An Unexpected Consequence of Autonomous Cars

We’re still in the early stages of the first wave of semi-autonomous cars, with fully autonomous vehicles promised soon after. But as technology begins to take over behind the wheel, a new and startling consequence has been realized.

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Episode Transcript

Speaker 1 (00:02):
Go behind the wheel, under the hood and beyond with
car Stuff from house stuff works dot com. I welcome
to car Stuff. I'm Scott and I've been We are
joined as always with our super producers Noel the Resurrectionist
Brown and Dylan nicknamed t P. A. Fagan. He's saying

(00:24):
he's a resurrection man. Yeah, yeah, resurrectionists, but resurrection man
is is a great turn. Well yeah, I mean I
hope not. I hope that's not what he's doing after
hours or whatever. But where does he go? Where does
he go? Let me let me ask you a question.
If you ever use the driving service like lift or

(00:45):
uber or something? Yeah, sure, yeah, when when do you
find do you find yourself using them to like go
to concerts like venues or never locally? It's always when
I'm traveling, Okay, so we're in a strange city, yeah,
or it replaces a rental car in some cases, and
it can be much more affordable depending on the kind
of rental car lifestyle you are accustomer. So you you're

(01:07):
a user of these services right, oh yeah, yeah, because
it's it's easy for me to link up with a
friend or if you know, parking now downtown parking is
is pretty challenging here and I have a spot, you know,
I've got all my strategies about where to put my car.
I'm driving the Monte Carlo again for a little while,

(01:28):
by the way, and if I am in in the
home base area, I will park the car in a
safe spot, which is kind of also hard to find
in my part of town, and I'll walk a lot
because it's exercise. But if I'm going somewhere more transportation
is required and it's in town and there isn't decent parking,

(01:51):
by which I also being affordable, then yeah, man, four
bucks for an uber ride is gonna be way cheaper
than fifteen bucks to park, or even even valet service
or something where you know you got a tip at
the end or where. And not only that, I get
a lot of anxiety about parking downtown, and I'm thinking
about it before i leave my house up in the suburbs,
Like if I'm headed down here for an event or

(02:13):
to a restaurant or whatever it would be. Um, I'm
honestly like, I'm just going through my head, like what's
what's in the area. How tight is that parking structure
going to be? Um? If it is a valet only thing.
You know, is there a self parking option available? And
if so, how tight is that going to be? Its
cash exactly right? So yeah, yeah, so I know that
you're a much more frequent user of that type of

(02:35):
thing than I am. I do find myself in situations
where it just financially is a better choice. And you know,
like any other rides service, the people who drive are
typically pretty interesting too, so it's it's entertaining to hear
their stories. You know, it's always here like what what's

(02:58):
the craziest fair Edvard had what's the what's the weirdest thing?
Said stuff like that. You're pretty forthcoming, and yeah, I
mean that's it's always interesting to talk to In the
past taxi drivers, but now it's the Uber drivers, the
Lift drivers, because they're the ones that come in contact
with everybody. And I bet you, ladies and gentlemen, some
of you out in the audience have driven taxi cabs

(03:20):
in the past or present, and many maybe driving Uber
or Lift or some other equivalent service. Now I might
be listening to this podcast while they're driving for that service.
It's quite possible. It's quite possible if you are I
want to go ahead and preemptively ask you to send
us an email with your stories, because we are all

(03:41):
ears or in this case eyes. You get the gist,
that's that's not bad idea, And I bet we can
get some unusual stuff and then probably some more. And
for the most part, I bet it's kind of a
vanilla job, you know. I for the most part, like
nine percent of affairs are the normal I need to
get across town type of thing. But then there's that
one time, you know, one out of a hundred where

(04:02):
it's really something unusual, something strange happens on the way,
you know, whatever it may be. Has someone hops in
and there they're dressed as if they're like, uh, they're
they're dressed in like a three piece conservative suit. And
then part way through the ride they ask if you
would like to see their jar of teeth, you know,

(04:22):
and oh, man, yeah, like did you know that on
the tooth faory? Yeah right, they say it in a
reasonable voice. That's the scariest um. All right. So the
thing is that a lot of these rides share services
seem set to continue, they're growing. You know, people have
their favorites and people have their problems with certain ones,

(04:42):
but they're not only growing, they're evolving in the service
they deliver. And something that we've been hearing a lot
about is the rise of autonomous vehicles and like self
driving vehicles in this kind of field. Sure, yeah, yeah,
so autonomy. And we're seeing just the very hints of this,
the very beginnings of this, of this whole thing. It's

(05:04):
going to come through in waves. We're not anywhere close
to fully autonomous vehicles for every day use for everybody
at this point. We're still I mean, they love to
say a decade out, but it's probably a little bit
longer than that. Um, maybe a decade in some European countries,
but the US is huge, and we're talking like full
on autonomous vehicles, I mean, no driver input at all,

(05:27):
really other than here's where I need to go. Um,
we have what right now? Right now, what we have
is kind of like the in between. It's like the
early baby steps version of the whole thing. So we've
we've covered so many of these advancements along the way,
and uh, you know, I still I like every time
we talked about this, I'd like to say that, remember
how when we started this podcast is back in what

(05:48):
two thousand eight, I think it was, and we were
convinced that there's just no way that you know, self
driving cars would be around, and then the whole world changed. Really,
I mean that fast. We've only been doing that. We've
been doing this nine years. I say, only that's a
long time. But um, it's changed so much that of course,
I mean, you can't say that you're a believer. I
mean it's happening right now. It's really happening. And this

