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[ Music ]
>> Stanford University.
>> Thank you Howard.
The new graduates are going to get a chance now
to discover how wonderful Howard is.
Howard is just the best Alumni Association President
in the country and you will now get the chance to see that.
I wanna thank you again for inviting me
to celebrate Class Day with the graduates and their families.
You know the classic 2010 is my very favorite class.
[ Laughter ]
>> But don't tell anybody else.
It's also my pleasure
to introduce this year's Class Day speaker,
Professor Debra Satz, a colleague of mine.
Professors Satz's husband Don Barr is here along
with their son Isaac.
Now I have to say something about Don, last night,
Don won the Phi Beta Kappa Teaching Award for the year.
Congratulations Don.
[ Applause ]
>> And Isaac hasn't won a teaching award yet
but I know he's got it in his genes.
So, I wanna welcome you both and we're delighted
that you could join this morning.
Before I introduce Professor Satz,
allow me a word with the graduates.
Graduates, you may not remember this but I was the first
to give you an assignment years ago during New Student
Orientation and some of you still owe me your answers.
So I'm gonna also give you your last assignment tomorrow during
commencement when I ask you stand to receive your degrees.
And I want you to know that in doing so doing
so will be an honor for me,
just as being here today is an honor for me.
Please know how proud we are of you
and how much we hope you will remain active
in the life of the university.
We will ask for your time and your support on behalf
of students who will follow.
I hope, you will respond as have the generations before you.
The affection between Stanford alumni and students
and the close bonds that they create is one
of the institution's greatest strengths.
So now, let me introduce today's speaker, Professor Debra Satz,
the Marta Sutton Weeks Professor of Ethics in Society
and Director of the Bowen H. McCoy Family Center
for Ethics in Society.
Debra Satz is an inspired choice as a class day speaker.
She is a renowned political philosopher
and an award-winning teacher.
Her research focuses on social and political philosophy,
philosophy of social science, philosophy of economics,
and feminist philosophy.
She is the author of many works, the most recent
of which is Why Something Should Not Be For Sale:
The Moral Limits Of Markets.
As you're about to learn,
Professor Satz challenges her students and those
of us influenced by her scholarship with hard questions.
What do we owe each other as fellow citizens
or members of the human species?
How is equality to find?
Is it fair that some are rich and some are not?
What are the appropriate remedies to the legacies
of racism and injustice?
Professor Satz has been exploring questions like those
from her childhood in the Bronx to our undergraduate studies
at the City College of New York to her doctoral work at MIT.
And probing these questions in her teaching research,
she helps her students to think critically
and to analyze choices we as a society must make.
This is the second time in a month that I've had the honor
to talk about Professor Satz.
I recently presented her
with the University's highest faculty award
for volunteer service.
She won that award
for establishing the Hope House Scholar's Program
in which faculty
and undergraduates offer liberal arts courses to residents
of a drug and alcohol treatment facility for women.
The courses focus on ethics, social justice,
and moral responsibility and engage the women
in college level work as part of their recovery.
The effect on the women is profound
but the effect is equally profound
on the Stanford students and faculty who participate.
They begin to understand the realities of poverty
and see the world through other's eyes.
One of our colleagues, political science scientist John Ferejohn
said this about Professor Satz.
What sets you apart for many other philosophers is
that they tend to focus on conceptual or technical analysis
as an end in itself while Deborah gets interested
in issues because she sees that stakes are involved.
Please join me in welcoming this year's class day speaker,
Professor Deborah Satz.
[ Applause ]
[ Music ]
>> Wow, thanks John and welcome to everybody.
I have a couple of preliminary remarks.
First, I want to say to the class of 2010,
thank you for inviting me to give this talk.
It's an enormous honor for me to be here with you today
and I also would like to thank your families for sharing you
with us these last four years
because this place is what it is.
Not only because of the faculty and staff who are here
but because of the students who stimulate us and engage us
and push us to ever more
and more critical thinking and experiments.
Third as a preliminary, as the graduating seniors know,
sometimes papers don't turn out the way you've planned
and so it is with talks.
So instead of lecturing on responsibility
in a globalizing age which is I think what it says on the--
I don't know I it says on the screen
but it says on your handout.
I'm going to be talking about the moral limits of markets.
