For Sale: One Kidney?

Virginia Postrel examines the kidney donation system in the United States, where 11 people die every day waiting for a kidney transplant. Exchanging organs for payment is illegal in the U.S. although recent developments in organ exchanges, including donation chains, have been successful. These innovations alone, however, won’t solve the problem, and Postrel advocates a new system that includes both financial incentives and measures to protect donors. [%comments]


Not only should paid donations be allowed they should be actively encouraged by the tax system by being considered tax free expenses.


It is fundamental that one's body does not belong to the government. Everybody has the natural right to dispose of it all or in part without consulting the government.

At most, the government may regulate the commerce for public health and fraud prevention purposes only.

Time for one of those Jeffersonian revolutions!


Donors can't make money off of their organs, but everyone else in the process can. That's patently unfair.

I'm sure that legislators are worried that there will be a rush of people willing to sell their various parts, but that seems just as unlikely as the rush for assisted suicides.

John Hilliard

People are dying waiting for a kidney transplant, while other people fret about whether paying for a kidney is "ethical". Since when is it ethical for us to stand by and let funeral after funeral pass by, while a line of people wanting to donate kidneys await justifiable compensation.

Its nice to know my death is going to be "ethical".

Best regards,
End Stage Renal Disease


The point of banning organ payments is not to keep you from selling your kidney...but to keep someone else from selling your kidney.


I'd probably donate a kidney if only the expenses related to donation were covered. Missed pay all medical care ect. Right now its just medical care and I can't afford to lose money on a donation.


My father had a kidney transplant 7 or 8 years ago after three years on the waiting list. His disease was genetic and triggered the doctors believe by a case of scarlet fever he had as a child. Clearly it took years for the disease to run it's course. I have a friend whose father also had a transplant, but his kidney failure was due to high blood pressure and other self inflicted maladies related to very poor diet and weight. So why don't we as a nation decide to focus on preventative measures so that the list is shorter.

Joe Salcedo

We're blessed that here in this country selling kidneys are for the most part regulated.

Back in my home country Philippines (and other "poor" countries)--highest bidder gets it!

Just to show the perks of living here.


It should be a crime to let perfectly good organs be buried or cremated when people who can use them to live a better life are dying. I don't really care whether people get paid for their organs (though, that would certainly encourage more to donate) but I think donating your organs should be an opt-OUT system, not opt-in. The default should be to donate.

Tilemahos Efthimiadis

1) Putting a price tag on a kidney leads: to putting a price tag on human life, create the grounds of changing the criteria from most needed/suitable to most wealthy, will feed to the paranoia that still exists that doctors will kill you for your kidney....

2) The monetary incentive is not always the best way to go. Take blood donation. In the US you get money for donating blood while in (most of) the European countries this is forbidden. Surprise, surprise, studies show that Europeans give more blood and of higher quality as it is a gift of life and not just a revenue scheme for the homeless. I've actually heard Americans say "why should I give blood? I have a job".

3) Donor chains might be tricky but they make sense. Has anyone noticed that these essentially resemble the microloans schemes?


@9 That's a great point. It takes a relatively small amount of effort to opt-out or opt -in, however it appears that most people aren't willing to go through the small effort of doing either. Making it an op-out system would result in a huge gain of available kidneys and it's unlikely to "force" many unwanted donations after death. Anyone who feels strongly they don't want to donate can make the small effort of opting out.

I don't personally have a problem with paying live donors, but I can see the potential pitfall that prices will get bid up far out of reach for most Americans. There would have to be a way to mitigate that. Paying only live donors and making after-death donation an opt-out system might just be the best solution.


@10: "In the US you get money for donating blood"

I've never been paid for donating blood, unless you count the cookies and OJ they give you afterward. Nor do I know anyone in the US who has received payment for donating blood.


@9 and 11

I agree completely about the opt-out system. Just a few moments ago I was speaking with a co-worker about this article, and she said she would like to donate organs but she isn't sure how to sign up for it. When I explained it to her, she said she wants to register, but usually she forgets when she's at the DMV, because of the stress/confusion. It's a perfect example of why opt-out is the superior system!


Don't know about blood, but here in our college town there's a plasma center that will pay you to donate your plasma. Donors get $20 a donation, and plenty of starving college students are more than ready to pick up $20 bucks for donating their healthy plasma. One woman I know donates regularly to supplement her meager salary.


How about making the kidney chain require 2 committed donors to join the chain?

So to get a kidney in the chain you have to convince 2 people who care about you to donate.


If the concern for paying for body parts is that the richer recipients will get the best parts.

How about the government buying the parts at a fixed price, and giving them out using some objective criteria?

Would we as tax payers be willing to pay for this collective insurance? I think yes.

Dibin Das

I a m Dibin Das 24 years old from Kerala India. I am healthy man non smoker and non drinker. I am ready to donate my kidney. My Blood group is B+. If u want please contact me


I wrote a comment a while ago, in response to another blog about kidney donation. I tried for years to persuade a close relative to accept one of my kidneys, but she continued to refuse. She survived on dialysis for 9 years, but her death was indirectly caused by the kidney failure: she fractured her hip, and she was too weak to undergo an operation.

But my point now is that kidney donation is not the same thing as donating blood, because you regenerate the blood completely. I have donated gallons of blood - got a lot of coffee and a little pin for it - and I am exactly the same now as if I had kept all the blood.

A kidney is almost, but not quite, a "spare part". If you have one kidney that is functioning almost (but not quite)100%, you have "complete kidney function". Normally, if one kidney fails, they will both fail, and so if you donated one kidney and your remaining kidney fails, you will not say, "Oh, I wish I had that other kidney." The only case where you would want the spare kidney is if one kidney suffers an accident (auto crash, shooting, etc.) and fails for mechanical reasons.

That said, for a suitable donor (healthy, safe driver, with friends who don't have guns) the risk of donating a kidney is pretty small, although not zero. But it is higher than the risk taken by the surgeon, the anaesthesiologist, and all the other people who get paid for the transplant process. Why shouldn't the donor be paid, if it is not an act of love (as it would have been for me) but an act that is meant to benefit society by keeping one (anonymous) person alive?

However, I have seen one red flag in these comments: the notion that "starving students" might want to sell their kidneys for money. This is where the counseling and the medical care comes in: someone has to TELL them that this will change their lives - it is NOT like donating blood. Advise them to donate blood.

But they, and everyone, should have the option.

And cadavers? For heaven's sake, yes. I don't drive a car (so no driver's license), and I very much wanted to "opt in", but I couldn't get through the paperwork, and I needed several witnesses, and I couldn't get it organized. Of course I want to opt in, and I hope someone will help me. If I am dead, why do I need my kidneys?


Myron B.

Win Win solution, I am 51 years old in good health. My blood type is ab+, my kidney is up for donation, in exchange for all expenses paid. I AM READY AND WILLING. LETS DO THIS. Myron B.

Peter Cervino

Hi My name is Peter.Do to hard times I'm looking to donate a kidney for a price.My e-mail is know its not the right thing to do.But i'm just trying to survie and also make sure my animals have a home.