(06:11):
is the subject of our episode. Uh it's pretty tough
to predict the future, no matter how easy your local
Madam Bell or whatever makes it sound. The issue here
is that with such a profound change or potential for change,
there also come many we don't have to call them consequences,

(06:34):
but let's call them results or ripples. Uh. These things
are part and parcel such a big change, and a
lot of people have not considered fully a lot of things. Today.
Our podcast is about something that you came to me
with that I had never thought of. I had neither

(06:54):
until I read this article, and it was something that
I thought was interesting enough to bring to this audience
because it'll make you think. I mean this this brings
up you know, a moral and ethical dilemma as well.
You know, we'll talk about this as we as we
go through. And I really just I want to kind
of put it out there, let people kind of digest
it and have more time to think about it than
we have probably and uh and and pieces together in

(07:15):
your head, and then get back to us with your
comments and and tell us what you think about what
we're going to discuss today, because we're not gonna say,
you know, which way we're really for here at this point,
I don't think. Um. Again, there's some moral and ethical
stuff that will come up as the topic comes around.
But this is the strangest thing. But no one has
really thought about this. Where somebody has um this comes

(07:36):
from an article in Slate and slate dot com and
the headline is a grabber. It says self driving cars
will make organ shortages even worse. And I hadn't thought
about this, but they're talking about organ donors from automobile
accidents and there's already a shortage of of organs for
people on waiting list. And we'll talk about numbers in
a moment here. But um, the idea is, and this

(07:59):
is not given anything away, but the idea is that
self driving cars are safer cars generally right less driver
air or no driver air, and it means less fatalities,
and that means less organs available for those people on
the list, because a lot of times the circumstances of
a fatal accident in in an automobile will lend themselves

(08:23):
very well to the requirements needed, the requirements rather that
an organ has to meet to be transplantable. If transplantable
is a word, and if I didn't just churchify that,
I think that's a good word. I think it's a
good word. But there are already I mean, we're already
at the point where we have shortages of organs and
people are kicked off the list, and people are denied

(08:46):
organs for various reasons, but one of them is that
there's no organs available. So you know, this, this will
complicate matters, and it's just an angle that I hadn't
really thought about. And we're gonna walk through this this
article a bit, and I'm gonna read it. I'm gonna
read a little bit from here, but also we're going
to discuss a little bit and then again, I really
just want the audience to think about this because it's

(09:06):
it's so intriguing to me. This is just this thought.
So tune in, ladies and gentlemen, because we we have statistics,
we have some anecdotes, we have some what if very
on the way, and we'll dive right into it after
a word from our sponsor and we're back. And Ben,

(09:35):
I think we should just jump right into this article
because it's it's got some intriguing ideas and some I mean,
I'll tell you right now, I don't agree with some
of the stuff that's in this article. The way it's
the way it's stated. Maybe this is a controversial issue.
It really is. And and again just again think about
this in your own time and then and then get
back to us. Would love it. Um. So here's here's
where it starts. It starts about talking starts talking about

(09:58):
the very first organ transplant and the first successful one,
the first successful recorded kidney transplant was back in nineteen
fifty four. But ever since that point, we've had shortages
because people want these organs, people need these organs. Really,
that's a better way to say it. And of course
there's a limited number of donors of bill and for
many reasons. People again get deemed not ill enough to

(10:21):
make the list, or get kicked off the list because
they become too ill and can't receive the organ. It
won't do any good at that point. Um, there's just
a lot of reasons you might be kicked off of
the list. But that list is growing right Currently, around
six thousand, five hundred US residents die waiting on an
organ transplant each year, and that's not counting the other

(10:44):
four thousand that are removed from the waiting list because
they are deemed not even for moral or ethical reasons,
just because they are ill. There their hardware, the other hardware,
if you want to look at it like a vehicle,
the other hardware to physiologically damage for it to be
worth the time. By way of comparison, this would be

(11:06):
an equivalent death toll to twenty two jumbo jets crashing
every year. Holy cal Just to put it in perspective. Now,
I've got a little bit more information about the about
the list itself, since this is going back eighteen years
from from right now, the waiting list has doubled. Inside
so it was about sixty five thousand, three hundred and

(11:29):
thirteen people looking for an organ of some sort and
is now the current waiting list is one hundred and
twenty three thousand. Now, most of that is liver and
kidney donations because liver and kidney disease kills more people
than breast cancer or prostate cancer. And the CDC, the
Center for Disease Control and Prevention UM says that, you know,

(11:49):
the incidents of these chronic diseases will is going to rise,
and the need for more organs is going to continue
to trend upwards. So we're going to continue to need
more and more livers and kidneys for people. Uh, you know,
I know there's other organs that are transplanted to you
know that well exactly, but liver and kidneys are the
number one thing. And we'll talk more about those some

(12:11):
specific and just in just a moment here, But um,
but how how do you how do how do how
do car? How do the self driving cars factor into this?
Now we already kind of hinted at at this whole thing,
and maybe not the self driving yet, Let's just talk
about how cars factor into this whole thing, because it's
not something that I had really put together, and I
don't know why I hadn't, because you know, when you

(12:31):
go to the d m V or you know whatever
your driver's service places. They always ask you if you
want to be an organ doner every time, and sometimes
they give you they'll kick a little off the the
price of yours. I don't know if that's still possible,
are still true or not? That's interesting. Well, you know
I'm thrifty, brave, clean, and reverence right the first so,

