http://online.wsj.com/news/articles/SB10001424052702304632204579338492295096438Is a Market in Kidneys the Right Answer to Shortage?
It is a tragedy when people die while waiting for a lifesaving transplant, but paying for organs isn't the answer.
In "Cash for Kidneys" (Review, Jan. 18) the economist authors recommend establishing a market for human organs to alleviate the organ shortage in the U.S. It is a tragedy when people die while waiting for a lifesaving transplant, but paying for organs isn't the answer.
In our current system, openness about the potential donor's health, high-risk activities and family history is presumed because the only compensation donors receive is the restoration of health to someone they care for. Payment can introduce health risks for the recipient because important medical information can be withheld to receive an incentive. A system of payment for kidneys often exploits poverty-stricken sellers who can be manipulated or coerced into selling their kidneys for quick money or to repay debts.
The National Kidney Foundation believes there are other ways to increase kidney donation and has advocated for the following: expanding paired exchange and donor chains; protecting job security for those who take time off to donate; covering all donation-related expenses; and ensuring the availability of health, disability and life insurance for all living donors.
Bruce Skyer
CEO
National Kidney Foundation
New York
One option not included in the essay is the policy of reciprocal donation. In some countries, a person isn't eligible to receive an organ unless he also is a designated organ donor. This seems like a better place to start.
Valerie J. Connor
Davenport, Iowa
Last Saturday's article misrepresents the Iranian system of compensated donation. I spent nearly two months in Iran interviewing paid kidney donors for a documentary film I was planning. I visited six different regions and returned with over 200 transplant stories. Sometimes money is what makes helping others possible.
I disagree with economists who say you can put value on someone giving up part of their body to save another person's life. A conscious, informed decision to risk oneself for another is an invaluable gift both to the person and to society.
Iran is the only country in the world that has solved its kidney shortage, and it has done so by legalizing and regulating compensated donation. Paid donors know the system works to protect their rights as much as the rights of recipients.
Kidney donors receive on average the equivalent of six months' salary for a registered nurse in Iran, or approximately $32,000. All receive at least one year of health insurance and an exemption from Iran's two-year mandatory military service. With other goods and services, I estimate the total average package that paid donors receive in Iran is close to $45,000 in value.
In many regions of the country there is a waiting list for people who want to donate. Maybe it's time we learn something from their experience.
Sigrid Fry-Revere
Lovettsville, Va.
Dr. Fry-Revere is a bioethicist and founder and president of the nonprofit organization Stop Organ Trafficking Now.
What advocates of living-donor kidney transplants won't mention is that kidney function declines with age, and an elderly person needs two kidneys to maintain healthy kidney function. Kidney donors shouldn't take aspirin or ibuprofen for the remainder of their lives, and they should forgo activities that risk impact to the remaining kidney. Kidney donors, who are extensively screened before donation, are healthier than the general population before donation but lose that advantage following donation. That doesn't sound like a "normal life."
Dan Hiltz
Fort Mitchell, Ky.
The arguments made in "Cash for Kidneys" fail to assuage moral concerns for the commodification of human life. Mutatis mutandis, Oscar Wilde's quote, "Nowadays people know the price of everything and the value of nothing," is quite apropos.
Rev. Michael P. Orsi
Ave Maria School of Law
Naples, Fla.