Is It Alright to Pay Donors for Their Organs?

The technique of kidney transplantation is now so well-developed and widely available that the biggest problem is the shortage of donor kidneys. The question of paying donors has not been taken very seriously – except in novels and movies – until recently. Two opposing viewpoints have been presented in a recent British Medical Journal issue.

Professor Arthur Matas, form the Department of Surgery, University of Minnesota, pleads for legalization of payment for living donors to shorten waiting times, which are growing longer every year. In the existing unregulated systems, there is little oversight of the donor before and after removal of the kidney, and no protection of either the buyer or the seller. Often a broker makes a good profit from the deal, while the result is sometimes unsatisfactory for both donor and recipient. A regulated system would provide strict control and limit harm. As dialysis is much more expensive than a transplant, compensation and the regulatory expenses could be cost-neutral to the healthcare system. A regulated system would increase donation and cut down on “transplant tourism’ to countries with flourishing unregulated systems.

Professor Jeremy Chapman, from the University of Sydney Centre for Transplant and Renal Research, Australia, is against payment to live kidney donors, arguing that it would reduce the supply of organs. He points out that sale of organs is advocated by the rich as a fundamental human freedom, but this right is exclusively exercised by the poor. Absent poor people in the Philippines or Pakistan, the numbers of donors would fall. And the unregulated systems operating today carry all the attendant health risks to the donor and recipient associated with such a deal. Regulation, on the other hand, would destroy family-member donations. No family member would donate if the government (as health provider) would pay someone else $100,000 for a kidney – and no recipient would take a family-member’s kidney when they could get one through the regulated system. Finally, families will demand money for the retrieval of organs after death. As Professor Chapman says, “The last vestige of human altruism is at stake”. He is adamant that purchase of organs is not the answer to the present-day shortage.

What’s to be done? While eminent surgeons debate, the ‘black market’ flourishes. One solution would be a localized pilot trial of regulation, to test which of the pros and cons are pre-eminent. Of course, there would be the problem of transplant candidates moving to the pilot trial state or states . . . However, ‘Probieren geht ueber Studieren’, as I’ve said before (rather often).

Comments

[Healism]

In some countries Doctors have become brokers and making profits in Kidney transplantation. For making fast money they are going to the extent of stealing kidneys from the innocent patients. If "payment to live kidney donors" has made legalized, in some countries, especially in India, thousands of people will come forward to sell their kidneys in order to face the poverty. Recently some farmers resorted to this act and got cheated for low/non-payment by brokers. Anyhow, nice and thought provoking Article on Kidney transplantation Market and "Transplant Tourism". Thanks!
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Does medical tourism really offer affordable health care options for those who lack insurance? Or is it just a marketing gimmick for baby boomers?