workers?
Fourth, if B.E. is the boss, she's in a position to make her home a good working environment, and not to exploit her employees.
A servant's job, or a service job, is completely different from a craft job where one works with one's hands. I think it is demeaning. It is demeaning to have to be friendly and smiling and accommodating to people who are rude and abusive. And if you need your job, and you're a waiter/maid/caddy/chauffeur, that's what you have to do.
You may be a nice person, but if you invite a friend over and he's rude to the maid, does the maid feel she has the right to slap him? She has to depend on you to stand up for her, which you probably won't do, and which in any case emphasizes her powerlessness.
Don't get me wrong, I don't think people who have to do these jobs are somehow made less by them, but the potential for abuse is there, and everyone involved in the relationship is aware of it on some level, all the time. If I had to choose between two low-paid difficult jobs, and one was on the assembly line and the other was being a maid or waitress, I'd pick the factory every time, and so would (so did) everyone else. That's where the native-born servant class went.
I understand completely why Ehrenreich wouldn't want to enter into such a relationship.
221: We've seen this problem before, though. There was a story a few years back about a successful effort by NGOs to stop child labor in country X. The problem, of course, is that the families had less much needed cash, and the kids weren't any better off. The NGOs realized child labor might be the best available solution at the moment, and tried to make some changes in the conditions under which the children labored.
I'm not saying she's obliged to hire someone. I just won't subscribe to her justification unless she has a lot politicians in her back pocket and she's able to change the welfare laws.
The cable guy and social workers aren't employed by the people whose homes they work in. They're not domestic employees, even though they work, sometimes, in domestic spaces. It's a big difference.
In fact it is demeaning to have to be friendly and smiling and accommodating to people who can choose to be rude and abusive, even if they choose not to be.
225: Well, what she's working for isn't to make domestic labor illegal. Which is quite different from the stopping child labor thing.
I get that no one's saying she's obliged to hire someone, but it seems to me that people are looking askance on her refusal to, and arguing that somehow that decision is morally suspect (is denying someone a job, is demonstrating a sense of superiority on her part, or whatever). What I'm saying is there are very sound reasons for her to refuse to do so, and that these reasons are both moral and responsible. No one has to imitate them, but I don't see what we gain by objecting to them.
There is a difference in status between a skilled craftsperson you hire to do things you don't know how to do, and an unskilled person you hire to do things you don't want to do.
230: No, but a housecleaner who works for a service is paid worse than a housecleaner who doesn't, b/c the service has to charge market rates and then take a cut off the top. And of course if you're undocumented, working for a service might present documentation problems as well. OTOH, it's true that a service pays social security and unemployment, and will communicate to the employer certain regulations, and will serve as a buffer between employer and worker (I've experienced this myself--if you hire a service, you can't negotiate *how* a job gets done; the employees will do it in the way the service has trained them to. So if you want them to wax the floor on their knees, say, tough luck.) So in some ways a service is better--more protection--and in some ways it's worse--lower pay. In other words, the service thing doesn't fully excape the inherent problems of domestic labor--which is precisely the point.
Capitalism is just one big demeanfest. Seriously. The other week one of my bosses yelled at me for no good reason. I was working hard to compensate for his procrastination, and his procrastiation caused him another problem I didn't have control over, and he got mad at this third party, so he yelled at me, or rather, to me, since he wasn't directly criticizing me, and swore. It was really fucking obnoxious. In a personal interaction, I would told him where to shove it. Since it was my job, I thought it was best just to calm him down. Later, he apologized to me, because he's not really a dick. But if he hadn't, it would have been best for me to suck it up. There is no way to avoid the gross heirarchies capitalism creates, and I don't think having a housecleaner come to your house twice a week is a particularly gross one, except in that maybe they're not unionized.
228: I'm saying that her justification isn't that she thinks it would make her a bad person. Which is different from saying that the weak position domestic laborers are in is inherently degrading to their human dignity. I can go along with MCMC on this one, although I think that Ehrenreich's position (if I remember it accurately) is more about the structural and cultural inequalities of domestic labor, full stop, than it is about the shuck n jive problem. Heck, if domestic labor were seen as work in the proper sense, one wouldn't have to shuck n jive.
229: But wouldn't the domestic worker's assumed conviviality fall under the category of people-skills, and apply in any job where interpersonal communication is important? As a lawyer you might have to be polite to an obtuse judge who insists on falling asleep during testimony and inevitably wakes up crankily to an intrusive "objection!" or to a twice-divorced partner who counts his angry life in billable hours and demands that you do the same. As a soldier you might have to gel with other members of your unit even though you think some of them are unqualified assholes with the moral sensitivities of a dinosaur. As a factory owner you might have to smile and laugh with wholesalers and suppliers, even when you think that they're boorish fools with no appreciation for the tender aesthetics of mass-production. Ditto for doctors, psychologists, presidents, even professors if they have any kind of brain. So... is it really demeaning if a domestic worker must be politic with her customers as well? Domestic workers shouldn't get any special breaks, imho.
The real problem with domestic work is that there's no obvious career ladder to climb up. No small part of what you get paid with at good jobs is experience, which lets you bolt jerk employers. As regards exploitive jobs (or any employment terms), you should always trust the market and never your boss. That seems to be a difficult thing to do in domestic work or most retail work.
I still don't see any inherent problems with domestic labor. I see a problem with people who work in cleaning service being ununionized and underpaid, but there are still plenty of situations in which we'd all think it was fine to invite someone into our homes to do work. I know how to paint my room, which is currently lime green. I'll probably never get around to it unless I hire someone. What is the inherently exploitative aspect of that?
There is a difference in status between a skilled craftsperson you hire to do things you don't know how to do, and an unskilled person you hire to do things you don't want to do.
And I should say more explicitly: not an important one. I pay for lots of things that are only timesavers. I know how to cook my food, but I often don't feel like it. I drop my laundry off; I could do my own laundry. For that matter, there's nothing stopping me from learning to sew my own clothes. I'm using my money to buy time. Everyone does this. There is nothing sacrosanct about cleaning.
OTOH SCMT, reputational costs might be lower if you're an independent contractor in the domestic service industry and located in a high population area. You can bolt asshole customers who aren't worth the wages they pay, stay with bearable customers, and only reference customers who like you when asked/offering references.
But in other industries you can't be as choosy. You might be able to leave a jerk employer after a year or two, but the reputation you develop while in her employ will count.
And my experience has been that there's a not insignificant difference between paying somebody to deliver food to my door and padding around an apartment drinking coffee in sweatpants while the hired help very professionally cleans the place up.
I understand rationally that the difference is not an economically structural one. But in the second case, I'd say that the structure can get very personal, particularly for the employer; the employee tends to be very clear about who is paying the bills and what that means.
The apartment-mate who hired the cleaning-lady usually manages to be out before she arrives. He leaves her cash on the dining-room table. I find this combination offensive, partly because I've spent the night over there when my honey had to let the cleaning lady in, which then cut into our private mornngs together, and partly because the cash on the table seems so damned crass. If the cash is for her, direct it to her, maybe in a specifically addressed envelope!
I composed a comment just before the downage which started to answer the question already answered since, what is the difference between the mechanic and the housecleaner? We try to minimize the difference for the benefit of the housecleaner. This is what cleaning-up-for-the-cleaning-woman is about. First we do it so that her time is on the hard cleaning we don't usually get to, like washing floors. But just as important is the notion of depersonalizing the work, so that she cleans a house, not up after people. If I find my daughter has not cleaned up her personal messes, I'm pretty angry about it. She should not be exposed to our personal crap, drawers open, books strewn around, etc. We should do that. We wash and put away the dishes, find our shoes and put them in closets, etc. For us, that makes the night before her visit a major chore-performing occasion, so that we meet her halfway. I stay out of her way, unless she needs supplies or sometimes an equipment repair. My Russian and her Polish can communicate to some extent, mostly on words, never sentences. Close supervision is out of the question.
I understand rationally that the difference is not an economically structural one. But in the second case, I'd say that the structure can get very personal, particularly for the employer; the employee tends to be very clear about who is paying the bills and what that means.
I totally don't disagree with any of your comment, and in fact, this quoted bit is part of the point I'm trying to make. This is really an issue about the employer's feelings about his or her relationships and domestic space; it doesn't have to do with the employee's well-being. There are lots of things you can do to be a good employer within the home; there are lots of structural changes that need to be made so that domestic workers are protected; there is no reason it's inherently exploitative to have someone employed in a domestic space.
We try to minimize the difference for the benefit of the housecleaner
I doubt the housecleaner cares, except in that you might be making less work for her (I presume it's a she). I think to the extent that you are trying to minimize her contact with something personal, rather than making less work for her, you are doing it for your own benefit, not for hers.
259: I've done this job, when I was in school. You do care. The more personal the mess, the more repellent. and the more difficult to clean up, since you need to figure out where the person ordinarily puts the stuff.
So it's settled. We'll pay top dollar for the organs of domestic workers, because, hey, they're already denigrated. But only after they're unionized, and we promise not to make them clock in in a manner that may jeopordize their personal information. Sweet. I love Amuricka.
You're all on crack, you know that, right? There are tasks that are traditionally personal and private. Most of them are tasks done in the home (some, like cleaning hospital bedpans, aren't). To do those tasks for someone else, for pay, is demeaning, no matter how good the working conditions. It's difficult to articulate precisely what makes the selling of the private demeaning--I guess I'd say something about being unable to keep what's most your own for yourself--but I didn't think there was any serious question that it *is* demeaning. That's not dispositive for the question BE raises--we're generally willing to let people demean themselves for money, as long as we can distinguish it from exploitation--but there ought not be any mystery about why Ehrenreich doesn't feel comfortable hiring household help.
I think one of the standard concerns is that this will lead to rationing of healthcare by ability to pay, and that such a system will not long survive.
Posted by SomeCallMeTim | Link to this comment | 05-18-06 10:05 AM
Maybe I should have said, "Poverty decreases your life expectancy; kidney donation doesn't."
Posted by Tia | Link to this comment | 05-18-06 10:05 AM
1: Yeah -- a problem I can see is the possibility of well-off patients sucking up all the available organs, even those now available for free (that is, one assumes that many people who now donate organs for free would take money if it were offered).
What if an organ is a great match for a poor patient, and an okay match for a rich patient, and the rich patient buys it? I'm not categorically opposed to payments for organs, but I can see a lot of problems.
Posted by LizardBreath | Link to this comment | 05-18-06 10:10 AM
How about some kind of incentive/pool system, where the patient doesn't pay the donor *directly*, but donates to a pool that then pays donors? What would be really awesome is if the hospital, say, or the state, or whoever, rewarded donors with lifelong, irrevocable health insurance.
Posted by bitchphd | Link to this comment | 05-18-06 10:15 AM
I'm also pretty uncomfortable with selling eggs.
Posted by Jackmormon | Link to this comment | 05-18-06 10:29 AM
I am in favor of the cash payments. If we are lucky we will get lifelong, irrevocable health insurance like the rest of the civilized world soon enough.
Posted by Joe O | Link to this comment | 05-18-06 10:31 AM
I considered egg-selling at one point. I wouldn't have done it for 8,000, but I wondered if I could get one of the 25K deals they advertised in my college newspaper. I figured it was a way to do a program like the one I'm doing to get me into a PhD program without a lot of debt. But then I got a job that mostly pays for it.
Posted by Tia | Link to this comment | 05-18-06 10:33 AM
I'm also pretty uncomfortable with selling eggs.
How come, JM? I'm a little creeped out by it myself, but I couldn't say why.
Posted by SomeCallMeTim | Link to this comment | 05-18-06 10:34 AM
Me too. A while back, there was one of those really, really specific egg donation solicitation ads all over the place that was unambiguously looking for Dr. Oops (that is, they wanted a blue-eyed six-foot serious athlete with SAT scores above a cutoff point as an egg donor) and was offering 50k. She never even considered it, and I have to say that I wouldn't either -- who would want their kid to be raised by people that screwy? Once the kid isn't related to you, why not adopt someone who needs a home?
Posted by LizardBreath | Link to this comment | 05-18-06 10:35 AM
For people who object to egg donation, do you see sperm donation the same way? It seems that people draw a strong distinction between them, if only because I never see ads offering $20K for sperm donors.
Posted by Matt F | Link to this comment | 05-18-06 10:44 AM
9: Well, I think the egg donation thing means that the kid *will* be related by blood to the father, no?
Posted by bitchphd | Link to this comment | 05-18-06 10:44 AM
FSR I keep reading all these references to "egg selling" as "ego selling" and that has started me wondering what the world would be like if that were possible and accepted. Lots of formerly poor people living comfortable but self-less lives? The rich trading some of their wealth for a new way of looking at the world? Would you be able to keep your name and identifying characteristics if you sold your ego? What about government-issued id numbers? Those certainly seem to me to be attached to a body rather than a psyche but is that how it should be?
Posted by The Modesto Kid | Link to this comment | 05-18-06 10:48 AM
Well, sperm donation doesn't potentially risk your future fertility or health. Where I don't think we're really certain about what the long-term effects of massively boosting one's egg production is. Are.
Posted by bitchphd | Link to this comment | 05-18-06 10:51 AM
True, which does mean there's some point to it from the recipient's point of view beyond adopting. I'm still uncomfortable with egg and sperm donation though -- I wouldn't do either, except maybe for close family. If you're going to bring a child into the world, I think you're responsible for its well-being, and I have a hard time considering that responsibility fulfilled by handing it over to someone who you know nothing about beyond their capacity to pay.
This isn't a well thought out position, it's more poorly analyzed discomfort.
Posted by LizardBreath | Link to this comment | 05-18-06 10:51 AM
10 -- collection of sperm for donation is a substantially easier process than of ova.
Posted by The Modesto Kid | Link to this comment | 05-18-06 10:52 AM
My fascist liberal tendencies come out most strongly with organ donation. It's so vital to saving so many lives to have available organs, and the shortage is so acute, and voluntary measures so far have produced such inadequate results, that I'd like to see very strong consideration given to making the option on the back of your driver's license/ID (in most states that I'm aware of, at least) of opting-in to organ donation be switched to an opt-out.
I'm also well aware of the slippery slope arguments here (hey, I was a science fiction kid who read Larry Niven's "organlegging" stories when I was single-digit age, and don't want to go that far), but this is literally life and death for so many people, and so long as we emphasize that opt-out is a perfectly legitimate choice, I think the good to be done is worth the strongest consideration.
"Once the kid isn't related to you, why not adopt someone who needs a home?"
I tend to feel that way about people spending money (a fortune, by my standards, in many cases) on thoroughbred dogs, when there are a jillion mutts, or at least paperless dogs, being killed every year, and every day.
But, then, I did once spend the better part of a year working for Seattle Animal Control.
Posted by Gary Farber | Link to this comment | 05-18-06 10:53 AM
"It seems that people draw a strong distinction between them, if only because I never see ads offering $20K for sperm donors."
