Should It Be Legal to Buy a Kidney?

The kidney is one of the most important organs in our body; it removes waste products from the blood by excreting them into the urine. If a person experiences kidney failure, waste products can’t pass out of the blood, which causes waste to build up in their bodies. While a patient can choose to replace their kidney with a working one, dialysis is also an option in cases of kidney shortage. Dialysis provides the same functions a kidney does. It clinically purifies the blood as a replacement for the lost kidney, by separating the particles in a liquid of the basis of differences in their ability to pass through a membrane.

There have been an increasing number of people experiencing kidney failure within these last couple of years. This could be due to the increased prevalence of diseases common to a ‘western’ lifestyle like diabetes and hypertension, leading to more chronic kidney disease and renal failure. Kidney disease is a growing problem in the United States, mainly due to unhealthy lifestyle – lack of exercise, sleep and proper diet. Over 162 million cases of common chronic diseases are reported in the US every year. The growing number of people in need of kidneys and the small supply for one is a problem many countries are still trying to address today.

Since the first kidney transplant performed over fifty years ago, it has offered the chance of life and the freedom from dialysis from thousands of people. However, demands for kidneys have always exceeded supply. Kidney shortage is prevalent due to the lack of kidney donors. Even though a person can live without one of their two kidneys, there’s still a high risk in the operation. The donor would have to avoid activities that could cause their remaining kidney to fail. The idea of losing their only kidney could be daunting for the donor. Most people would be unwilling to donate their organs to someone they know, let alone a total stranger. People who are willing to do so are usually in it for the money, which is illegal in most countries. The other group of willing kidney donors are the people who sign off on their organs after death. Because of the scarce number of people willing to donate their kidneys, and the long waiting list for one, many patients are dying from the lack of a working renal system.

The constant demands for a kidney donor leads to patients desperate enough to obtain one illegally. The existence of an international black market for organ trade has become a popular topic. Everyone has heard of the obscene tales of victims being knocked out in dark alleys, only to find themselves waking up in a tub of ice, with their kidneys removed. America acknowledges these stories but goes against such claims. “There is absolutely no evidence of such activity ever occurring in the U.S. or any other industrialized country,” says the United Network for Organ Sharing, “While the tale sounds credible enough to some listeners, it has no basis in the reality of organ transplantation.” While there is no evidence of this actually happening, there is constant debate over the legalization of kidney trade. On one hand, there is a high risk of abuse and exploitation, and on the other hand, legalizing kidney trade could save countless lives.

Many say that the buying and selling of kidneys is unethical and preys on the desperate, encouraging people to sell their kidneys for money. Some people might see the need to murder the innocent for profitable organs. It is unethical because donors get financial awards for their organs. If people want to donate their kidney, it should be for the sake of saving lives, not financial profit. In some cases, there are those who are desperate for money and find that the only way to escape their financial crisis is to donate a kidney. Patients who can’t afford to pay for a kidney are also at a disadvantage. The wealth of any waiting dialysis patient shouldn’t affect their place on the waiting list.

However, the legalization of kidney trade would prevent people from selling their kidneys to black markets. A financial reward for helping people seems appropriate if someone is desperately in need of one, however unethical. If organ murderers really exist, the killings would cease and street children won’t be killed off for their organs. Patients have the opportunity to buy from a healthy, willing donor, that increases the chance for dying patients to obtain a kidney, go through with the transplant and lead a normal life.

One of the few countries that have legalized kidney trade is Iran. The first kidney transplant in Iran took place forty years ago. In the early 1980s, the Iranian government recognized the increasing strain on dialysis resources as the renal failure population grew in Iran. As written by Alex Tabarrok in his article ‘Financial Compensation for Organ Donors is Working’ in Marginal Revolution, “Only one country in the world has eliminated the shortage of transplant kidneys. Only one country in the world has legalized financial payments to kidney donors. That country is Iran… The government pays donors $1,200 plus limited health insurance coverage. In addition, charitable organizations also provide remuneration to impoverished donors.

Thus demonstrating that Iran has something to teach the world about charity as well as about markets.” Within the first year of the establishment of this system, the number of transplants has almost doubled; nearly four fifths were from living unrelated sources. In addition to payment from the government, donors also receive free health insurance and often payment from the patient or a charity. The receiver of the ‘new’ kidney is provided with highly subsidized immunosuppression and charitable organizations allow those unable to pay for the transplant themselves to receive a new organ for free. However, it is still illegal for the medical and surgical teams involved or any ‘middleman’ to receive payment. A potential donor is also not allowed to contact anyone on the waiting list. This comes to show that legalizing kidney trade could solve the problem of kidney shortage and save countless lives, which is why kidney trade should be legalized.

As the pressure of demands for kidneys continue to increase, the idea of financial compensation can be seen as unethical to some people. But for the people that are on the brink of death, a financial reward seems like a suitable compensation for the sacrifice of a kidney. Until an alternative to human donors can be found, either artificial or xenotransplantation, this ethical issue will continue to be discussed. Even doctors and the medical profession have qualms about the payments on an ethical-level, but the increasing problems caused by black markets for organ trade and the large number of dialysis patients in need of a working kidney are starting to become good reasons for the legalization of kidney trade.