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The ethics of paying kidney donors

Wednesday, March 17th, 2010

A new study seems to knock down some of the ethical objections to paying people to donate an organ. The study authors are with the University of Pennsylvania and the Philadelphia VA Medical Center.

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The researchers studied people’s willingness to donate a kidney with or without a cash incentive. Penn assistant professor Scott Halpern says his study suggests that financial incentives would increase the number of organs available for transplant without exploiting low-income people.

Halpern: Payments did not seem to influence the poor any more than they influenced the rich. Ten thousand dollars offered to people earning more than $100,000 a year didn’t seem to have any different effect than that same $10,000 when offered to people earning less than $20,000 per year.

Nearly 84,000 people are waiting for a kidney transplant in the United States. Last year, a United Nations commission concluded that it would be very difficult to effectively regulate a kidney market, even in a prosperous country like the United States.

University of Pennsylvania bioethicist Arthur Caplan says creating a market for kidneys would cause too many problems. Caplan was not involved in the new study, but he served on a the U.N. commission that studied potential fixes to the worldwide organ shortage.

Caplan: It would take a lot of policing and oversight to make sure that people weren’t getting their arms twisted to sell a kidney if they had gambling debts, or even by family members if somebody said: ‘We’ve been good to you, so now you’ve got to pay us back.’ The prospects for being able to regulate that were very poor.

Caplan says the United States should create a system that assumes everyone wants to be an organ donor and would force those who object to opt-out. Right now, the United States has an opt-in system.

Some ethicists worry that payment would blind donors to the health risks of giving up an organ, but Halpern says his study suggests that’s not the case.

Halpern: We allow people to get paid to play in the NFL or to be workers in a coal mine or to be stunt doubles in a movie all the time. They take money in exchange for the risks. The risks of kidney donation are relatively small by comparison.

Each year, about 4,400 people in the United States die while waiting for a kidney.


  • robert dennis says:

    i want to donate my kidney for money any information about this should please contact me on or call me on +2348052847545,

    hope to hear from you soon.

  • Kidney Donor says:

    I donated five years ago. Suffered an injury during recovery that resulted in nerve damage. Had three exploratory surgeries in an effort to resolve the pain. To this day, I still hurt. Here are some facts I’ve learned over the years that people should be aware of:

    *There are no support groups for donors in my situation.

    *The medical community would prefer not to discuss the realities of my situation as it may discourage others from donating.

    * While the recipients insurance pays for the transplant, yearly check ups for the donor are covered for only two years after the donation. After that you are on your own. I also had to pay out of pocket for the exploratory surgeries.

    Seems to me if organ donation was so great, there would be more support and more truth offered to donors.

  • ANDREY says:

    My name is Andrey to me 27 years a blood type B + live in Russia to me money is very necessary as a world economic crisis the small 2 son has left me without work and out-of-pocket existence and at me. So I will become the donator of a kidney for compensation in 250 000 $ my email phone number +79041738610

  • Dave Undis says:

    In response to Sue Jaymes (5/7/2010)

    A lot of doctors support LifeSharers. You can see some of them on our web site. The article you mention is 7 years old.

    Organ donations are gifts. You have no right to decide who gets my gift, just as I have no right to decide who gets any gift you give.

    As for “playing God”, what about the people who refuse to donate their organs? They would rather bury or cremate their organs rather than save lives. Aren’t they the ones playing God?

    As for Orthodox Jews, in Israel it’s now the law that registered organ donors get preferred access to donated organs. This is very similar to the LifeSharers idea.

  • Doug Dolde says:

    I think the big question is being overlooked.

    Why should someone give away (or sell) something that was given to them by The Creator? Do you think The Creator gave you two kidneys so you’d have one spare to donate? I don’t think so.

    Being an organ donor after you die is another issue altogether, and I don’t have any problem with that.

    I don’t believe that just because “modern medicine” has developed a way to do something that it’s a valid solution.

    Everyone is way too afraid to die. That’s why all these Frankenstein cures even exist. Oh another reason is all the profit MD’s make doing the procedures.

  • Dave Undis says:

    livingdonor101 is incorrect when she says LifeSharers “perates outside legal parameters so no tranplant center has any responsibility to comply with membership rules”.

    LifeSharers members use directed donation, which is legal under federal law and under the laws of all 50 states, to offer their organs first to other members. This is the same process that got Natalie Cole, the famous singer, a kidney a few months ago. Under UNOS rules, organ procurement organizations are required to facilitate all legal directed donations.

    LifeSharers is a “donor registry” as defined under the Revised Uniform Anatomical Gift Act. That law has been enacted in about 40 states. The 2006 UAGA sats that whenever a hospital refers a potential donor to an organ procurement organization, the OPO must check all donor registries that operate in the area where the potential donor lives. All OPOs know that LifeSharers exist, since we officially notified them, so they’re required by law to check the LifeSharers registry.

    So if you want to donate your organs to other organ donors, please join LifeSharers at Your organs belong to you, and both federal and state law protect your right to determine who gets them.