Setting aside the relative pain question (which should be more than a little obvious is a pretty effing large differential), there's the point of perfectly obvious supply and demand distinction.
It's a straight-forward case of classic market dynamics. But possibly you've not read anything on the topic.
Posted by Gary Farber | Link to this comment | 05-18-06 10:55 AM
This, absolutely. I think there's too much respect for people's squeamishness around organ donation, and opt-out and heavy education and publicity directed at the reasons for not opting out (they really won't kill you for your organs! You can have an open casket! You'll be saving lives! You were through with them anyway!) would both be a very good idea.
Posted by LizardBreath | Link to this comment | 05-18-06 10:56 AM
LB, children for the childless issues are near and dear to my heart, and I'm uncomfortable (in a poorly analyzed way) with your poorly analyzed discomfort -- feeling responsible as I do for the well-being of a child whom I had no part in bringing into the world.
Posted by The Modesto Kid | Link to this comment | 05-18-06 10:56 AM
It's a straight-forward case of classic market dynamics. But possibly you've not read anything on the topic.
Geez, Gary, lighten up.
Posted by LizardBreath | Link to this comment | 05-18-06 10:58 AM
Well, SCMTim, there are a number of things that make me unhappy about it.
Just to start with, we're one of the only Western countries to allow their sale. In Europe, egg-donors receive some compensation for their duress, but it is *illegal* to buy or sell eggs. That way, the people who donate eggs really want to, you know, donate eggs, whereas here, the people who "donate eggs" really want $10,000. I tend to see eggs as a little more human than sheer commodities (although, obviously, not human enough to merit Constitutional personhood).
The market here also strikes me as being somewhat exploitative. Every single college newspaper I've ever looked at has been crammed with ads solliciting egg donors, and the amount of money on offer varies wildly. Are there any governmental regulations on this? Any limit to how many times a single donor can donate? The hormonal treatments that donors undergo are not trivial--have there been any long-term studies on their effects?
Last, or at least last for now, I also think that the balance between the child's future need-to-know and the donor's desire for anonymity will shift dramatically in the future. The UN charter on the rights of children has language that suggests a children has a right to know his or her parents. The EU recently decided that a sperm donor was required to support "his" child, even though he and the lesbian couple he'd donated his sperm to had signed a pre-natal contract absolving him of financial responsibility. As research into genetics advances, people might have very good reasons to demand a right to know their parents' family histories. We'll see how this all shakes out in the future, but I strongly suspect that further down the road, egg donors are going to see those eggs coming back in the form of adult people with pointed questions. This last concern doesn't directly address the monetary exchange, but I do think that all of the money in the fertility business does obscure these questions, especially for the donors.
Posted by Jackmormon | Link to this comment | 05-18-06 10:59 AM
So who among us has a driver's license marked accordingly?
Mine has a miniature form you could fill out which refers to the Uniform Anatomical Gift Act, but also has a place for a Medical Information/Living Will Seal. ? I'll have to go look up the act to figure it out.
Posted by I don't pay | Link to this comment | 05-18-06 10:59 AM
17: This is true, I have read but little on the subject. I'm largely ignorant as to the specifics of the procedure.
Posted by Matt F | Link to this comment | 05-18-06 10:59 AM
Hey Gary, as long as you're on the thread: Do you know any good sf books exploring the idea of ego-selling?
Posted by The Modesto Kid | Link to this comment | 05-18-06 11:09 AM
What does 'ego-selling' mean?
Posted by LizardBreath | Link to this comment | 05-18-06 11:10 AM
LB -- see my 12.
Posted by The Modesto Kid | Link to this comment | 05-18-06 11:14 AM
Alex Tabarrok's Entrepreneurial Economics has some a good chapter on organ donation and incentives.
Posted by ptm | Link to this comment | 05-18-06 11:14 AM
I actually feel the same poorly analylzed discomfort LB does--and I'm aware that this includes some discomfort with adoption, at least where *my* kid or potential kid might be concerned. I know someone who put a baby up for open adoption and then later the adoptive parents fled the country to evade prosecution for tax fraud or somesuch. If it had been my baby, I would find that wrenching. And of course there are occasional stories of abusive adoptive parents.
Now, of course I know that the *vast* majority of adoptive parents are fabulous, loving parents. And I'm totally not anti-adoption (or sperm or egg donation). But I have to admit, I don't think I could do it. I could adopt someone else's child, but I think I'd have a very hard time placing one of my own.
Posted by bitchphd | Link to this comment | 05-18-06 11:30 AM
Years ago, a bioethics professor of mine--who also happened to be a complete moron--insisted that the main problem with payment for organ donation (given that inequity concerns could in fact largely be addressed with variations on the pooling suggestions made above) was that such a system would "cheapen the gift": that is, once payment for organs was on the table, it would make it more difficult for people to enjoy the opportunity to give selflessly, and thus diminish the world supply of genuine altruism.
This argument--and related ones, such as the notion that a "donated" organ is somehow more valuable than a "sold" organ--is raised with considerable frequency by opponents of donation incentives (the Institute of Medicine's objections mentioned in the op-ed are, I think, of this nature).
Mind-boggling, and, to me, nearly obscene: potential shortage of altruism was a bigger concern to this guy than actual shortage of life-saving organs for transplant. Opportunity to give selflessly more precious than opportunity to, um, stay alive. (To say nothing of the fallcy at the heart of it: allowing sale does not entail prohibiting donation.)
Posted by ettinauer | Link to this comment | 05-18-06 11:30 AM
I think there is much to LizardBreath's concern expressed in 3, but in principle, why shouldn't we figure out a way to allow people to sell their organs, particularly if it appears that it does them no harm? We allow boxers to box, even though it clearly is not good for them. I assume that many on this thread support decriminalization of one of more currently-ilegal drugs, even though they are demostrably bad for you, so why not this? Is it better to tell someone that they have to do without something that is vitally important to them or their family because we are squeemish about their choices regarding how to get the money to pay for what they want?
Further--and I want to try to state this as a musing only, I am not trying to call anyone out for being inconsistent--it is interesting the reaction some are having to the notion that selling an egg is in some way selling a child and there are concerns about having your child raised by someone else. In discussions of abortion, it seems to be the accepted wisdom that an egg is nothing--indeed, it is a point of strong disagreement whether or when a fertilized egg is ever a child. So it surprises me that one would consider an unfertilized egg something to be squeemish about. I mean I'm pro-life, but I realize that unfertilized eggs are discharged every month by almost all women of child-bearing age. Why are we squeemish about this?
Posted by Idealist | Link to this comment | 05-18-06 11:30 AM
I'm relatively uncomfortable with egg-selling, but since I don't have any to sell, I've refrained from forming any set opinion on it. From what I've seen though, it seems that those transactions occur between relatively wealthy couples and still relatively well-off younger women. The women selling the eggs may not be wealthy, but they are generally white and college educated, like in LB and Tia's cases above (though, of course I don't know their race, but I'd wager most of the couples in the egg-market are white). This makes sense, since generally, these couples want a baby with a high likelihood of turning out like them, in terms of race, intelligence, health, etc.
As far as I know though, one is pretty indifferent about who one gets their kidney from. Organ transplants are tricky for sure, but as far as I know, it's very possible to get a kidney from someone of a different race (I should look these factors up, really). This, to me, creates the potential for an organ-selling underclass, made up of poor minorities selling their kidneys to rich (and probably mostly whites).
This potential outcome makes me extremely uncomfortable.
Posted by Carl | Link to this comment | 05-18-06 11:33 AM
We don't consider the egg to be a child. If you don't donate it or conceive yourself, it passes out of your body eventually, and that's the end of it.
We do, however, consider the child that *develops* from the egg to be a child.
Posted by bitchphd | Link to this comment | 05-18-06 11:35 AM
In discussions of abortion, it seems to be the accepted wisdom that an egg is nothing--indeed, it is a point of strong disagreement whether or when a fertilized egg is ever a child
I think the mistake you're making is treating this as a classification problem with only two categories. I'm not sure what's improbably about a system with more categories: (a) nothing, (b) something other than a child, and (c) a child.
Posted by SomeCallMeTim | Link to this comment | 05-18-06 11:36 AM
Because in the case of an abortion, there is, in the end, no child. Pro-lifers think the zygote or fetus that is destroyed has moral status equivalent to that of a child, and pro-choicers don't, which is why they disagree. From my point of view, when I had an abortion, no child came into existence, and so no responsibility to such a child was implicated by my actions. If I had donated an egg, on the other hand, if everything worked out as intended, a child would have come into existence, and as its mother I would have been responsible for its welfare, but I would have not been in a position to carry out that responsibilty.
I don't think my position is inconsistent or difficult to understand.
Posted by LizardBreath | Link to this comment | 05-18-06 11:37 AM
it's very possible to get a kidney from someone of a different race
Possible, but I think less likely -- my understanding that your odds of a tissue match go up with ethnic similarity, and of course up further with family relationship.
Posted by LizardBreath | Link to this comment | 05-18-06 11:38 AM
Coming soon to a bookstore near you.
Shameless, I know.
Posted by Kieran | Link to this comment | 05-18-06 11:38 AM
the child that *develops* from the egg to be a child.
OK, but why is that so important? Indeed, what makes it your child? You did not give birth to it. Is someone to whom you donate blood or a kidney part yours? The child is an independent person. It gestated in, and was given birth to by, another woman. And is being raised by another family, with no knowlege or connection between you other than the donation of a single, unfertilized cell.
I'm really not trying to criticize your intuitions here, it's just very interesting when you look at it analytically.
Posted by Idealist | Link to this comment | 05-18-06 11:42 AM
I sort of agree with Idealist about the egg-selling stuff. Seems that it doesn't make much sense to feel a moral or emotional tie to the child grown from your egg just because of the genetic relatedness. On the other hand, I can see how you could regret enabling the child to exist in the first place (regardless of relatedness) when the child ends up having terrible parents.
Also, child support from sperm donors? How incredibly crazy is that?
Posted by pdf23ds | Link to this comment | 05-18-06 11:47 AM
You did not give birth to it. Is someone to whom you donate blood or a kidney part yours? The child is an independent person. It gestated in, and was given birth to by, another woman.
It is conventional in our, and most (all right, I'm being sarcastic here. In freaking ALL) cultures to feel closeness to and responsibility for those with whom one has a genetic relationship, on some level regardless of the shared experiences normally necessary to create a strong emotional bond. Particularly strong (as in, what are you from MARS or something) is the genetic relationship colloquially referred to as the parent-child relationship.
For a thought experiment as to how this might play out, consider the possibility of a parent being erroneously told that their newborn had died at birth, when in fact the baby had been given to a different family in error. Even, say, five years later, perhaps after having had an additional, replacement child, it is my intuition that most parents would still feel interest in and concern for the welfare of the first child if they discovered its continued existence, despite the fact that it was being raised by another family.
Posted by LizardBreath | Link to this comment | 05-18-06 11:48 AM
36: Cool, and topical.
Posted by LizardBreath | Link to this comment | 05-18-06 11:50 AM
"Seems that it doesn't make much sense to feel a moral or emotional tie to the child grown from your egg just because of the genetic relatedness."
On the other hand, the evolutionary psychology explanation is almost too obvious to state.
Posted by pdf23ds | Link to this comment | 05-18-06 11:50 AM
You're all hereby forbidden from ever again criticizing the New York Times for being blinkered about class. When organ-selling becomes legal, people in desperate straits will often feel that they have no choice but to sell an organ to get through a rough patch, send a kid to college, raise money for an operation, etc. You end up with a society in which the underclass keeps the affluent in "good organ." That's morally gross. When things are so bad that the poverty vs. giving up an organ calculus starts to favor giving up organs, we're living in a sick world.
Posted by ogged | Link to this comment | 05-18-06 11:52 AM
Re 12: It is to be hoped that an altruistic ego-donation pool would develop to succour the psychically dissatisfied but impoverished -- perhaps the donors to this pool would be wise men who had attained enlightenment and had no longer need of their egos? Or perhaps, this could be an opt-in form on the back of your driver's license -- if the EMS arrived at the scene of your accident before the spark of life had left your body but were able to determine that your prognosis were negative, they could harvest your ego -- no reason a healthy young ego should expire with the body. I am wondering what the donor-recipient match-up process would be like, and how long the queue would be. Would connections with those in power allow you to jump the queue?
Posted by The Modesto Kid | Link to this comment | 05-18-06 11:52 AM
42: Absolutely. I swear I would have gotten there, but I got off on this egg-selling tangent.
Or, of course, you're just jealous because you're locked out of the lucrative kidney-selling market.
Posted by LizardBreath | Link to this comment | 05-18-06 11:55 AM
No, blood and kidneys are not sentient human beings. A child is. Gestation and birth are indeed very important labor in the creation of a child, and I don't discount them. I don't, however, discount genetics, either.
I honestly don't see what's "interesting" about this, analytically speaking. An egg isn't a human being; nor is a zygote or a fetus. I'd be quite willing, putting aside incovenience and possible health risks, to donate eggs for the development of embryonic stem cells, for instance. A child, however, *is* a human being, and I would feel uncomfortable having a child that was related to me brought up by someone I didn't know. I'd feel the same way if one of my nieces were adopted out to a stranger; hell, it bothers me that my friend's baby was adopted by tax-dodging assholes who broke their open adoption agreement. And it's pretty well established that adoptive kids and children conceived via donor sperm often want to find their biological parents. I don't think it's weird to feel a biological connection, or at all inconsistent with the idea that an egg isn't a person.
Really, I'm having a hard time not finding the question kind of insulting. It seems kind of similar to the "if you don't value the life of an embryo, what's to keep you from infanticide" question.
But, more charitably: maybe the disconnect is that you're hearing me say I'm "against" egg donation. I'm not. What I said was that the *risks* of a donated egg->child, or adopted child, being raised by someone who's an asshole would keep me from being comfortable doing it. If the adoption/donation turned out just fine and the kid were happy and well-cared for and not a selfish jerk, then hey: flowers all around. The problem is, you don't know that that's going to be the case, and absent that knowledge, I would be uncomfortable creating, or helping create, a child.
Come to think of it, this is *entirely* consistent with being pro-choice. I don't want kids raised in shitty circumstances. I especially don't want *my* kids raised in shitty circumstances, and I figure most women probably feel the same way. So it makes sense to me that if the probability is that the kid is going to be raised in shitty circumstances, a responsible woman would prefer not to have one of *her* kids brought into the world.
Posted by bitchphd | Link to this comment | 05-18-06 11:55 AM
Also -- would there be a recreational ego-swapping fad among the dissipated idle rich?
Posted by The Modesto Kid | Link to this comment | 05-18-06 11:57 AM
"It's a straight-forward case of classic market dynamics. But possibly you've not read anything on the topic.
Geez, Gary, lighten up."