(12:54):
uh so the idea to me of remember being a
young driver seeing I can't remember if in my state
it was something where you got a discount or if
it was just vote your conscience, because I remember one
time there was a reduced fee, and then another time

(13:14):
there was not. And when there was not a reduced fee,
I was instantly I said, you know what, I'm gonna
be a safer driver. I'm going to keep all these
bits of me together in this one Ben Bolen thing.
I don't need to be part of someone else's life
just yet, in the one Ben bowlen bowl. Yeah, yeah,
exactly right. We'll keep it. We'll keep it with the

(13:35):
original packaging. Well there. The truth about this whole thing
is that that automobiles and people that die in automobile
rex are one of the uh the most reliable sources
for healthy organs. They count on organs and tissues coming
from drivers that are killed in these in these accidents.
And that's that's horrific to think about. But each year,
every single year, in the United States, thirty five thousand

(13:58):
people are killed in automobile accidents. Yes, and one in
five Oregon donations comes from the victim of an accident.
So one in five, so we're counting. That's a pretty
big percentage really, I mean, when you consider all the
other ways that you can you can expire, Um, that's
a that's a huge group of donors that you know

(14:20):
is a potential donors. I should say they're they're always
potential donors until the event actually happens, right, So they're
they're under with the understanding that come from this source,
which is drivers and drivers are well, I guess maybe
in fatalities. I got a number here that I'm looking
for right now as we're talking, but I think it's

(14:41):
something like, um, oh I found it. Then it's it's
so and estimated of motor vehicle accidents involves some kind
of driver air. Now, before we continue, I don't want
to get too far away from this. Let's just spell
out the reason, the somewhat morbid and gory reason that

(15:05):
accident victims are so valuable for organ donation. Here here's
the reasonings. So roads are actively monitored by emergency services,
by law enforcement, firefighters, mts and so on. And this
means that if fatality occurs, and there are going to

(15:29):
be people professionals on the scene who can tan, who
can transport someone or in some cases even keep them
alive long enough doing their best of course not oregon harvesting,
doing the best to save the person um. And that
just that presence severely reduces the amount of time needed

(15:51):
to move this out. So it's all ultimately a question
of time of death. So typically someone will roll up
on a scene then minutes of the accident happening, and uh,
and that means that the organs are still viable for transplantation, right.
That means that they're able to uh safely do that.
It's kind of there's there's an expiration point where you know,

(16:12):
the blood flow hasn't been to this organ for for
X number of minutes and it's no longer safe to
use and or for use in somebody else. But um, yeah,
that's a good point that you know, it's it's so
quick that that somebody is on top of that scene.
So what we're talking about those we're talking about preventable fatality.
So these are these are the ones that involve driver air.

(16:33):
That means that the problem is with you know, you
and I behind the wheel, didn't look left, didn't look right. Yeah,
I didn't check the life And theoretically, you know, theoretically,
I always have to say theoretically with these but theoretically
autonomous vehicles won't do that. Now, I know we've heard
of instances where that does happen, but consider that, you know,
way that against the number of driver mistakes that you

(16:53):
see on the road, just on the way home tonight
from work or from school or wherever you're going to
and from, uh, you're gonna see a lot of accidents
that are of course, you know, human caused. There. You know,
there's a mistake that was made by the driver. So
they're saying, if you remove that part, that element of this,
that that that factor, then it's going to greatly reduce
the number of fatalities on the road, and it's also

(17:14):
going to reduce the number of available organs. So right away,
I mean we're almost cutting nearly it's nearly of the
of the the pool I guess of of organs that
are available or thought to be available each year, you know,
based on the stats that we already know. Um, so uh,
you know, I don't know. I mean maybe maybe that's
just an oversimplification of it. You know, maybe there will

(17:36):
be more accidents because you know, everybody's gonna have an
autonomous car and we we only know what Uh these
kind of can you call them rogue autonomous? Because I
don't think you can, because they're so modern, So they're
so guided, they're so um precise. Even now, Um, somebody's
there with them, they're they're they're inside the vehicle at
all time. I know that doesn't stop all the rex,

(17:56):
but um, what my point is that there's really only
a few truly autonomous vehicles on the road right now,
and those are the ones that are licensed to be
there specifically for testing. What's it really going to be
like when there's you know, you know again of the
vehicles on the road are are autonos or the road?
Oh that's tough too, I mean that's so far out though,

(18:19):
I would say the problems begin. Let's keep a good number.
I would say that issues arise as soon as it
hits even twenty or fift because the way that we've
talked about this in the past, the way that we
have predicted or speculated that autonomous vehicles would roll out

(18:41):
would be in first city network, neighborhood, then sitting networks,
and then maybe in some cases expanding regionally. So small releases,
small releases. Yeah, yeah, small releases. And the problem with
that is it creates a boundary and border. There's no
way for every vehicle to automatically turned autonomous, So I

(19:05):
see a lot of I still see a lot of
accidents occurring, you know, at the border. Let's say, um, Austin,
Texas was somehow past the thing where everybody has to
drive an autonomous car, right. Uh. I imagine most of
the people in Austin, Texas would be livid because that's

(19:27):
a lot of overreach, right, But let's just say it
happens anyway. They caught everybody on a good day, and
now they all have these autonomous vehicles. But you had
to pick Texas. But what about the maybe not the fact,
but I picked Austin. Some balances out, but maybe they well,
it doesn't matter any town, you know what I mean, Indianapolis.

