#2: Sell Your Kidneys

The phrase “selling your body” could get a lot more literal if certain experts have their way. With more than 85,000 people currently waiting for kidney transplants in the United States, some doctors and economists have argued that healthy people should be able to part with a kidney for cash. 

Arthur Matas, the director of renal transplant at the University of Minnesota, tells Big Think that existing proposals to reform the transplant system won't solve the massive shortage. And while there may be promising scientific solutions in the future, like cloning fully functioning organs from samples of living tissue, they are simply "not ready for prime time today." The same goes with using pig organs for human transplants (xenotransplanting). These options, he says, are "decades away." Meanwhile, the median waiting time for a kidney was 1,100 days (for those who registered in 2003-2004). "The longer someone is on dialysis before a transplant, the worse the transplant results," says Matas. 

Matas wants the government to compensate healthy people who choose to give up a kidney. “I’m not talking about an unregulated market,” says Matas. Rather, the government would remunerate a donor and then allocate the kidney to the person at the top of the waiting list. Matas envisages the remuneration to be more than cash or tax credits. To minimize the risks associated with giving up a kidney, the donor would receive long-term health care and one year of life insurance. 

4,540 Americans died waiting for a kidney transplant in 2008. So it’s no wonder a global black market for kidneys is thriving. Last year, a FBI corruption sting in New Jersey caught a man attempting to sell a kidney for $160,000—the first documented case of organ trafficking in the U.S.

 Why We Should Reject This

Critics suggest that this policy will lead to exploitation of the poor.  However, a recent study by Dr. Scott Halpern at the University of Pennsylvania's School of Medicine suggests that with proper incentives, this policy would attract donors from across the socio-economic spectrum.  Even if the poor ended up donating more kidneys than the rich, that’s not an ethical problem for Matas. "What’s bad about giving poor people an opportunity to do something better?" he asks.

Other experts worry that a paid kidney market might actually reduce the organ supply if fewer sellers stepped forward than altruistic donors pulled out. (Such donors provided 38% of transplanted kidneys in the first four months of 2010.)  “There are very, very good reasons—many drawn from behavioral economics, some drawn from past experience—that suggest that, in fact, to create a market might diminish the supply, not increase it," argued David Rothman, a professor of social medicine at Columbia University. "In England, where the sale of blood was not allowed, rates of donation were considerably higher than the U.S., where the sale of blood was allowed."

More Resources
The United Network for Organ Sharing, a non-profit, scientific and educational organization that administers the nation's only Organ Procurement and Transplantation Network.
— 2008 Intelligence Squared U.S. Panel debate about legalizing a market for organs.
— 2010 study by Scott Halpern: "Regulated Payments for Living Kidney Donation: An Empirical Assessment of Ethical Concerns," originally published in Annals of Internal Medicine.
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