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Christopher Courtney
Dr. Martin
English 1102
11th May 2016
Selling Human Kidneys
A person selling one of their kidneys? It is absurd, it is immoral, it is unethical, right? The
number of organ donors has grown substantially, but the number of people in need of a transplant
has grown at an even more exponential rate. The growth rate of the transplant list is
unprecedented and cannot be met by organ donors. The shortage of kidneys is creating a battle
against time for some patients. According to the National Kidney Foundation, the median wait
time for a kidney on the transplant list is 3.6 years and can vary depending on the health,
compatibility, availability of a kidney. People are dying from the lack of available organs. In an
annual joint report published by the OPTN (Organ Procurement and Transplantation Network)
and the SRTR (Scientific Registry of Transplant Recipients) in 2013 the waiting list grew to
121,272 people. Published in that same study they reported that 28,954 transplants took place.
The OPTN and SRTR started keeping track of transplants and the waiting list in 1991. In 1991,
the transplant list had 23,198 names on it and 15,756 transplants took place. Over the past 22
years, there have been approximately 600 more transplants every year. That kind of growth is
fantastic until it is compared to the growth of the waiting list. The waiting list has grown to the
point where approximately 4,458 names are added every year. Every year approximately 3,858
people are recycled onto next years list. The supply cannot meet the demand so patients have

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started turning to alternative methods to get a kidney. That alternative is the black market and the
illegal organ trade.
For people to reach the black market they do so through a broker. A black market broker
is comparable to a stock broker on Wall Street. A buyer puts in their order to the broker as to
what they would like to buy. A stock broker would buy the stocks from the owner of the stocks,
while the black market broker buys the illegal item from the person interested in selling that
item. In this case, that illegal item is a kidney. The difference between these two is that one of the
items being bought and sold is an intangible part of a company while a kidney is an organ that
works conjunction with its twin to help remove waste products from the body. If a person was to
sell off one of their kidneys, then theoretically the waste removal process should take twice as
long. With one kidney removed, the person is left with one kidney to do twice the amount of
work. According to Doctor Francis Delmonico, the Chairman of the Ethics Committee of
Transplant Surgeons and Director of Renal Transplants at Massachusetts General Hospital, You
could do all the same things you did before the transplant. (Delmonico). Selling a kidney should
be perfectly safe. The kidney they are left with can function as good as two healthy kidneys and
they have some extra money in their pocket. That is not the case. A study of kidney sellers in
Iran has shown that vendors frequently experience feelings of worthlessness and shame. They
perceive themselves akin to prostitutes and their scars as stigmata (Kerstein 29). For a person
to perceive themselves in such a low light is horrible. The word stigmata is not a word used
lightly. The definition of stigmata listed in Oxfords dictionary is marks corresponding to those
left on Jesus body by the Crucifixion, said to have been impressed by divine favor on the bodies
of St. Francis of Assisi and others. This is extremely disturbing. A person is comparing

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themselves to a crucified religious figure. It is impossible to comprehend the thoughts going

through the head of the vendors.
Lets back track to what happens as the vendor is selling their organ. The vendor is
probably trying to pay off a debt, pay the bills, or just provide for their family. In 1989, The UK
(United Kingdom) public was outraged over a Turkish mans decision to sell one of his kidneys
at a London clinic to pay for urgently needed care of his leukemic daughter. (Guibilini 25).
Legalizing the organ trade is supposed to create another opportunity for people on the waiting list
to get the kidney they need. Could the system possibly backfire? Could the system actually be
taking advantage of the less fortunate and poor? The Turkish man needed money fast to help
treat his daughter. One way to do that is sell a kidney. This could be the beginning of a trend.
How many relatively well-off people would sell a kidney and would the advantage gained by
their sales be offset by the reductions in the numbers of altruistic donations (e.g., donations from
people who get fungible recompense)? (Kerstein 30). Kerstein makes an excellent point. The
people of low economic status would sell their kidneys to people of high economic status. The
rich would essentially be taking from the poor. That is not the only bad thing that would come
out of this situation. It is not guaranteed that people will continue to donate organs. They will see
people being compensated monetarily for their organs and they will want money for their
relatives organs. It will create a trickledown effect. Why pay for a kidney and take a liver or
lung for free? People will demand compensation for other organs. Giving money out in the open
may not be the answer, but the government can motivate people to donate by other means. The
government could offer tax write-offs to donors or free health care, even pay for the hospital
bills. This will probably not solve the organ shortage that the country is experiencing but it will
be a step in the right direction. Doctor of Philosophy Simon Rippon proposed that the United