(19:48):
All right, Okay, we're still cool. We're okay, we're all
right now, we're work friends. Yeah, that's right. Uh So
the point being that, uh, Scott and I are actually
of friends. But the point being that the the accidents
will occur in that gray area where where like most
like with most cities, a lot of people work in

(20:10):
Austin or Indianapolis and live outside of it where they
wouldn't have to have an autonomous vehicle. So you see
the problem as being when a a driver interacts with
an autonomous vehicle. Yeah, that's the that's the that's the
problem zone there. It's the it's again going back to
the human causing the air. It's got potential. Yeah, oh

(20:31):
yeah it does. We've seen that too. I mean, when
you know, the autonomous vehicle counts on the human driver
allowing them into that spot, but they don't because you know,
people are jerks. That happens, Hey, buddy, well that happens,
you know. So okay, but but I guess it getting
back to the stats and the and the and the figures,
I mean, the ntsb IS has chimed in on this

(20:51):
now the guy. His name is Christopher Hart, and he's
the chairman of the NTSB, then the National Transportation Safety Board,
and his quote in this article says drive A cars
could save many, if not most, of the thirty He says,
thirty two thousand, But I saw a thirty five thousand
number earlier. Um, I could save most of the thirty
two thousand that are lost every year in our streets

(21:12):
and highways. Even if self driving cars can only realize
a fraction of their projected safety benefits, and decline in
the number of available organs could begin as soon as
the first wave of autonomous UH and SI autonomous vehicles
hit the road, threatening to compound our nation's already serious shortages. So, um,
you know, it's I mean, it's it's something that they're

(21:32):
thinking about at the top levels here. You know, something
that the NTSB is already you know kind of well,
they've got their their people working on it. You know,
what's what's what are we gonna do here? What are
we gonna do about this? And I don't know if
that's the right way to say it or not, because
it's not really them that has to work on it.
It's it's what are we gonna do once this happens,
like that's this is where the ethical and moral stuff

(21:54):
starts to come in, because, as you may have already
kind of gleaned from this discussion, is that this might
open the door for some black market trade of organs
for markets for organs. Right, So here's the here's the
engineering problem. Let's look at it from an engineering perspective.

(22:18):
Everybody needs a compliment of specific organs. Right. The body
has some built in redundancy. You can get around just
one eye, kidney. It's a few you can just tear
out and not even need them. Yeah, but you will
degrade your quality of life. Vestigial organs the ones that
you don't really need, like a gallbladder, Yeah, gallbladders one.

(22:41):
What's the other one? Everybody? Pendix is another one. They
seem like there's more than that. Well, let's see just
kind of leftovers from you know, things that we don't
need anymore. I think that it wasn't the appendix something
that was supposed to aid in digestion of like a
bark or something like that. We don't tend to eat
bark a whole lot anymore, So I don't think that's
necessary that's true, and I think that's the case. I

(23:02):
read something about that a long time. I think it
was definitely for herbivorous um plant base. And and you
can get by on one lung. It's not you know,
it's not recommended. And you can get by on one kidney.
And some people donate one good kidney and leave themselves
with one in order to save the life of another.
And that happens a lot. But you only get one
of certain other organs, like a liver. Heart, Yeah, heart's

(23:25):
a good one. I mean a brain. Not everybody gets one. Apparently,
we talk most people do. We talked a little bit
about this morning. We were having a meeting here at
the office, and we're talking a little bit about eye transplants.
And I had thought that all along. I thought that
I transplants were happening all the time. But it turns
out it's just pieces of the eye um cornea is
or something like that. You know. They often go to
a recipient um but not a full eye transplant. But

(23:49):
they're working on it. And the problem with all that
is that we the human species have yet to build
a technology that will like we we have yet to
effectively figure out a better large scale method of organ
transplant other than taking them from the debt. Yea. So

(24:13):
the idea would be that we need to come up
with something right away, pretty soon, a way of replicating organs,
a way of growing organs if you want to, maybe
so that you know, there is no shortage, There is
no um uh, there's no deficit between the number of
you know, people donating and the people needing these organs.
You can grow whatever you're short, you know, for this

(24:35):
year or this month or whatever it is, and and
everybody then on the list is satisfied or at least
at the number of people that we have now, we're
not losing ground in that way. So in some related
how stuff works shows, we and some ore colleagues have
explored the organ trade, which may strike a lot of
people as strange to think of that it's such a

(24:58):
such a lurid, almost too weird to be true thing,
but oregan harvesting does still occur, and it's not you know,
I assume a lot of us have seen the movies
where some regular everyday guy gets a little wild partying
with an interesting stranger and then wakes up with staples

(25:20):
on one side of his rib cage and then he's
in a bathtub of ice. That might happen, sure, but
what what's far more likely to happen. We found is
that people in developing countries or impoverished people will sell

(25:41):
UH an organ like a kidney right for a bargain
basement price to an illegal broker who will spike the
price and then sell it to a wealthy person who,
for one reason or another, is not on the list.
So when you hear the term organ harvesting, that's what
we're talking about, illegal uh removal of organs from somebody

(26:01):
and passing them on to somebody else. And it's not
just you know these one off cases, you know where
somebody wakes up in a bathtub advice. This is also
happening sometimes. This is real. This is uh, you know
the diamond dirty stuff here. Uh. If you pass away
in a hospital, there's a chance that your loved ones
organs could be removed from them without you really knowing

(26:22):
that it happens. And it's it's rare. It's rare. I
want to point that out. It doesn't happen often. And
when it does, I mean they get caught eventually, they really,
they do get nailed on this and then so it
ends up being, you know, a bad news story of
you know, it's bad press for the the not only
the surgeon that performed the illegal surgery, but also for
the hospital and for the insurers and all that. So, um,

