The Case for Legalizing the Sale of Organs

It's not as creepy as you might think

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The idea of paying for live organs has always made people a bit squeamish. It's illegal in the U.S. and many feel that providing financial incentives for organs would exploit poor people. However, a new study by the University of Pennsylvania is challenging conventional wisdom. Researchers say paying people for organs would greatly increase the supply of organs without resulting in a disproportionate number of poor donors. In the study, willingness to offer one's organs was not affected by personal income. Many libertarians have long argued that financial incentives are necessary to eliminate the shortage of organs. Here are their arguments:

  • The Status Quo Isn't Egalitarian Anyway, wrote Virginia Postrel in a 2009 piece for The Atlantic: "Outlawing payments to donors is ostensibly a way to keep the system fair, giving rich and poor an equally lousy chance of getting a kidney. But wealthier people can already more easily register at distant centers with short lists. They're also more likely to have friends and relatives who can afford the nonmedical expenses that living donation often entails, including time off from work, child care, hotel rooms, or cross-country travel. (It is legal for recipients or third parties to pay such expenses, but, unlike medical costs, they are not covered by insurance.) Patients with enough money and the right networks have yet another option. They can go abroad, to countries where the authorities sanction or ignore payments to living donors."
  • Prohibition Creates Black Markets, writes Sally Satel, a scholar at the American Enterprise Institute: "[It's a] time-tested fact that efforts to stamp out underground markets either drive corruption further underground or causes it to flourish elsewhere. The illicit organ trade is booming across the globe. It will only recede when the critical shortage of organs for transplants disappears. The best way to make that happen is to give legitimate incentives to people who might be willing to donate."
  • Iran Found a Solution, writes Alex Tabarrok at The Wall Street Journal: "Only one country, Iran, has eliminated the shortage of transplant organs--and only Iran has a working and legal payment system for organ donation. In this system, organs are not bought and sold at the bazaar. Patients who cannot be assigned a kidney from a deceased donor and who cannot find a related living donor may apply to the nonprofit, volunteer-run Dialysis and Transplant Patients Association (Datpa). Datpa identifies potential donors from a pool of applicants. Those donors are medically evaluated by transplant physicians, who have no connection to Datpa, in just the same way as are uncompensated donors. The government pays donors $1,200 and provides one year of limited health-insurance coverage."
  • Let's Look at the Big Picture Actor/comedian Drew Carey gives his libertarian take at Reason:

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