There should be a legal market for kidney transplants in order to incentivize the saving of lives. Keeping this ban on the sale of kidneys is quite literally killing people. There are nearly 100,000 people on the kidney transplant waiting list that are in need of a kidney. Most wait on average 5 to 10 years to be the recipient of a kidney transplant and approximately 4,500 people a year die waiting (Kidneylink). In regards to living donors, approximately 1 in every 3,000 procedures results in death, that is .0003%, not bad odds. (Wilkinson). If you are like many people in the U.S. these odds do not really do it for you. By ‘do it for you’ I mean that these odds are not enough for you to go into an operation that has potential dangers. This operation, while could truly benefit others, does not have enough value. How can I make that assumption you may ask? Well, if both the odds and a full understanding of how much one could help without large benefits in return was enough, there would be more live donors and fewer people waiting for a kidney. Incentives, specifically economic rewards, would encourage people to donate and thus would save lives. Both parties could benefit; the number of people who need money would significantly decrease and the number of people waiting for a kidney would significantly decrease.

To save a life. Is that payment enough? As humans, we travel through our everyday lives interacting with and enjoying the company of other human beings. Many people attribute the value of their life’s work to working with people and they feed off of that human interaction. If it was the norm to put yourself and your body on the line in order to save an absolute stranger, even if the reasoning was just for some extra money, I think more people would take part. Are there disagreements in the peanut gallery? Well let us look at it this way. For the average sperm donor, why are they giving others the chance to actualize their own genes? Money. People would more than likely not hand out their sperm for nothing in return. Not a fan of generalizations? Studies show around 80% of sperm donors are entirely in it for the cash. The other 20%? They are in it for other reasons. Maybe they entirely want to help people… or maybe they understand what people in need are going through and they just want to take away that pain (Docterman).

Since there is no economic incentive that influences live donors to donate kidneys, like there is with sperm donors, the amount of live donors remains low and has actually decreased every year over the last four years. The procedure is safe and could make the difference in someone’s life (Mysel). Without incentive to donate, the live kidney donors are similar to that of the 20% of sperm donors doing it for their own reason, whether it be sparked by the struggle of a family member or simply by the want to help others. As mentioned above, nearly 100,000 patients are on the waiting list for a kidney transplant. If there was an economic incentive, the supply versus demand could eventually find an equilibrium and lives could be saved. While any operation sounds risky, it is certainly possible for people to live with just one kidney. Approximately 1 in every 750 people are born with just one kidney and their life expectancy is no different because of it. That being said, those of us with two have an extra kidney that could be supplied to someone in need.

A point that has very much so caught the attention of many is as follows, “If we should be allowed to sell our labour, why not sell the means to that labour?” (Wilkinson). This point holds great value. Why is it that we can pursue dangerous careers at the hope of a large paycheck but we cannot pursue said paycheck by selling a piece of our body to help others? We can put on a uniform every day and venture into the deep seas or into mines for a dollar but we cannot donate a kidney for a similar reward? Does it seem fair for there to be a ban of what we do with our bodies? While just like in the workforce there are regulations, shouldn’t there simply be regulation over the selling of our own means as well? Many would say just that regulations, not bans, and would allow for a proper equilibrium of safe supply and demand. We sell our labor and there is regulation on that sale, the same should be true for selling the means to said labor.

On the note of regulation, the following regulations should be included into the removal of the ban on the sale of kidneys. One, there should be intensive screening processes to ensure the donor is both needed and healthy enough to donate. Since the donor is going to be paid, it must be especially ensured that they are able to do so in order to prevent future complications. I am no doctor, but there should be standards expected to be upheld. There must be demand for this donor's kidney and safety precautions must be entirely taken into account to ensure a safe transplant. Two, proper postoperative health care should be provided to the donor. If complications stir up as an aftermath of the surgery, the donor should be well taken care of. They are the heroes in this story and should not be left to suffer. Three, the compensation to a live donor should not depend on the person intended to receive the donation. The third regulation should especially be enforced to prevent those who are economically fortunate from influencing how quickly and swiftly they receive a kidney. Whoever receives the kidney first should stay consistent to the list’s methodology that is currently in place. The method currently being used should remain in effect to test the efficiency and the change caused by the incentive to donate. Essentially, keeping all things equal, we will minimize the waiting list for recipients in need and therefore prove to people in opposition that this was the best possible route of change. The current methodology should still stay in place because over the years it has seemed to work and the flaws that are found in the current methodology could be mended by the influx of people willing to donate with the incentive in place.