(26:42):
you know this is this always makes news whenever you
find out that something like this is happening. Um, and
for good reason. But the number is just astounding. There.
It's thought that worldwide there's nearly ten thousand, actually there
are ten thousand black market medical operations that are performed
every single year with these illegally, illegally purchased organs. Scott, Scott,

(27:04):
I'm gonna throw you for a loop here a little bit.
There's a book. I know you're a big true crime fan. Um,
there's a book I have found in my research. When
we did organ the organ trade on another show and
No Ladies and gentlemen, I'm sorry. I tried my best,
but I wasn't able to avoid a pun about the

(27:26):
Oregon Trail tracking these people down. They call it the
red market. You know, there's like a black market for
auto chop shops or something. They called this like the
red market for the organ trade. Really and there's a
book that I would like to recommend to you and
anyone interested in this. It's called The Red Market, and

(27:48):
it's by an author named Scott Carney C. A. R. N. E. Y. Okay,
just wrote that down, all right, The red Market. Interesting.
I had an idea that there was another term for
because you always heard it here described as black market,
because it's a black market sale of something illegal, you know,
something that that they're not supposed to have but they do.
And the thing you're right about it exploiting poverty in

(28:10):
some situations because people, I mean, you offer somebody who's
really really down on their luck or has just has
nothing and they've never had anything, but they've got two
working kidneys that you know, somebody who's very wealthy would
love to have, you know, just just two towns over.
Uh and somebody kind of you know, is the go between,
I guess the what would you call it, the liaison
between them um and says, you know what, I'll give

(28:33):
you five thousand dollars for that kidney. And that looks
like a pile of money or something, but it oftentimes
is far far less than that. We're talking about. Five
thousand might be the prices they charge the wealthy individual
to put it in. But the one that is it's
being removed from, that's more money than they have ever
seen sometimes or or will ever see. Um, so it's

(28:53):
but but what do you do? And that's the again,
this is the moral and ethical thing, because now they're
left with one kidney. What happens you're in life? If
that that kidney that they're left with begins to fail,
then there, you know, then that was an extremely poor
decision that was made early on for a very relatively
small amount of money. And that happens all the time.
It happens way more than you think. There's an HBO

(29:15):
documentary about this, about the organ transplant trade. Um, you know,
it's it's I don't even know if you can call
it that. Really, it's there's there's I guess it's more
like the red market stuff that you're talking about. Yeah,
so you're you're absolutely right. People can game these waiting
list if they're wealthier, you can travel to countries with
lower restriction less rule of law. You can also just

(29:37):
go to different centers perhaps and get on a multiple list.
Now here's the thing. Then this is this article. I
remember I said I don't agree with everything that's in
this article. I want to talk about something that this
article brings up. There's a few things here, but but
let's do it after a quick word from our sponsor.

(30:00):
Good call Scott Good. Save on the sponsor break, because
I was, I was getting into it. You know you could.
We can tell because I started just gesticulating and gesturing
about stuff even though no one can see it. About
this top of your jacked Yeah. Yeah, man, if you
can say that about us, you can say that about
organ transplant eractor Thiever. It's fascinating. It's a hidden thing.

(30:21):
But also it's incredibly controversial, problematic. And you mentioned before
the break that you have some disagreements. I do because
this article there are paragraphs that start out with stuff
like this, and I just can't get my head around this.
Maybe that's the problem. Maybe I just need to think
about this more. But like this, this article or this
this paragraph here starts out with the most straightforward fixed

(30:43):
would be to amend the federal law that prohibits the
sale of most organs, which would allow for a development
of a limited organ market. Now you're talking about amending
the constitut of the Federal law that prohibits the sale
of organs. And this is something that we've had in
the United State eights since about nineteen eighty four. There
was a there's a law of those paths that bands

(31:05):
the sale of organs in nineteen eighty four. And we're
talking about again, um, the sale of organs for for profit.
I mean that you can't you can't harvest the organs
from somebody, sell them off to a medical school or
you know whoever is doing uh these illegal surgeries. Uh.
That means that you know, if you're caught in the
in the process of either selling or buying these organs,

(31:25):
you're in big trouble. I mean, it's it's a it's
a u S law. That's something that's been on the
books since nineteen eighty four. They're saying, hey, well, we're
in twenty seventeen now, and these self driving cars are
going to greatly reduce the number of our pool of donors.
Maybe we should consider amending that so that, yeah, you
can sell organs again in the United States. I just
don't Yeah, I see what you're saying. I don't know.

(31:47):
I'm torn, man, because half of well, where are you
before you interrupt? Where are you coming from. Well, I
mean again, I think that well again going back to
the books that I read, and this is probably where
I'm getting a lot of this. So you have to
you know, weigh that into this decision. But um, I
see this as you know, turning turning into people again

(32:08):
starting to illegally harvest or organs from people that don't
necessarily want them harvested. I mean, the same thing happened
when you could sell skeletons to medical schools for um,
for you know, learning purposes, an articulated skeleton that you
could put together and self for a huge profit. That
led to a lot of people offering other people to
get their skeleton or or digging up great you know,

(32:31):
reading like New Graves, so that they could then articulate
that skeleton and sell it to a medical school. Um,
it's just some horrific things can happen. It's not saying
that it will, but I'm saying some things like that
can happen. That's a that's a UM, it's a consequence
of amending something like this insane. It's it's once again
it's something that we're not going to frown upon quite

(32:51):
as much. Yeah, one of the concerns was that people's
organs might be treated like quote, fenders in an auto junkyard. Okay,
I see a couple of different angles to this one.
My cursory instinct in a world where everyone is treated
fairly is my cursory instinct is uh, hell man, it

(33:17):
belongs to you. Do what you want with it, you
know what I mean. I don't want to be like
someone who tells somebody not to sell their car radio.
But this, in this case, the thing is a little
more complicated because no matter how much liberty we want
to give people their ownership over their own bodies, what

(33:38):
we run into is the fact that the same people
who are gaming the system as it exists today are
more than capable of gaming the people who would consider
selling their organs. Yeah, and I'm I want to get
this out there. I'm not not against somebody who's willing
to give up a kidney or willing to give up
whatever organ that they can to to help somebody else out.

