Guilty of Saving Lives

Law enforcement authorities have arrested an alleged dealer in forbidden commodities, and the condemnations are flying thick and fast. What is the dastardly crime with which this individual is charged? Saving people's lives by bringing together buyers and sellers of kidneys.

It's illegal in this country to buy or sell organs for transplant. This is an unjust law made and enforced by people who desperately need neither organs nor money. It condemns kidney-disease sufferers to death and potential organ donors to poverty. It's a law that I will unhesitatingly break if one of my children needs a kidney, and I hope you will have the decency to do the same if a member of your family is in a similar situation.

The AP story I linked to above discusses some of the ills that supposedly flow from a market in organs. It quotes a medical ethicist at my own alma mater arguing that it's better for people to die than buy organs:

"There is a black market, almost exclusively in kidneys," Caplan said. "All international medical groups and governments ought to condemn any marketing in body parts. It's simply too exploitative of the poor and vulnerable. The quality of the organs is questionable. People lie to get the money. The middle men are irresponsible and often criminals. They don't care about the people who sell."

Yet it seems to me that all these supposed problems (none of which deterred the defendant's alleged kidney-patient clients) are the result of the ridiculous prohibition on organ sales. The middle men, for example, are only criminals because of the stupid law, just as sellers of bourbon were during Prohibition. The lying is also related to the ban. A legal, regulated and transparent market could  solve the problems of exploitation and organ quality. The huge buy/sell price spread apparent in Mr. Rosenbaum's alleged operation would collapse if the risk, subterfuge and bribery were taken out of the trade.

The sanctimony of those who condemn these transactions strikes me as outrageous. If someone has the right to abort her own fetus, why does she not have the right to sell her own kidney? By what authority does the state tell me I cannot save myself or my family members by paying money I earned to a willing seller of a surplus item? In fact, why wouldn't a system of national health insurance include a provision for organ purchases? These transactions should not just be legal for the rich but subsidized for the poor, all in a carefully designed and closely regulated marketplace serving buyers, sellers and even medical ethicists. It's a shame that even one more person has to die before this law is changed.

UPDATE: From the July 27 Wall Street Journal:

More than 80,000 Americans now wait for a kidney, according the United Network for Organ Sharing. Thirteen of them die daily; the rest languish for years on dialysis. The number of donors last year was lower than in 2005, despite decades of work to encourage people to sign donor cards and donate to loved ones.


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Daniel Akst

Dan Akst is a journalist, essayist and novelist who wrote three books. His novel, The Webster Chronicle, is based on the lives of Cotton and Increase Mather. More

Dan Akst is a journalist, novelist and essayist whose work has appeared frequently in The New York Times, The Wall Street Journal, The Boston Globe, Wilson Quarterly, and many other publications.

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