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….
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