However, I hope you'll see that the question
of global responsibility is very much on my mind and is involved
in all the kinds of questions
that I'll be looking at with you today.
Okay, sometimes it seems as if everything is for sale.
Markets and market-like practices are extending their
reach in almost every sphere of our lives.
Here are a few of the weirder recent examples.
A Russian company offers services with a minimum charge
of 34 dollars to provide an alibi
for an adulterer's absence.
A Chilean cemetery is now charging 462 dollars
for an alarm built into coffins to ensure
against being buried alive which has been a problem
at this recent-- at this particular cemetery.
[Laughter] Some University
of Michigan students have been getting a 100-dollar cash
payments if they agreed to keep their dorm rooms presentable
and open the doors of respective students
and their parents can take a look during campus visits.
[Laughter] Participants must let tour groups see their room
in the middle of the day and they have to be out of bed
and dressed before noon [Laughter].
And as you can imagine, the compliance rate is low.
[Laughter] Here's another one I like,
item 248619068, the meaning of life.
Somebody finally figured it out
and they put it up for sale on eBay.
[Laughter] Even with eight bids.
This incredible find didn't fetch much
but it was probably the best three dollars and 26 cents the--
winning bet-- bidder ever spent.
Earlier this year, a computer game retailer revealed
that it legally owns the souls of thousands of online shoppers.
The British firm game station has added the following clause
to its sales contracts.
So, here's the clause,
"By placing an order via this website on the first day
of the fourth month of the year, 2010 Anno Domini you agree
to grant us a nontransferable option to claim for now
and forevermore your immortal soul."
[Laughter] "Should we wish to exercise this option,
you agree to surrender your immortal soul
and any claim you may have on it within five working days
of receiving this notification from gamestation.company.uk
or one of its duly authorized minions."
Now, as you might have guessed, this was meant
as an April fools joke.
Nevertheless literally, thousands of people
who bought online games that day unwittingly checked the box
agreeing to these terms.
[Laughter] So, if you take one idea from this lecture
about markets, always be sure about what you are agreeing to.
Okay, here's one that unfortunately is not a joke.
Carry Smith [phonetic] sits with her 11-year-old son Brady
at a tattoo parlor in Salt Lake City
after goldenpalace.com was tattooed on her forehead.
Smith advertised the space on her forehead on eBay
which the Golden Palace Casino purchased for 10,000 dollars
and she plans to use the money
to send her son to a private school.
As seniors here well know, there are ads for egg donors
in almost every issue of the Stanford daily.
Finally, one cartoonist's reaction to the news
that the US government was going to allow companies to buy
and sell the right to pollute.
So, this is tom-- tomorrow and let me--
I don't know if everybody can read.
So, I'm gonna read for you.
Under the clear air act, companies can emit
up to a certain level of pollutants but a company
that emits less than its level can sell its unused portion
to another company whose admissions exceed that level.
Where will this lead?
The tail of market-driven crimes,
Martin Ryder was awakened by the sounds of a burglary.
His hand reaches to a drawer
and he corners the surprised intruder.
I have every right to kill you.
I'm in my own dwelling and I fear for my own life
but I have a better idea.
Hello crime brokers, I have a justifiable homicide.
I'd like to sell.
Certainly sir, the going rate for the right
to kill is 30,000 dollars, done.
Moments later, yeah you found a seller.
Thanks crime brokers.
Okay Sluggo, go ahead.
Rider decided not to use his legal right to kill but instead,
sold it to Sluggo who had no such right.
Thus, Rider over complied with the law
so that Sluggo could under comply.
Okay bub, beat it!
Scoot. The same number of deaths result
but with a more efficient allocation another happy outcome
when crimes are market driven.
[ Applause ]
>> Okay, this is-- might go back,
I'm not ready for that one.
Okay, the-- now more seriously, the question of whether
or not markets have limits is actually very serious.
Many of our most heated debates
about justice involved the role of markets.
Is the market fair?
Are there goods money can't buy or shouldn't?
If so why?
Markets are right now spreading across the globe as forms
of social organization.
Market globalization holds out new hopes to millions
of desperately poor people although the results
on that front up to this point are mixed.
But there's a strong case for markets resting on two claims.
The first is that letting people engage
in voluntary exchanges respects their liberty.
As the libertarian philosopher, Robert Nozick puts it,
"It's wrong to interfere with capitalist acts
between consenting adults."
