Yale Medical Professor Proposes that Kidney Sales be Legalized

by Don Boudreaux on February 19, 2006

in Health

Amy Friedman, Associate Professor at Yale University School of Medicine, proposes that the sale of human kidneys be legalized.  (Dr. Friedman’s article appears in the journal Kidney International; I learned of her proposal from this NPR interview.)

Professional ethicists and behavioral economists, I’m sure, stand ready to offer 1,001 reasons why people cannot be trusted to choose to be donors and why, if they are allowed to so choose, the result will be catastrophic re-distribution of kidneys from poor to rich, exploitation of poor by rich, and our civil society darkened by a mushroom cloud of crass commercialism.

For reasons I lay out in my article proposing legalizing the sale of parental rights in infant babies — a proposal identical in most relevant respects to that of the proposal to legalize the sale of transplantable body organs — I doubt that these horrors will emerge.

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{ 13 comments }

Robert Cote February 19, 2006 at 8:21 pm

I'm so glad to learn that it is illegal to charge for organ transplant procedures. Here all this time I thought the transplant teams were getting paid. Now that I know they follow the lead of the single most irreplaceable participant (the donor) in not charging on ethical grounds I feel so much better. Face it, we already charge for organ transplants we just pay the least important participants because, surprise, those same least important set themselves on a a throne and dictate transplant ethics for other people.

econgeek February 19, 2006 at 9:41 pm

Don; while the pre-emptive ad-hominen at behavioral economists is cute it is not very intelectually kind of you (one usually listens to those with an oposing view before dismissing them).

You outright dismiss the redistributive effects of creating a market in kidneys, somethign I see no ood reason to do and does not require one to be a behaviouralist.

While I am sure under some welfare criterions (e.g. Kaldor-HIcks) this might be a good thing, under others it is seems unlikely (eg Pareto) that it would be an improvement over the status qou. So the question is; why do you favour a redistributive non-pareto improving change so strongly?

Kevin February 19, 2006 at 11:58 pm

Hell I'm so short on cash twixt now and payday I'd be tempted to see a kidney AND one of my livers.

Lab_Frog February 20, 2006 at 4:09 am

Hmmm, usually the order of preference is Pareto, then Kaldor-Hicks when Pareto is unrealistic given certain (usual) constraints.
Froggy justice is blind and paternalistic/oppressive towards none. Those idiots who need oppression have failed to earn it, as the oppression is likely to spread to the non-idiots (excluding extremely unusual circumstances). If you feel that you have a right to use violence to be paternalistic to others, then Frog proposes that you need paternalism and should give all your wealth to Frog (to prevent you from be exploited from a evil & cold-hearted pragmatic economic system). Despite the lack of incentives you can trust Frog to look out for your interests as Frog loves you without knowing you. Frog kisses!
The above was 90% sarcasm, although you should feel free to give money to the Frog for Dictator of the Solar System Fund.

Slocum February 20, 2006 at 11:24 am

Well, I'd be more likely to go for the legalized kidney selling than 'parental rights' selling. With kidneys, the market is naturally limited–nobody's going to buy one unless they *really* need one. And if you need one, I believe one kidney is pretty much as good as another (so long as there's a tissue match).

But babies? I think there are many potential unintended consequences not envisioned in the article. For example, why wouldn't it turn out that the parental rights for certain 'pure bred babies' go for enormous sums while the rights to less desirable 'mutt babies' (which would have been in demand under the old system) are offered 'free to a good home' — which 'good home' often would not be forthcoming?

And that doesn't factor in surrogate mothers. Combine the sales of parental rights and surrogacy, and one might imagine blond, beautiful college students with perfect SATs earning large sums by donating eggs & sperm, hiring a surrogate to carry the fetus, and then selling the rights to the designer baby.

asg February 20, 2006 at 1:33 pm

There's a huge waiting list for Down's babies, which suggests that people have sufficiently varied preferences as to what babies they want to adopt that a market in parental rights might not be so uniform as Slocum suggests.

Ivan Kirigin February 20, 2006 at 3:57 pm

Slocum,
You are currently free to give up a child you don't want for _whatever_ reason to adoption.

That people don't do this en mass for "mutts" shows that wouldn't give them "'free to a good home'"

"Combine the sales of parental rights and surrogacy, and one might imagine blond, beautiful college students with perfect SATs earning large sums by donating eggs & sperm, hiring a surrogate to carry the fetus, and then selling the rights to the designer baby."

That sounds like an excellent business.

Slocum February 20, 2006 at 7:45 pm

> You are currently free to give up a child
> you don't want for _whatever_ reason to
> adoption.

> That people don't do this en mass for
> "mutts" shows that wouldn't give them
> "'free to a good home'"

I'm not suggesting that more of the 'less desirable' kids would be put for adoption, but rather that the kids who might fall into that category (but who are eagerly adopted now under conditions of scarcity) might go begging if the supply expanded and prospective parents could shop for whatever 'pure breed' of baby they desired.

> That sounds like an excellent business.

Uh, yeah–that's a bug, not a feature.

Matt February 21, 2006 at 1:35 pm

Could a parent then sell his/her child's kidney?

asg February 21, 2006 at 2:45 pm

Parents are already allowed to give away their childrens' kidneys (ever hear of "savior siblings"?).

Tim M. March 5, 2006 at 10:16 pm

There's a good article in The Economist on the economics of the baby business. It discusses a book very related to Don's article. See it here:

http://www.economist.com/business/displaystory.cfm?story_id=5536142

(The fertility business
Cupidity
Feb 16th 2006)

Jesrad August 28, 2006 at 6:49 am

> I'm not suggesting that more of the 'less
> desirable' kids would be put for adoption, but rather that the kids who might fall into
> that category (but who are eagerly adopted
> now under conditions of scarcity) might go begging if the supply expanded and
> prospective parents could shop for whatever
> 'pure breed' of baby they desired.

I have to disagree with Slocum on this. Comparing the "perceived value" of respective babies isn't the correct methodology for predicting the redistributive effects of the measure.

The only meaningful redistributive effect is that babies are, under this system, actualising a higher value, in every individual case of exchange.

What I mean is that every baby sold in this manner ends up being valued _more_ than it would have otherwise, and not that some babies will lose value and some will gain value. The latter reasoning is fallacious, and thinking that maintaining scarcity by keeping the "official" value of babies at exactly ZERO will somehow make babies valued higher, is utterly absurd.

lab coats August 24, 2009 at 6:20 am

there are numerous benefits in legalize the sale of kidney.

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