As of January 2016, 121,678 people are waiting for life saving organs.  In the United States, the average person will wait anywhere from three to five years to receive a lifesaving organ, depending on their blood type (Organ Donation and Transplantation Statistics).  As the waiting list for life saving organs continues to grow on a daily basis, policy makers and private organizations, such as the United Network for Organ Sharing (UNOS), are beginning to publicly discuss and examine the different options on how to resolve the excess demand of organ donations.  Specifically whether the United States should allow the compensation of live organ donations.

Many individuals, who support the compensation of live organ donations, begin by arguing that the United States should not allow 22 individuals to die every day while on the transplant list merely because the commodification of an organ seems immoral.  Researchers and economists, such as Ilya Smith, claim that the “transfer of money does not magically render an otherwise defensible activity immoral.”  With a single individual being added to the organ transplant list every 10 minutes, the shortage of organs in growing at faster rate than ever before.  Individuals, who are opposed to compensating live organ donations, typically claim that compensation will bring about the exploitation of the poor.  However as Smith states, what is the difference between allowing a poor individual from selling an non-vital organ to benefit them economically, and allowing a poor individual to engage in high risk job in attempt to increase their yearly income, such as a window cleaner or lumberjack.  Both situations place the poor individual at a greater risk for harm, however if you are to ban the compensation of live donations, one should also ban the poor individual from engaging in higher risk jobs oriented at increasing his economic standing.

Many individuals believe that the commodification of the human body to be an immoral and shameful act, and that the United States should not benefit from the compensation of the human body.  However, throughout the United States history we can see many examples of when individuals are praised and compensated for giving parts of their bodies and engaging in industries oriented around compensation for the human body.  The donation of blood and plasma are two specific examples, along with the insurance industry.  In the United States today, the Red Cross collects an average of 13.6 million pints of blood from approximately 6.8 million every year.  Their donations are lifesaving and prevent the death of thousands who need blood due to car accidents, injuries, and cancer.  Although the donations are not tax deductible, the driving to and from the donation center and post care are tax deductible.  Along with the donation of blood, individuals in the United States are compensated anywhere from $30 to $70 a week for donating plasma.  This weekly income, combined with the ability to donate plasma up to four times a month can reap significant compensation over a year—anywhere from $6,240 to $14,560.  If individuals are allowed to donate blood and plasma, which are also considered to be non-vital organs, the question as to why individual cannot be compensated for donating kidneys and sections of their livers in hopes to lower the excess demand of organs is raised.

Compensating live organ donors focuses around the donation and compensation of kidneys and livers.  Both of these organs are considered non-vital and both organs have very low risk associated with surgery.  According to a study conducted by Jennifer Monti, that focused on the case for compensating live organ donors, the “mortality risk to a donor of a kidney is 0.03% and donors usually live a normal life span,” while the mortality for kidney transplants “stands at 0.25-1%, and the life span is not affected.”  It is noted that the liver will also regenerate to its normal and full size within a month after the transplant.  With statistics like these, many politicians are beginning to examine ways to compensate live organ donors.  Specifically they are examining Iran’s policy and the possible amendment of the National Organ Transplant Act.

In Iran, the compensation for live organ donors was legalized and encouraged in 1988 with the help of the Iranian government and a non-profit organization known as the Dialysis and Transplant Patient Association (DATPA).  This compensation not only eliminated Iran’s transplant waiting list within 11 years, but within 8 of those years, the waiting list for kidneys was completely eliminated.  This is significant because kidneys are the most needed transplant nationwide and specifically in the United States, the cost of individuals waiting for kidney transplants costed the US Healthcare $21 billion in 2005.  Donors of organs receive anywhere from $1,200 to $1,400 dollars and one year of health care from the Iranian government just from the government and then an additional $2,300 to $4,500 from the individual receiving the organ.  If the individual receiving the organ cannot afford to pay for the compensation, DATPA has partnered with charitable organizations nationwide to cover the costs.  This combination of government and non-profit organizations nationwide, allows for the fair and equal treatment of all donors.  In order to prevent poor individuals from being taken advantage of, the Iranian government regulates the approval process and requires mental capacity tests to ensure all individuals donating understand the risks of organ donation.  This test ensures understanding, but it also removes exploitation of individuals who are poor and may be targeted by wealthy families or individuals.

In a study conducted by Roger Blair and David Kaserman at Yale University, it was found that the demand curve for transplantable kidneys was incredibly steep over almost all price ranges, leading researchers to determine that the price of kidneys is inelastic and possibly even having a vertical demand curve.  This is significant because it demonstrates that demand for transplantable kidneys within the United States will not be influenced by the compensation.  However it was noted during the study that individuals who received what they deemed to be market value of a kidney, were almost three times more likely to donate their kidney to a stranger.  This increased willingness to donate is what is needed in the United States, where the amount of donors is declining yearly.  Determining the market value for a kidney within the United States was difficult, but economists at the University of Chicago determined it to be worth $15,200 and in India, economists determined the value of a kidney in the underground market to be $1,177—this value is based off of a pool of 305 kidney sellers and is important because India has the largest underground organs market.  In attempts to determine if the value deemed by the economists at the University of Chicago as true market value, critics have compared the Untied State’s expected value and India’s underground value.  When comparing $15,200 to the price individuals pay illegally in India and adjust for differences in living standards, the price for a kidney is almost equal at $15,200 in the United States and $17,000 in India.  It is significant that the market value determined by the economists in the United States almost aligned with the illegal market in India because it shows the value determined by the economist would accurately apply to the real world.

Since 1984, the National Organ Transplant Act has hindered the United States ability to not only engage in a free market, but it has also cost the lives of countless individuals.  Real world examples, such as Iran, show that with some government involvement the compensation of live organ donors would be beneficial to our society.  Instead of allowing 22 people to die daily from not receiving organs, the United States should repeal or amend the National Organ Transplant Act of 1984 to allow the vending of organs.  By forbidding the sale of organs based on the “consequences,” “costs,” or “issues” that might arise from permitting the sale, the discussion should be oriented to focus on the costs that “will be paid in the currency of years of human lives unnecessarily lost, as well as a massive increase in federal expenditures over the next decade and beyond.”


Why the United States Should Compensate Live Organ Donors