Sunday, September 29, 2013

The Moral Case for Legalizing Organ Sales

 Several years ago, one of my all-time favorite football players (Walter Payton) died because he was not allowed to use his wealth to fight for his life. What follows is my Op-Ed in today's Orlando Sentinel.  I hope you enjoy it.

I am often asked by students in my classes to address certain goods and services that are illegal to consume in America, but perhaps should be legal.  Of course, when this question - from my mostly teenaged audience comes up, they expect me to dive into drugs, gambling and other vices.
To shake them up a bit, I often begin my answer by asking them a question:

“If a stranger approached you on the street today and offered you $50,000 for one of your healthy kidneys, would you accept their offer?”
My students find this to be an odd way to begin a discussion of government interference in the marketplace, but they end up learning about a law that has helped ruin the lives of countless Americans.

30 years ago Congressman Al Gore offered up a bill that made the buying and selling of human organs punishable by up to five years in prison or a large fine.  The bill became law in 1984 and with its passage the official price of all of the organs in our body equaled zero dollars.
Of course, as we learned in the former Soviet Union, “official prices” and market prices are two entirely different things.  We also learned that when official prices (set by government) are below market prices it is inevitable that shortages and black markets will emerge.
According to the United Network for Organ Sharing, as of September 27th, there were 119,115 Americans on the national waiting list for transplantable organs.  Data from the Health Resources and Services Administration reveals that of that figure, 97,896 people on the national list are waiting for kidney transplants.  Moreover, the data reveals that 18 people die every day in America while waiting for an organ transplant.

It does not have to be this way.

 The problem is not that there are not enough organs.  After all, according to the Center for Disease Control and Prevention, more than 2 million Americans die every year.  The problem is that the price of organs is not allowed to rise to a level that will encourage more of us to act.
Out of those 2 million deaths, there are probably enough healthy organs buried or cremated to give the 119,000 – plus Americans who are suffering a chance to have a healthy life. 

Relying on moral suasion to get people to donate organs is not working.  When offered zero dollars for our body parts, rational humans often opt to hang on to our organs rather than do the morally-right thing and donate them.

But what if, for example, you could contract to sell your organs after you die, or in the case of kidneys, while you are alive?

Imagine your life insurance carrier offering you an extra $100,000 in coverage for your organs when you perish.  Your benefactors would be better off, as would the insurance company who sells them for say, $150,000 to hospitals in the area.  The hospitals in turn sell them for $200,000 to various patients who would be willing and able to pay.

How many people, if given the choice of waiting and suffering in the hope they find a kidney would buy one for several thousand dollars if they were given the opportunity to do so?  How many people – enticed by money – would gladly offer their organs up for sale?  It is not hard to imagine, given the far greater deaths than there are people waiting for organs, a large surplus that would emerge fairly quickly, suppressing prices and helping even more people afford a chance to survive.

In the case of kidneys, doctors tell us we only need one to live a normal life.  As a free human being I should be allowed to part with one of my kidneys while I am alive for any price I find agreeable.  After all, women can sell their eggs to help create life.  What is the difference then, if I sell my kidney to save a life?

In 2011, after a series of court challenges by a woman whose daughters suffered from Fanconi anemia, the federal government legalized the selling of bone marrow.  People are now allowed to earn $3,000 in the form of vouchers for things like housing and education as an enticement to help save lives.

Unfortunately, for the tens of thousands of other sufferers there is no end in sight to the violation of their rights to offer compensation for kidneys and other organs.  

The time has come to end this suffering by allowing the forces of supply and demand to work.




  1. I see absolutely nothing wrong with selling our organs. I am an organ donor, but if my children could get some extra cash after my death that would be nice.

  2. This is unrelated, but I thought you'd find this interesting.