Kidney for Sale: Is the Idea Legal, Ethical, or Economically Sound?
Abstract: Each year thousands of people die while waiting for a kidney transplant. A market for kidney sales is currently illegal in nearly every country. This paper addresses the legal and ethical issues, as well as the economic effects that a legal market would create. The following aspects of such a market were explored: the ethical pros and cons; the current price ceiling for a legal kidney; the current supply and demand of donor kidneys; the fair market price; and the effect on supply and demand in a legalized market. The conclusion is that if paying a living donor can be made legal and as ethically acceptable as other medical practices, kidney sales would be economically sound.
Keywords: Market for Organs, Health Market Reform, Sales of Organs
Should organ sales be legalized in the United States? In today’s society, many people are suffering from diseases and conditions that require an organ transplant in order to survive. The transplant list for those in need of a new organ such as a kidney seems endless. Every day, nearly 74 people receive an organ transplant, while each day another 17 people die waiting for their transplant due to the lack of donated organs (Friedman & Friedman, 2006). Why is the demand so large? Why are there not enough? Should someone be able to sell his organ to a person in need? Is it legal, ethical or even economically sound to create a market for the sale of a kidney? What economic effects might there be if kidney sales were legalized? In the past few decades, immunosuppressive therapy and improved organ transplant expertise have increased the survival rate of kidney transplant patients (Ghod & Shekoufeh, 2006). For end stage renal disease (ESRD), transplantation, not kidney dialysis, has become the preferred treatment, because it provides the patient with an improved survival rate and a better quality of life (Ghod & Shekoufeh, 2006). In turn, the number of patients with ESRD being treated by dialysis and waiting for transplantation continues to outstrip the donor pool of kidneys (Friedman & Friedman, 2006). The donor pool consists primarily of deceased donors and some live donors. Statistics show that only about 30% of Americans register to donate their organs after death (Knapp, 2005). Over the past ten years, the number of deceased donor kidneys has not increased despite efforts by the National Kidney Foundation, State Drivers License promotions, and celebrity ad campaigns (Friedman & Friedman, 2006). In First World and middle-income
countries, the demand for donor kidneys has increased. The populations of these countries live longer and typically develop ailments such as hypertension and diabetes caused by obesity 2|Page
which contribute to kidney failure (The Economist, 2008). Fewer deaths from strokes, heart attacks and motor vehicle accidents have reduced the supply of cadaver donors (The Economist, 2008). Each year, the wait list grows longer. Figure 1 illustrates that the demand for kidney transplants has grown faster than the actual supply of kidneys. As of January 2007, there were nearly 95,000 people waiting for an organ transplant (Bramstedt, 2007). In a one year period, 7,000 people died waiting. Of those 7,000, approximately 4,000 were waiting for a kidney (Bramstedt, 2007). The United Network for Organ Sharing (UNOS) predicts that by 2010, there will be nearly 100,000 people who will have to wait an average of ten years for a renal transplant (Bramstedt, 2007). If this trend continues, the supply of kidneys will never come close to meeting the demand. Given this dilemma, it is necessary to at least consider other options to procuring the needed kidneys.
2 Legalizing Kidney Sales?
A controversial solution is to lift the ban on purchasing kidneys from live donors, or permitting some type of compensation to the families of...