Should You Be Allowed to Sell Your Organs?

Should You Be Allowed to Sell Your Organs?
Should You Be Allowed to Sell Your Organs?

A woman who lives in California is flying to Syracuse, N.Y., to see if she is a suitable candidate to donate her kidney to a relative. What makes her story unusual is that there's money changing hands.

The potential donor is being reimbursed about $4,000 for the multiple trips needed to complete a medical evaluation. The money comes from a government grant administered through the American Society of Transplant Surgeons.

The National Living Donor Assistance Center, a 5-year-old program administered by the American Society of Transplant Surgeons, aims to see if reimbursing expenses will encourage more organ donations among people who might want to, but who otherwise couldn't afford the expense of being a donor.

Under the National Organ Transplant Act, it is illegal to provide anything of value in exchange for a human organ. The National Living Donor Assistance Center provides reimbursement that has averaged around $2,900 for travel and other incidental expenses, according to its website.

Making It About the Money

Such payments are legal, though buying organs outright is illegal in every country in the world except Iran. More doctors, however, are warming up to the idea of compensating donors.

"More are supporting the general concept that it's time to try the use of incentives under very controlled circumstances," says Dr. Amy L. Friedman, director of transplantation at SUNY Medical Center in Syracuse, New York, who is evaluating the woman. She added in an interview that "not one legitimate transplant surgeon believes that the black market is OK or that there should be a free market."

The Supply-Demand Conundrum

There is no starker example of the free hand of the market than organ transplantation. It's the ultimate "seller's" market: For instance, the number of kidney transplants performed in the U.S. rose from 3,786 in 1980 to 17,413 in 2008. Demand, though, still far outstripped supply, and patients paid the price: More than 4,500 people died in 2008 while waiting for a kidney, and another 1,506 patients died awaiting a liver, according to the National Kidney Foundation.

Government data shows that more than 20 million people aged 20 years or older have chronic kidney disease, and more than 300,000 are on dialysis and may need a transplant.

Many people are so desperate for organs that they sign up on waiting lists in multiple transplant centers, which is what Steve Jobs did before getting a liver transplant in 2008. This is perfectly legal to do, but it requires being able to get to centers significantly farther from one's home -- something which makes the organ donation system less-than-completely egalitarian.

Desperate Measures, Disastrous Consequences

The dangers of the underground organ market -- a business estimated at between $60 million and $100 million -- were illustrated in horrifying detail in a recent story that appeared in Bloomberg Markets.

The magazine found that U.S. citizens suffering from kidney disease were traveling to Nicaragua and Peru "to buy organs in a shadowy trade that injured and killed donors and recipients." The illicit trade reaches into Israel and the former Soviet Union as well.

Some critics argue that the same problems would come to the United States if organ markets were able to flourish legally. That's a fair point, which underscores the fact that such transactions would need to be closely regulated. Any organ market would have to be transparent and establish the same price for everybody to prevent bidding wars over rare commodities such as kidneys, which fetch about $100,000 in the black market.

Friedman argues that it makes little sense to prohibit organ sales when women are legally allowed to carry another person's baby in their uterus for money. "We are already on that slippery slope," she says. "Let's acknowledge that and not dance around the issue."

What are your thoughts about allowing a regulated organ market to operate in the U.S.? Weigh in below.

Jonathan Berr is a Motley Fool contributing writer.