A New Frontier in the Market for Organs

Well, I suppose I shouldn’t be surprised, but still I was when I heard this report late last night on the BBC World Service. A physician and his wife are divorcing. During the marriage he donated a kidney to save her health – arguably, to save her life. Now that they are divorcing, he wants financial compensation for the kidney.

The reason I shouldn’t be surprised is that there has been an argument out there, largely from folks who believe “the market” is the best way to structure social relations, that the solution to the vast difference between the number of people who might benefit from a donated organ, and the number of organs actually donated, is some sort of incentive other than goodness of heart to encourage folks to donate. You can read here two good discussions of that from the last year here and here.

Of course, a market does exist. In this country, to the small extent we see it, it is a black market because such trade is illegal. However, we know that open and black markets in human organs do exist. They raise significant questions about whether the poor or prisoners, or other populations that in this country we would call “protected,” are in one way or another abused, making decisions without truly being free in their choices.

That a market does exist doesn’t, however, suggest that it should, or that we would as a society benefit if it did. We would, I think, benefit significantly if we were successful in encouraging generosity generally, and a sense of social connectedness; and I think that would support greater donation. However, a market approach does just the opposite. It makes it about how it benefits me, and how that separates me from, and potentially sets me in opposition to, others in my society. As an American, I find that sad. As a Christian I find it utterly untenable.

This case does include a significant corollary: that people don’t know how to give freely. This doctor’s demand for reimbursement for the donated kidney makes clear that he didn’t really make it as a gift. Once given, a gift is gone, beyond my control. There is a risk it won’t be used as I would like. However, if I’ve really given it, if I’ve really let it go to another, I realize I have no more claim. It is essentially his argument that he delegated the kidney to his wife, but only for his own purposes. He may or may not have been explicit about that, even in his own mind. But, his desire for that level of control, and for that sort of compensation, makes clear this was indeed that sort of extension of himself in her, and not a gift to her; all of which may say something about how the divorce came about in the first place.

We have here an attempt to commodify a donated organ, and to do so after the fact of the donation. Morally it’s wrong; but at a much more basic and more human level, it’s just sad.