Current Events Public Policy

Organ Sales

What is do be done regarding the long waits for those needing a donated organ to save their life? As expected, economists recommend market creation as the solution. Freakonomics authors Stephen J. Dubner and Steven D. Levitt argue in the New York Times (“Flesh Trade“) that the creation of a market for organs makes sense.

Gary Becker and Julio Jorge Elias argued in a recent paper that “monetary incentives would increase the supply of organs for transplant sufficiently to eliminate the very large queues in organ markets, and the suffering and deaths of many of those waiting, without increasing the total cost of transplant surgery by more than 12 percent.”

What is more novel is that Canadian Public Health professor Abdallah S. Daar has published a paper in Nature which also advocates an organ market (“The case for a regulated system of living kidney sales“). He uses Iran as a model:

Paid transplants are currently available only to those who can afford them—except in Iran. The Iranian model of state-sponsored, transparent, noncommercial, middleman-free kidney transplantation, whereby donors are paid by a government-sponsored agency, has eliminated the waiting list completely—making Iran the only country in the world to have done so. All patients—rich, poor, educated, uneducated—receive transplants in well-run, scrutinized hospitals. The results are known; the system is transparent, discussed and continuously improved. Iranian transplant surgeons, who would have been ostracized a few years ago, are now invited to major international conferences and their findings are published in peer-reviewed journals.

Mr. Daar does not believe in a completely unregulated free market sale of organs, but does worry that the 5–7-year wait for a cadaveric organ is creating a black market. Transplant tourism is growing. For instance “Overseas Medical Services in Calgary will organize a transplantation from a living donor in Pakistan for CAD$32,000.” (see also CBC article).

Other alternatives to the market system include the Spanish presumed consent method: individuals are automatically enrolled in an organ donation program after their death unless they decide to opt out of the program (“Opt in or opt out“). Another interesting article regarding organ donation (“What is a kidney worth“) comes from the Christian Science Monitor.

Should the new motto for organ donors be: give the gift of life profit from the gift of life?


  1. Legalizing commerce in human organs would save thousands of lives every year in the United States. But it’s extremely unlikely that legalization will occur in the forseeable future.

    Fortunately, there’s an already-legal way to put a serious dent in the organ shortage — allocate organs first to people who have agreed to donate their own organs when they die.

    Giving organs first to organ donors will convince more people to register as organ donors. It will also make the organ allocation system fairer. People who aren’t willing to share the gift of life should go to the back of the waiting list as long as there is a shortage of organs.

    Anyone who wants to donate their organs to others who have agreed to donate theirs can join LifeSharers. LifeSharers is a non-profit network of organ donors who agree to offer their organs first to other organ donors when they die. They do this through a form of directed donation that is legal in all 50 states and under federal law. Anyone can join for free at or by calling 1-888-ORGAN88. LifeSharers has 6,453 members, including over 600 minor children enrolled by their parents. No one is excluded due to any pre-existing medical condition.

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