(33:59):
That's that's not That's not what I'm getting at. What
I'm getting at is that somebody could take that from you.
Somebody could then see that as a potential profit for them.
Right now, in the United States at least, it's it's
impossible to well not it shouldn't say impossible. It can
be done, but it's a lot harder to to sell
and illegally begotten kidney or liver or lungs or whatever.

(34:22):
I mean, the questions will be asked in most places.
If you show up at the door and you've got
you know, the big cooler in your hand, you know,
with the big red or the big the big red
cross on it um, you know, you might want to
find out where you got that human heart. But in
a situation like this, like they may say, like, well,
you know, someone gave to someone and someone decided that

(34:44):
you know, it's worth to me or to them rather,
and that's how I got this kidney. We did the
deal right outside. Yeah, and that happens, I mean, it
happens right now in other nations. I just don't know.
I mean, you can find the entire villages. We haven't
seen it here in a long time. We have seen
it here in a long time. The we we hope
that we're being pretty pretty clear about what those what

(35:09):
those concerns would be. Gaming. Gaming a system to take
advantage of people at a massive profit margin. That's the
other thing. At least now in the illegal market, the
profits are massive. But of course again this this is
not the majority of all these operations, right, and there

(35:32):
are two Scott's point. There are wonderful people around the
world who are donating to save a sibling, right or
a spouse relative, a loved one. They're doing it of
their own free will, not because they are being um
threatened with being crippled financially and in a safe, responsible

(35:52):
way and in a m in a very um I
guess monitored and uh I'm clean, you know facility tipally,
I mean you're gonna find that you know, it's done
in the appropriate way. And think about this. I mean,
people they don't only give up like kidneys and you
know whatever else they can, you know, give up from
their body that would help somebody else, whether his blood
plasma could it could be a sperm donation, could be

(36:15):
an egg donation. People have been doing this for long
and I have no problem at all with any of that.
I really don't know. What I have the problem with
is when you then become like a target for somebody
that that they can then you know, profit from that.
Um So it's not so much. Again, we're still like,
we're still talking about I guess the red market trade.
It's still not because if it's regulated, that's something that

(36:37):
people are willing to do. Again, Fine, that's fine. That's
that's the other thing. Man. A lot of times people
hate regulation. So someone would be Okay, here's my concern,
here's my like biomline, concerned ladies and gentlemen. I think
many of you can agree with me, though we buy gold.
Industry has exploited a lot of people, right, and it's

(37:03):
not illegal, right they are they're doing exactly what it
says on the tin, at least here in the US.
For people outside of the US, what we're talking about,
you may have this kind of thing in your neck
of the Global woods, but we have a thing here
in the States where people will offer to buy um

(37:24):
old jewelry or you know, rings, coins and things like that,
anything made of gold, and they'll buy it for relatively
low price, usually really low price pennies on the dollar. Yeah,
and then they will melt it down or sell it
by weight for what it's actually worth, plus a profit.
But you go into that knowing that you're not going

(37:45):
to get the best deal really right, you're willing to
You're willing to for that trade off because you just
want rid of the item and you want a few dollars, right,
and it's legal, So you're sacrificing profit for convenience. Yeah,
but I mean you're doing that for an or what
if there is a we buy kidneys, we buy livers? Well,
you know it may happen. Come on down a crazy doctor.

(38:06):
Mike's right away. I don't like it, just based on
the name of the documents. All right, So, Ben, I
got I got a couple more scenarios that I want
to lay out here, and I can think I can
go through the kind of quickly. But but there's three
more points here that, um, I'm getting varying degrees of
do I agree with this or not? And and first one, no,
I want just to tell you where I stand on
this one. But they're they're asking, um, and what wouldn't

(38:30):
what would an ethical fix to an organ transplant shortage
look like? So the idea here is that this is
kind of great. This You may have mixed feelings about
this too, so you know when you go into the
d m V, as we talked about earlier this episode
and you have to check the box to say that
you want to be an organ doner. Well what if um,
instead of that, there was a presumed consent rule, as

(38:52):
you had to opt out instead of opting exactly right, Yeah,
So you know when you check the box, that's saying no,
I don't want to be. But if you don't bothered
it at the box, then you're automatically in. And that
would lead to a huge increase in and in the
number of people that become donors, because right away a
lot of you know, a lot of people just don't
simply want to do it, or they don't take the
time to read the paperwork and fill it out. They would,

(39:14):
but they don't. They're just flipping through where do I sign? Yeah,
and so right now we have an opt in system,
but this could become an opt out system, which would
then open up a larger pool of potential donors. Completely disagree,
and here's why, because somebody, Okay, you should always read
what you signed in full. Well, just hang on for

(39:37):
a second. You're you're saying you disagree with me, or
you disagree with the article. I disagree with the article. Okay,
same here, you and I are on the same page.
Here's the problem. Uh, a lot of people. I'm not
saying the majority of the world or anything, but a
lot of people, due to their spiritual beliefs, they can't
have their corpse violated and it's seen as a violation.

