Organ sales by the living: a debate we ought to have

"...the one-year transplant survival rate from living kidney donors is 95 percent compared to 89 percent from deceased donors. The five-year
transplant survival rate is 80 percent from living donors and 65 percent from deceased donors. Kidney transplants are much cheaper than maintaining a patient in renal failure on dialysis.

Right now, 55 countries legally prohibit giving or receiving payment for organs. However, 62 countries do allow living donors to be compensated for their lost wages and medical expenses. Caplan and colleagues want to clearly distinguish between sales of organs, tissues, and cells, on the one hand, and trafficking in people whose organs are removed for transplantation on the other—and rightly so.

But the Caplan study cites estimates that “up to 5 to10 percent of kidney transplants performed annually around the world are the result of trafficking.” That translates into somewhere between 3,400 to 6,800 gray or black market kidney transplants per year. Until tissue engineering becomes a reality, enabling replacement organs to be grown in vats, the demand for “donated” organs will increasingly outstrip supply.

By prohibiting the development of legal markets in human organs, the United Nations is ultimately forcing more desperately poor people who wish to sell their organs into black markets, penalizing them for their poverty, and implying that they lack the ability to make rational decisions about what to do with their bodies. Paternalism is bad enough, but banning organ markets is ineffective and counterproductive paternalism at its worst.