When I donated a kidney a few months ago to a total stranger, I wasn’t thinking about market forces. I had simply realized that I couldn’t bear to have two healthy kidneys while knowing that someone out there would certainly die of renal failure. When I was wheeled out of the hospital, I began wondering what could be done, economically or socially, to make more people open to the idea of organ donation.
It’s illegal to buy and sell organs in the U.S., and the inflexibility of the market can be unbearable for someone hooked up to a dialysis machine. The problem isn’t low supply—in the U.S., there are millions of kidneys that could be donated without any risks beyond those of any typical surgery—so much as overwhelming, unfilled demand. Kidney disease is common, but treating it with dialysis is effective for usually a decade at most, not to mention very costly. While there were more than 17,000 kidney transplants performed in the U.S. last year, about 8,000 people became too sick to receive one or died waiting for a transplant. Another 100,000 people ticked off another year on a waiting list, on which the average stay is about six years.
The simplest solution—paying healthy people for their organs—quickly becomes complicated. Opening organ donations to the free market, even with robust regulations, invites some concerns. Would desperately poor people be forced into selling their organs? Would unwilling people have their kidneys forcibly removed and then sold? These nightmare scenarios are probably overblown, but the idea of selling organs is knotted up with the idea of sovereignty over one’s body.