Yet another important detail to note, currently there is a black market underground system of kidney transplants. This underground market should be pulled above ground and should be regulated to help the people in the system live. As noted in the Stanford Encyclopedia of Philosophy, J. Stewart Cameron and Raymond Hoffenberg state: “It is the marginalization of paid organ donation that leads to its performance in less than ideal circumstances. Paid organ donations need be no more risky than unpaid.” This essentially explains that the best way to avoid harm to those in the black market and to venders alone is to regulate the sale of organs, not ban it. Without regulations, people do not truly know just how much goes on in said market and it could be potentially dangerous for both donors and recipients of organs. Being brought above ground would allow for safer transaction in all places. Safety and the preservation of life are the two main goals of medicine anyways, right? That may have been off-putting to some readers with the argument that more people will go into operation therefore more people will get hurt. Well, this practice has become so standard that surgeons are nearly recommending it to patients. Who are we to deny other the chance at life just because we do not want to face an ounce of pain? As said earlier, those with two kidneys essentially have an extra one to spare. This is a standard procedure that with incentives could attract a large pool of individuals.

People fight back on this argument. Some would say that by providing incentives we will reduce the people that are donating organs out of the goodness in their heart. This statement, while has some base, falls through when one considers the truth of the matter. The truth was greatly examined by Kenneth J. Arrow when he states: “if to a voluntary blood donor system we add the possibility of selling blood, we have only expanded the individual's range of alternatives. If he derives satisfaction from giving … he can still give, and nothing has been done to impair that right” (Arrow 1972, 350). Essentially, he is stating that the reasons for donating can coexist, and that paid donations are just as valuable to the person receiving the organ as unpaid donations have been.

Those who oppose the selling of kidneys may argue that a financial incentive may have people jumping to the opportunity without full understanding of the risks. If the intensive screening is a piece of the process then this screening should involve if someone is mentally capable of consent to the surgery. Specifically, that there are no doubts or hesitant reactions in regards to the process of donating and the operation required to do so. There is also the opposition regarding a feeling of obligation. If people need money and they have this option are they going to feel obligated to donate their organs? If they feel obligated is their consent then invalid? The obligation argument would be a valuable one if the donor was not also gaining from the exchange. This argument could also again correlate to a dangerous job. If a person can sign up for a dangerous career in exchange for the money and benefits the career provides, why can they not sell their organs? If the obligation argument applies to donating kidneys does that mean that we shouldn’t have firefighters that are in it for the money and that we should take away coal mining careers altogether? The decisions people make are up to them. If we remove the right of making choices we are then inflicting on their right to liberty as well as their right to choose and thus their right to freedom.

Life is full of choices. Every choice is a cost benefit analysis in some way, shape, or form. Each person has their own set of values, and what is truly important to them is also a choice that they can make. People have priorities and how they act to fulfill said priorities is a liberty that no one person should step on. If an incentive is what they need to save lives, so be it. At least the life will be saved. If the selling of a kidney is what would best fulfill a singular person’s idea of the correct choice and life decision, who is the government to ban that? While yes, it would be nice if everyone could donate simply out of the kindness of their hearts, where we are in our culture and society leads that to be an unrealistic expectation. The sale of kidneys would do great things for the world as a whole. People in need of money would move forward in their life and in their bank accounts while receiving the satisfaction of saving a life. On the flip side of the donation, the recipient of the kidney would be able to live out the life that is there for them, and they will no longer spend their life waiting for the next generous donor. People die every day. By not making moves to make donations more plentiful we are passively letting them die. Regardless of if this is active killing or passive killing this is still killing and people deserve the opportunity to see their true life’s potential.

Works Cited

Arrow, K., 1972, “Gifts and Exchanges”, Philosophy and Public Affairs, 1: 343–362.

Cameron, J. and R. Hoffenberg, 1999, “The ethics of organ transplantation reconsidered”, Kidney International, 55: 724–732.

Dockterman, Eliana. "Delivery Man’: 9 Sperm-Donation Questions You’re Too Embarrassed to Ask." Time. Time, May-June 2013. Web. 16 Jan. 2017.

KidneyLink. "Risks Involved in Living Donation." Risks Involved in Living Donation. Kidney Link, 2014. Web. 16 Jan. 2017.

Mysel, Harvey. "Living Kidney Donor Network - Mission." LKDN. Living Kidney Donors Network, 2017. Web. 16 Jan. 2017.

Wilkinson, Stephen, "The Sale of Human Organs", The Stanford Encyclopedia of Philosophy (Winter 2016 Edition), Edward N. Zalta (ed.), URL = <https://plato.stanford.edu/archives/win2016/entries/organs-sale/>.