The second claim is that markets promote efficiency
in the general welfare.
When two people engage in trade,
it's because they have something to gain.
As long as it makes them better off without hurting anyone else,
it must over-- it must increase the overall well being
of the population and for those of you who've taken economics,
you know there's an important theorem in economics
that formalizes this idea.
Freedom and the promotion of the general welfare
of society are good things.
Yet the same time that more and more goods are up for sale,
there are heated controversies about the morality of markets
and child labor, body parts, reproductive services
like commercial surrogacy,
diamonds that fueled bloody civil wars, weapons,
life-saving medicines,
international debt, and addictive drugs.
There's also debate on the proliferation
of for profit prisons, schools, and hospitals.
Markets and these goods are seen as fundamentally different from
and elicit very different reactions than markets
in automobiles, apples, or soybeans.
Consider as an example, the famous World Bank memo
by its then chief economist, Larry Summers with the statement
and I quote, the economic logic behind--
dumping a load of toxic waste
in the lowest waged country is impeccable
and we should face up to that.
Since the logic is indeed impeccable, the economic logic,
why did the auth-- unauthorized release of the memo
to the New York Times cause global outrage?
What is it about trading toxic waste for money that's different
than trading apples for money?
Or continue or consider human kidneys.
Selling a kidney is current illegal
in every developed society of the world.
Even though there's a chronic shortage of donor organs.
From an economic perspective,
the ban on organ markets is inefficient
because it seems likely
that monetary incentives would increase supply
and thereby save lives.
From a liberty perspective,
it looks like it would be a free exchange
between competent adults.
But some people think we should not allow the sale
of human organs under any circumstances.
Why? More generally, what is it about the nature
of particular exchanges that concerns us to the point
that some types of markets evoke widespread discomfort
and in the extreme revulsion?
I'm going to call markets that evoke reactions of discomfort,
distrust, or revulsion noxious markets.
I could call them obnoxious markets
but I think I'll call them noxious markets.
What makes a market noxious?
Are all markets, noxious markets the same?
How should our social policies respond
to these kinds of markets?
These are the difficult
but increasingly important questions I want
to explore in this lecture.
One point of stage setting as should be obvious
from what I've said so far, I'm not going to be talking
about how should we evaluate the market system as a whole?
Markets can be powerful engines for social
and for individual good.
Instead, I'm interested only in the differing characteristics
of particular markets
that provoked objections even among those of you
who are otherwise enthusiastic about the market system.
So, let me get to my main question.
What makes particular markets appear undesirable
or in my terminology, noxious?
This is a puzzle given the liberty
and efficiency attributes of markets
to which there have been two main answers.
The first answer looks at the intrinsic nature
of certain goods and argues
that some goods are diminished or corrupted by sale.
The second looks to extrinsic external features
of market transactions.
I'm gonna begin by sketching the corruption answer
and then I'll spend the rest
of my time developing the extrinsic approach
but they really-- I'm not so much interested in getting you
to accept one approach or another but see,
there are two different kinds of lenses we can use
to view the problem of noxious markets and they each point us
to different kinds of solutions.
So, let me first motivate the objection
to certain markets from corruption.
And to do that, I'm gonna ask you to think about markets
and friends or various prizes and honors.
>> Suppose that you want more friends than you currently have.
Most of you would still not think of buying one.
Hiring a friend isn't the same thing as having a real one.
Although somebody told Paris Hilton has been running a TV
show on the basis that she could buy a friend but anyway.
So it is with respect to prices and honors.
Suppose you desperately want a Nobel Prize and decide
after failing to get one of the usual ways to try
and buy it, it won't work.
The market exchange immediately dissolves the good
that you're seeking, honor and prestige.
Celebrities certainly for sale although at a high price
but a good name cannot be.
Friendship, a good name,
and Nobel Prizes are actually example of things
that money cannot buy.
Money, markets, corrupt the good and change it
in the active exchange to get into something else.
The argument from corruption can also be applied
to explain some things that money can buy
but arguably should not buy.
So if the sale of human body parts is
intrinsically degrading.
If it's a violation of the sanctity of the human body,
then kidney sales are wrong independently
of the circumstances in which they occur.
