If the Price is Right: The Ethics and Efficiency of Market Solutions to the Organ Shortage

Abstract

Due to the shortage of organs, it has been proposed that the ban on organ sales is lifted and a market-based procurement system introduced. This paper assesses four prominent proposals for how such a market could be arranged: unregulated current market, regulated current market, payment-for-consent futures market, and the family-reward futures market. These are assessed in terms of how applicable prominent concerns with organ sales are for each model. The concerns evaluated are that organ markets will crowd out altruistic donation, that consent to sell organs is invalid, that sellers will be harmed, and that commodification of organs will affect human relationships in a negative way. The paper concludes that the family-reward futures market fares best in this comparison but also that it provides the weakest incentive to potential buyers. There is an inverse relationship between how applicable prominent critiques are to organ market models and the increase in available organs they can be expected to provide.

Fra innholdsløs altruisme til motsetningsfull feminisme: en analyse av høringen om kompensasjon for eggdonasjon

“…2021;Kool mfl. 2019) og debattene om betaling for organdonasjon (Albertsen 2020;Sterri 2021) og blodgivning (Titmuss 2019). Andre argumenter som ble identifisert i høringsrunden -saerlig de argumentene der mann og kvinne ble stilt opp mot hverandre for å vise forskjellene mellom saed-og eggdonasjon -viser derimot et skille mellom debatten om kompensasjon for eggdonasjon og lignende debatter om økonomisk kompensasjon for andre typer donasjon (Bayefsky, DeCherney og Berkman 2016; Klipstein mfl.…”

Public Opinions on Removing Disincentives and Introducing Incentives for Organ Donation: Proposing a European Research Agenda

“…Throughout the years, various policy proposals suggesting different reward systems for deceased and living organ donation have been proposed [15,[17][18][19][20][21][22]. In Netherlands in 2007, for example, the Centre for Ethics and Health, a partnership of the Dutch Health Council and the Council for Public Health and Society, recommended the introduction of financial incentives for deceased and living organ donations to the Dutch government [15].…”

The Morality of Kidney Sales: When Caring for the Seller’s Dignity Has Moral Costs

“…Albertsen ( 2020 ) identified four prominent proposals of market arrangements: the unregulated current market, the regulated current market, the payment-for-consent futures market, and the family-reward futures market. Assessing the academic literature, he discusses “an inverse relationship between how ethically controversial the market models are and the increase in organs they can be expected to produce” (Albertsen 2020 , 364). He holds that “the principled concerns regarding commodification seem to be the most relevant criticism across the board of models for introducing market mechanisms and incentives” (Albertsen 2020 , 363).…”

“…Assessing the academic literature, he discusses “an inverse relationship between how ethically controversial the market models are and the increase in organs they can be expected to produce” (Albertsen 2020 , 364). He holds that “the principled concerns regarding commodification seem to be the most relevant criticism across the board of models for introducing market mechanisms and incentives” (Albertsen 2020 , 363). Regarding regulated market arrangements, we demonstrate that saving more lives via market incentives trumps principled concerns considering commodification and that it is even possible to transcend this trade-off paradigm and save more lives while protecting human (and social) dignity.…”