Let me understand how I'm supposed to see this:

A-OK: Rich Americans die from kidney failure while poor Africans die from malnutrition/AIDS/TB/whatever.

Reprehensible exploitation: Rich American buys a kidney from a poor African, feeding his family for a decade in the process. Nobody dies.

> Rich American buys a kidney from a poor African, feeding his family for a decade in the process. Nobody dies.

Until the poor African's one remaining kidney goes bad, he can't get a transplant (nor the lifetime of expensive drugs to retain one), and his family starves for lack of a breadwinner.

I think that organ sales are substantially more complicated than this conversation is making it, but your point here could not possibly make less sense. It should be obvious with a moment's thought that "My family and I will starve right now" is way worse than "there's a small chance my second kidney will fail and then my family will starve" (and that's without considering the effect on the person who got a transplant).

(worth reading, tangentially answers your question, 10/10) http://slatestarcodex.com/2014/07/30/meditations-on-moloch/

Thanks for sharing this blog. It really jived with me how we could be in a dystopia no single person is responsible for creating, but which inertia keeps bringing forth untold misery.

It's a false premise - the "Rich American" has a duty to help those who are less fortunate (poor Africans), and that duty extends further than just quid pro quo transactions.

That's not going to happen and in the meantime this idealism is killing people.

We don't know that. In any case, the example is too simplistic anytime there is a lucrative market in organs, there will be middlemen who coerce victims into donating. That will / does kill people, no doubt.

Whenever you're thinking about human systems, you need to think about how humans will game the system. Essentially, you're not facing a static adversary, but an adaptive, motivated one.