Would You Sell Your Kidney? For What Price?

TedEd explores the ethics and the practicalities:

A pound of flesh?

Firstly we will note, this video assumes being in the US. Laws and regulations may differ from country to country. That said, the general principles do hold true for most places regardless.

The premise that sets the stage: kidney failure patients can face long waits for transplants (and importantly, the waits are usually longer than a person can survive on dialysis), while most healthy people can survive normally with one kidney.

The central question: the video explores why people are generally prohibited from selling their organs, even when a transplant could save another person’s life and the donor could benefit financially.

Indeed, in the video, which is presented as a narrative, the character Ada notes that if a kidney donor could be paid, she could potentially receive compensation for donating a kidney, comparable to the amount the government already spends covering dialysis (which is presented as being around $100,000, though we’re willing to bet providers bill for more). She imagines using the money to leave her job and focus on graduate studies.

The natural argument for this is that that compensated donation could increase the supply of organs, save recipients from years of dialysis, and compensate donors for lost income, travel, and the risks they take. It is also arguable that people should have considerable freedom to decide what risks to take with their own bodies.

On the other hand, allowing organ sales could coerce financially desperate people into accepting medical risks they otherwise would not take.

But then, this already happens with other compensated activities that involve significant bodily risks, such as pregnancy through surrogacy. Or, for that matter, even just dangerous occupations—the video makes strong comparisons to being a firefighter, in which one takes serious risks, for which one is financially compensated, to save other people’s lives.

And, further, while banning payment may protect vulnerable people from financial coercion, it can also place an unfair pressure on patients’ friends and relations, who may feel compelled to donate because someone they love needs an organ.

That said, it’s not guaranteed that being a relative means necessarily being a match; sometimes you might not be a match for a close relative, and a stranger is. To remedy this, there is already a practice of “paired kidney exchange“, in which person A wants to donate a kidney to person B but isn’t a match, so instead donates it to person C, in order to receive a kidney for person B from person D who is a match and is subscribed to the same scheme.

Back to the top-down approach: one hypothetical system presented includes a “Ministry of Transplantation”, that approves donors and guarantees standardized medical care, information, and compensation. This is intended to prevent a completely unregulated market in human organs.

In short, it’s a complex matter with a lot going on both ethically and logistically, and we haven’t found a perfect answer yet:

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Want to learn more?

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Take care!