HEALTH DISPARITIES BLOG

January 20, 2009

Monetizing Compassion

The New York Times is reporting on the changing culture of medicine.

In the piece, Pauline W. Chen comments on how a recent divorce case has evolved into a fight over compensation for a donated kidney:

It is hardly headline news anymore that kidneys and livers are available for a price. But what has been particularly worrisome about the Batista case is the ease with which that topic has gone from black market alleyways to local courthouses and national media. What should have been outrage over putting a dollar value on a human organ became curiosity over the accusations and the pictures of those involved. Many of us reading, listening to and even writing about the story — myself included — accepted the premise long enough to wonder how Dr. Batista and his “medical expert” came up with that high a figure or if it was even physiologically possible for him to take back the kidney.

Also linked in the story is a recent article that appeared in the New England Journal of Medicine. The authors write:

Researchers have described two types of relationships that involve giving a benefit to someone else. In a market relationship, when you provide goods or services, you expect to receive cash or bartered goods of similar value in return. In a communal relationship, you are expected to help when there is a need, irrespective of payment.

Medicine involves both kinds of interactions. It has marketplace elements that are inherent in any business — a physician receives payment for services. But there is also a communal relationship, an expectation and obligation to help when assistance is needed. We believe that in the current environment, the balance has tipped toward market exchanges at the expense of medicine's communal or social dimension.