The morality of a free market for transplant organs.

Abstract

Adelmann von Adelmannsfelden has a deal for you: give this German businessman your kidney he'll give you $45,000 - then he'll resell the kidney at a higher price to someone else in need of a transplant. Although the Count has lots of interested potential buyers sellers, he also has lots of critics; I'm doing good, he complains, and people are acting as if I were just a cold-hearted brutal businessman.1 Is there anything brutal about this arrangement? This is the question I shall pursue in this paper. A few decades ago, this question would have been unthinkable; now it is not only thinkable, but pressing, because of recent medical advances, such as the development of cyclosporin, which have dramatically increased the success rates of transplant operations. The success rates for kidney cornea transplants, for example, are now as high as 95 %.2 As a result, there are now long lists of medically needy persons waiting for suitable transplant organs, on something like a first-come, first-served basis.3 The American Council on Organ Transplantation estimates that some 15,000 Americans are now waiting for new kidneys alone. The fact is there simply are not enough transplant organs to go around, many persons die before their turn comes up, or else live under years of debilitating sickness painful treatment. II. Remedies for the Shortage What can be done to make up for this shortage of transplant organs? Three possibilities suggest themselves. The first would be to increase voluntary donation, which typically involves educating the public about the need for donated transplant organs, making donation easier. Following the Uniform Anatomical Gift act, a signed statement suffices to make one a donor, in 43 states, a simple checkmark in the appropriate box on a driver's license suffices. Further, some states have enacted required re63