  • Halpern is either misinformed or purposely being misleading. No one knows the true risks of kidney donation because no one in the transplant industry has ever bothered to follow or study kidney donors comprehensively. OPTN’s database is ‘woefully incomplete’ to quote an SRTR official, and according to Dr. Matthew Cooper, in 2006 alone, 1 out of 5 six-month follow-up forms were never submitted.

    Living donors DIE. They also suffer from hernias, intestinal blockage, lymph leakage, adrenal gland dysfunction, pancreatitis, organ laceration, infection, permanent nerve damage, and chronic pain (and more). Some suffer from depression, anger, anxiety and PTSD symptoms, yet not ONE transplant center offers aftercare or support services.

    There is a well-established link between renal insufficiency and cardiovascular disease, yet 50% of transplant professionals in a 2007 study believe being a living donor increases the risk of cardiac issues and do not discuss it during the Informed Consent process. Recent studies indicate that living donors have much higher risk pregnancies, yet transplant centers have no problem taking kidneys from women of childbearing age.

    Separate studies from Ghols and Goyal regarding paid donors in Iran and India both indicate that living donors’ experience greater financial and physical complications and have a lower quality of life overall. Nearly 80% would NOT recommend selling a kidney to someone else.

    In the U.S. living donors are discharged to a primary care physician that may not exist and recipient’s insurance is refusing to pay for LDs complications over a certain amount or after a certain time period. LDs are being denied health and life insurance, and falling into financial straits becauase of time off work. Yet somehow Halpern wants the public to believe that paying prospective donors won’t be taking advantage of them?

    Learn the truth:

    (Ignore Mr. Undis, he spams every site he can find remotely related to organ donation. His ‘club’ operates outside legal parameters so no tranplant center has any responsibility to comply with membership rules. In addition, none of his members have had the good manners to die and donate organs so the entire paradigm is moot.)

    • Sue Jaymes says:

      I agree with … Mr Undis does spam every site he can find. Personally I find his ethic sickening. There are many reasons why some people cannot sign the organ donor register becuae medical conditions would prevent the use of their organs anyway. So his illegal “club” is denying some of the most vulnerable people from getting an organ. I am not sure when he was voted God, but in my book he is not the God I wish to follow. My God treats everyone as equal – regardless. What would impress me is if Mr. Undis and his “club” actually all donated a kidney now!!! They can then choose who they donate to and pick someone who is on the register. It is easy talk to promise things once you are dead and gone in the hope you will get specialist treatment when alive. And yes, I have already donated a kidney and to a stranger and I do not expect any preferential treatment should I require a kidney in the future. I will go on the waiting list like everyone else.

      • Dave Undis says:

        Sue’s generosity in donating one of her kidneys is wonderful.

        She says she doesn’t expect any special treatment if she needs a kidney in the future. But she will get special treatment under UNOS rules. UNOS moves live organ donors up the waiting list if they later need organs. That’s a good thing. UNOS should do the same thing for people who promise to donate their organs when they die. If UNOS did that, millions more people would sign up to donate and thousands of lives would be saved every year.

        • Sue Jaymes says:

          David Undis you are wrong. I am not from the USA but from the UK where we treat every person as an equal. I will get absolutely no special or preferential treatment becuase I have donated and the idea that someone would sickens me. What a selfish nation the USA seems to have become. Education is what is needed. Spend your time educating people as to why they should donate that is really what is lacking. Back a law that makes donation the default and people have to opt out if they dont want to. What about the orthodox jews who dont believe in organ donation. Are you going to penalise religious groups? Most doctors are totally against what you are doing
          Who are you, David Undis, to play at being God? I know that I could not allow someone to die just because they had not signed the donor register. That is what you are also doing. If you are so keen on people donating their organs GO AND GIVE ONE OF YOUR KIDNEYS TO A STRANGER NOW! Get all your members to go through the evaluation to give a kidney? Then and only then will I and many others have any respect for you at all.

    • Student says:

      RE: “No one knows the true risks of kidney donation because no one in the transplant industry has ever bothered to follow or study kidney donors comprehensively.”

      Please see the recent JAMA article entitled “Perioperative Mortality and Long-term Survival Following Live Kidney Donation.” The researchers of that study found no difference in mortality of donors vs. the general population after ~6 years. It was an impressively comprehensive study. Dr. Halpern is neither misinformed or misleading; rather, it appears that you are doing both.

  • Dave Undis says:

    As the death toll from the organ shortage mounts, public opinion will eventually support paying for human organs. Changes in public policy will then follow.

    In the mean time, there is an already-legal way to put a big dent in the organ shortage — allocate donated organs first to people who have agreed to donate their own organs when they die. UNOS, which manages the national organ allocation system, has the power to make this simple policy change. No legislative action is required.

    Americans who want to donate their organs to other registered organ donors don’t have to wait for UNOS to act. They can join LifeSharers, a non-profit network of organ donors who agree to offer their organs first to other organ donors when they die. Membership is free at or by calling 1-888-ORGAN88. There is no age limit, parents can enroll their minor children, and no one is excluded due to any pre-existing medical condition.

    Giving organs first to organ donors will convince more people to register as organ donors. It will also make the organ allocation system fairer. Non-donors should go to the back of the waiting list as long as there is a shortage of organs.

    David J. Undis
    Executive Director


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