Dynamist Blog

Discouraging Kidney Donors

My latest Forbes column looks at the outrageous refusal of some prominent hospitals to do kidney transplants for people who've found their donors through Internet sites or media publicity. Sally Satel addresses the same issue in The Weekly Standard.

The transplant establishment is, unfortunately, all too accustomed to managing the shortage rather than expanding the supply of organs. Too many powerful "experts" consider a donor who is moved by a particular stranger's story to be a generic "altruistic donor," for whom one stranger should be exactly the same as another. By their lights, favoring someone you've read about over whoever's first on the list is "unfair." (Check out Dr. Douglas Hanto's example toward the end of my article.) In fact, such a donor is someone who would not have given at all without empathy for a particular person. That empathy is no different in principle than the empathy one feels for a friend or relative.

And, no matter what The Onion says, organs don't grow on trees. Even assuming no change in the law, hospitals should do whatever they can to encourage, rather than discourage, donations. Sixty thousand Americans are waiting for kidneys. Even if every single family of a potential deceased donor agreed to contribute that person's organs, that would only double the number of cadaver kidneys available--to about 13,000 a year. Until biomedical advances make it possible to produce organs on demand, live donors are the only hope for the tens of thousands of Americans who need kidneys.

Inspired by op-eds by Sally Satel in the NYT and Richard Epstein in the WSJ, the Freakonomics blog features a lively discussion of organ markets. Richard Epstein published a related article in the WSJ in 2002 and, unlike his latest one, it's available online to nonsubscribers.

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