Selling a Market for Kidneys
Carolyn O’Hara at Foreign Policy’s excellent blog Passport writes, somewhat disapprovingly, about a South Carolina bill that would offer prisoners shortened sentences in exchange for kidney or bone marrow donations. She laments that “since prisons are disproportionately full of low-income people, this is just another way of getting one class of society to provide for the health of a wealthier class—the reason why we don’t want an organ market in the first place.”
I’m not so sure I agree.
First of all, kidney and bone marrow transplants are safe and effective, and stand apart from other organ transplants in this respect (liver transplants, for instance, are slightly riskier and their effectiveness is disputed). Carolyn conflates an “organ market” with incentives for only kidney and bone marrow donations.
(Image credit: The Economist)
And, really, the organ market isn’t big enough to make for hordes of lower-class donors crashing the gate for cash — there are about 70,000 people waiting for kidneys in the U.S. Also, if too many do so, a true market would quickly swat them down by lowering prices. According to the Economist (subscription required), “if just 0.06% of healthy Americans aged between 19 and 65 parted with one kidney, the country would have no waiting list.”
The Economist also provides (subscription required) an interesting example, from Iran of all places. A particularly telling excerpt:
“Another man wandering round the district, aged around 30 and wearing torn, cheap clothing, is hoping he can find a buyer as decent as Gholamreza claims to be. He expects to get between $3,000 and $4,000 for one of his kidneys. “I need the money because I lost out in a pyramid investment scam. After the operation I won’t be able to lift heavy things, but I can still live with only one kidney.”
Iran’s Association of Kidney Patients, a non-government organisation which obviously enjoys official favour, is responsible for all legal kidney transplants: it insists that commercial deals are the exception, not the rule. For one thing, it says, the religious authorities encourage voluntary gifts: in other words, cases where a patient receives a kidney freely offered by a friend or relative. Pious Muslims may also offer up a kidney to anyone who needs it.”
We’d need proper regulation in any such market, and I would feel differently if there was profit to be had in less expendable organs (hearts, lungs, even livers, etc.), but incentives to donate kidneys and bone marrow do not seem inherently wrong-headed to me.