Proponents of the corruption view use it argue
against allowing markets and sex, commercial surrogacy,
human organs, a volunteer army which they argue
with just soldiers for hire, and rights to pollute.
The corruption argument looks
at the intrinsic character of certain goods.
The circumstances of the sale
or its possible consequences aren't the issue.
Instead the corruption argument claims
that when we put some things up for sale,
we're valuing them in the wrong way.
A contrasting argument which I've developed in my work looks
at extrinsic features of particular markets.
It's a bit more complex to theory
and I'll spend a little bit of time just laying it out for you.
As I said, I want you to think of it as a lens that you put
on to think about the issue.
I explained the noxious nature of particular markets
by four considerations that cut
across different kinds of markets.
So there are four considerations.
The first two have to do with the sources of the market.
These are what I'll call weak agency and vulnerability.
The second two concern the effects of a market.
They have to do with the fact
that some market transactions are extremely harmful
for individuals and some are extremely harmful for society.
My hypothesis is that the higher a given markets scores
on these dimensions the greater will be our intuitive distrust
and then the extreme are disgust about that market.
So, let me say just a bit about each of these dimensions
and then we'll run through with you how it will work
and then turn to-- contrast the corruption view
with the extrinsic view with respect to kidney markets.
Okay, so first weak agency, if I do that I can look at that.
The idea of an agent who's fully aware of the consequences
of her own actions and who acts freely
on her own behalf is central to the offensive markets.
But in many circumstances these assumptions do not hold.
So consider a person selling their ability to have a child.
Even without thinking about the background circumstances we
might wonder that a woman can't really know the consequences
of selling the right to a child she'll bare nine months
after getting pregnant.
And in the famous case baby M a woman name Mary Beth Whitehead
agreed to be impregnated with the *** of William Stern
and give up her maternal rights to the child after its birth.
She was to be paid 10,000 dollars on delivery
of the child plus medical expenses.
But after the baby was born, she decided she could not bear
to part with the baby and wanted to keep it.
Some cases of weak agency involve not
so much a person lacking information but the fact
that some people are transacting for the agent on the market.
So, in the majority of cases of child labor it isn't children
who are transacting on the market, it's their parents
who are transacting on their behalf while parents usually act
on behalf of their children's best interest,
we can't always assume this is the case.
So, there's a gap between the actor
and their interest that's been opened up by the fact
that they're being represented.
Moreover, there can be information that the parents
of child laborers are not aware of.
Most children who are child laborers are children of people
who themselves were child laborers
and don't know the benefits of education
because they themselves never experience them.
Agency is even weaker in international credit markets.
During the 1970s and '80s many African governments contracted
huge amount of debt to international firms,
lending agencies, and governments.
In many cases the governments contracting the debt
on the market where corrupt dictatorships.
They pocketed the loan money
but their impoverish populations are now saddled
with the cost of re-payment.
Should we enforce these loan contracts?
One the one side we have the idea, a deal is a deal.
On the other side we have the thought that it's unfair
to hold people responsible for loans that were undertaken
without their consent and which brought no public benefit.
So, that's weak agency.
Vulnerability, so now consider a case where weakness
of agency is not an issue.
The agents have information but they're not identical.
Sometimes the inequality
of the transacting agents structures are intuitions
about the morality of particular markets.
When people come to market
with varying resources they're unequally vulnerable
to each other.
So, consider asset sales of livestock and land
at fire prices which regularly happens
in droughts stricken areas and poor countries.
In such cases, desperately poor subsistence farmers are willing
to accept lower prices than they would have accepted
if they had any decent alternative.
Or think of somebody going in to a recent disaster area
and charging a hundred dollars for a bottle of water.
It's important to note that in these cases, and I'll talk
about kidney markets in a minute, along the lines
of vulnerability, what bothers us is not the market per se,
it's rather that the market functions is a mirror
through which we see clearly the underlying extremes
of wealth and poverty.
In many cases, the inequality that people bring
to the market is what's affecting their prospects
on the market.
And banning the market won't necessarily address the moral
problem, the inequality that concerns us.
Okay, two more, let me see if I can run
through these a little faster.
Some markets can lead to outcomes that are very bad
for the participants or for third parties.
Think about markets that deplete the natural resource space
of a country or lead to the fueling of a genocidal war.
How extreme do market outcomes have to be
to make the market appear noxious?