(39:58):
So maybe it's saving some and but it's saving someone
in a way that fundamentally betrays what the unknowing donor belief.
So they need to enter the afterlife whole or complete,
not missing anything like the caved. They can't have, you know,
stuff going back. We're going back to the Egyptian. So
they would they would remove all their organs, but they

(40:20):
would keep them with them in the tomb, so it
was like they were they were there but separate with this'
that's this kind of a strange thing too. So um,
but here's one thing we're we're neglecting in this argument,
and this is this comes down to like the final
point here, I guess is that if we're talking about
autonomous vehicles anyways, driving is gonna be safer, So those
people that never opted out or in rather, um, it

(40:42):
won't really matter because what we're talking about is automas
vehicles saving lives. So this is maybe not the place
to go. According to this article, this is maybe not
the way to do it because it won't really open
up anything brand new. It will be increasingly irrelevant exactly. Well, yeah,
as autonomous vehicles come online, that's the thing. So kind
of discounts that whole argument. Anyways, at a certain point,

(41:04):
the next thing would be that there is a how
this is interesting benefits packages for people that do donate organs,
so you know what, there's some examples are an example
of this. In two thousand and eight, Israel instituted a
benefit package for living donors that included full wage reimbursement
for forty days and up to five years of paid

(41:26):
expenses for a variety of services, including health and life insurance.
So it's like a health policy that you get for
five years. Plus you get time off of your job,
you know, whatever you do with benefits, you know, with
pay forty days. But you know you're again you're being incentivized,
I guess in order to to to you know, give
this organ It's not just a kind gesture, you know,

(41:47):
something that in the past, you know, normally people would
just say, well, you know, my cousin needs a kidney.
Of course I'm going to give him one of my
my my working kidneys. Otherwise that person is going to
die and I can live with one. Hopefully someone will
help me out if that ever gets into that situation
later in life, if you only got one left. But

(42:07):
um the idea to um amend you know, the these
these organ transplant plant laws, I guess is is an
interesting idea that you know, you do incentivize it in
some way and offer up packages like this. So what
do you think about that one? I I don't know, man, Okay,
so long pause there, Ben, Yeah, because I don't want

(42:28):
to be I don't want to be hypocritical here. The
the idea of allowing um a family member to transplant,
I think that's of course, that's great, you know, uh,
But the idea of well, I've been interrupted one second.
Family members received priority for these organs when they were donated.

(42:50):
So you could say that you wanted to also give
it to a cousin or nephew or whoever it is.
They would get the priority, they would get the organ,
but you would still get this benefit pack it, Okay.
I While I completely agree with the with the ability
of the donor to donate, to specify the recipient Uh.

(43:12):
The the issue that I see here is again people
seeing it as a way to kind of go on
the doll you know, like I I don't know without
and this we're talking about we're literally talking about a

(43:33):
foreign country. Things work very differently there. They have a
much smaller population, right and I don't know their wealth
distribution or their their demographic statistics very well. So I
don't know if we can compare that to the US.
Is it Is it a good move on their state's
part um It is I think important to take care

(43:56):
of people after they have what surely must be a
traumatic operation. Makes you wonder what the what the value
is of of the health and life insurance and the uh,
you know, other services that they offer, whatever that may
be medical services. Of course, do they already have um
some kind of healthcare system for everyone or is it
a situation where people who did not otherwise have affordable

(44:18):
access to a doctor would just have to sell their
kidney and then get free doctors for life. Well, it
has paid expenses, I mean, so, I mean I guess
they're they're covering the charge of the cost of that.
And and you know, using Israel as as our example,
if you want to look at what happened there. Now
we said that in two thousand eight, that's when it
happened when they amended that law. And the number this
is going forward a couple of years. They had the

(44:40):
program in place for a while, but between two thousand
and eleven and two thousand thirteen, compared with the same
you know, the previous three year period before that, from
O eight to eleven, the number of organ donors increased
by sixty seven percent scents a huge horse it did.
I mean, look at all this stuff you're getting if
you donate an organ. Well, I understand on but I
mean it's it has proven results. You know that it

(45:02):
that it does increase the frequency I guess with which
people would say, yeah, I mean, of course I'll do
that for my either relative or a stranger. It does.
My hesitation is because I feel like I would need
more information. Two really really make up my mind. So
the first one don't like it, second one need more info. Well,

(45:25):
a paid donation system like this would be a lot
more complex to set up, so it would be a
difficult thing to to enact, I guess. And and this
one doesn't take into account the autonomous vehicle thing. I
mean it's simply on its own. This is its own thing.
It's addressing a current issue, it is, but it may
kind of balance out what we were going to see,
you know, potentially, you know, if if, if these these

(45:47):
stats hold up. And as you know, Scott, as you
said earlier, we do need to remember that while these
vehicles are on the horizon, while there's potential to be there,
we're looking at a pretty long time horizon here. Yeah, yeah,
yeah for sure. So you know, there's a lot of
barriers in the way of of of something like this
really working. And I know this this Slate article, I'm

(46:09):
sure they're just throwing out some ideas like here's what
we could do. Um, but I gotta say I just
don't agree with you know, amending laws that are in
place that again make you possible. Um. I want to
say target. I keep wanting to say target, But I
guess that's kind of the way it would be, right. Um,
there could be some nefarious things happening if you were
to put a dollar amount, attach a dollar amount to

(46:32):
all these organs, and then somebody who is in that
game could could potentially see you as a mark that
you know, they see the dollar signs in the eyes
when um, when you walk by, you know, like, there's
there's to two usable kidney at least one usable kidney
that I could help. You want to tell scary stories,
what about going to Vegas where you can put up
a kidney as collateral, which would totally happen. You know what,

(46:57):
You know, it's funny you think you would take it
to that, to that level it. I think it might
go to that. It might get to that. If that, Yeah,
if that occurs, it's like a higher roller thing it.
Who knows, Maybe it's happening now. Maybe there's somebody right
now in Vegas who's like three kidneys deep and going
double or nothing on the liver. Oh, that got dark.

