The kidney trade: unfair or unethical?

A recent chat with one of my friends reminded me of a topic that I haven't given much thought as of late: the economics and ethics of kidney donations. In the United States, there is an extreme shortage of kidneys, basic economics suggest that an increase in price will lead to an increase in supply, thus reducing this shortage. But this is illegal in the United States, so the list of organ donors is composed of the dead and the altruistic. Clearly the number of altruists falls short of the number of patients. Even though you only need one kidney to live a normal life and the procedure is very safe, most citizens are unwilling to sacrifice their body for another human's life. From an economic standpoint, the answer to this seems clear: let people sell their organs.

But not so fast. Understandably, there is a "yuck" factor in regards to an organ trade. Many think that selling one's organs is repugnant or unethical. Others argue that it devalues human life. These arguments mark valid opposition to a kidney market. I have little interest in making a normative argument over the ethics of selling one's body parts. There is, however, another argument against the organ trade that I find preposterous: that it unfairly benefits the rich.

I won't deny that an organ trade would probably benefit the rich more than the poor. Certainly, with more money at their disposal, were a kidney trade legalized, the wealthy would have easier access to the market. I don't, however, think this should limit the ability of a wealthy citizen to, essentially, save their own life. I'm sure the rich "unfairly" benefit from plane tickets to Hawaii and I'm sure the rich "unfairly" benefit from the housing market (though an effort to change that sure didn't work out too well). Should making these purchases be illegal? Last time I checked, the United States was not a country found on socialist values. Point is, we're talking about saving lives here, ceteris paribus, a rich person's life is worth no more than a poor person's, rich people deserve a kidney no more than a poor person. But denying the rich access to a market that would save their own lives is in itself unethical.

Despite the fact that a kidney trade would be "unfairly" beneficial to the rich, that doesn't mean it would be detrimental to the poor. In fact, plenty of poor people could afford to buy organs themselves, through health insurance or donations. Not only that, but the waiting list would be shorter and the probability of any individual on the waiting list receiving a kidney would go up. In addition, as the organ market stands now, the rich can often buy their organs illegally either through the black market or otherwise. In regards to those on the waiting list for kidneys, creating a kidney market would get as close to a pareto improvement as I can imagine.

While the logistics of a legalized kidney trade would need to be worked out, I believe it is an area that deserves more attention. It seems that a kidney trade could be appealing to individuals who are either pro-life or pro-choice. Hopefully this is not a topic that is above our President's pay grade. Maybe a kidney trade is unethical. If it is, however, it's not due to inequality, but rather moral righteousness.