诺贝尔奖得主Alvin Roth谈肾脏市场与道德经济学
Should you be able to buy a kidney? | The Gray Area
While Iran is the only country that has a legal market for selling kidneys, there are black markets [music] elsewhere. And the fact that it's so universally illegal to pay donors has in some cases driven those black markets out of the hospitals and into hotel rooms and apartments and places where you wouldn't want to have surgery done, where [music] where the the there might not be a sterile field, things like that. So, so people who go to those markets get very poor medical care.
虽然伊朗是唯一一个肾脏买卖拥有合法市场的国家，但其他地方存在黑市[音乐]。事实上，向捐赠者付费在绝大多数情况下都是非法的，这在某些案例中导致黑市从医院转移到了酒店房间、公寓等不适合进行手术的场所，那里可能没有无菌环境，诸如此类的问题。因此，那些在黑市交易的人得到的医疗服务非常糟糕。
Whereas in Iran, where it's legal to pay, apparently the medical care is good. [music] [music] Welcome to the gray area. I'm Brian Walsh filling in for Shaun Illing. Today my guest is Alvin Roth, Nobel Laurate Economist and the person who designed the kidney exchange that now produces roughly a third of all living donor transplants in the US. His new book is moral economics and it's about the deals we won't let people make even when both sides want to.
而在伊朗，由于付费是合法的，医疗护理似乎很好。[音乐] [音乐] 欢迎来到灰色地带。我是布莱恩·沃尔什（Brian Walsh），代肖恩·林格（Shaun Illing）主持节目。今天我的嘉宾是阿尔文·罗斯（Alvin Roth），诺贝尔经济学奖得主，也是设计了目前在美国产生约三分之一活体捐赠移植手术的肾脏交换系统的人。他的新书是《道德经济学》（Moral Economics），探讨的是即使双方都愿意，我们也不允许人们进行的交易。
There are around 90,000 Americans on the kidney waiting list right now. Most won't get one. Some will die before their name comes up. And the strange thing is we probably know how to fix it. There are people who would sell a kidney if we let them and people who would buy. In most of the world that exchange is a felony. So the question we focus on is a hard one. Where should markets reach and where are we right to refuse?
目前大约有9万名美国人排在肾脏等待名单上。大多数人得不到肾脏。有些人在轮到自己之前就会死亡。奇怪的是，我们可能知道如何解决这个问题。如果我们允许的话，有人愿意出售肾脏，也有人愿意购买。在世界大部分地区，这种交换属于重罪。因此，我们关注的核心问题是一个艰难的问题：市场应该延伸到什么程度？我们在哪些情况下有权拒绝？
Al Roth, welcome to the gray area.
阿尔文·罗斯，欢迎来到灰色地带。
Thanks.
谢谢。
So, I want to start off with the title of your book, Moral Economics, which to my mind, I think a lot of people's mind, kind of sounds like an oxymoron. I think people think economics strips out morality decisions, just focuses on prices uh and preferences. So, what does that phrase actually mean to you?
那么，我想从你的书名为《道德经济学》开始谈起，在我看来，我认为很多人的想法也是如此，这听起来有点像矛盾修辞法。我认为人们认为经济学剔除了道德决策，只关注价格和偏好。所以，这个短语对你来说到底意味着什么？
Uh, it's about controversial markets and the moral morally contested transactions. So it's about disagreements about how people should organize themselves into markets, some of which don't use money at all. Money isn't the essential element of markets. The essential element of markets is that they aggregate information to try to get efficient and equitable outcomes. You talk in the book about what are called, I think you call repugnant transactions.
嗯，这本书是关于有争议的市场和道德上备受争议的交易。它涉及关于人们应该如何组织进入市场的分歧，其中一些市场根本不使用金钱。金钱并不是市场的本质要素。市场的本质要素在于它们聚合信息，试图实现高效和公平的结局。你在书中谈到了所谓的“令人反感”的交易（repugnant transactions）。
And to understand that there's kind of distinction you use, we're at the top of disgust on one hand, repugnance on the other. Can you walk me through walk us through an example of what that actually means? Like when people hear, you know, they think of something that's gross, they think of one thing, but you're I think talking about something else when you mean a repugnant transaction,
为了理解你所使用的这种区分，一方面我们在厌恶（disgust）的顶端，另一方面在反感（repugnance）的另一端。你能带我们举个例子，说明这到底意味着什么吗？比如当人们听到这个词时，他们想到的是令人作呕的东西，想到的是某件事，但我想当你提到‘反感的交易’时，你指的是别的东西。
right? So what I mean by a repugnant transaction is a transaction that some people would like to engage in and other people who aren't directly involved in in any easily measurable way think shouldn't be allowed. So in particular, I'm I'm ruling out all those familiar things where people object to some markets because of the negative externalities they cause, the the obvious harms they cause. But when I speak about repug
对吧？所以我所说的‘反感的交易’是指一些人想要参与，而另一些虽未直接卷入但在任何可衡量方式上认为不应被允许的人所反对的交易。具体来说，我排除了所有那些人们因负面外部性或显而易见的伤害而反对某些市场的熟悉情况。但当我谈到‘反感的”时
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