I was just hypothesizing. I wasn't condemning. There isn't any reason to assume any given person has looked into the issues and situations regarding sperm and egg donation, and every reason to presume they haven't. I'm unaware of anything pejorative about that, or why assuming kindly that someone hasn't looked into it is unkind. When I want to condem, I, you know, condemn.
Jeepers, in trouble already am I. Begins, the yoda-speak, does.
"Hey Gary, as long as you're on the thread: Do you know any good sf books exploring the idea of ego-selling?"
Well, I'm pretty out of touch with the field in the last ten-plus years. Not per se, off the top of my head. I can think of a variety of stories dealing with personality transfers, and personality/brain-add-ons, and with uploading minds, and the like, but not so much with the selling. But, as I said, I've really kept up with almost nothing in the past ten-plus years, so I'm not the ideal person to ask. I'd recommend posting a query to rec.arts.sf.written on Usenet (I think you can probably do this via Google Groups, if you don't have more convenient access, with a little trouble).
"In Europe, egg-donors receive some compensation for their duress, but it is *illegal* to buy or sell eggs. "
Last I looked, that's how it is here, too, actually. The fees are "compensation," not payment for eggs. Same for sperm. (And what I meant about supply and demand is that since sperm donation is pretty easy [yeah, go for it], and not exactly painful, most of the time [unless you like it that way], there's plentiful supply, and sperm banks are very picky about who they accept, because they can be.
Whereas egg donation is excruciatingly painful and complicated and puts you in the hospital, and so not so many volunteer, and so there's a large un-met demand absent compensation.
32: "We do, however, consider the child that *develops* from the egg to be a child."
Half a child.
Posted by Gary Farber | Link to this comment | 05-18-06 11:58 AM
your odds of a tissue match go up with ethnic similarity, and of course up further with family relationship.
Sure, I'll concede the differences in odds, but I don't know what the level of the odds are in various cases, so it's hard to say how likely we'd see inter-racial organ sales. Even conceding that it's unlikely, you still have a potential market where poor whites/blacks/etc sell their organs to rich white/blacks/etc., so you still have a kind of underclass occuring. (I'm assuming that sales will not be taking place b/w families members. If you have a feasible donor in the family, you wouldn't need to go on the market.)
From the summary in the link to Kieran's book:
In the end, Healy suggests, successful systems rest on the fairness of the exchange, rather than the purity of a donor’s altruism or the size of a financial incentive.
I guess this is what I'm getting at... if we opened up a market for kidneys what would those on either side of the exchange look like, and what are the implications for the fairness and rights enforcement in that exchange? I'd be interested in what Kieran's take on that is
And a question for the women: which would you be more willing to sell: your kidneys or your ovaries?
Posted by Carl | Link to this comment | 05-18-06 12:00 PM
Erm, it's a whole child. The egg isn't the only component of it -- there's sperm, and gestational nutrition and developmental support -- but parents generally feel responsibility for their whole children regardless of the fact that there are two parents involved.
Posted by LizardBreath | Link to this comment | 05-18-06 12:01 PM
Modesto: I should note that there's quite a market in fake and good IDs.
More people should probably also donate spare super-egos to others.
Posted by Gary Farber | Link to this comment | 05-18-06 12:01 PM
42: Well, of course it's morally gross. OTOH, poverty is morally gross. I see clearly the argument in favor of not buying other people's bodies (or parts thereof). On the other hand, like prostitution, it seems to be something that happens anyway. Which raises the question (like prostitution) of whether there are ways to make it less morally gross, and to properly reward people who, let us imagine, make conscious decisions to do it for whatever reason--including thinking its better than starving. No?
Also: Ogged!! Hooray!!
Posted by bitchphd | Link to this comment | 05-18-06 12:02 PM
42: so it's less morally gross to not let the would be doner have the money they decide they really need? I think we should structure the world so that everyone's needs are always cared for, too, but we're not living in it. I'm not sure that "that's gross" is considering the interests of the poor more than the discomfort of the rich.
Posted by Tia | Link to this comment | 05-18-06 12:03 PM
the top Google hit for "ego-swapping" looks promising, as does the last one.
Posted by The Modesto Kid | Link to this comment | 05-18-06 12:03 PM
Also: regardless of what a biological parent may feel, the biological child, in my opinion, deserves to know what sort of person his or her parents are.
Knowing, for example, that both biological parents were raging drunks who died at 35 of liver failure would most likely change the child's attitude towards alcohol--which would therefore probably prolong the child's life.
And that's only the easiest example. My sister is a genetic counseler; I've got lots more.
Posted by Jackmormon | Link to this comment | 05-18-06 12:04 PM
I'm unaware of anything pejorative about that, or why assuming kindly that someone hasn't looked into it is unkind.
It's a straight-forward case of respecting conversational norms. But possibly you've not read anything on the topic.
Posted by Standpipe Bridgeplate | Link to this comment | 05-18-06 12:05 PM
"I was just hypothesizing. I wasn't condemning."
By pointing out a possible explanation for a fact, where the explanation is not obvious, but the principles guiding the explanation are considered to be common knowledge among the audince (supply/demand), suggesting that the reason the explanation didn't occur is that the audience wasn't aware of the common knowledge, instead of the more likely explanation that the relevance of that knowledge hadn't occurred to them, is rightly taken to be patronizing.
Now, if the principle of supply and demand was blindingly obvious in the formulation of the question, your reaction would be more appropriate, but still snippy.
Posted by pdf23ds | Link to this comment | 05-18-06 12:05 PM
This Christian Science Monitor (not a religious paper, despite the name) series has some useful case studies on organ-donation-for-pay.
Posted by Witt | Link to this comment | 05-18-06 12:05 PM
There's no such thing as "half a child."
Kieran: fabulous cover image. The book looks great, too--I don't mean to sound all "wow, great cake, especially the [canned] frosting!" (does anyone remember that commercial?)--but I'm always interested in how much control authors have over their covers and the other design elements of the book, and I presume that one was entirely yours.
Posted by bitchphd | Link to this comment | 05-18-06 12:05 PM
The women selling the eggs may not be wealthy, but they are generally white and college educated
Do you have a cite for this, Carl? I'm not so sure.
Posted by Tia | Link to this comment | 05-18-06 12:06 PM
Holy hell yes -- what Ogged(!) said.
Posted by Carl | Link to this comment | 05-18-06 12:06 PM
42, 51, 52: The thing is, I can't see any way it could be enough money. Someone who's poor enough to sell a kidney for $10K? They're still going to be poor after they get the $10K, they just won't have a kidney. At that point, I am more horrified by the class implications than reassured by the fact that they're getting the money they need.
Posted by LizardBreath | Link to this comment | 05-18-06 12:08 PM
More people should probably also donate spare super-egos to others.
Well I could see the benefit to the recipient, but who wants to become conscienceless? I think the net benefit to society would be a wash. I mean say some good soul donates his/her conscience to Dick Cheney -- the total number of psychopaths remains constant.
Posted by The Modesto Kid | Link to this comment | 05-18-06 12:09 PM
Tia, I don't know about citations, but I'd make the same assumption Carl makes, based solely on the ads I've seen for egg donations. And the presumption that people with access to that kind of money (or health insurance that good) are likely to be white and college educated, and that most people tend to place a high value on things that reflect their own values. If that makes sense.
Posted by bitchphd | Link to this comment | 05-18-06 12:10 PM
"You end up with a society in which the underclass keeps the affluent in "good organ." That's morally gross. When things are so bad that the poverty vs. giving up an organ calculus starts to favor giving up organs, we're living in a sick world."
We live in a sick world. A world in which people often can't sell organs, and die, or suffer, or their family suffers, because they don't have that fillip of additional income at a crucial time.
Which is not a disagreement with you, but the flip side of the point.
It would be nice to think that, eventually, stem cell and other r & d will lead to the ability to regenerate organs whether organically, or externally and grafted, and thus no eventual need for transplants from a living person, by the way, and sooner or later that will inevitably be the case, though no one can say precisely when that will be possible, let alone wide-spread. But within fifty years seems a very safe bet. Probably within thirty, I suspect.
(I wrote a post about you the other day, by the way; I'd like to fancy that you saw it since you can't bear to miss my posts, but I kinda doubt that's actually true in this universe.)
Posted by Gary Farber | Link to this comment | 05-18-06 12:11 PM
You can donate half a liver, maybe half a super-ego? It might regenerate.
Posted by LizardBreath | Link to this comment | 05-18-06 12:11 PM
I was envisioning a mandated sum of something more like 100K. I assume that dialysis and everything associated with the operation would cost easily that much, so it can't be that inconceivable to double the cost.
And really, I think, if anything, it's the perspective of the rich to think, no, it would just be too unsavory to pay for this, so considering the possibility is not being blinkered with regards to class.
Posted by Tia | Link to this comment | 05-18-06 12:11 PM
So, legalizing an organ market would worsen the class divide, but help more people to live.
Which is worse? And is it relevant whether other actions are being taken or planned to independently lessen the class divide?
If we go on the moral principle that a social policy should increase the quality of life of those whose quality of life is worst, that leads us to try to decide whose life is worse--a poor healthy person, or a middle-to-upper class ill person without a needed organ donor. If we decide it's the poor person who's worse off, we need to decide whether their life would actually be improved by letting them sell an organ.
Posted by pdf23ds | Link to this comment | 05-18-06 12:14 PM
61: I don't know about that. Let's say $25K, and hypothesize an international market. $25K is enough to make a difference between destitution and comfort, or even wealth, in some places. I mean, think about the immigration discussion: if people are willing to risk their lives and not see their families for decades, possibly forever, for a job that pays $150/week and keeps their kids in school, $25k (or even $10k) is a huge, huge amount of money. I think that if I were given the choice between emigrating from Honduras to Los Angeles and abandoning my kids in order to provide for them, or donating a kidney, I'd take choice B.
Posted by bitchphd | Link to this comment | 05-18-06 12:14 PM
Re 62: I guess you can make an argument that Dick Cheney is powerful where the freshly-minted psychopath is not -- but my hunch is that the newly-ensouled would fall quickly from power and the newly-conscienceless would rise like bubbles of swamp gas. Maybe we could work out some kind of system (assuming the superego-transfer process were quick and painless) where the two would exchange superegos whenever the one posessing the conscience fell too far below the median power status -- this seems like it would require a pervasive and intrusive bureaucracy to monitor and keep going but I suppose that's not such a huge flaw.
Posted by The Modesto Kid | Link to this comment | 05-18-06 12:17 PM
Do you have a cite for this, Carl? I'm not so sure.
No, I've been looking around, but I think it'd be hard to find proper stats, since these kind of private market exchanges are really quite private. Nonetheless, you see a tremendous amount of these ads in college newpapers, so you get a gist of the target audience here. My reasoning is just that, the buyers probably want ovaries from someone as much like them as possible (otherwise, why not just adopt?). This makes the exchange a lot more equitable, in a socio-economic sense. This is just supposition -- I'd be glad to get pwned by the facts, if I'm wrong.
Posted by Carl | Link to this comment | 05-18-06 12:18 PM
Kieran: fabulous cover image. The book looks great, too--I don't mean to sound all "wow, great cake, especially the [canned] frosting!" (does anyone remember that commercial?)--but I'm always interested in how much control authors have over their covers and the other design elements of the book, and I presume that one was entirely yours.
Hey, thanks -- I believe you can judge a book by its cover, or at least that's what people do. So I wanted a good one. Presses -- maybe even editors -- vary a lot in their policies about covers. Some let you pick your own within broad limits, others have a house-style you can't avoid -- especially if the book's is in a series. Chicago allowed me to suggest a few images (of which the final cover was one) but made it clear that their designers would be doing the designing, not me. With this topic, the bog-standard is Gray's Anatomy style cutaway shots of torsos, or alternatively some anonymous bit of medical equipment like a blood-filed pipette or an organ cooler or whatever. So I looked pretty hard to find some non-cliche images. I was lucky to discover some good ones. Then I waited anxiously and was very happy when they picked one of them for the cover.
Posted by Kieran | Link to this comment | 05-18-06 12:21 PM
"the top Google hit for "ego-swapping" looks promising, as does the last one."
Well, swapping isn't selling. Remember, I'm a bit literal-minded. (And, also, I was a bit unclear what you had in mind as regards "ego," since it's just a Freudian metaphor.)
"It's a straight-forward case of respecting conversational norms. But possibly you've not read anything on the topic."
A moderate amount. Suzette Haden Elgin and Deborah Tannen, and a few others.
"There's no such thing as "half a child.""
See, now it's not me being the only literal one. I was simply making a kidding point about an egg not developing from an egg alone, as you later acknowledged.
"At that point, I am more horrified by the class implications than reassured by the fact that they're getting the money they need."
Sure. But the primary issue here is worldwide poverty, not organ donation policy. Cure worldwide poverty, and that problem disappears.
I'm sure the Underpants Gnomes are worth consulting on this.
Posted by Gary Farber | Link to this comment | 05-18-06 12:21 PM
64, 66, 67, 68: Man. It's not that I don't see the point, I just really, really don't want to accept it. Any advocacy for a policy that follows the form: Of course it's nightmarish, but in our horrific society, it's better than the available alternatives, seems wrong to me. Once you're looking at an argument like that, stop making an effort to institute the nightmarish policy, and work on fixing the horrific society.
Posted by LizardBreath | Link to this comment | 05-18-06 12:23 PM
"More people should probably also donate spare super-egos to others.
Well I could see the benefit to the recipient, but who wants to become conscienceless?
Thus my use of the modifier "spare." I was assuming some have enough left over to have some to spare.
I'd suggest checking notoriously anal-retentive types. I won't suggest where one should check.
"You can donate half a liver, maybe half a super-ego? It might regenerate."
And kinda along those lines. Healthy super-egos seem to have that tendency.
Of course, possibly those in need of a transplant provide an unhealthy environment, and the transplant would simply wither and die off and not take.
Clearly clinical trials are in order.
Posted by Gary Farber | Link to this comment | 05-18-06 12:24 PM
"I mean say some good soul donates his/her conscience to Dick Cheney -- the total number of psychopaths remains constant."
Oh, and perhaps this reveals a bias towards the elite, but I'd rather the ultra-powerful Veep had a conscience than an ordinary schlub had it go missing, if it came down to it. Less overall harm from a lower-class psychopath than a ruling psychopath, generally speaking, as I believe we've seen proven by control experiment now.
Posted by Gary Farber | Link to this comment | 05-18-06 12:26 PM
72 -- yeah but Google hits for "ego selling" are uniformly useless.
Posted by The Modesto Kid | Link to this comment | 05-18-06 12:27 PM
That CSM story is pretty good:
Also, Brazil used to have an opt-out organ donor system but switched to a system where the relatives need to consent due to complaints.
Posted by Joe O | Link to this comment | 05-18-06 12:29 PM
"Hey, thanks -- I believe you can judge a book by its cover, or at least that's what people do. "
Of course they do. That's why covers are so crucial to book-selling.
