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by David Holcberg, Ayn Rand Institute


If you were sick and needed a kidney transplant, you would soon find out that there is a waiting line—and that there are 70,000 people ahead of you, 4,000 of whom will die within a year. If you couldn’t find a willing and compatible donor among your friends and family, you could try to find a stranger willing to give you his kidney—but you would not be allowed to pay him. In fact, the law would not permit you to give him anything of value in exchange for his kidney. As far as the law is concerned, no one can profit from donating an organ—even if that policy costs you your life.

Patients’ attempt to circumvent this deplorable state of affairs has led to the emergence of “paired” kidney donations, an arrangement whereby two individuals—who can’t donate their organs to their loves ones because of medical incompatibility—agree that each will donate a kidney to a friend or family member of the other. But this exchange of value for value is precisely what today’s law forbids. Thus, under pressure to allow this type of exchange, in December the U.S. House and Senate passed The Living Kidney Organ Donation Clarification Act, which amends the National Organ Transplant Act to exempt “paired” donations of kidneys from prosecution.

But if our politicians’ goal is to eliminate the irrational policies leading to innocent people’s deaths, they should legalize not only “paired” exchanges but all voluntary trades in organs.

If individuals were free to sell one of their kidneys or a piece of their livers, for example, tens of thousands in the waiting list might be able to buy the organs they so desperately need. The decision to sell a kidney or a piece of liver may seem radical, but it need not be irrational.

According to the New England Journal of Medicine, the risk to the life of a kidney donor, for instance, is just 0.03 percent—not negligible, but not overwhelming either. Moreover, kidney donors usually live normal lives with no reduction of life expectancy.

A person may reasonably decide, after considering all the relevant facts (including the pain, risk, and inconvenience of surgery), that selling an organ is actually in his own best interest. A father, for example, may decide that one of his kidneys is worth selling to pay for the best medical treatment available for his sick child.

Those who object to a free market in organs would deny this father the right to act on his judgment. Poor people, they imply, are incapable of making rational choices and must be protected from themselves. The fact is, however, that human beings (poor or rich) have the capacity to reason, and should be free to exercise it.

Of course, the decision to sell an organ is a very serious one, and should not be taken lightly. That some people might make irrational choices, however, is no reason to violate the rights of everyone. If the law recognizes our right to give away an organ, it should also recognize our right to sell an organ.
The objection that people would murder to sell their victims’ organs should be dismissed as the scaremongering that it is. Indeed, the financial lure of such difficult-to-execute criminal action is today far greater than it would be if patients could legally and openly buy the organs they need.

Opponents of a free market in organs also argue that it would benefit only those who could afford to pay—not necessarily those in most desperate need. But the need of some people does not give our government the right to damage the lives of others, either by forbidding individuals to sell their organs or by prohibiting individuals from buying organs to further their lives. Those who could afford to buy organs would benefit at no one’s expense but their own. Those unable to pay would still be able to rely on charity, as they do today. And a free market would enhance the ability of charitable organizations to procure organs for them.

Ask yourself: if your life depended on getting an organ, say a kidney or a liver, wouldn’t you be willing to pay for one? And if you could find a willing seller, shouldn’t you have the right to buy it from him?

The right to buy an organ is part of your right to life. The right to life is the right to take all actions a rational being requires to sustain and enhance his life. Your right to life becomes meaningless when the law forbids you to buy an organ that would preserve your life.

If the government upheld the rights of potential buyers and sellers of organs, many of the tens of thousands of people now waiting for organs would be spared hideous suffering and an early death. How many?
Let’s find out.




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