should that be for sale? to answer your question? >> so i do not have a easy way of answering this. i this i that the questions are more complicated than people have thought. so what i have tried to do in my book is take some infutureive reactions that people have to different kinds of markets. so most people react differently even if they think that prostitution should be legal. they think there is something different about selling sex and selling apples or cars. they think there is something different about selling organs and they may think there something different filling health care. so i try to see whether there are features of the markets that concern us. not about what we should do about them but if there is away of understanding why we react differently to these markets than other markets. i have developed in my book a theory about that. the a little bit of a complex thoery. there are four different dimensions that i argue, and

give to concern and not all markets that are worrying or are worrying in the same way. what was said about the happy families, they are all the same. unhappy families are all unhappy in their own way. so they are problematic markets that differ. they have the four dimensions that are similar so think of prostitution. a couple of things of prostitution that are important. one is that in the way that prostitution exists in our society is that often it is especially if you think of street prostitution people are pretty desperate. and often people that are desperate and under the control of other people like pimps, a high percentage of street walkers are addicts. so there are a lot of features that the normal market. the apple market is you know. doesn't have most people are

buying and selling apples are not addicted and not sum of somebody controlling them. they have the ability to say no. walk away from the trade. that is not the case. in many of the instances of prostitution. one thing that i look at is could we regulate prostitution to get rid of the sufrns? would there be other concerns that would still reeven in a society which got rid of the desperation that drives a lot of people to prostitution. those four program terz here, quickly, i want to read those. they are vulnerability. weak agency, harmful outcomes for individuals and extremely harmful outcomes for society. where does prostitution fall in those four parameters. >> so vulnerability of the prostitute would be one of the most important aspects of prostitution.

there is some agencies, so prostitution will take many forms but some prostitutes are very young. some of them are under the control of other people that are making decisions about what they do. who they sleep with. what conditions so they are not making. they are not transacting in the market on their own behalf so some forms and not all forms are like this. then there is systematic inequality between men and women x society and the way that they are viewed. and prostitution may play a role in reinforcing certain kinds of images that people have about women. so the instance of rape and violence against prostitutes is many, many times higher than the instance of rape and violence against women that are not prostitutes. so one question is why is that? that is partly because we are dealing with an illegal activeity and some that may go away if legal and some is

that we are dealing we have, very vulnerable people and circumstances. >> if we can take that same the same parameters and to apply it to selling a kidney. right now. do people have a right. if they want to sell a kid, can they do so? >> it is illegal in almost every count reef the world. to sell an organ. i think that iran is currently the only country in the world in which it is legal to sell an organ. there have been times in other countries it has will not been legal. it is big black market. though illegalal not enforced. and in the context of the globe when we look at the black market, we will see a lot of the parameters that i mentioned in play so many people. i will give you striking example. i had an undergraduate student here. stanford and studied the

people that fill their kidney in india. and the period of kidney selling was legalized for a very short period so he went and he found 85 people that had sold their kidneys. and one thing that he found was that a significant number of them did not know how many kidneys that they had so that is very bad information. they didn't understand what the qons consequences of selling a kidney would be in the united states. giving up an organ is relatively safe. there are not very bad health consequences and it is possible to live with kidney. it has health consequences as you age. when you have access to clean water and live a comfortable life. you could be fine. and in the context where the people were selling their kidneys in india, there was a lot of health consequence that's they were not aware of. it was all about weak information and a lot of people sold their kidney the main reason is to get out of

debt. and most people did not get out of debt. where body parts are available, creditors use them as collateral for loans this. is the third party affect. and even if i did not want to sell my kidney. i am affected if i am very poor. i am trying to get a loan. and the amount of credit that is constant. the pricing of loans has changed. other people have this collateral that they can put up. if i do not put up my collateral i will be less likely to be in an attractive prospect for the creditor. so that there is actually been an anthropologist that studied that that is a very concerning issue. that tells you something else about the markets that is markets that often have third party effects on other people. they don't affect just the two transact ors but in fact will effect those not involve in the exchange at all. i will give you another example that i think is --

really shows this is child labor. so where the society has child labor. child labor is also illegal in most countries and not enforced and the state will not often. can't and does not want to enforce. and often when the child labor is widespread. adult wages are low. that means that if i do not want to send my children to work, and my wages are lower, because of the bigger supply and demand, i am going to be less able to keep my child from going into work. so sometimes when you can close off a market option, you can actually enlarge the options that are open for people. it is not always the case. we will have to be careful and have to be careful when we think of the policy. i do not dry immediate policy could not cluptions from anything that i write but i am trying to analyze what i think is a pretty widespread set of intuition that not all markets are the same.