"Some let you pick your own within broad limits,"
!!! Not in trade publishing, that's for sure. In academic publishing, which I know little about, I can believe you.
Posted by Gary Farber | Link to this comment | 05-18-06 12:30 PM
But LB, that's easy to say, but the horrific society isn't going to be fixed any time soon. In the mean time, you have actual poor people who might benefit. One one hand you have poverty (hazardous to your health), and kidney donation (probably not as much so). I think someone could rationally choose the latter for a variety of reasons, and I'm not sure it's fair to let our sense of squick be the deciding factor.
Posted by Tia | Link to this comment | 05-18-06 12:30 PM
75 -- see my 69.
Posted by The Modesto Kid | Link to this comment | 05-18-06 12:31 PM
12: Would you be able to keep your name and identifying characteristics if you sold your ego?
I would. But I guess that only goes for me.
Posted by My Alter Ego | Link to this comment | 05-18-06 12:32 PM
"Once you're looking at an argument like that, stop making an effort to institute the nightmarish policy, and work on fixing the horrific society."
In a situation where a solution headed in the right direction (such as, say, universal healthcare) is politically infeasible, and where a stopgap solution that wouldn't have any relevance in a better society *is* politically feasible, is it appropriate to push for the stopgap solution?
On the other hand, I'm not sure even in a well off society that there would not be a shortage of organs. Is there some specific factor in the US causing the shortage that can be solved without a market? And if it can be solved, would that solution be a stopgap, and not worth implementing on its own? For instance, making organ donation opt-out would be appropriate even in a society without gross class inequities, not a stop-gap solution at all. An organ market, on the other hand, is quite different.
Posted by pdf23ds | Link to this comment | 05-18-06 12:33 PM
In the mean time, you have actual poor people who might benefit. One one hand you have poverty (hazardous to your health), and kidney donation (probably not as much so).
But surely you folks are setting up a false dichotomy. There are tons of policies we could enact to help alleviate poverty. Letting people sell their organs is probably the worst one.
And as far as solving the organ-shortage problem...donation consent rates are at less than 50%. Encouraging more people to consent to have their organs donated would be a better policy than setting up a kidney-market.
There are better ways to solve both the problems of poverty and organ-shortage.
Posted by Carl | Link to this comment | 05-18-06 12:36 PM
Carl, I don't think anyone's suggesting that we alleviate poverty with an organ market. They're suggesting that the presence of poverty shouldn't overly affect our considerations of the effects of an organ market, because it's a separate problem that can be solved with separate measures.
Posted by pdf23ds | Link to this comment | 05-18-06 12:40 PM
One one hand you have poverty (hazardous to your health), and kidney donation (probably not as much so).
See, I suspect that those two things intersect. Question: Does the poverty of the donor mean an increased likelihood of developing serious illness later on?
I have no hard data whatsoever, but I can easily imagine a case in which a poor person donates an organ, gets $25K, finds a great one-time use for the money and doesn't have any healthier a life afterwards...and a few years down the line develops FITB chronic/serious illness and is now much more likely to die from it. Am I crazy?
(I'm assuming that a disproportionate number of current organ donors are middle-class and above, what with the whole affording-to-take-time-off-from-work and so forth. Maybe this is completely wrong.)
Posted by Witt | Link to this comment | 05-18-06 12:40 PM
"Letting people sell their organs is probably the worst one."
Nah. We could have The Running Man and similar scenarios. Or appearing on the "Torture Queen For A Day Show."
How about the game show version of Sophie's Choice, for profit?
Posted by Gary Farber | Link to this comment | 05-18-06 12:41 PM
We're not setting up a false dichotomy; I think, rather, that you are, by suggesting that one must choose between universal health care, better job training, etc., and compensation for organ donotion. I'm just recognizing that the amount of social work to be done before there's no more poverty is considerable enough, and there's enough resistance even to a consensus that we should give a shit about poverty, that it won't be eliminated for a while. Given that, I'd err towards allowing people to choose something which, all things considered, might perversely in the end be better for their health.
Posted by Tia | Link to this comment | 05-18-06 12:42 PM
Also, I really don't support an "organ market" if that means competition, etc. I'd support mandated, high cash payments, and healthcare for life if we don't get to universal health care by other means
Posted by Tia | Link to this comment | 05-18-06 12:45 PM
85: This. I have a very easy time believing that organ donation is not hazardous to the health of current donors, because they are self-selected to be healthy and with access to good care. Once it's a market, I would be unsurprised to find that a lot of kidney sellers found themselves on dialysis down the road.
Posted by LizardBreath | Link to this comment | 05-18-06 12:46 PM
85, 89: That's a good point. I wonder, though, if that risk would be diminished by giving every donor health insurance. Also, donors would be screened for their underlying health.
Posted by Tia | Link to this comment | 05-18-06 12:48 PM
Maybe I am from Mars, because I really have a different intuition here. For sure, there is a notion (unjustified in my view, but it obviously is there), that there is a bond between parent and child which we value even if the parent did not raise the child--for example, children who are adopted often feel a need to find their birth parents.
But it seems to me that this notion of their being a strong connection is based on more then mere genetics. It is based on the notion that the mother carried the child and gave birth to him or her. Does this idea really make sense in the case when the only contribution to the child is an unfertilized egg (or sperm, for that matter). Indeed, would we have the same intutions if we were talking about the connection between a child and a sperm donor? Sure, we might also feel a connection to brothers, sisters, aunts, uncles etc., who we have never met, but isn't that about their role in the family we do know rather than the mere fact that you share genetic material?
Maybe I'm just weird, but I do not see it.
Posted by Idealist | Link to this comment | 05-18-06 12:49 PM
Carl, I don't think anyone's suggesting that we alleviate poverty with an organ market. They're suggesting that the presence of poverty shouldn't overly affect our considerations of the effects of an organ market, because it's a separate problem that can be solved with separate measures.
I didn't mean to oversimplify your points, but, I really can't see how you can imagine opening up a market for organs without the effects of class and income having a huge impact on the nature of that market, and likely in a way that's going to be detrimental to the poorest and most desparate.
Posted by Carl | Link to this comment | 05-18-06 12:51 PM
I agree with 84 and 87.
OTOH, there's a case to be made that creating an organ-donation market pretty much adds one more serious conflict-of-interest problem w/r/t alleviating poverty, no?
Posted by bitchphd | Link to this comment | 05-18-06 12:51 PM
We could have The Running Man and similar scenarios. Or appearing on the "Torture Queen For A Day Show."
Buck once had a National Lampoon? comedy record with an episode of Catch It, And You Keep It: "Look, Mrs Johnson is maneuvering to catch those gold bars... Ooo, that had to hurt. There goes Mr. Brown with, ow, what is that, a set of steak knives? And here comes a brand new washer-dryer set!"
Posted by LizardBreath | Link to this comment | 05-18-06 12:52 PM
But it seems to me that this notion of their being a strong connection is based on more then mere genetics. It is based on the notion that the mother carried the child and gave birth to him or her.
Um, so in my thought experiment above, would you expect the mother but not the father to feel a connection to the lost newborn refound at the age of five? Because that strikes me as peculiar.
Posted by LizardBreath | Link to this comment | 05-18-06 12:54 PM
OTOH, there's a case to be made that creating an organ-donation market pretty much adds one more serious conflict-of-interest problem w/r/t alleviating poverty, no?
You betcha. See those Larry Niven stories Gary cited above -- they start out with forced organ donation as a non-wasteful means of execution for death penalty crimes, and end up with the death penalty covering every offense down to parking tickets.
Posted by LizardBreath | Link to this comment | 05-18-06 12:56 PM
You write about this as if it's a hypothetical. It's not. People in India do sell kidneys. And according to a study published in the Journal of the American Medical Association, (1) they do it to get out debt (2) they fail to get out of debt and are economically worse off afterwards than before and (3) their health declines.
Economic and Health Consequences of Selling a Kidney in India, Madhav Goyal, MD, MPH; Ravindra L. Mehta, MBBS, MD; Lawrence J. Schneiderman, MD; Ashwini R. Sehgal, MD; JAMA. 2002;288:1589-1593. Abstract at http://jama.ama-assn.org/cgi/content/abstract/288/13/1589
Posted by JR | Link to this comment | 05-18-06 12:56 PM
Hey, facts! That support my uneducated squeamishness! Yay, JR!
Posted by LizardBreath | Link to this comment | 05-18-06 12:57 PM
Yay, facts! I'd be curious about all the specific circumstances though. Like about what their health care is like.
Posted by Tia | Link to this comment | 05-18-06 12:59 PM
there is a notion (unjustified in my view, but it obviously is there), that there is a bond between parent and child which we value even if the parent did not raise the child--for example, children who are adopted often feel a need to find their birth parents.
Arg. What do you mean, "mere genetics"? And "unjustified"? It's not at all unjustified to wonder about one's biological parents, or biological offspring--it's the most fundamental bond living things *have*. It would be insane, probably literally, to be indifferent to it. And if your sense of the emotional attachment between mothers and children is entirely based on carrying and giving birth, then what's the case for fathers? Or the case against abortion? Or is the caes against abortion predicated on a belief that women *are* completely indifferent to anything except an actual living baby, and that this makes them unreliable, morally? But then your position vis-a-vis egg donation seems to be that people *shouldn't* feel any connection to the child that results from it, so why is there a moral problem with not feeling anything about a fetus?
It seems to me that there's this underlying assumption you're making that if something is a *feeling* its illogical. But the mind/body thing isn't, in fact, a dichotomy. Responsibility towards children generally and one's own children specifically is about as important, and logical, a feeling as we could possibly have, I should think.
Posted by bitchphd | Link to this comment | 05-18-06 12:59 PM
91: "Sure, we might also feel a connection to brothers, sisters, aunts, uncles etc., who we have never met, but isn't that about their role in the family we do know rather than the mere fact that you share genetic material?
Maybe I'm just weird, but I do not see it"
I think you're not seeing it. Interest in your genetic children/parents/siblings absent any other connection is pretty understandable to me. Consider the number of adopted children who want to seek out their genetic parents, and the certain number of mothers who gave up children to adoption who similarly wind up seeking or being open to finding their genetic child.
Posted by Gary Farber | Link to this comment | 05-18-06 1:00 PM
Similarly cases of siblings split up by adoption interested in finding each other later in life.
Posted by Gary Farber | Link to this comment | 05-18-06 1:01 PM
Hi ogged.
Hi Gary.
Nice to see guys around here. Hope everything is going all right with your respective health situations (I almost wrote "healths").
Rest of the thread: so far the empirical evidence on blood donation versus payment is, afaik, that you get at least as much blood and of a much higher quality when you disallow payments. I can't find a good link for this, I read about it (and the economics debate about which would be better) somewhere in the Dukeminier and Krier property casebook.
Posted by washerdreyer | Link to this comment | 05-18-06 1:02 PM
Also, whoo! 100!
Also, whoo! Facts! But again I'll revert to my prostitution analogy--is it *inevitable* that organ selling will turn out this way, or might it be run in a way that could have better results for the seller? That said, however, I'll then revert to my feminist philosophy, which is that what actually happens is more important than what might happen in theory, and say "hm, that's a really good argument against organ selling. Now what's to be done about the organ selling that's already happening?"
Posted by bitchphd | Link to this comment | 05-18-06 1:03 PM
Anyway, if empirical evidence suggests that compensation donation makes donors' lives worse, I obviously wouldn't support it. That it works that way in India is an important piece of evidence, though not the end of the story. I just really disagree with the notion of valuing a kind of squeamishness over what kind of relationship the rich should have with the poor over the poor people's actual well-being. I might do a post about this.
Posted by Tia | Link to this comment | 05-18-06 1:06 PM
I've finished my little research project on the Anatomical Gift Act. As of the first of this year my state, Illinois, has gone over to a first-person consent system. Those miniature witness lines on my driver's license are now obsolete. I'll be able to donate by registering online, and I'll probably sign my dl just for good measure. Under the old system, apparently, next-of-kin were often pestered to approve at the worst possible time. My n/o/k will be informed but not consulted.
Since we're not open casketeers anyway, I don't expect any problems. I'll do it today. Even if my bike is hit and I'm sent sailing, I've always got my wallet with me on the bike. The life I save might be Ogg's!
Posted by I don't pay | Link to this comment | 05-18-06 1:07 PM
I just really disagree with the notion of valuing a kind of squeamishness over what kind of relationship the rich should have with the poor over the poor people's actual well-being. I might do a post about this.
It's funny, I'm generally as right-brained logical as they get, but on moral issues I think you ignore squeamishness at your own risk. I believe that moral intuition tends to incorporate subliminal knowlege about how things work out in practice that is very easy to overlook when we simplify situations to their 'essential' elements.
Posted by LizardBreath | Link to this comment | 05-18-06 1:10 PM
Also, whoo! Facts! But again I'll revert to my prostitution analogy--is it *inevitable* that organ selling will turn out this way, or might it be run in a way that could have better results for the seller?
I think the prostitution analogy is apt. One might want prostitution were legalized, and then regulated and, say, unionized so that women could enter into the industry with a large degree of autonomy. The exchanges in the market (between the prostitute and her employer, between her and her client) were on relatively equitable footing.
Similarly, if you could insure that those selling kidneys were guaranteed health care and a fair income afterwards, there'd be less objection to it.
But this is reality -- a world in which we could guarantee those things would be a world were people wouldn't HAVE to sell their friggin' kidneys to get out of debt.
Posted by Carl | Link to this comment | 05-18-06 1:11 PM
For IDP's poll: I've always checked off the organ donor box on my driver's license. Or, rather, put the pink sticker on the license and carried the signed consent form behind it. Pretty much everyone in my immediate family has done the same, and my father has specifically indicated that he'd like his body to go to Science, if possible. We don't really do funerals.
Posted by Jackmormon | Link to this comment | 05-18-06 1:15 PM
108: Well, women *and* men. But yeah, more and more I suspect that the real reason prostitution is such a shitty thing, ultimately, isn't about lack of regulation but because of the idea that women, in the end, are basically the sex class.
LB, thanks for 107. I think that's an awesome articulation of the importance of moral *feeling.*
Posted by bitchphd | Link to this comment | 05-18-06 1:16 PM
Seems I saw a documentary on prostitution being legal and autonomous in the Australian Outback. Mature woman kept house, received visitors as if she were a hair stylist or some other kind of home worker, all on the up-and-up.
Posted by I don't pay | Link to this comment | 05-18-06 1:17 PM
Your feelings of squeamishness might be a useful guide, an indicator of a problem, but you really have to figure out what's causing it and figure out an overt justification for your problem. Because people feel squeamish for bullshit reasons, about things there's no reason to feel squeamish about. Lots of people feel squeamish about gay adoption. Another cause of squeamishness is just wanting to avoid contact with something gross or uncomfortable.
