"It's against the law to buy or sell human organs for transplant"

"It's against the law in most countries, including the United States, to buy or sell human organs for transplant. But that doesn't mean organ sales don't happen, as evidenced by the recent story of organ-brokering uncovered as part of a larger corruption scandal in New York and New Jersey."

"There is increasing evidence of an international black market that connects eager-to-buy patients with ready-to-sell donors. This shadowy market exists because of increasingly desperate patients who can't afford to wait years to make their way up the official waiting lists for cadaver organs, but who are willing and able to spend thousands of dollars to circumvent the allocation system.

With a chronic shortage of available organs and patients dying while they wait, why not bring organ selling out of the shadows and into the light of day?

Given recent events, we may want to think twice about even considering the question.

Anyone who lived through the news events of the last year has to realize that the market, regulated or otherwise, has serious shortcomings when it comes to protecting individuals. Predatory lending, Ponzi schemes, transactions whose sole motive was to reap huge profits at astronomical risk -- all caused serious harm to individuals and nearly brought about the collapse of the global financial system.

Aside from the known failures of even regulated markets, there are two compelling moral objections to the sale of organs.

The first is exploitation -- that is, when one person takes advantage of the misfortune of another for his or her own benefit. There are many people in the world who have few opportunities to improve their lives, and for whom 5,000 or 10,000 USD offers truly life-changing possibilities. But it is only because of existing social conditions that selling a kidney for what seems to be an impossibly large sum becomes attractive.

Organ donation has always relied on the altruism of donors and their loved ones, with the hope that any risk for the patient is balanced by the benefit of the good deed. But most people have a price at which they might ignore whatever qualms they have about donation and become willing sellers. That changes the relationship -- from giving a gift to being paid enough to ignore the risk.

A market allows this shift, and it is a change we should be loath to accept.

Second, the sale of organs gives an advantage to those with the means to pay for them. Although the current system of organ allocation has problems in terms of shortages and waiting times, it is at least fair. Rich patients can't pay to jump to the front of the queue. But that is exactly what happens in the case of black or even gray markets for organs: Those who can pay get organs first.

We might accept such a free market approach with other commodities -- the newest car or the latest electronic gadget -- but it is much less defensible to allocate scarce lifesaving medical technology in the same way.

While the existing system of organ donation is far from perfect, it saves thousands of lives every year. It is a system built on a fragile trust that took long years to develop and needs constant attention. It is a trust that cannot withstand the prospect of classified ads and online auction sites for human organs, alongside antiques, art and sporting goods.

Unlike banks, a bankrupt system of organ sales would allow no bailout."
Article by JEFFREY KAHN
Jeffrey Kahn, Ph.D., MPH, is a professor at the University of Minnesota and director of its Center for Bioethics.

Featured comment:
"Organs for organ donors
As the death toll from the organ shortage mounts, public opinion will eventually support a legal organ market. Changes in public policy … read more will then follow. In the mean time, there is an already-legal way to put a big dent in the organ shortage -- allocate donated organs first to people who have agreed to donate their own organs when they die. UNOS, which manages the national organ allocation system, has the power to make this simple policy change. No legislative action is required. Americans who want to donate their organs to other registered organ donors don't have to wait for UNOS to act. They can join LifeSharers, a non-profit network of organ donors who agree to offer their organs first to other organ donors when they die. Membership is free at www.lifesharers.org or by calling 1-888-ORGAN88. There is no age limit, parents can enroll their minor children, and no one is excluded due to any pre-existing medical condition. Giving organs first to organ donors will convince more people to register as organ donors. It will also make the organ allocation system fairer. Non-donors should go to the back of the waiting list as long as there is a shortage of organs. David J. Undis Executive Director LifeSharers www.lifesharers.org"

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