(47:17):
But the but three kidneys, three kidneys, but the but.
The idea that we should also mention is that as
societies grow closer and closer to a real practical rollout
of autonomous vehicles right and reducing deaths due to driver

(47:38):
error other it doesn't exist in vacuum this kind of evolution,
other forms of technology will advance as well, including the
possibility of three D printing. At some point, it's going
to be possible to print some sorts of organs, and
I don't think that's gonna happen before autonomous vehicles are

(48:03):
more widespread. But we have to remember that, you know,
we're we're pretty we're pretty smart bunch of well we
do our best. Well, look back at like the okay,
the Jarvik seven heart, and take a look at a
photo of one of those things, and it's it's a
great big plastic and I think there's metal in there,
but there's it's a big pump. Really of course it's

(48:23):
a heart, but um it's very clunky in the way
that it looks. I mean, it could totally see something
like that being three D printed. But what we're talking
about our other organs that are soft tissue, that that
have a function. You know, they create by all they create,
they filter things, um, so they have to be able
to regenerate themselves. They have you know, there's all these
um these all these other factors. It's not just a

(48:45):
mechanical heart, you know, because mechanical heart is easy enough
to see that. You know, it can be a pump
that there's functions that just operates. I could almost see
a lung operating in the same way with some external
device that makes it, that makes it move or function.
Maybe I'm ben I'm known doctor. Clearly, I'm clearly not
a doctor. But but what I'm saying is there are
certain things in the human body that you can you

(49:07):
can understand could be more mechanical than other things. So
printing biological material like three D printing a liver or
something like that, I see that as been a long
way off, I really do. I just I don't know
how it would function in the same way that you know,
a mechanical heart is so easy to understand. It's easy
to understand how a pump would work or how it

(49:28):
could work. Um, I don't know. I'm just I'm I'm
not a full I'm not a full believer in the
fact that they're gonna be able to three D print
that type of thing. But then again, I'll probably eat
my words in four years from now. They happen so fast.
How great would that be? Though? Yeah, I wanted to.
I want it to happen because that would eliminate you know,
the was it a hundred and twenty three thousand? I

(49:49):
said on the waiting list? No more waiting list. You
just get it. And another thing that's acceler is people
will probably live longer to yeah, and wear out some
parts once they're warring. Tease kind of expire. Yeah, I mean,
isn't it strange though that this this all spawns from
our our discussion at the very beginning of autonomous vehicles
and how safe they are really? What an strange unintended

(50:12):
consequence that it's going to create an organ shortage, and
who knows what other unintended consequences may arise from a
world without drivers. So we hope you enjoyed this episode, folks,
let us know what you think. This is a very
interesting one. We've got a lot of questions. Have you
ever driven for Uber Left? I think that's how we

(50:33):
got there today, I mean thematically and not physically. Um,
have you yourself received an organ transplant or if you
donated an organ someone in your family, are you on
a wait list? Because that's got to be a nervous
that's very serious. Yeah, and I can't imagine if so.
We're regardless of your personal experience, we'd like to know

(50:56):
what you think about this topic. Um, it seemed set
to affect over time a significant amount of people, and
we have to remember that other parts of the world
may well have autonomous networks, regional autonomous networks before the US,
So will they be a precursor or will it be

(51:18):
apples and oranges? Yeah? And will we be able to
see the same type of thing happen here? I mean,
is it going to be something that we can learn from?
But really more than learning from anything, I mean, we're
than we can kind of see this coming. You can forecast. Um,
if it doesn't happen to this extent that we're talking about,
then then there will be some form of shortage from this.
There will be because of the whole driver era thing

(51:40):
number and again astounding thirty five thousand a year that
are that are lost on our highways. So there's going
to be um a result of consequence from this. And
I'm going to use the word consequence. We said earlier
on we weren't but I think I might have even
used it a couple of times. But, um, we do
see something that's happening. So what are we going to
do to be able to read generate organs or or

(52:01):
how we how are we gonna how are we gonna
do this in the future? How is it going to happen?
I'm really interested. I'd love to know what people think, like,
I'm morally and ethically about this too, because that's what
we struggle with here. So um, we are struggling with
that today. It's a strange topic anyways, I know, I
understand that it kind of got a little bit off track,
but it's all based on this autonomous, the equal thing.

(52:23):
I mean, it's it's it's coming. And that book again
is the red market. It's got to have a copy.
I'll bring one in for you think, So let us
know on Facebook, let us know on Twitter with your
car stuff h s W on both of those, and
if you would like to take a page from your
fellow listeners and right in with something that has nothing
to do with this weird ethical uh supplying man problem

(52:46):
that we're speculating about today, If you have a topic
that you think your fellow listeners should know about, right
to us directly. We're all ears and you can find
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(53:07):
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