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States institutes an opt-out or presumed consent approach. (Rippon 344). In an opt-out

system, which is already in place in many European countries and planned in Wales, people do
not have to opt in as organ donors by providing explicit consent, but must rather place their name
on an opt-out register before their deaths if they prefer not to donate their organs (Rippon 344).
The system proposed by Rippon would not alienate an entire class of people and would keep
people donating. Even more people could donate. Since it is an opt-out program, people would
be educated about organ donating. The majority of people donating a kidney right now are
donating to a friend/family member or because they made an informed decision to help save a
life upon their death.
In the country of Moldova lives Nina Unguryanava. She is the mother of two and has just
lost her job along with her husband. When you see your children hungry you will do anything,
even take a step towards your own death. (Unguryanava). This is a prime example of how the
kidney market takes advantage of peoples current situations. The money will only solve the
short term problem. Nina will still have to find a job so she can provide for her family. The
money that she does receive from selling one of her kidneys will not last the rest of her life. Nina
also only received half of the money she was promised. The broker and doctor took more money
than they said they would. I would like to wish the woman I helped a long life with my kidney.
But what about me now? Im in bad shape, shes not to blame. She paid her money but we
werent paid ours. (Unguryanava). Would a market that is regulated by the government keep
this kind of activity from happening? If the government or an organization was to replace the
middleman, then people would get the money they were promised. However, that still would not
stop people of a lower economic status from being taken advantage of or help the lingering
health problems caused by the procedure. Just ask Nicolae Burdan from Minzhir, Moldova. He

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needed money to buy a new house. He was able to buy the house, but the operation left him
unable to work and provide for his family. I didnt realize I would be invalid, that I wouldnt be
able to lift anything, to do hard work. I wouldnt want anyone to be in the position I am in. Im in
worse shape than I was to start with. (Burdan). Both Nina and Nicolae did what they had to do
to provide for their family. They thought that the money could help them through hard times and
they could get back to work soon. They did not account for long term health problems that would
stem from the operation.
Organs should be understood as gifts, not commodities. (Cherry 4). An organ is a
representation of something more. When a man or woman donate a kidney they are giving
someone another chance at life. A kidney is essentially a gift of life. It will keep a person alive at
least another ten years. Altruistic donation is seen as a voluntary expression of important human
values as well as of communal commitments (Cherry 6). Human values are something that
should not have a price tag put on. Doctor Frank Delmonico agrees. When asked if he would
perform a renal transplant if he knew that money was involved he simply answered, No.
(Delmonico). Most doctors have high standards and want to do what is best for their patients.
Most doctors also have very high morals and a strong sense of right and wrong. If a doctor
perceives something as wrong, then it is most likely the entire medical community discourages it.
Since medical professionals discourage the buying and selling of kidneys, who would perform
the operation? One of the reasons doctors feel this way is the lack of education on the procedure.
The quality of consent in the existing organ market is often questionable, to say the least.
Vendors frequently report poor understanding of the consequences of the sale, as well as
coercion and deception at the hands of the brokers. (Malmqvist 27) People see the money and
figure they have a second kidney that can do the work just fine. Doctors and other medical

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professionals see the organ trade for what it is. It is an immoral market place where people of
low socioeconomic class are being taken advantage off.
Overall, the kidney shortage is a curious issue. Creating a regulated market in the United
States would help people awaiting a transplant, but the repercussions would be extremely severe.
Vendors are shown to be uninformed people of low economic status and will live with not only
physical, but also mental scars the rest of their lives. On the other hand, the buyer is clearly at an
advantage. They get a new kidney that could possibly last the rest of their life. The opt-out
system could possibly spike the number of donors as people would be more informed. People
would know upon death what was happening to their organs and would have to opt-out rather
than opt in. The United States should not create a regulated market for the buying and selling of
kidneys; instead they should adopt the opt-out system in place in Europe.

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Bibliography
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Washington D.C. Georgetown University Press, 2005. Print.
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Kerstein, Samuel J. "Are Kidney Markets Morally Permissible If Vendors Do Not Benefit?" The
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"Organ Procurement and Transplantation Network." OPTN: United States of America, n.d. Web.
08 May 2016.

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Rippon, Simon. How to Reverse the Organ Shortage. Journal of Applied Philosophy. 29.4
(2012): 1468-5930. Academic Search Complete [EBSCO]. Web. 20 April 2016.
Stigmata. Def. 1. Oxforddictionaries.com, Oxford Dictionary, n.d. Web. 8 May 2016.