>> final question. debra satz. adam smith. carl marks. are we anywhere in the same vicinity when talking about markets today? anywhere near what they were writing about? hundreds of years ago? >> some of their insights are still with us. economics have become a powerful discipline. but a very abstract discipline. when the could not mist writes an equation on the blackboard it doesn't matter whether it is kidneys or apples that the equation is about. right? >> you are getting the properties. when adam smith wrote, he was very concerned about effects of markets. no equations in the wealth of nations the idea of the equal librium and supply and demand. he worries a lot that kinds of markets affect people's motivations in ways that may

not be come pat agent with a democratic society. so he worries that some of the markets shape people in one way to think about this is that it is very if i pay you to hang out with me. t is very different than you hang out with me if we are friends. in fact if i offered you money for hanging out with me. you would be insulted so there is a lot of ways of which engaging with people. and markets. again has many fantastic consequences and has a consequence of sometimes driving out other kinds of motivation that's we may care about. there is called offend only none of crowding out. croding happens when you pay somebody for doing something that they would have done for free. in such a way that once they are paid their whole

motivation for doing the action changes and stanford years ago they studied little kids and gave them jellybeans if they read. and some of the kids just read. they stopped giving the kids jellybeans for reading and those kids stopped reading. now they thought where is the jellybeans. if you are not giving me the jellybeans i will not read. ichb -- incentive crowds out the reason they may have had. that happens across the board in a lot of market situations. it doesn't tell us not to use markets but we need to make sure that they are not dimensions of life where we are not always thinking about the financial rewards that come from interacting with people. debra satz teaches philosophy and ethics at san fords. here is her book. we gave you the taste of it. "why some things should not be for sale, moral limits of

markets" beneficiary of the right total hip. i had daily nocturnal pain. if i did not know better, i would think that i had better prostate cancer. cancer to the bone. i saw the best procedure. just 7 weeks ago and a week ago i played nine holes of golf. that is how good it is.

i would challenge anyone ipt greated medicine to say would you have done that? somebody has pneumonia you need penicillin. if something has been hepatitis, you have to have the right medications and so many you will need a good sling and a good orthopaedic surgeon. so western medicine does amazing things. we should not forget that. if somebody needs a liver transplant. i had a patient that required a hundred units of blood and survived a liver transplant and two years later ran the boston marathon. so complimentary. and integrated medicine has a major role in preventive medicine. how to prevent obesity. how to prevent depression. if we cure some of this. there is in my mind a certain limit to it. and as --

[laughter] i preface this by saying. --. it has a role. i have actually experienced i had knee surgery. and out of the blue. suddenly my knee was swollen. and i had canceled the golf that i would play that weekend it was depressing. a summer spring day boston and i meet a friend and she said sanji you said that you got relief from your back pain. aid had an herniated disk. i saw the lady and my knee was hurting and swollen. i got acupuncture and she got out of the car in the parking lot of the country club and kicked her foot into the air. see how good it is. the next day, friday. evening 4:00, i had a hiatus. and i quality acupuncturist

early in the morning and i went to see her. she did the acupuncture. and i got up and you can compare one knee to the other. the swelling was gone. the pain was gone. i couldn't believe it. i don't understand how it happened. i called home my wife was not there. so i called around on the cell phone. she was going to come home two hours later. doing shopping and i went to the country club. i played nine holes of golf. so i benefited from acupuncture and things of that sort. [laughter] i pass it on. from what i practice, i never took medicationors had surgery or hospitalized. but i agree with much of what he said. i want to answer your question. she had asked specific question. about medicine and how it is practiced. and coming in from harvard medical school. the gold standard and many

other places like that. there are statistics that you can look them up. and i did not make them up. between 36 to 40% of the patients suffer from disease that means disease that has been a result of medical treatment. 80% are optional or marginal benefit. that means it would not make a a little bit of a difference exempt for save you aside effects. and money and it starts with giving sexual impotence and could cause death. [laughter] it is the panarama. and also the most common heart surgery is cabbage.

coronary artery bypass. an guyana will not prolong life in 2% of people. but the most common procedure the second most common procedure for the heart is plasty. for 3% of people. and these are a, laing statistics owe much back surgery. useless skpb hysterectomy 995% is useless. and so we are talking about huge amounts of money that are spent on procedures. my father. our father will make a neurological diagnosis with precision. today if you have a headache. will you go to the emergency room. if you do not walk out with a cat scan or a mri you are lucky, okay? nobody has the time to do it. so we have a crisis.

what we call health reform that is not health reform. this is insurance reform. it has nothing to do with health. most of the expenditure is end of life care. and nobody is allowed to die in the house. i made a l i said i am not going to die in the hospital. i am not going to have any of these resuscitation procedures. have i been in community hospitals where same standards donna apply and i see doctors directing something called hypocalemia. a little minor not minor but aboration and elect lights that if in correct the patient would die. and they keep correcting it though what is there is has no life there. for longation of suffering. for the patient. for the relatives. and the only people that make money are the medical providers. so, this has been a huge

problem. i have discuss it had with politicians. i have even brought it up to our president. okay? but we have a system. we have a system. [applause] . we have a system. this again is nothing to do with the gold standard. we have a system wherefore every congressman that there are 28 lobbyist in washington. okay. and they are only business. this reeither medical industrial complex lobbyist or military industrial so where do we think the country makes money? does it supply for pakistan, afghanistan supply arms to india. they go to dubai. you know. they trade. so we have huge problems. with incentives for treatment become money and

it becomes that. if you go to the baker what will he sell you? >> bread. how do you think that chemo they are pivots make money? >> for every chemotherapy treatment that they give? >> you are saying not to have chemotherapy? >> i am not saying that i am saying question. i will ask everyone here to be adult patient. question your doctors, get the statistics. go to google and get. you will know more than the avenue medical provider. [applause]