Posted by Tia | Link to this comment | 05-18-06 1:18 PM
For IDP's poll, I have a sticker on my driver's license and my best friend is my health care proxy, and she knows I consent to be carved up as much as anyone likes.
Posted by Tia | Link to this comment | 05-18-06 1:19 PM
Sure -- I'm not talking about being a slave to squeamishness in the face of logic. Just that it's a very good reason to keep looking for information.
Posted by LizardBreath | Link to this comment | 05-18-06 1:20 PM
Or rather, my state ID, since I don't know how to drive.
Posted by Tia | Link to this comment | 05-18-06 1:20 PM
And has anyone else noticed that NYS driver's licenses are glossy to the point that ballpoint smears right off? I had checked the little box and signed it, but when I looked at it (whichI hadn't for years) there was the merest smudge left. So I just re-signed.
Posted by LizardBreath | Link to this comment | 05-18-06 1:21 PM
Will Apo be pledging his cock to science? A-and what about Labs?
Posted by The Modesto Kid | Link to this comment | 05-18-06 1:23 PM
The class/exploitation objections people are voicing here seem to be focused on markets in live kidney donations. What about markets (of some sort or another) in cadaver organs? Still likely to appeal disproportionately to the underclass, but concerns about poverty compelling people to risk their health by ripping out a kidney wouldn't be a factor. Would the possibility that poverty might compel some to put aside their notions about proper treatment of a corpse be as objectionable/exploitative?
(There might be a concern that payment to survivors would provide a perverse incentive to die/let an ailing relative die, but structuring the payment to, e.g., cover funeral expenses would avoid that possibility. Pennsylvania was planning something like that in the late '90s, but I can't find any info on whether they went ahead with the plan, and, if so, what effect it had.)
Posted by ettinauer | Link to this comment | 05-18-06 1:24 PM
Your feelings of squeamishness might be a useful guide, an indicator of a problem, but you really have to figure out what's causing it and figure out an overt justification for your problem.
That strikes me as wrong. I don't know that we ever definitively settle why we're creeped out by things like Derbyshire talking about 15 year-olds. At most we convince a sizeable number of people and then enforce our will.
Moreover, part of the problem is going to be determining in what sort of society the poor are so disadvantaged that part farming is OK. Then there are the associated problems. For example, are really poor people going to increase the number of kids they have specifically to guarantee income down the line?
Posted by SomeCallMeTim | Link to this comment | 05-18-06 1:26 PM
Also, watch out for this. The first-person consent is now permissible because my state has adopted the revised Uniform Act. But the registry under the old act will not automatically roll over into the new; you'll have to re-register now. Your Sec'y of State probably has a web page about it.
Posted by I don't pay | Link to this comment | 05-18-06 1:26 PM
116: Don't you need a pair of witnesses?
Posted by washerdreyer | Link to this comment | 05-18-06 1:26 PM
Well, women *and* men.
Fair enough. I tended bar a place that was swimming in male prostitutes, so I should know better!
It's a hard argument for me, as an economist, to make to folks who I think have more of a sociology-type background, but I think it's really problematic to let people treat certain things as "assets" to buy and sell because of the social environment such selling would occur in. Everyone buys and sells cars, homes, old records, etc. Only the most desparate amongst generally sell our bodies (sexually), our organs or our children. That, I think, *should* make us squeamish.
Posted by Carl | Link to this comment | 05-18-06 1:27 PM
105: I just really disagree with the notion of valuing a kind of squeamishness over what kind of relationship the rich should have with the poor over the poor people's actual well-being.
Maybe this is just more squeamishness, but I have a hard time squaring "poor people should donate organs for money!" with concern for the well-being of the poor. I don't see how it's possible to structure a "money-for-poor-people's-kidneys" program that isn't susceptible to massive exploitation and abuse.
I think we can generally agree that it would take significant financial straits before any of us would be willing to undergo a potentially life-threatening surgery, just for the money. Given that, I think our squeamishness is on to something. If our actual goal is to get the poor out of poverty, why not just give them some money? Or a good paying job? Or the health insurance? Why dangle those things at the end of a scalpel?
Posted by mrh | Link to this comment | 05-18-06 1:27 PM
Would the possibility that poverty might compel some to put aside their notions about proper treatment of a corpse be as objectionable/exploitative?
To me, not at all. I have no problem whatsoever with payment for cadaver organs. (Well, not true. I have a problem with a survivor who has an objection to donating cadaver organs that can be overcome by payment -- I think they're awful. But I don't see any ill effects from catering to awful people in this regard.)
Posted by LizardBreath | Link to this comment | 05-18-06 1:27 PM
Tia: Your feelings of squeamishness might be a useful guide, an indicator of a problem, but you really have to figure out what's causing it and figure out an overt justification for your problem.
SCMT: That strikes me as wrong. I don't know that we ever definitively settle why we're creeped out by things like Derbyshire talking about 15 year-olds. At most we convince a sizeable number of people and then enforce our will.
I can say why I'm creeped out by Derbyshire talking about 15-year-olds. At length if need be. How do you "convince a sizable number of people" if you're not going to work on consensus forming? Is consensus forming saying "that just doesn't sit right" and someone else saying "I think so too"? I think you (ideally) form consensus by reasoning out your opinion, articulating the values you think the society should share, and figuring out empirically what actions lead to best outcomes ("best" according to your values).
Posted by Tia | Link to this comment | 05-18-06 1:34 PM
Reminded me of this discussion: http://www.becker-posner-blog.com/archives/2006/01/should_the_purc.html
How the hell does one make those hyperlinks anyway?
Becker makes one point w/r/t the poor as organ growers effect that I haven't seen in these comments, but is interesting:
Although this is not an exact analogy, predictions that a voluntary army would be filled mainly with poor persons have turned out to be wrong. Many of the poor do not have the education and other qualifications to be acceptable to the armed forces. In the same way, many poor persons in the US would have organs that would not be acceptable in a market system because of organ damage due to drug use or various diseases.
But that aside, the slums-as-the-fields-where-organs-do-grow argument seems misplaced. In our system, the rich can afford better health-care period. Health and wealth are already related. The rich will be able to purchase organs where the poor will often not, much as the rich are able currently to purchase a variety of health-enhancing products that the poor are not. In other words, I don't see how allowing organ purchases adds to the inequality problem, which is caused by the structure of the health-care system and not by the availability to purchase a particular product.
Posted by Andrew | Link to this comment | 05-18-06 1:36 PM
I think you (ideally) form consensus by reasoning out your opinion, articulating the values you think the society should share, and figuring out empirically what actions lead to best outcomes ("best" according to your values).
Right. But ultimately, your values are going to sit on a set of moral intuitions that aren't much more than "that creeps me out." Or so I believe.
Posted by SomeCallMeTim | Link to this comment | 05-18-06 1:37 PM
The rich will be able to purchase organs where the poor will often not, much as the rich are able currently to purchase a variety of health-enhancing products that the poor are not.
Yeah, but, for us, that's a bug not a feature. See #1.
Posted by SomeCallMeTim | Link to this comment | 05-18-06 1:39 PM
How the hell does one make those hyperlinks anyway?
<a href="http://www.becker-posner-blog.com/archives/2006/01/should_the_purc.html">Like this</a>.
It's the only HTML I know.
Posted by LizardBreath | Link to this comment | 05-18-06 1:41 PM
SCMT, there are plenty of people who hold to values that, in general, match their moral intuitions, but that violate those intuitions in certain circumstances, and often those people are willing to ignore those intuitions for the sake of their explicit values. There are probably many more people who directly rely on their intuitions, however.
Posted by pdf23ds | Link to this comment | 05-18-06 1:43 PM
It's the only HTML I know.
This is refuted by your use of <em> and </em> and < and > in the same post. Generally the best way of reproducing some bit of HTML is to find an instance of it and "view source" -- this is generally an option on your browser's "view" or "file" menu -- and copy the source.
Posted by The Modesto Kid | Link to this comment | 05-18-06 1:45 PM
New York doesn't appear to require witnesses, but is still requiring the approval of n/o/k.
Posted by I don't pay | Link to this comment | 05-18-06 1:46 PM
Maybe this is just more squeamishness, but I have a hard time squaring "poor people should donate organs for money!" with concern for the well-being of the poor. I don't see how it's possible to structure a "money-for-poor-people's-kidneys" program that isn't susceptible to massive exploitation and abuse.
That's a totally legitimate argument. If there's no way the program could work in the real world without descending into something that would just create incentives to damage your health and for no real benefit, then it's obviously a bad idea. But that's different from elevating a principle against commodifying a body part
The line about what kind of thing it's okay to pay for is also far from clear, and that's part of what I was going to talk about in my post, but I guess I'll just say it in comments here. There was a Daily Show segment a few years ago about a student-run dorm room cleaning service at Harvard, and a lot of students wanted it eliminated because it created class differences among the students. I thought this was the height of absurdity, since the class differences obviously existed, and it was good for the students running the service to have the income. Relatedly, Barbara Ehrenreich won't have anyone clean her house because she doesn't want to have that kind of relationship with another person. Obviously, B.E. has lots of anti-poverty cred, but I think that's kind of silly? What kind of relationship with another person? The kind where people have less money than she does, and for want of money they do something they'd rather not that she benefits from? The kind of relationship all of us have with millions of people in the world? I think this attitude is confused.
I think we can generally agree that it would take significant financial straits before any of us would be willing to undergo a potentially life-threatening surgery, just for the money. Given that, I think our squeamishness is on to something. If our actual goal is to get the poor out of poverty, why not just give them some money? Or a good paying job? Or the health insurance? Why dangle those things at the end of a scalpel?
No one thinks that the primary goal of organ donation compensation is to end poverty, or that it should be allowed to the exclusion of other anti-poverty measures. I think that given the premise that generous compensation would have better outcomes for the donor than keeping their kidney, a sense of the proper relationship among the classes should not inhibit allowing the donor to be compensated. It's totally possible that premise is false, though.
Posted by Tia | Link to this comment | 05-18-06 1:49 PM
Andrew in 126:
I think Becker's point is a bit misleading -- you don't need organ sellers to come from the waaay bottom of the income/class distribution for the inequality to be troubling. No, I don't think we'd end up in a situation where homeless heroin addicts are selling kidneys. But there are enough families who are working class low imcome families facing desperate enough situations who would be viable organ sellers. So yes, the very poorest amongst us may not, but for sure no one above a certain income level is going to be selling their organs.
Similarly with the volunteer army issue. The army is solidly lower-middle class. And there are few very poor people in the army for the reasons Becker cites. But there are also very very few rich people in the army. And furthermore, the army's middle class status frankly is buoyed by the fact that until the Iraq war, the military has been able to be relatively selective in who it takes. We're seeing evidence that recruiters are becoming much less selective lately -- something that will surely bring down the median income stats of those enlisted.
Posted by Carl | Link to this comment | 05-18-06 1:51 PM
I understand that it's a bug and not a feature SCMT, but my point is that allowing organ sales doesn't make the structural problem any worse. The same type of unfairness exists when we allow organ sales, but fewer people will die if we allow organ sales. Ideally, we would reform the health-care system so that health does not depend on wealth, but since that solution isn't possible at the moment, we should opt for second-best solutions that still result in an improvement over the status quo.
Ah hah, thank you LB. My knowledge of HTML has just doubled! :)
Posted by Andrew | Link to this comment | 05-18-06 1:51 PM
oops, I didn't finish a sentence in there. Maybe I should do a post after all and be more clear.
Posted by Tia | Link to this comment | 05-18-06 1:57 PM
Handy HTML tags. Collect the set! (I only know two handfuls, myself, but I consult as needed when not in a hurry.)
To link to something, aside from following above instructions, but if you want to find in future, scroll ">here to "link something."
Don't leave your online keyboard without it. (Someday I may figure out divisions and tables, and then CSS, but I've gotten by for about 11 years online without it.)
Posted by Gary Farber | Link to this comment | 05-18-06 2:01 PM
I'm wary of squeamishness as a touchstone; I'm reminded of Leon Kass and his "wisdom of repugnance." It's not always the angels who have icky feelings about things.
Posted by mjh | Link to this comment | 05-18-06 2:02 PM
My license has two lines beginning with "witness" followed by a colon and a blank line, I assumed therefore that witnesses were required.
Posted by washerdreyer | Link to this comment | 05-18-06 2:02 PM
Carl in 134:
I agree with you. But I don't think that Becker's point is entirely irrelevant. There still might be some inequality with respect to class representation in the military, but because those in the most desperate financial situations are not overrepresented, we can say that there may not be any troublingly coercive effect deriving from the combination of a capitalist system and a volunteer military. Ditto w/r/t organ sales. If there is no coercive effect in giving persons the option to sell their organs, then it makes more sense to think of their decision to sell as rational and considered, and in their interests, than as an irrational decision coerced by an institutionalized desperation. And if that is the case, then we're not doing ANYONE any favors by denying an option to sell organs.
Posted by Andrew | Link to this comment | 05-18-06 2:02 PM
133: Yeah, this might be one of those principle vs practice things. I'm not certain whether my revulsion to the idea of organ sales is rooted in principle or in certainty that it would fail to be beneficial. Since that's not an exclusive or, I'm content to argue against it on practical grounds.
Take supply-side economics. Or neoconservatism. I'm not an economist or international relationsist, so I can't tell you why it's a bad idea in principle, but I can tell you why it's a bad idea in practice.
I'll leave the decision as to whether compensating organ donors is, in principle, good or bad to the philosophers here.
135: The same type of unfairness exists when we allow organ sales, but fewer people will die if we allow organ sales. Ideally, we would reform the health-care system so that health does not depend on wealth, but since that solution isn't possible at the moment, we should opt for second-best solutions that still result in an improvement over the status quo.
I think there are at least two unsupported and tendencious claims in there.
Posted by mrh | Link to this comment | 05-18-06 2:02 PM
Barbara Ehrenreich won't have anyone clean her house because she doesn't want to have that kind of relationship with another person.
That is so appalling I do not even know where to begin.
Posted by Idealist | Link to this comment | 05-18-06 2:03 PM
Handy HTML tags. Collect the set! (I only know two handfuls, myself, but I consult as needed when not in a hurry.)
To link to something, aside from following above instructions, but if you want to find in future, scroll ">here to "link something."
Don't leave your online keyboard without it. (Someday I may figure out divisions and tables, and then CSS, but I've gotten by for about 11 years online without it.)
Posted by Gary Farber | Link to this comment | 05-18-06 2:03 PM
Tia:The kind where people have less money than she does, and for want of money they do something they'd rather not that she benefits from? The kind of relationship all of us have with millions of people in the world? I think this attitude is confused.