As a starting point, we might think of the extreme outcomes
in terms of those which render a person destitute.
Say below some contact specific poverty line.
We might go beyond that and think
about whether there's a minimum level of basic interest
that people have which ought to set a line below
which nobody should be allowed to sink.
Now again, I'm not denying that markets are a powerful force
for bringing people over and out of poverty,
but under some circumstances they can work in the reverse way
and when they do they elicit our distrust and discomfort.
Markets in apples are less likely
to generate extreme outcomes than markets in weapons,
toxic waste, parental right, or child labor and that's why
in general we're not that worried about apple markets.
But if apples suddenly became poisonous or were closely tied
to their producers' subsistence, we might then come
to worry about such markets.
Finally, the fourth parameter is
that some markets can be extremely harmful
for a society beyond the individual.
Some markets may operate to undermine the capacities
that a person needs to claim her rights
or participate in society.
This is a problem with child labor markets,
with having a pure market system and education,
some markets may condition people to be docile servers
or servile or shape them
into passive acceptors of a status quo.
>> Adam Smith, yes that Adam Smith worried a great deal
about the possibility that labor markets would shape people
to be not capable of democratic citizenship
because without education they would lose the habit of thinking
about the important questions of their country.
And that's why he advocated for example,
universal education system and job rotation.
Okay, so to summarize we get four criteria, four parameters
and then we look and see how different markets might score
on these-- we don't want Smith we're going ahead
and this will be on the test-- okay.
So, I don't want to run through all
of the ins and outs of these.
This is just to tickle your thinking about this issue.
So, what I'm doing is looking at a bunch of markets
that people have responses to that differ from their responses
to apple markets, like child labor, prostitution,
diamonds that are used to fuel bloody civil wars,
addictive drugs, and I'm asking along these four dimensions
would these market score high and X means it scores high,
a dash means there might be some problem, but it's not clear
and a blank means I can't see any problem.
And the one thing I really want you to take from this chart is
if I can steal a line from Tolstoy's remark
about unhappy families,
"Each noxious market is noxious in its own way."
That is there are different parameters
that are driving our intuitions and I invite you
to test your own intuitions by thinking about whether markets
that arouse your discomfort would score high on at least one
or more of these parameters.
Think for example about markets and credit derivatives,
hard drugs, healthcare, political influence,
K-12 education as examples.
Okay. So, let's see, how much material?
Okay, I'm gonna quickly run through one example which is
to return to the Larry Summer memo and then I'm going
to talk about kidney markets.
So as two ways of illustrating the approach
between the different lenses you could put
on to view the problem of noxious markets.
So, first to go back to Larry Summers--
okay, I should go back that way.
Larry, where are you?
There, okay.
So, remember the memo was about the trading between rich
and poor countries of toxic wastes and the idea was
if both parties wanted to enter
into this agreement they would do so because it was
of a mutual benefit
and therefore economic logic would argue, right?
Mutual benefit that the trade should be made.
So, why was there an uproar
and how does this view illustrate reasons
that we might think a toxic waste market is problematic?
Now, I'm gonna be quick 'cause I want to get to kidneys.
In the first place there is the unequal vulnerability
of the transacting parties, trade and toxic wastes holds
up a mirror to global inequality.
So he was talking about dumping the toxic waste
on very poor countries in exchange for money.
Critics might suspect that were these countries not
so poor they wouldn't accept the transfer of toxic wastes
to their lands or at least they hold out for better terms.
In the second place there is weak agency.
Many poor countries are run by corrupt governments
that don't represent the interest of their own citizens.
When accepting toxic waste in exchange for money the interest
of these citizens or at least the poorest
and most vulnerable might be neglected.
In addition to the weak agency
of the poor there is information problems many
of us don't have adequate knowledge
about the long term effects of storing toxic wastes.
Finally there is extreme harm to individuals.
Shipping and storing toxic wastes or at least some forms
of it are likely to have very bad consequences.
Many people might suffer health consequences.
Beyond this, future generations who themselves are not parties
to the agreement might also suffer bad consequences.
So, on my view the toxic wastes market looks bad
on the first three parameters.
What about kidneys?
This is a really difficult issue and one that--
if you've been following the newspaper is a constant theme
among a number of writers,
the Freakonomics columnists have been on a campaign
to actually liberalize and open
up kidney markets in the United States.
