Kidney for Sale by Owner: Human Organs, Transplantation, and the Market

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Kidney for Sale by Owner: Human Organs, Transplantation, and the Market by Mark J. Cherry Georgetown University Press * 2005 * 258 pages * $26.95

Reviewed by William L. Anderson

When I was a graduate student I had a professor who had been through a kidney transplant. Being both an economist and someone badly in need of a new kidney had led him to examine the dynamics of organ transplantation and, more specifically, why it was that people often had to wait years before a human organ was available. He came to the conclusion that the current government-run system leads to needless deaths and that a market system in organs would be economically and morally appropriate.

My professor is in a distinct minority. The law prohibits individuals from selling organs, and anyone who disobeys can find himself in federal court facing serious prison time. The sale of organs is illegal because most people in power regard organ sales as immoral-or at least that's the reason they give for the current policy.

Yet, as Mark Cherry demonstrates, the current government-run system has an enormous cost. From 1992 to 2001, he notes, "more than 44,308 patients died while waiting for organ transplants. . . . An additional 6,385 people died in 2002, and 6,509 in 2003." In the face of these staggering numbers, Cherry writes:

Despite the significant potential of commercialization to increase the efficiency and effectiveness of organ procurement and distribution, to shorten waiting time, and thereby to reduce human suffering-while expanding the number of available organs-the possibility of creating a market in human organs for transplantation provokes in many feelings of deep moral repugnance, conjuring up nightmarish images of spare parts medicine.

Cherry, who teaches philosophy at St. Edward's University in Austin, Texas, believes otherwise, and examines the various arguments against organ sales. While he deals with the economic issues, his attack on the current regime of prohibition originates from a moral and philosophical point of view. In other words, he looks at the situation through the lens of a philosopher, not an economist. His conclusions, however, square somewhat (he wants a "regulated" market) with what we might hear from an economist trained in the Austrian tradition.

If the current regime is to be overturned, it will take more than the utilitarian arguments that most economists (though not necessarily Austrian) are likely to give. Cherry provides a strong philosophical justification for change.

It isn't entirely correct to say that organs can't be bought and sold. The buying and selling prohibition applies to individuals (dead or alive) from whom viable organs are "harvested. …