The Ethics of Kidney Sales: Legalization Debate in Bioethics

This essay delves into the contentious bioethical debate surrounding the legalization of kidney sales in the United States. It begins by highlighting the prevalence of kidney disease and the need for transplants, setting the stage for the central question of whether the sale of kidneys should be permitted. The author presents arguments for and against legalization, discussing the historical context of kidney donation, the shortage of donors, and the rise of black-market activities. The essay explores the potential benefits of a regulated market, including fair compensation for donors and increased organ availability, while also addressing ethical concerns regarding exploitation and the commodification of the human body. References to the viewpoints of researchers and philosophers are also provided. The essay concludes by advocating for the legalization of kidney sales to improve patient outcomes and increase life expectancy for those with chronic kidney disease, emphasizing the need for a balanced approach that considers both the practical and ethical dimensions of organ donation and transplantation.

BIOETHICS
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Introduction:
Despite years of progress in science and technology, certain challenges continue to affect
the human population. One of these challenges is vital organ failure. In this regard, about 80
million people in the United States of America are at a higher risk of kidney disease. On these
same note, research shows that one out of every seven people suffers from the condition,
necessitating a kidney transplant in most cases. Kidney transplantation may also require the
selling and buying of a kidney, which has become a hotly debated topic in recent years. There
have been divergent opinions on whether the sale of vital organs such as the kidney should be
legalized. This informs the focus of my discussion.
The process of donating kidneys has been associated with heroic sacrifices. However, it
is debatable whether the process conforms to the same aspect especially due to the painful
surgical procedures involved (Hurst). The notion of a kidney transplant as a heroic sacrifice dates
back to the 1980’s when the process was painful and chances of survival after donation were
minimal(Martin).On the same regard, the number of cases of kidney disease has risen over the
years, which has consequently increased the number of individuals needing a kidney transplant.
Notably, there has also been an acute shortage of kidney donors, which explains why the process
is still considered as a heroic sacrifice. As per 2010 statistics, there were more than 34000 people
in the waiting list of kidney transplants with only 17000 of them able to successfully receive a
kidney transplant (Martin; Young). The ban on kidney sales has been cited as the main reason
why the remaining percentage to get donors. Similarly, the associated exploitation of the poor by
the rich, in which the poor compel the poor to sell their kidneys at a poor price, is the primary
reason why the sale of kidneys has remained illegal since 1984(Mahoney). Majorly those
affected by the ban on kidney sales have been the poor African Americans as their white

counterparts manage to get out of the waiting list before long. One of the major demerits of the
ban has been the rise in black-market business in which desperate individuals end up selling their
organs at throwaway prices (Hurst)
Consequently, the introduction of a legalized market for a kidney would help in
breaching the gap between the rich and the poor in terms of fair treatment. It would ensure that
the recipients fairly compensate the donors of kidneys. Generally, no amount has been agreed
upon as the most appropriate compensation for a donor. However, researchers believe that an
amount equivalent to $50,000 would be appropriate (Berger-).
Additionally, for the sake of the credibility of the business, it should only be restricted to
the government or non-governmental organizations. Similarly, the distribution should be done on
a need basis as opposed to the financial status of the recipient (Brennan, Jason and Peter Martin
Jaworski). The implementation of such a system would encourage the participation of a large
number of donors, which would significantly reduce the number of people on the waiting list.
The legalization of kidney sale would not be a concept that has never been witnessed before
because the sale of eggs, sperm, blood plasma and bone marrow and compensation of surrogate
mothers are already legalized (The Washington post ).
The bioethics involved in the consideration to take part in kidney donation is perceived as
an altruist in nature. There has been no appropriate rationale to associate it with financial
considerations (Young). Researchers and philosophers have argued that the inclusion of a
commercial perspective in organ transplants would diminish the sanctity of the undertaking. It is
also important to note that the altruistic nature associated with the practice has led to poor
outcomes for a large number of affected patients on the waiting list. In most cases, these people
may end up dying due to a lack of donors (Hurst). Finally, the sale and purchase of kidneys

should be legalized as this would to a large extent, help in improving the outcomes for the
affected patients. Additionally, it would also enhance the life expectancy for patients diagnosed
with chronic kidney disease (Hurst)
In conclusion, the topic on whether the sale and purchase of kidneys should be legalized
in the United States of America is a widely debated topic. The ban in the sale of kidneys has led
to negative outcomes including a deterioration of health conditions for the affected individuals
and increased the number of people on the waiting list. The legalization of the commercialization
of kidneys would, therefore, improve patient outcomes and increase the number of donors.

References:
Berger, Alexander. "Opinion | Why Selling Kidneys Should Be Legal." Nytimes.Com, 2019,
https://www.nytimes.com/2011/12/06/opinion/why-selling-kidneys-should-be-legal.html.
Brennan, Jason, and Peter Martin Jaworski. "Markets without symbolic limits." Ethics 125.4 (2015):
1053-1077.
Cancer, Cansu. "The unjustified policy against a market in kidneys." Asian Bioethics Review 8.3 (2016):
177-194.
Canca, Cansu. "The unjustified policy against a market in kidneys." Asian Bioethics Review 8.3 (2016):
177-194.
Hurst, Samia. "The ethics of selling body parts." (2015): 47-56.
Mahoney, Julia D. "Altruism, markets, and organ procurement." Law and Contemporary Problems 72.3
(2009): 17-35.
Martin, Dominique. "Trade in kidneys is ethically intolerable." Indian journal of medical ethics 1.3 (2016):
180-184.
Taylor, James Stacey. "Autonomy, vote-buying, and constraining options." Journal of Applied
Philosophy 34.5 (2017): 711-723.
The Washington Post. 2019, https://www.washingtonpost.com/news/in-theory/wp/2016/01/04/if-
youre-willing-to-buy-a-kidney-youre-willing-to-exploit-the-poor/. Accessed 8 Dec 2019.
Young, E. W., et al. "Trade in kidneys is ethically intolerable." Indian Journal of Medical Ethics, 1.3
(2016).