I'm not gonna argue for any particular policy here
but I want you to think
about the way the two different lenses I've given you,
the corruption lens and then the extrinsic lens, would lead you
to think about these kinds of markets.
So first just a few facts as background,
in the United States people can donate their kidneys after death
or while they're alive if only through altruism.
The result is that live kidney donations tend to come
from close relatives or intimates.
Cadaver organs come from two groups,
people who've consented explicitly
to have their organs used after death.
Usually you put a pink spot on your driver's license
or you have a living will or those
who are presumed to have consented.
Individuals also have the right not to donate their organs.
No society makes kidney donation mandatory.
Current law protects people from having their organs taken
from them without their consent even in cases
when another person's life is at stake.
So, if you fail to get an organ you have no choice but to wait
and get to the waiting list, put your name on the waiting list.
And as of Thursday afternoon when I last checked there were
over 85 thousand Americans on the wait list for a kidney.
Many of the people waiting will die while they are waiting
for an organ to become available.
So, we have a situation where some people have more kidneys
than they need to stay healthy, you can actually--
you have two, if you're lucky you're born with two.
You can stay healthy with one and some people are dying
or very ill because they lack one
and we've blocked mutual exchanges--
we've blocked market exchanges for mutual gain.
So, given this fact it's not surprising
that there's an international market a thriving black market
in kidneys that criss crosses the globe.
Proponents of organ markets argue
that if we legalize sales some of the most exploitative aspects
of the international trade would disappear and we'd save lives
by increasing the supply of kidneys.
It's no wonder then that the idea of a legalized market
in the United States is gaining enthusiasm in many quarters.
Proponents argue that both liberty
and social welfare incline us in the direction of a market.
Okay, now what responses would be given
from the two perspectives that I've been discussing.
Well clearly, advocates
of the corruption argument would disagree and they have.
They argue it's a moral mistake to treat parts of your own body
as if they were mere commodities.
They claim that there is an important distinction
between commodities that exist to be used like--
and persons that exist to be respected.
The greatest defender of this approach was Immanuel Kant.
He argued that if you put a price on yourself,
if you offered to be someone's slave in exchange for money
for your descendants, you would have thereby failed
to treat yourself with respect.
You would have degraded the kind of object you are,
a human being, and treated as if it were a mere thing.
Things are worthy of-- or to be looked at and valued for use,
human beings are to be valued in terms of respect
and you could imaging how you might try to extend this idea
to think about body parts.
If we could put a price on our body parts Kant might argue,
he didn't argue this, but you could imagine he could and each
of my body part has a price and then you add them up,
you might think I have a price
and therefore you might think a human being has a price and so
on this view if you are opposed to slavery, voluntaries,
even voluntary slave exchanges you ought
to wanna block a kidney market.
>> Now, I don't want to dismiss this approach but I want
to know two problems it faces.
And there are actually three problems it faces
in the context of kidney markets.
The first is judgments about the value
of things is bound to be controversial.
No, that doesn't mean we should shy away from controversy
but we should just know that on many,
many goods in society even goods,
sex and commercial surrogacy people disagree
about the appropriate way of valuing those goods.
And so we need some argument for defending one or in other ways
of valuing different goods and so there is something more
that needs to be said in the corruption case on the case
of organs for giving one reading of the organ good,
the correct way of valuing our organs.
But second, even if proponents could give this case there is a
deeper problem.
And that's the problem that there is often a gap
between the way that we value things and their expression
in the market by price.
So consider for example
that a very religious person can buy a bible on Amazon.com
without thinking that the market price she pays
for it expresses how she values it.
One of the great things about markets is they allow people
with different conceptions
of a good's value to buy and sell them.
So it might be the case with kidney markets that people
with very different views about the value of parts of the body
or the integrity of the body might be able to buy
and sell those things without the market expressing a degraded
view of human beings.
But finally there is a third and more serious problem
for the corruption approach which is
that it doesn't really give us a way to wait the lives of those
who are lost because of the shortage of available kidneys.
So it might be claimed that your argument fails
to show proper respect for those who are dying.
Now there's a lot more to be said
about the corruption argument but I'm going to turn to--
just to think through how the approach I've outlined would
think about this.
