Blackadder’s Lair

The home of many a cunning plan

If It Saves One Life…

One often hears it said, in justification or support of a given policy, that if it saves even one life, it will have been worth it. I don’t happen to subscribe to this view (at least in all cases), but it does have a kind of moral earnestness about it that I admire. I wonder sometimes, though, to what extent people really mean it, and to what extent it is just a slogan.

For example, in the last ten years more than 30,000 people in the U.S. alone have died from kidney failure while waiting for a transplant. While most kidney transplants currently come from deceased donors, live donor transplants are also possible, with fairly little risk to the donee (typically a person with one kidney is just as functional as with two, and since the causes of kidney failure usually strike all of a person’s kidneys, the main health risks associated with kidney donation are no different than for any other surgery). Most if not all of those 30,000 could have lived, if only someone could have been induced to donate a kidney. Yet under the National Organ Transplant Act of 1984, it is illegal to pay someone to donate, even if only to compensate them for the lost wages and medical costs associated with the surgery. Repealing the law has the potential of saving tens of thousands of lives, and if it saves even one life….

As it happens, there is a country where the sale of organs is legally permitted. What is the name of the bastion of freedom and laissez-fair, you may ask. Well, turns out the answer is Iran.

Obviously the Iranian government has its problems, but the organ market it has introduced seems to work fairly well. As Alex Tabarrok reports:

In the Iranian system organs are not bought and sold at the bazaar. Instead a non-profit, volunteer-run Dialysis and Transplant Patients Association (DATPA) mediates between recipients and donors. Recipients who cannot be assigned a kidney from a deceased donor and who cannot find a related living donor may apply to the DATPA. The DATPA identifies a possible donor from a pool of people who have applied to the DATPA to be donors. Donors are medically evaluated by transplant physicians, who have no connection to the DATPA, in just the same way as are non-financially compensated donors.

The government pays donors $1,200 plus limited health insurance coverage. In addition, charitable organizations also provide renumeration to impoverished donors. Thus demonstrating that Iran has something to teach the world about charity as well as about markets. Will wonders never cease? Recipients may also contribute to donor remuneration.

More information on organ markets is available here. Living donor sites can be found here and here. And remember, if it saves even one life….


April 17, 2008 - Posted by | Health Care, Law


  1. Allowing people to sell organs would save thousands of lives every year. Unfortunately, there is no reason to think Congress will legalize this in the foreseeable future.

    Fortunately, there is an already-legal way to put a big dent in the organ shortage — allocate donated organs first to people who have agreed to donate their own organs when they die. The United Network for Organ Sharing, which manages the national organ allocation system, has the power to make this simple policy change. No legislative approval is required.

    Americans who want to donate their organs to other registered organ donors don’t have to wait for UNOS to act. They can join LifeSharers, a non-profit network of organ donors who agree to offer their organs first to other organ donors when they die. Membership is free at or by calling 1-888-ORGAN88. There is no age limit, parents can enroll their minor children, and no one is excluded due to any pre-existing medical condition.

    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.

    Comment by dju316 | April 19, 2008 | Reply

  2. I find myself in the unusual position of being fanatically opposed to the killing of innocents while putting no great value on human life per se.

    Still, I like this kind of system. It seems to get around a lot of the grubby capitalist haggling that many find objectionable in the context of organ donation.

    Comment by Adam Greenwood | April 22, 2008 | Reply

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