Why our plan achieves efficiency #2

In this argument we will respond to some of the criticism as well as offer an additional mechanism through which our plan ensures efficient allocation of liver transplants. Let's start with our response to their rebuttal: (a) The opposition accused us of being brutal utility-maximizers. We believe that this disagreement is a semantic one. We never said that our definition of utility includes only base pleasures like sex, food etc. We simply stated that, given that we know what we want, we should strive to maximize it. These aims obviously can also include protecting citizens. We already aknowledged the problems with agreeing on what these desirable ends should be and presented reasons why saving lives should be important. There is no real disagreement here. The opposition agrees with us that protecting lives of citizens is an end we should strive for. We believe that then they should agree with our plan. After all, the transplants are scarce. If a liver is given to an alcoholic, another person in the queue dies and maybe also alcoholic dies. If liver is given to someone else, that person lives and alcoholic dies. There is simply is no way of saving everyone with the available technology and current rates of transplant donation (more about that later), so government has to make a painful choices about the most efficient distribution of livers. (b) The opposition noted that the study we quoted finds that 38% of alcoholics use alcohol after transplantation and also provided some other statistics. We agree that there are studies with different findings regarding relapse of alcoholism. That is not surprising. The most important point is that there still is an important proportion of alcoholics who start drinking after the transplantation. Even if it is one person in ten, it is still a lot. We have shown how consumption of alcohol can often lead to lethal consequences after the operation. Why is that bad? Because even if the number of alcoholics who start drinking is not overwhelming, it still means deprived opportunity to live for people who have made the right choices in their life. Meanwhile, the recipients of the liver squander their opportunity as well. We find this absolutely unacceptable. (c) The example of obese people was not used appropriately. There is a far stronger causal link between being an alcoholic and failed transplantation/recovery process than between being fat and failed transplantation/recovery process. If our aim is to distribute as efficiently and justly as possible, this distinction is very important. (d) We never that all people are perfectly rational and always take availability of transplants into account when going on with drinking. However, it is clear that our plan sends a clear negative message about the use of alcohol. Even if people do not care about transplants, their desire to conform socially means that the costs of drinking will go up. Attitude of their fellow citizens will make them understand that drinking is a very bad decision. Finally, our fourth reason why our plan achieves distributional efficiency: (4) It will increase the level of organ donation Both sides in this debate agree that is unfortunate that we have so few livers that can be used for transplantation. Currently, very few people decide to donate their livers - a pitiful state of affairs. It does not have to be that way. There are many reasons why people do not decide to give their organs for transplantation. We believe that one of the important factors (although not necessarily the most important one) is the recepient of the transplant. People like helping others who share their genes, worldview, ethnicity, nationality and other things. This is a basic aspect of group psychology. Some people think it is unfortunate; however, that is the way human beings are wired up. According to the United Network for Organ Sharing, most living organ donors are family members of the recipient [[http://www.unos.org/news/newsDetail.asp?id=163]]. We believe that many potential donors are not agreeing to give away their liver precisely because it can received by a person the donor is not fond of. It is no surprise that there are many people who dislike alcoholics, think it is their own fault and would not want to give away their organs to help them. This is particularly true when consenting to donate a liver - after all, heavy drinkers represent a big proportion of the current recipients of livers. If people know that their livers will be received by people who are not alcoholics, the level of donations is likely to go up. Why is that efficient? Well, because it will help us to solve the disgraceful mismatch between people who have organs and can give them away with little cost (for instance, after death) and people who desparately need these organs to stay alive. Of course, alcoholics as a group will be significantly worse off; however, we are ready to accept this if it helps us to save the lives of all other people.