I think you're right, this kind of attitude can border on the absurd and/or patronizing. A lot of us have a certain squeamishness about people hiring nannies or housekeepers who are lower income immigrants (legal or not). But it's not that we object to the exchange in theory. If you're poor, you have your labor, if you're rich you've got some money -- exchanging one for the other is fair enough. As long as the employee has reasonable autonomy (ie, to quit, to object bad working conditions, etc.). *But* even you must see there's a difference between these kinds of exchanges, and things like working in the sex trades. Some exchanges because of the society we live in, are simply going to be grossly inequitable. I think we're arguing that an organ trade would be something more like that. That there's a difference between selling your kidney, and selling your labor.
Posted by Carl | Link to this comment | 05-18-06 2:06 PM
I thought this was the height of absurdity, since the class differences obviously existed, and it was good for the students running the service to have the income.
Except that we don't care about class differences except that they're made manifest. It seems reasonable to me, for example, to believe that if your co-worker was also your maid, you might not treat them as equals. Would that be wrong of you? Yeah, but also pretty typical.
Posted by SomeCallMeTim | Link to this comment | 05-18-06 2:07 PM
This thread is making me very sympathetic to the idea that there are better ways to combat organ shortage that don't have problems with market perversities. If we fully explore and even implement some of these, and the problem remains, a market solution might be the next best thing.
"Barbara Ehrenreich won't have anyone clean her house because she doesn't want to have that kind of relationship with another person. Obviously, B.E. has lots of anti-poverty cred, but I think that's kind of silly?"
Perhaps silly, but I can certainly understand how one would want to avoid seeing oneself as upper-class, and domestic help is usually associated with the upper and upper middle class.
Posted by pdf23ds | Link to this comment | 05-18-06 2:07 PM
Feh. That comment (143) appeared a second time not because I hit "post" again, but because since I got the familiar "misconfigured" page, I just hit F5 to reload the page. I won't do that again.
Posted by Gary Farber | Link to this comment | 05-18-06 2:07 PM
Handy HTML tags. Collect the set! (I only know two handfuls, myself, but I consult as needed when not in a hurry.)
To link to something, aside from following above instructions, but if you want to find in future, scroll ">here to "link something."
Don't leave your online keyboard without it. (Someday I may figure out divisions and tables, and then CSS, but I've gotten by for about 11 years online without it.)
Posted by Gary Farber | Link to this comment | 05-18-06 2:10 PM
Right. There is a practical difference between things that a reasonable number of people do, even in the absence of desperation, because they seem to be in their own best interest (such as cleaning houses -- if I were out of work, I'd clean for money. You'd have to be an idiot to hire me, but I'd do it if I couldn't find anything higher paying) and things that, as a matter of practice, it seems that people just don't do unless really desperate or fucked up somehow (prostitution, paid organ donation). I really want to treat those two categories differently -- not as if they were on the same continuum of slightly less desirable money-making opportunities.
Posted by LizardBreath | Link to this comment | 05-18-06 2:12 PM
That is so appalling I do not even know where to begin.
How so? Idiosyncratic maybe -- appalling? What is the problem, that she is violating noblesse oblige? Should she have to hire somebody to clean her house? This seems to me like a perfectly acceptable area to allow her freedom of choice.
Posted by The Modesto Kid | Link to this comment | 05-18-06 2:13 PM
Andrew:
then it makes more sense to think of their decision to sell as rational and considered, and in their interests, than as an irrational decision coerced by an institutionalized desperation.
In theory, I'd agree, giving the poor property rights to make rational decisions sell their "assets" should be a thing to be encouraged and far be it from me to impose some ill-defined moral stance on them. *But* I think the study from India cited above (at 100 I think) is illustrated. In the abstract the authors claimed that most of those who sold their kidneys did so under the duress of debt, and in retrospect would not have done it, or advise people the know to do it. That does NOT sound like a rational, non-coerced decision to me.
Posted by Carl | Link to this comment | 05-18-06 2:14 PM
s/b "to sell their assets". duh.
Posted by Carl | Link to this comment | 05-18-06 2:14 PM
I don't know about appalling, but definitely weird. Choosing not to hire a cleaning person? Totally reasonable. Seeing something fundamentally wrong with the relationship between employer and employee? A bit off.
Posted by mrh | Link to this comment | 05-18-06 2:16 PM
and "illustrated"="illustrative". Jeez.
Posted by Carl | Link to this comment | 05-18-06 2:17 PM
141: I think there are at least two unsupported and tendencious claims in there.
;) Three if we count that one.
Posted by Andrew | Link to this comment | 05-18-06 2:17 PM
The 'right' was to 144.
The housecleaner thing is interesting, because I kind of sympathize with it emotionally. On the other hand, I pay someone to stay in my house and mind my children for me, and that doesn't bother me. But it doesn't bother me largely because the interpersonal dynamics work out well -- Nancy is very professional, and relates to us like co-workers, and Buck works at home and has become good friends with her.
But I could completely see having a nanny-relationship that would creep me out or make me feel guilty.
Posted by LizardBreath | Link to this comment | 05-18-06 2:17 PM
To take off from #149:
There is a humanitarian crisis in Somalia; no food, warlords, etc. Life expectations are less than three years from however old one is now. I am Berb, and I like really young girls. I go to Somalia and say to a very young girl, "I'll pay you a lot of money and take you out of here if you'll act as my sex toy for five years. I can guarantee that you'll have an longer expected lifetime, even if you exclude the five years you'll be working for me." It looks like there's at least a colorable argument that the young girl is better off, but I really don't want Berb to be able to make that offer.
Posted by SomeCallMeTim | Link to this comment | 05-18-06 2:18 PM
Precisely, you betcha, what he said, absolutely, right on.
Posted by LizardBreath | Link to this comment | 05-18-06 2:21 PM
Carl at 151: *But* I think the study from India cited above (at 100 I think) is illustrated. In the abstract the authors claimed that most of those who sold their kidneys did so under the duress of debt, and in retrospect would not have done it, or advise people the know to do it. That does NOT sound like a rational, non-coerced decision to me.
I agree. OTOH, the US is not India, and India---outsourcing hysteria aside---is not yet the US. Since the very poor here are apparently not coerced into joining the military, perhaps there's good reason to suppose that they also wouldn't be coerced into donating a kidney.
Posted by Andrew | Link to this comment | 05-18-06 2:23 PM
How so? Idiosyncratic maybe -- appalling? What is the problem, that she is violating noblesse oblige? Should she have to hire somebody to clean her house? This seems to me like a perfectly acceptable area to allow her freedom of choice.
I am in no way questioning her right to choose not to hire someone to clean her house, whether because she does not want to spend the money or because it makes her feel more self-reliant, and not part of the pampered class.
What is highly obnoxious is the notion that there is something unseemly about having to sell your labor by cleaning houses. Does she think that whatever she does makes her morally superior in some way to a person who cleans toilets or cooks french fries or digs ditches. Is it embarassing to her to participate in a direct manner in the employment of a person who does meanial tasks like clean houses? Is being poor or having to work with your hands something demeaning which a good person should be embarassed to witness? I mean, wtf?
Posted by Idealist | Link to this comment | 05-18-06 2:25 PM
I agree. OTOH, the US is not India, and India---outsourcing hysteria aside---is not yet the US. Since the very poor here are apparently not coerced into joining the military, perhaps there's good reason to suppose that they also wouldn't be coerced into donating a kidney.
Why in Gawd's name would you limit it? There are already people who fly to outside countries for various healthcare work; why wouldn't people fly to India to get cheaper kidney work? It would make it more affordable to the American middle-class.
Posted by SomeCallMeTim | Link to this comment | 05-18-06 2:25 PM
Does she think that whatever she does makes her morally superior in some way to a person who cleans toilets or cooks french fries or digs ditches.
I think you're misreading where her concern lies. She doesn't want home labor, I assume, because she believes she'll change, and not for the better, if she does.
Posted by SomeCallMeTim | Link to this comment | 05-18-06 2:27 PM
LB in 156:
I think often the problem some of us feel about the housekeeper issue is not the class differences -- clearly the person hiring the housekeeper/nanny is going to be higher up the class/income ladder than the employee. And I think if the housekeeping/nanny trade had a more, ehm, ethnically diverse make-up, I don't think I'd feel there's anything off about the situation. But I think that the idea that a large number of domestic workers (in a lot of areas) are minorities/immigrants with limited english and cultural capital, makes us feel that the employer-employee relationship may not be as on-the-level as one where the housekeeper is a native. Not just from a legal standpoint, e.g. scrub the windows or I'll call immigration, but also, I think, the cultural difference is more likely to make the employers have that "oh, it's 'the Help'", attitude.
Again, I don't have a major issue with this -- I wouldn't condemn anyone else for hiring domestic help unless they were assholes otherwise. But it is the source of my personal discomfort.
Posted by Carl | Link to this comment | 05-18-06 2:28 PM
160 -- Have you read any Ehrenreich? Her body of work speaks very strongly against her feeling herself morally superior to a person who cleans toilets or cooks french fries or digs dishes, or being embarrassed to witness being poor or having to work with your hands. Very strongly.
Posted by The Modesto Kid | Link to this comment | 05-18-06 2:29 PM
What is highly obnoxious is the notion that there is something unseemly about having to sell your labor by cleaning houses. Does she think that whatever she does makes her morally superior in some way to a person who cleans toilets or cooks french fries or digs ditches. Is it embarassing to her to participate in a direct manner in the employment of a person who does meanial tasks like clean houses? Is being poor or having to work with your hands something demeaning which a good person should be embarassed to witness? I mean, wtf?
What would trouble me is the prospect of being treated as a social superior by a housecleaner. Again, the reason I don't have a problem with hiring a nanny is because she considers herself my social equal -- we both work for a living outside the home. I see nanny-boss relationships that fall much more into a social master-servant category, and I find that unseemly and unpleasant -- if I couldn't hire a nanny without having that sort of relationship, I would do a lot to avoid it.
Posted by LizardBreath | Link to this comment | 05-18-06 2:31 PM
161: As far as I know, Americans can already fly to India to purchase kidneys and have them transplanted there. Maybe we're talking past each other though. My point is that the situation for organ-sellers in America and for organ-sellers in India might be materially different w/r/t the question of coercion. So far as the purchasers of organs are concerned, I agree that there might be very little difference between the two countries.
Posted by Andrew | Link to this comment | 05-18-06 2:32 PM
My wife and I pay someone to clean our house twice a month. We had some initial moral discomfort, but we got over that by paying her generously and treating her like a person.
(Also, 155: Well played!)
Posted by mrh | Link to this comment | 05-18-06 2:34 PM
she believes she'll change, and not for the better, if she does.
How? Why? Has she never gone out to eat? Paid a mechanic to change the oil in her car? Paid an accountant to do her taxes? She likely is all the time paying someone to do things for her which whe could do for herself.
Posted by Idealist | Link to this comment | 05-18-06 2:35 PM
Does a traveller returning from India with a freshly-purchased kidney need to declare it to customs? Are there import duties?
Posted by The Modesto Kid | Link to this comment | 05-18-06 2:35 PM
163: Belle Waring had an interesting series of posts on a similar issue. I've never lived in Singapore, where BW lives, but in Hong Kong, the middle and upper classes *all* have maids, nearly all of whom are Filipina. The economy of the region (created in no small part by colonialism in which the U.S. participated) is such that if you are from the Philippines, leaving your home, family, and your own children, to take care of someone else's kids in another country, is your best option. It's fucked up, and I think it's perfectly sensible to have serious misgivings about participating in such a system.
Posted by jms | Link to this comment | 05-18-06 2:35 PM
Andrew:
Re. the difference b/w the US and India. I'd hope you're right. Part of me finds it hard to believe though -- perhaps I'm more cynical than the evidence justifies. And since there are so many better solutions to both poverty and organ shortages, I don't think it's worth the risk to find out which of us is right.
Posted by Carl | Link to this comment | 05-18-06 2:36 PM
I think that selling a kidney is different from selling labor. I'm as much of a fascist liberal as anyone and I'm not sympathetic to the idea that poor people should have the freedom to choose to sell their kidney if it's not in their best interest. But I think their best interest should be the ruling consideration, not a principled avoidance of the commodification of body parts (that was the sentence I neglected to finish). And actually, I only agree with SCMT insofar as it has the same problem with creating incentives for exploitation, which maybe the organ thing does too, and that the thing he's talking about is actually probably more damaging than giving up a kidney. As an individual, there's some degree of horrible abuse I'd want to be able to trade for my life.
Posted by Tia | Link to this comment | 05-18-06 2:37 PM
It would make me feel weird to hire such domestic help. In an ideal world, there would not be enough inequality for domestic work to be a worthwhile job (at pay below, say, 15.00 an hour). By hiring someone below that wage, you're taking advantage of that gross inequality, and I can see how that would make someone feel weird. Would Ehrenreich be opposed to paying someone 15.00/hr for her domestic work?
Posted by pdf23ds | Link to this comment | 05-18-06 2:38 PM
As far as I know, Americans can already fly to India to purchase kidneys and have them transplanted there.
I think that's illegal. I couldn't swear to it. My larger point is that if there is demand here, there will be supply in India (or China or wherever), and we have some evidence that the market in India creates bad outcomes.
Posted by SomeCallMeTim | Link to this comment | 05-18-06 2:38 PM
How? Why? Has she never gone out to eat? Paid a mechanic to change the oil in her car? Paid an accountant to do her taxes? She likely is all the time paying someone to do things for her which whe could do for herself.
Again, none of those are conventionally master-servant relationships. It may be (all right, I'm sure that it is) possible to hire someone to clean your house in a way that doesn't fall into that social pattern, but it's not irrational to distinguish between housecleaning and auto mechanics on the basis of wanting to avoid the pattern.
Posted by LizardBreath | Link to this comment | 05-18-06 2:38 PM
My honey's apartment-mate has hired a cleaning lady who comes in twice a month to clean everywhere but my honey's room. She's a nice person, and she's clearly totally empowered in the labor-for-cash exchange, but even as a bystander, pretty much, I feel strange about it. I'm sleeping in on a lazy Sunday morning, and somebody is cleaning up Saturday's dishes in the kitchen. And it does create perverse incentives. The apartment-mate will say things like: "Oh, just leave that; the cleaning lady is coming tomorrow." I don't know that feeling weird about it is a moral impulse on my part, though.
Posted by Jackmormon | Link to this comment | 05-18-06 2:40 PM
My inept googling hasn't turned up any hits, but I recall reading somewhere about a theory that Americans preferred self checkout lines and such because they are very uncomfortable about class differences, particularly in the context of service relationships. There was an article in the NY Times a couple of weeks ago along similar lines involving wealth inequality between friends.
Posted by Andrew | Link to this comment | 05-18-06 2:41 PM
I understand Ehrenreich's aversion to hiring domestic help, and share it to some extent; I think part of the issue is that by hiring a full-time maid you become The Boss, which is an uncomfortable position for a lot of liberals. Hiring an occasional cleaning service or whatever just makes you a client, without the feeling of an asymmetrical employment relationship that causes discomfort. (I may not be accurately judging this; I'm also uncomfortable with the situations Ideal mentioned for similar reasons, so my explanation could well be off-base.)