And so I'll look back at my parameters and just run
through them very fast and then talk for--
well, run through them very fast.
I have some other things but I'll think I'll run
through them very fast.
Okay, so weak agency.
In the 2002 study of India's kidney sellers in the journal
of the American Medical Association 86 percent
of those interviewed who had sold their kidney had
unforeseen complications.
So what we know it's pretty safe in the developed world to--
you can easily live with one kidney we don't know much
about what it's like in the developing world
where people don't have access to clean water,
regular medical care, or adequate--
with nutrition or desperately poor.
A majority, 79 percent,
said they wouldn't recommend the practice to others.
A study by a Stanford undergraduate Joe Shapiro found
that almost 40 percent
of the nearly 100 sellers he interviewed in Janai,
India did not know how many kidneys they had.
So that's an example of weak agency I would say
with a vengeance.
Second, vulnerability and inequality,
a kidney market would have the likely consequence
that the very poor would disproportionally be the organ
sellers of the world.
By contrast, the system that relies
on donation is much more likely to have suppliers that come
from all classes of people.
The sociologists, Richard Titmuss,
found just such a contrast in his famous study of the American
and British Systems of Blood Donation.
Current markets-- black markets reflect the different market
positions of buyer and seller,
most sellers are desperately poor, buyers are wealthy,
there's no reason to think
that a legal market would be different
at least an unregulated market except in scale.
However, let me raise one third point,
and that is on the extreme harms to society.
One thing is that we don't know enough about is the way
that the introduction of a market
in one realm changes nearby markets.
So, you introduce a market in second homes
and you can change the price of homes in a community for people
who are buying homes for the first time.
An anthropologist has found
that where kidney markets are introduced the price
of credit changes.
Because now, given that the amount of loans they constant,
people have a new source of collateral that they can put
down namely an organ and so they are able
to get the better loans whereas the people not willing to put
up their kidneys for sale
or as collateral are less likely to get loans.
So introducing the kidney market changes the availability
of credit.
And you can test your intuitions by thinking
about whether this is a problem by thinking
about how you would have felt if in signing your loan documents
with Stanford one of the things that was asked for you to put
up collateral was an arm.
I know some of the parents feel like they paid an arm and a leg
to send you here but I don't think they meant or had
in mind literally giving up your arm.
Okay, a defender could argue
that these problems can be addressed through regulation.
We could require informed consent,
mandate appropriate followup care, an access to an organ
if needed and have the government subsidize the kidney
purchases of the poor so that organs are not distributed
on the basis of ability to pay but it will be very hard
to do this in a world with massive poverty
and institutional failures.
Let me go ahead and I'm gonna go, just go to this one, there.
So, you can think about how different proposals
for different kinds of markets might look
from the vantage point I've developed.
So, you'll notice an unregulated market where kidneys just go
to the highest bidder with no protections
for the poor looks bad on all four of my parameters
but there are other kinds of markets
that people have been talking about, a future's market
where you get some incentive to give up your kidney
after you die, a market only in supply
where the government is the sole purchaser of the kidneys.
These look less noxious and even an altruistic donation there's
enormous pressure and some weak agency.
So that's another lens for thinking about the problem.
Okay, I want to close by throwing
up two challenges to you and a story.
And I have thirty seconds so let me see if I can do this.
So the first challenge is that noxious markets,
markets in kidneys, toxic waste, child labor, bonded labor,
and international weapons open a window into some
of the most fundamental problems of our troubled globe.
Desperate poverty, environmental degradation, premature mortality
and morbidity, civil wars that have as their origin conflicts
over natural resources, hundreds of millions of people
around the globe don't have their basic needs met
and their human rights are insecure.
Even if we wanted to we can not make noxious markets go away
without addressing these underlying problems.
Moreover, some of these cases are ones
about which we still have deep disagreements.
We need a public debate about the moral limits of markets.
Second, look to your right and look to your left.
You should see people that you love and who love you,
may you never forget that there are some goods
that markets do not honor and money can not buy,
find these goods, treasure them
but don't keep them to yourselves.
Spread them around.
Form a relationship with a child who comes
from the wrong side of the tracks.
Volunteer at a non profit.
Take time to find out why some stranger is poor.
Take an interest in the lives of others.
And don't forget to fill out your organ cards today.
Thank you.
[ Applause ]
[ Music ]
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