Should the government legalize organ trade?

By Wentian Sun

Edited by Evey Firth, Angela Erickson and Jiansheng Zhang

In 2011, a piece of news ignited the Chinese Internet when a high school student sold a kidney to buy the latest iPhone. Though the sale of kidneys is outlawed in China, the student chose to take the risk regardless.

A question is then posed, why is organ trade illegal in the first place? Suppose someone’s kidney breaks down. They must either undergo kidney dialysis every month or opt to receive a kidney transplant. However, a patient’s options remain limited as a result of most countries prohibiting direct payment to donors and their families, or in other words, someone selling their kidney. As a result, a shortage of transplantable kidneys occurs, leading to a welfare loss for people willing and able to buy one for an organ transplant.

In 2020, 106,325 people were waiting for an organ donation worldwide, but only 39,000 organ transplant surgeries ended up being performed. Moreover, 17 people die daily because they cannot find a suitable organ substitute. Among all the organs, the shortage of kidneys is more than almost all other organs combined.

Economists at the University of Chicago and the State University of New York at Buffalo also

conducted an in-depth study on the cost of legal organ transplants under market conditions. They found that market incentives effectively increase the supply of transplantable organs, eliminating long waiting lines in the organ market, with no more than a 12 percent increase in the total cost of the procedure.

The most recent data suggested in 2021, it would cost $440,000 to replace a kidney in the United States and experience post-operative care. Usually, the government pays around $100,000, so the patient pays just $340,000. In the meantime, before China banned organ trade in 2007, a transplant surgery cost only $120,000 in Shanghai and as low as $80,000 at a provincial hospital in Nanjing.

On a global scale, it costs an average of $52,000 to perform a year of kidney dialysis, and a patient waits an average of nine years before they can get a kidney. 52,000 x 9 is already a number that exceeds 340,000, and we’re not considering the opportunity cost, for example, the wages lost due to poor health conditions. Ultimately, which action is more humane, turning organs into a commodity or allowing patients to die when waiting for usable organ transplants?

But legalizing organ trade does have its drawbacks. The biggest problem is that more poor people will take the risk of making ends meet. So in the short term, this person's family has a substantial additional income; in the long term, they might lose more money from being unable to work. These problems have already occurred in some developing countries. In the meantime, the local medical care is not adequate, bringing difficulties for kidney sellers to get quality medical care afterwards, leading to more significant health problems.

But if they don't sell their organs, their lives won't even change in the short term.

The documentary Tales From the Organ Trade is set in Quezon City, Philippines, five hours from Manila. People there take pride in selling their kidneys and often gather to brag about what they have gained in return for their kidneys, such as fridges, motorcycles, houses and even marriages.

In Manila, 22-year-old Eddie's family lives in a modest house surrounded by rags because he could only earn $2.50 a week. At last, he chose to sell his kidney. His wife said with tears, “I understand why my husband is doing this, and others will not understand because they have not experienced the hardship of being poor.”

Overall, the advantages of permitting organ trading outweigh the disadvantages. Economically, legalizing organ trading would reduce the misallocation of resources, solve the shortage of organ transplants, and make the black market easier to regulate. Although there are ethical concerns, organ trade might give those in need a chance to uplift themselves from poverty or pain.