Posted by teofilo | Link to this comment | 05-18-06 5:23 PM
I think it's also partly being The Boss in a domestic space.
Posted by Jackmormon | Link to this comment | 05-18-06 5:34 PM
you become The Boss, which is an uncomfortable position for a lot of liberals. Hiring an occasional cleaning service or whatever just makes you a client, without the feeling of an asymmetrical employment relationship that causes discomfort.
I understand (even though I do not share) the concern you voice. But this is a bit like eating meat, but trying to ignore that someone had to kill the animal. Your avoidance of being an employer means that instead of getting to work for you--someone who will be a kind and considerate boss and who will pay the best wage you can afford--someone has to go get a job cleaning grease traps at McDonalds for less money and have a total dick for a boss. And you eat at that McDonalds (or substitute work as a dishwasher as that cool restaurant the just got a great review in the Times--McDonalds probably treats its workers better than the people who wash the dishes in a lot of the places most of us eat).
So you are avoiding being a boss because you feel uncomfortable about it, but you sure are not making life any better off for the person who did not get a job because of your reservations. And you are still enjoying the results of their labor, it's just that you do not have to look in the kitchen.
I'm not trying to be a dick--the concerns voiced here about hiring people to work for you are I am sure motivated by the best of good will and intentions--but such motivations do not IMHO help the persons toward who you trying to show concern.
Finally, I will note that you may be overanalyzing the employer-employee relationship. Someone may be your domestic servant, and they may even act subservient (which is maybe what freaks out some people), but people who do shitty jobs are people just like you and me, and if it makes you feel any better, they know that it's just a job--maybe a shitty job--but likely the best they can get. Few people are actively happy about having a shitty job, but they peobably are not nearly as emotionally invested in working for you as you are about having them work for you. It's just a job. Money on the table. If a better one comes along, they will take it. If you are a nice boss, they will appreciate it. Just like you.
Posted by Idealist | Link to this comment | 05-18-06 5:44 PM
I used to feel a bit like Idealist--in part I read you as finding people inconsistent, Ideal--but now I think people have heuristics that we often don't realize. I don't have a problem with someone cleaning my place once every other week. I might have a problem with something more frequent. And my best guess as to the difference? The people I know with lots of help are generally dicks. I'm not crazy about the name Susan for roughly the same reason.
Posted by SomeCallMeTim | Link to this comment | 05-18-06 5:49 PM
I just think there should be a distinction between the rich (or just relatively priveleged) people's feelings about their moral status with respect to the poor and poor people's actual interests. The former is only the rich people's concern, and is not that important relative to the latter. If Barbara Ehrenreich wants a clean house (and by her own telling her house is really messy and her children grew up to keep extra clean house and told her it was a reaction to her), but she won't hire a housekeeper because it feels uncomfortable to her, she hasn't helped anyone, and in fact, if she probably would have helped someone if she'd paid some housekeeper a good wage. Similarly, what's important in figuring out whether compensation for organ donation is what the actual outcomes would be for all parties, including everyone who might be affected by any perverse incentives it created, not rich or priveleged people's feelings about their moral status.
Posted by Tia | Link to this comment | 05-18-06 5:50 PM
Similarly, what's important in figuring out whether compensation for organ donation is what the actual outcomes would be for all parties, including everyone who might be affected by any perverse incentives it created, not rich or priveleged people's feelings about their moral status.
If you invent the magical future-telling machine, I totally want to invest.
Posted by SomeCallMeTim | Link to this comment | 05-18-06 5:52 PM
I certainly don't think you're being a dick, Ideal; I understand the issues you're raising and I've been pondering them all day. I think a lot of the problem is how personal it becomes when you're actively being The Boss--when you go to a restaurant or whatever you can just ignore it (although as I mentioned above going to restaurants bothers me in the same way), but when it's in your house and you have to decide what to pay the person etc. it hits home in a way you can't avoid. It doesn't really matter on an intuitive level if the person is just doing a job and would be doing a different one if you hadn't hired them, althought that is of course true.
Posted by teofilo | Link to this comment | 05-18-06 5:52 PM
Also, as Tim points out, another part of the problem is that people with servants tend to be unpleasant, and hiring servants makes you uncomfortably similar to them. This may be a more salient issue in practice.
Posted by teofilo | Link to this comment | 05-18-06 5:54 PM
what do you mean, SCMT?
Posted by Tia | Link to this comment | 05-18-06 5:54 PM
people with servants tend to be unpleasant
Hey, don't talk that way about LizardBreath!
Posted by Idealist | Link to this comment | 05-18-06 6:04 PM
LizardBreath is Teh Oppressor!
Posted by teofilo | Link to this comment | 05-18-06 6:18 PM
186: Just that, as described, I think you would find very few people to disagree with you. The problem is that our ability to model anything complicated is terrible. People end up making decision based on their faith in the market, etc. And, as the people most likely to be effected are poor, we have relatively little reason to make sure things are working out as expected. The other option is to go with our moral intuitions until someone changes our mind. I feel, at least in some areas, that the latter method of decision is usually better.
Really, we should just make Kieran tell us the answer, as (per his link) he probably has a fair bit of insight into this.
Posted by SomeCallMeTim | Link to this comment | 05-18-06 6:22 PM
He would probably prefer that we bought his book, though.
Posted by teofilo | Link to this comment | 05-18-06 6:24 PM
LizardBreath is Teh Susan!
Posted by SomeCallMeTim | Link to this comment | 05-18-06 6:24 PM
189: I think people have disagreed with that position as stated in this thread. And I continue to think that "would be unlikely to work out as planned"; "there wouldn't be sufficient safeguards" etc. are better arguments than "we should just go with our moral intuitions." When people's moral intuitions are leading them not to pay someone to clean their house, it seems to me that people feel bad about somehow dirtying their hands as often as they do about injustice per se, and those feelings can be interesting guides and indicators, but are not a good way to organize society. No one knows for certain how anything is going to work out whenever you propose any kind of change to social policy. You just have to make arguments from evidence about the best likely outcome and reverse course if things aren't going well.
Posted by Tia | Link to this comment | 05-18-06 6:35 PM
Do you guys remember that nanny-blogger story? The one where the boss became totally obsessed with the nanny's blog, fired the nanny for weirdly overwraught emotional reasons, and then wrote it all up for one of those ghastly NYT "Modern Love" columns?
I remember that the consensus that emerged from the blogs--okay, the opinion I thought most compelling--was basically that the woman didn't know how to interact with servants. Or, put more nicely: she didn't know how to maintain professional boundaries and forgot that it was structurally impossible to be coequal friends with someone in an economically subservient position.
I guess I found that explanation compelling because maintaining professional boundaries at home would be really difficult for me too. I can maintain all those boundaries and be hardnosed and openeyed in the outside world, but at home I tend to embrace naive illusions.
Posted by Jackmormon | Link to this comment | 05-18-06 6:43 PM
I put this here as a courtesy to LizardBreath, Susan though she may be.
Posted by slolernr | Link to this comment | 05-18-06 6:47 PM
193: I was also thinking of that story in connection with this discussion. I think not knowing how to interact with servants is probably a common problem among people in her position. I certainly wouldn't have a clue.
Posted by teofilo | Link to this comment | 05-18-06 6:48 PM
No one knows for certain how anything is going to work out whenever you propose any kind of change to social policy.
Right. But sooner or later (in the best of all possible worlds) you're going to get to a model that says something like, "There is X chance of ill Y happening." In evaluating whether to go forward, you're going to have to try and evaluate how bad an ill Y (say, body farms) is, and your evaluation of Y is going to be based, I think, on your moral intuitions. You can, of course, model Y, but then you'll just have Z to decide on.
You just have to make arguments from evidence about the best likely outcome
I think I flip your argument. Discussions, models, and the offering of justifications are good and fine, but primarily because they flesh out the contours of the moral intuitions that are actually the deciding factors.
and reverse course if things aren't going well.
Yeah, I have no faith in our willingness to review programs and reverse course if it's primarily the poor getting fucked. Not because the non-poor are bad people; I just don't think we do it that often.
But really, Kieran's just being a dick. He should tell us the answer.
Posted by SomeCallMeTim | Link to this comment | 05-18-06 6:52 PM
Not knowing how to bridge class boundaries can lead to problems.
Posted by slolernr | Link to this comment | 05-18-06 6:53 PM
What about selling embryos? I happen to have a couple kids that, from a market standpoint, are pure Aryan goodness. Seriously. What if there was an offer to my wife and I for 50K? 100K? I can't say I wouldn't be tempted to sell an embryo.
Posted by gswift | Link to this comment | 05-18-06 7:08 PM
Oh my. I hadn't expected Daniel Davies to look like that.
Posted by Jackmormon | Link to this comment | 05-18-06 7:08 PM
Ain't the internets a hoot?
Posted by slolernr | Link to this comment | 05-18-06 7:10 PM
That's pretty much exactly what I expected him to look like. Except I expected glasses.
Posted by SomeCallMeTim | Link to this comment | 05-18-06 7:12 PM
I expected dark hair. And older. And maybe a feral scowl. Not a clearskinned redhead looking wistfully into a setting sun.
Posted by Jackmormon | Link to this comment | 05-18-06 7:18 PM
None of my mental images of people have ever turned out to be the least bit accurate.
Posted by Standpipe Bridgeplate | Link to this comment | 05-18-06 7:19 PM
That is actually pretty much exactly how I've always pictured dsquared.
Posted by teofilo | Link to this comment | 05-18-06 7:21 PM
I like how the pic cuts off at the top. It's like "maybe I'm bald, but you can't prove it."
Posted by gswift | Link to this comment | 05-18-06 7:25 PM
Whenever I see a picture of someone I "know" from the internets I realize I don't actually have an imaginary picture of them in my head. You are all just floaty electronic text to me.
Very nice, albeit disembodied, floaty electronic text, that is.
Posted by slolernr | Link to this comment | 05-18-06 7:26 PM
Also.
Posted by slolernr | Link to this comment | 05-18-06 7:27 PM
I think the "fat young man without a good word for anyone" line led me to mistakenly assign him a high degree of frumpage.
Posted by Standpipe Bridgeplate | Link to this comment | 05-18-06 7:27 PM
192, 196: You're both (half-)right! It's the magic of reflective equilibrium. Which is the iterative process of going back and forth between broad moral principles and concrete moral reactions to specific situations, trying to alter, or even unconsciously altering whichever one needs to be, just a little bit, each time. I accept feedback from the professionals and really anyone else who has an idea about what I might be getting wrong.
Davies' post about his picture. I was also surprised.
On preview, damn you slol.
Posted by washerdreyer | Link to this comment | 05-18-06 7:29 PM
Ok, I have to get caught up (good god, people. The comments go down so I go out to dinner and I come back and now I have *homework*). But a couple things from a ways back:
1. are really poor people going to increase the number of kids they have specifically to guarantee income down the line? Well, historically poor people have increased the number of kids to guarantee income, yes--for farm labor, for support in old age, whatever.
2. predictions that a voluntary army would be filled mainly with poor persons have turned out to be wrong. They have? The officer class isn't primarily poor folks--although given that ROTC scholarships can pay for a college education, I'd be surprised if the bulk of the officer class weren't primarily from the middle and lower-middle class, rather than the children of doctors and lawyers. But aren't the enlisted folks, in fact, pretty much largely from blue-collar backgrounds? Not truly destitute, perhaps, but pretty poor. And aren't there also, in fact, a much higher proportion of immigrants and Indians in the military than in the population as a whole, precisely because it's a route to benefits and security (including citizenship) that's not available in other ways?
Posted by bitchphd | Link to this comment | 05-18-06 7:29 PM
Although right now I picture B as the kind of person who would ruin a perfectly good threadjacking.
Posted by slolernr | Link to this comment | 05-18-06 7:33 PM
SB, read the comments, some is explained.
Posted by washerdreyer | Link to this comment | 05-18-06 7:34 PM
Finally, does anyone want to opine on whether the following is an ok time, place, and manner restriction? I only pretend to know some con law.
The following:
The regulations of the Port Authority of New York & New Jersey for this location prohibit:
...
Posted by washerdreyer | Link to this comment | 05-18-06 7:41 PM
210: I think in context "poor" was taken to mean truly destitute (homeless people and such), and it is therefore true that the military doesn't have too many of those types (requiring a HS diploma does a lot of this). I believe the military was actually found to skew rural, and probably Southern too. I'm sure the Hispanic (not just immigrant) and Indian percentages are way out of proportion as well.
Posted by teofilo | Link to this comment | 05-18-06 7:44 PM
I don't know squat about con law, but I do know that I loathe the democratically unaccountable, corrupt, and authoritarian institution that is the Port Authority.
I hope that helps.
Posted by Jackmormon | Link to this comment | 05-18-06 7:49 PM
An adjunct to 213-
I would guess that the first person to make a good faith guess (or someone might just know and not have toguess) as to where that sign appears will be correct in their guess.
Posted by washerdreyer | Link to this comment | 05-18-06 7:54 PM
I do think it's kind of obnoxious to object to Barbara Ehrenreich's refusal to hire a nanny, if one knows what her objection is; otherwise, of course, it's simply ignorance. The problem, from her point of view--and it is a very good one--is summed up by Jackmormon in 179 and 193. Basically, the equation Idealist is making between hiring someone to change the oil in your car and hiring someone to clean your home is a false equation: one form of labor is done outside your home, in the "public sphere" of the work place, and in part because of this the worker is both protected by labor laws and on a more or less equal footing with the customer--"we reserve the right to refuse service." On the other hand, domestic labor happens in the home: domestic laborers are *far* more subject to exploitation and dealing with "employers" who don't know the first thing about employment law than workers in most other fields. Domestic workers also have no control over their workplace environment whatsoever, nor is their workplace environment subject to any kind of legislation or oversight. They don't get fifteen-minute breaks. Because we think of the domestic space as "private," we think of the relationships between individuals and "their" nannies/housekeepers as private arrangements, which makes them ripe for exploitation and confusing the professional and the personal. Hence the cliche that "our nanny/housekeeper is just like one of the family."
It's a similar problem to the problem of women's domestic labor, which is largely unpaid, invisible, and devalued.
So I don't think Ehrenreich's position is because she's worried about her *own* moral agency, or because she thinks of herself as better than nannies, or because she's uncomfortable with being "the boss." It's because she thinks of herself as *not* being better than nannies, and she sees the domestic workplace--rightly, I think--as one that's inherently exploitative.
I say this as someone who has, in fact, hired nannies and housekeepers. Like the other folks in the thread who've done that, I got myself past feeling weird about it by paying well, giving them paid vacations and raises, blah blah blah. But the point is, that was something I *chose* to do--I could just as easily have chosen not to. It wasn't something the workers were in a position to negotiate or expect.
