Legalizing Kidney Sales Would Save Thousands of Lives, Save Taxpayers a Bundle

Kidney sales should be legal, explains kidney donor Alexander Berger in The New York Times. Berger is a research analyst for GiveWell, a nonprofit that helps charitable donors decide where to give. As Berger notes, allowing kidney donors to be compensated would save countless lives by providing people with an incentive to donate their kidneys. Right now, you have to be unusually altruistic to donate a kidney, since you have to spend several days in the hospital to donate one, take off a lot of time from work, and run a tiny, tiny risk of death from surgery. Most people just aren’t that altruistic. Allowing kidney sales would also help the poor, who currently often unable to obtain kidneys: as Berger notes, people unable to get kidney transplants now are “disproportionately African-American and poor.” 

If kidney sales were legal, the taxpayers would save money, too, since the government would be able to give kidneys to poor people and elderly people who need them, with the increased number of kidneys that would become available due to kidney sales, rather than paying for incredibly costly and debilitating dialysis treatment, which has consumed billions of tax dollars over the years. It would be much cheaper for the government to buy a kidney for a poor or elderly person rather than paying for years and years of dialysis. As Berger notes, paying for kidneys would likely “save the government money; taxpayers already foot the bill for dialysis for many patients through Medicare, and research has shown that transplants save more than $100,000 per patient, relative to dialysis.”

Moreover, people who receive compensation for their kidneys will not be “exploited”: while there is some risk associated with donating a kidney — the whole reason compensation is needed — “the risk of death during surgery is about 1 in 3,000,” smaller than many risks that everyone is already allowed to take in exchange for money or just for the heck of it, and a kidney donor’s “remaining kidney will grow to take up the slack of the one that has been removed,” enabling them to live perfectly normally even after donating a kidney. As one commenter notes, “the risk of dying during kidney donation (0.03%) is equivalent to going sky diving twice, or driving 20,000 miles. Donating a kidney has the same risk as commuting 40 miles to work for one year! People are willing to take an equal risk for a $50,000 salary, but for some reason selling a kidney is wrong.”

As Berger notes, the ban on kidney sales is based on myths, ignorance, and misconceptions, and thousands of people die each year

because there aren’t nearly enough saints in the country to tackle the growing waiting list for a kidney. More than 34,000 people joined the waiting list in 2010; fewer than 17,000 received one. Thousands of people die waiting each year.

This is a tragedy, but it doesn’t have to be this way. The people waiting for kidneys aren’t dying because of kidney failure; they’re dying because of our failure — without Congress’s misguided effort to ban organ sales, they would have been able to get the kidneys they desperately needed.

It has been illegal to compensate kidney donors in any way since 1984. The fear behind the law — that a rich tycoon could take advantage of someone desperately poor and persuade that person to sell an organ for a pittance — is understandable. But the truth is that the victims of the current ban are disproportionately African-American and poor. When wealthy white people find their way onto the kidney waiting list, they are much more likely to get off it early by finding a donor among their friends and family (or, as Steve Jobs did for a liver transplant in 2009, by traveling to a region with a shorter list). Worst of all, the ban encourages an international black market, where desperate people do end up selling their organs, without protection, fair compensation or proper medical care.

Paying people for other kinds of body parts is often legal. The U.S. Court of Appeals for the Ninth Circuit recently ruled that it is legal to compensate bone marrow donors. Professor Ilya Somin rebuts the standard objections to organ markets here and here, explaining why organ sales are a good idea.

As Berger notes, “we already allow paid plasma, sperm and egg donation, as well as payment for surrogate mothers. Contrary to early fears that paid surrogacy would exploit young, poor minority women, most surrogate mothers are married, middle class and white; the evidence suggests that, far from trying to ‘cash in,’ they take pride in performing a service that brings others great happiness. And we regularly pay people to take socially beneficial but physically dangerous jobs — soldiers, police officers and firefighters all earn a living serving society while risking their lives — without worrying that they are taken advantage of. Compensated kidney donors should be no different.”