Kidney market not unethical

In 2000, there were 50,000 Americans on waiting lists for kidneys – 3,000 of those Americans… In 2000, there were 50,000 Americans on waiting lists for kidneys – 3,000 of those Americans died waiting for a kidney. There was about a four-year waiting period. These stats come from Gary Becker, Nobel Laureate in economics, who believes that you should be allowed to sell one of your kidneys to someone who needs a kidney transplant.

I agree with Becker. Decriminalization of kidney sales is justified on two grounds:

First, you have the right to your own body. America observes this right even to the degree that a woman may terminate a fetus inside her body. Why is she not then allowed to sell a dispensable piece of her body to someone whose body is failing?

Arguments against drug use do not hold up against the natural rights argument on this account. A meth junkie will often set buildings on fire or drive recklessly, endangering other people. If I sell my kidney, however, it is wholly my business.

Second, there is the stronger, humanitarian argument. By prohibiting kidney sales, the government sets a price ceiling of $0. At $0, supply for anything would be low. But by allowing people to supply kidneys at a market price for people who desperately demand them, we could increase the total number of kidneys available. Clearly, more kidneys means more lives saved.

I read online a few arguments for prohibiting kidney sales, but none were convincing:

1. Kidney sales are unfair because rich people could buy kidneys while poor people couldn’t.

But poor people aren’t worse off when a rich person buys a kidney instead of going on the waiting list, any more than a poor person is worse off when a rich person goes to work. A given purchased kidney wasn’t going to get donated; it was going to stay in the body of the seller. That’s unfair in that rich people have a better chance of survival, but saving people’s lives is good, even if they’re rich people. The overall number of lives saved would increase, and that is what concerns a person who is both compassionate and reasonable.

2. People would sell their kidneys hastily, like at a pawn shop.

Becker says this could be easily remedied by mandating a “cooling off” period between the sale of a kidney and the extraction during which the seller could cancel the transaction. Even without a cooling off period, I think it’s still beneficial. A hastily sold kidney saves a life just like a well considered one.

3. People will sell their kidneys but then need them later.

An average seller, though, shouldn’t need two kidneys in his lifetime. In contrast, every buyer definitely needs the kidney. Even if a seller needs a kidney later on, he can buy it. In fact, you can sell your kidney when you’re 25 for $15,000, spend $7,500, and then save $7,500 in the stock market. Then, at 70 when you might need one, you’ll have around $150,000, which is enough to buy a kidney and pay for the transplant surgery if you don’t have insurance.

4. Thugs would kidnap people, steal their kidneys and sell the organs on the free market.

But this is more unlikely to happen in a legal market than it does now in the black market, because in a legal kidney market, the price would be much lower. And, it is fairly easy to track the source of a given kidney through some type of government agency.

Likewise, there’s no reason to restrict the sale to only kidneys. Every organ is precious. It’s a shame that people go to the grave with perfectly good livers, eyeballs, hearts, lungs, kidneys and bone marrow. In a reasonable society, I could receive money as a down payment on my organs. I could even arrange for the proceeds of my organ sales to go to my children – organs could be everyone’s built-in life insurance. And there is no sense in which I could be “exploited.” Would it ever be the case that I have already sold them to a slick-talking organ-dealer, but then it turns out that I need them after I die?

Finally, I believe prisoners should be allowed to donate organs in exchange for shorter sentences. It’s ironic that what we call “paying one’s debt to society” actually costs taxpayers upward of $40,000 a year. And, although I oppose the death penalty, it would make sense for death row inmates to be granted additional years in exchange for their organs.

All of this reasoning is very impersonal, I realize. Someone is thinking now, “That bastard Lewis thinks about lives like money.” But when you actually consider what the results could mean – family members living who would have died – you’ll feel something vital is at stake.

A fractional increase in lives saved isn’t a distributed quantity. Lives are whole numbers, and when we improve survival chances, it means whole persons, indivisible and real, are carrying on when they would have dropped off the balance sheet.

See, Lewis has a heart – but he’ll sell it to the highest bidder. E-mail him at ljl10@pitt.edu.