Posted by bitchphd | Link to this comment | 05-18-06 7:54 PM
You're so smart, B.
Posted by teofilo | Link to this comment | 05-18-06 8:02 PM
It's because she thinks of herself as *not* being better than nannies, and she sees the domestic workplace--rightly, I think--as one that's inherently exploitative.
I would guess that Idealist's objection--certainly mine--is that the solution is not to be a dick to whomever works in your home. But money is better than no money, and an offer from a non-exploitive house is better than one from an exploitive house. All she has done is remove a relatively good job from the list of potential jobs available to domestic workers. So I was totally wrong; that sounds exactly like what Tia objected to in other places.
Posted by SomeCallMeTim | Link to this comment | 05-18-06 8:02 PM
Okay, all caught up now. Continue with the threadjacking.
Posted by bitchphd | Link to this comment | 05-18-06 8:02 PM
219: Well, no, that isn't the solution. Because the problem isn't a private one, hence it isn't solvable by your own personal private non-dickishness.
"All she has done" is to make a career out of analyzing these things and promoting better labor conditions and farier labor law. It seems to me that passing judgment on her for not giving one housecleaner a "good" job is extremely silly. Excuse the hyperbole, but isn't it a bit like criticizing an abolitionist for refusing to own slaves, thereby providing "good" servitude to a few?
Posted by bitchphd | Link to this comment | 05-18-06 8:07 PM
Well, there imight be a best of both worlds solution: don't hire someone and give the same amount of money, or almost as much, to a charitable organization that targets people who match the one's you would have hired. Possibly even one that gives out weekly sums around the amount of a paycheck.
I'm not suggesting that this feasible for the vast majority of people.
Posted by washerdreyer | Link to this comment | 05-18-06 8:07 PM
I did not read that it was a nanny B.E. refused, first of all, but a house cleaner. Second of all, if domestic workers aren't protected by labor laws, then they should be, but that is not an inherent feature of domestic employment, and it is not for that reason any more inherently exploitative than any other. Third, workers in the house can leave the house--that's the equivalent of refusing service. It's more problematic if they're living there, but that's not what B.E. was objecting to, since she wouldn't have a cleaning service come to her home. Is anyone who travels outside a confined workspace automatically exploited? The cable guy? social workers?
Fourth, if B.E. is the boss, she's in a position to make her home a good working environment, and not to exploit her employees.
Posted by Tia | Link to this comment | 05-18-06 8:09 PM
A servant's job, or a service job, is completely different from a craft job where one works with one's hands. I think it is demeaning. It is demeaning to have to be friendly and smiling and accommodating to people who are rude and abusive. And if you need your job, and you're a waiter/maid/caddy/chauffeur, that's what you have to do.
You may be a nice person, but if you invite a friend over and he's rude to the maid, does the maid feel she has the right to slap him? She has to depend on you to stand up for her, which you probably won't do, and which in any case emphasizes her powerlessness.
Don't get me wrong, I don't think people who have to do these jobs are somehow made less by them, but the potential for abuse is there, and everyone involved in the relationship is aware of it on some level, all the time. If I had to choose between two low-paid difficult jobs, and one was on the assembly line and the other was being a maid or waitress, I'd pick the factory every time, and so would (so did) everyone else. That's where the native-born servant class went.
I understand completely why Ehrenreich wouldn't want to enter into such a relationship.
Posted by mcmc | Link to this comment | 05-18-06 8:10 PM
221: We've seen this problem before, though. There was a story a few years back about a successful effort by NGOs to stop child labor in country X. The problem, of course, is that the families had less much needed cash, and the kids weren't any better off. The NGOs realized child labor might be the best available solution at the moment, and tried to make some changes in the conditions under which the children labored.
I'm not saying she's obliged to hire someone. I just won't subscribe to her justification unless she has a lot politicians in her back pocket and she's able to change the welfare laws.
Posted by SomeCallMeTim | Link to this comment | 05-18-06 8:12 PM
The cable guy and social workers aren't employed by the people whose homes they work in. They're not domestic employees, even though they work, sometimes, in domestic spaces. It's a big difference.
Posted by bitchphd | Link to this comment | 05-18-06 8:14 PM
224: This objection holds for everyone who works in retail, or in customer service in any fashion.
Posted by Tia | Link to this comment | 05-18-06 8:14 PM
I understand completely why Ehrenreich wouldn't want to enter into such a relationship.
As I understand her, B's specifically disclaiming this (or at least Ehrenreich's side of this) as Ehrenreich's justification.
Posted by SomeCallMeTim | Link to this comment | 05-18-06 8:15 PM
In fact it is demeaning to have to be friendly and smiling and accommodating to people who can choose to be rude and abusive, even if they choose not to be.
Other than that, everything Bitch said.
Posted by mcmc | Link to this comment | 05-18-06 8:16 PM
226: Neither is a housecleaner, necessarily.
Posted by Tia | Link to this comment | 05-18-06 8:17 PM
225: Well, what she's working for isn't to make domestic labor illegal. Which is quite different from the stopping child labor thing.
I get that no one's saying she's obliged to hire someone, but it seems to me that people are looking askance on her refusal to, and arguing that somehow that decision is morally suspect (is denying someone a job, is demonstrating a sense of superiority on her part, or whatever). What I'm saying is there are very sound reasons for her to refuse to do so, and that these reasons are both moral and responsible. No one has to imitate them, but I don't see what we gain by objecting to them.
Posted by bitchphd | Link to this comment | 05-18-06 8:19 PM
227: a. there are differences of degree. b. these jobs are also demeaning.
Posted by mcmc | Link to this comment | 05-18-06 8:19 PM
228: I don't think so.
Posted by mcmc | Link to this comment | 05-18-06 8:20 PM
Or a self employed electrician or carpenter? They would be employed by the people whose homes they entered.
Posted by Tia | Link to this comment | 05-18-06 8:21 PM
Or a self employed electrician or carpenter? They would be employed by the people whose homes they entered.
Posted by Tia | Link to this comment | 05-18-06 8:21 PM
There is a difference in status between a skilled craftsperson you hire to do things you don't know how to do, and an unskilled person you hire to do things you don't want to do.
I think I need to adjust my medication.
Posted by mcmc | Link to this comment | 05-18-06 8:24 PM
230: No, but a housecleaner who works for a service is paid worse than a housecleaner who doesn't, b/c the service has to charge market rates and then take a cut off the top. And of course if you're undocumented, working for a service might present documentation problems as well. OTOH, it's true that a service pays social security and unemployment, and will communicate to the employer certain regulations, and will serve as a buffer between employer and worker (I've experienced this myself--if you hire a service, you can't negotiate *how* a job gets done; the employees will do it in the way the service has trained them to. So if you want them to wax the floor on their knees, say, tough luck.) So in some ways a service is better--more protection--and in some ways it's worse--lower pay. In other words, the service thing doesn't fully excape the inherent problems of domestic labor--which is precisely the point.
Posted by bitchphd | Link to this comment | 05-18-06 8:25 PM
And no, I did NOT expect cleaners to wax the floor on their knees. But some people do. Those people are, of course, assholes.
Posted by bitchphd | Link to this comment | 05-18-06 8:28 PM
Capitalism is just one big demeanfest. Seriously. The other week one of my bosses yelled at me for no good reason. I was working hard to compensate for his procrastination, and his procrastiation caused him another problem I didn't have control over, and he got mad at this third party, so he yelled at me, or rather, to me, since he wasn't directly criticizing me, and swore. It was really fucking obnoxious. In a personal interaction, I would told him where to shove it. Since it was my job, I thought it was best just to calm him down. Later, he apologized to me, because he's not really a dick. But if he hadn't, it would have been best for me to suck it up. There is no way to avoid the gross heirarchies capitalism creates, and I don't think having a housecleaner come to your house twice a week is a particularly gross one, except in that maybe they're not unionized.
Posted by Tia | Link to this comment | 05-18-06 8:30 PM
228: I'm saying that her justification isn't that she thinks it would make her a bad person. Which is different from saying that the weak position domestic laborers are in is inherently degrading to their human dignity. I can go along with MCMC on this one, although I think that Ehrenreich's position (if I remember it accurately) is more about the structural and cultural inequalities of domestic labor, full stop, than it is about the shuck n jive problem. Heck, if domestic labor were seen as work in the proper sense, one wouldn't have to shuck n jive.
Posted by bitchphd | Link to this comment | 05-18-06 8:31 PM
229: But wouldn't the domestic worker's assumed conviviality fall under the category of people-skills, and apply in any job where interpersonal communication is important? As a lawyer you might have to be polite to an obtuse judge who insists on falling asleep during testimony and inevitably wakes up crankily to an intrusive "objection!" or to a twice-divorced partner who counts his angry life in billable hours and demands that you do the same. As a soldier you might have to gel with other members of your unit even though you think some of them are unqualified assholes with the moral sensitivities of a dinosaur. As a factory owner you might have to smile and laugh with wholesalers and suppliers, even when you think that they're boorish fools with no appreciation for the tender aesthetics of mass-production. Ditto for doctors, psychologists, presidents, even professors if they have any kind of brain. So... is it really demeaning if a domestic worker must be politic with her customers as well? Domestic workers shouldn't get any special breaks, imho.
Posted by Andrew | Link to this comment | 05-18-06 8:31 PM
The real problem with domestic work is that there's no obvious career ladder to climb up. No small part of what you get paid with at good jobs is experience, which lets you bolt jerk employers. As regards exploitive jobs (or any employment terms), you should always trust the market and never your boss. That seems to be a difficult thing to do in domestic work or most retail work.
Posted by SomeCallMeTim | Link to this comment | 05-18-06 8:34 PM
I still don't see any inherent problems with domestic labor. I see a problem with people who work in cleaning service being ununionized and underpaid, but there are still plenty of situations in which we'd all think it was fine to invite someone into our homes to do work. I know how to paint my room, which is currently lime green. I'll probably never get around to it unless I hire someone. What is the inherently exploitative aspect of that?
Posted by Tia | Link to this comment | 05-18-06 8:36 PM
We must rise up...
Posted by mcmc | Link to this comment | 05-18-06 8:41 PM
There is a difference in status between a skilled craftsperson you hire to do things you don't know how to do, and an unskilled person you hire to do things you don't want to do.
And I should say more explicitly: not an important one. I pay for lots of things that are only timesavers. I know how to cook my food, but I often don't feel like it. I drop my laundry off; I could do my own laundry. For that matter, there's nothing stopping me from learning to sew my own clothes. I'm using my money to buy time. Everyone does this. There is nothing sacrosanct about cleaning.
Posted by Tia | Link to this comment | 05-18-06 8:42 PM
OTOH SCMT, reputational costs might be lower if you're an independent contractor in the domestic service industry and located in a high population area. You can bolt asshole customers who aren't worth the wages they pay, stay with bearable customers, and only reference customers who like you when asked/offering references.
But in other industries you can't be as choosy. You might be able to leave a jerk employer after a year or two, but the reputation you develop while in her employ will count.
Posted by Andrew | Link to this comment | 05-18-06 8:43 PM
And my experience has been that there's a not insignificant difference between paying somebody to deliver food to my door and padding around an apartment drinking coffee in sweatpants while the hired help very professionally cleans the place up.
I understand rationally that the difference is not an economically structural one. But in the second case, I'd say that the structure can get very personal, particularly for the employer; the employee tends to be very clear about who is paying the bills and what that means.
The apartment-mate who hired the cleaning-lady usually manages to be out before she arrives. He leaves her cash on the dining-room table. I find this combination offensive, partly because I've spent the night over there when my honey had to let the cleaning lady in, which then cut into our private mornngs together, and partly because the cash on the table seems so damned crass. If the cash is for her, direct it to her, maybe in a specifically addressed envelope!
Posted by Jackmormon | Link to this comment | 05-18-06 9:05 PM
I composed a comment just before the downage which started to answer the question already answered since, what is the difference between the mechanic and the housecleaner? We try to minimize the difference for the benefit of the housecleaner. This is what cleaning-up-for-the-cleaning-woman is about. First we do it so that her time is on the hard cleaning we don't usually get to, like washing floors. But just as important is the notion of depersonalizing the work, so that she cleans a house, not up after people. If I find my daughter has not cleaned up her personal messes, I'm pretty angry about it. She should not be exposed to our personal crap, drawers open, books strewn around, etc. We should do that. We wash and put away the dishes, find our shoes and put them in closets, etc. For us, that makes the night before her visit a major chore-performing occasion, so that we meet her halfway. I stay out of her way, unless she needs supplies or sometimes an equipment repair. My Russian and her Polish can communicate to some extent, mostly on words, never sentences. Close supervision is out of the question.
Posted by I don't pay | Link to this comment | 05-18-06 9:16 PM
I understand rationally that the difference is not an economically structural one. But in the second case, I'd say that the structure can get very personal, particularly for the employer; the employee tends to be very clear about who is paying the bills and what that means.
I totally don't disagree with any of your comment, and in fact, this quoted bit is part of the point I'm trying to make. This is really an issue about the employer's feelings about his or her relationships and domestic space; it doesn't have to do with the employee's well-being. There are lots of things you can do to be a good employer within the home; there are lots of structural changes that need to be made so that domestic workers are protected; there is no reason it's inherently exploitative to have someone employed in a domestic space.
Posted by Tia | Link to this comment | 05-18-06 9:46 PM
And in the same vein, on this:
We try to minimize the difference for the benefit of the housecleaner
I doubt the housecleaner cares, except in that you might be making less work for her (I presume it's a she). I think to the extent that you are trying to minimize her contact with something personal, rather than making less work for her, you are doing it for your own benefit, not for hers.
Posted by Tia | Link to this comment | 05-18-06 9:58 PM
259: I've done this job, when I was in school. You do care. The more personal the mess, the more repellent. and the more difficult to clean up, since you need to figure out where the person ordinarily puts the stuff.
Posted by mcmc | Link to this comment | 05-18-06 10:09 PM
So it's settled. We'll pay top dollar for the organs of domestic workers, because, hey, they're already denigrated. But only after they're unionized, and we promise not to make them clock in in a manner that may jeopordize their personal information. Sweet. I love Amuricka.
Posted by Stanley | Link to this comment | 05-18-06 10:34 PM
You're all on crack, you know that, right? There are tasks that are traditionally personal and private. Most of them are tasks done in the home (some, like cleaning hospital bedpans, aren't). To do those tasks for someone else, for pay, is demeaning, no matter how good the working conditions. It's difficult to articulate precisely what makes the selling of the private demeaning--I guess I'd say something about being unable to keep what's most your own for yourself--but I didn't think there was any serious question that it *is* demeaning. That's not dispositive for the question BE raises--we're generally willing to let people demean themselves for money, as long as we can distinguish it from exploitation--but there ought not be any mystery about why Ehrenreich doesn't feel comfortable hiring household help.
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