Organ Markets

This chapter examines the arguments in favor of and opposed to a market for kidney grafts from living sources. Although the National Organ Transplant Act (NOTA) of 1984 made it illegal to buy or sell organs in the US, and the World Health Organization recommended a similar ban in 1991 (which was reaffirmed in 2010), there is some support for a kidney market in academic circles. While measures to make living donation financially neutral for living donors are ethical and widely popular, payments that serve as incentives or bribes are neither. The buying and selling of living organ grafts are not an ethical means to mitigate the shortage of organs for transplantation.

Paired Exchanges, Chain Donations, and Organ Markets

This chapter introduces the use of an innovation called “paired exchange,” a way to encourage donations even when there is no match. The chapter shows a graphic presentation to simply describe the idea of paired donation exchange. It explains the risks of paired exchange for the donors' and recipients' perspective, arguing that the risks were the same from the donors' perspective, while the outcomes from the recipients' perspective would be much better as a result of receiving a histocompatible organ than they would be if they received their own designated recipient's organ. The chapter also offers some legal questions after lawyers wondered whether a paired kidney exchange was a sort of barter and thus the beginning of a gray market in organs. Ultimately, the chapter looks at another suggestion of creating a serial chain of donor–recipient pairs, with the world's first kidney–liver swap took place in 2017.

Ethics, Organ Markets, and Dry Ice

This chapter argues that thr author's dry ice saga graphically illustrates one of the central problems in organ donation today. It examines why most medical centers make it harder than is needed for people to donate organs. Advocates for markets in organs talk about the power of incentives, however, what we see today, is the power of disincentives. The chapter offers a better model to treat organ donors: to treat them like financial donors. Philanthropy professionals in medical centers around the country are expert at taking care of donors, making it easy for them to give, cultivating them, and showing gratitude. The chapter explores how organ donation programs could improve their customer service, and possibly retain more potential donors, if they developed the ethos of their philanthropy departments instead of the ethos of their surgery departments. The chapter also explains the logic of supply and demand in relation to the barriers of cost and inconvenience for people who are willing to donate. Ultimately, it presents the arguments of the opponents and the defenders of markets about the idea of legalized organ markets.

Trafficking, Tourism, and Trading

Organ transplantation has become a victim of its own success with the global need for organs outstripping supply. Organ trafficking and transplant tourism have developed as ways to circumvent the shortage. Responses from the United Nations and World Health Organization have condemned these practices and called for their elimination. There are increasing calls to permit legalized organ markets, claiming they would not only ease the organ shortage, but also reduce trafficking and transplant tourism. This chapter argues that organ trafficking, tourism, and trading are all inter-related and harm results to the vendors from all three. The arguments for legalized organ markets from philosophers, economists, and clinicians are presented and critiqued with a particular emphasis on the work of Janet Radcliffe-Richards. The criteria for an ideal organ market as outlined by Arthur Matas are then summarized and discussed, and followed by an exploration of the current situation regarding organ transplantation in Iran—the only country in the world to have a state-regulated organ market. A brief résumé of the history of organ markets is given, followed by an assessment of whether the Iranian model is one which should be followed as Western advocates of organ markets suggest, or whether it illustrates many of the problems of payment for organs of which opponents of such markets warn. It is concluded that the poor and vulnerable are overall the most likely to be the biggest losers in all forms of organ selling, whether by trafficking, transplant tourism, or trading in organ markets.

Medical Economics: Legalize Organ Markets

The article argued to the contrary that at least insofar as organ transplants were concerned, this general assumption lied 180 degrees away from the truth. The first reaction of most concerned people, at the prospect of buying and selling human body parts, was one of revulsion. And, yet, this was the tried and true means that used for supplying more pedestrian goods and services. The article was the economic principles responsible for adequately making available to us such as items such as apples, shoes, and gardening services were the best ones in this case as well. The method was to argue that the institutions responsible for most goods and services in the economy that the last best hope for solving the problems that faced transplants of human body parts. The researchers consulted google scholar and mises.org and generated in this manner and cited almost a dozen publications which discussed the relevant subject matter and commented on several of them. It finds that Pro-organ sellers have a long way to go, but with determination and logic, one day the world will find a place for organs in the free-markets. And, then, many lives will be saved.