A few years back it was big news when someone tried to sell a human kidney on eBay. Bidding reached $5.7 million before the company put a stop to it. They had to put a stop to it, because selling a kidney is illegal. But should it be?
Steve Rivkin, who spent years waiting for someone to donate a kidney to him, doesn't think so. While he waited for an organ donation, he relied on dialysis machines to stay alive.
Dialysis machines clean your blood because your kidneys can't. Dialysis saves lives, but it's painful, expensive and tedious. You have to plug into the machine 3 days a week, 5 hours at a time. Many dialysis patients desperately want kidney transplants that would get them off the machines. But because so few people donate them, few are available. Some 80,000 people are on the waiting list for organs now, and more than 6,000 Americans die every year waiting for a transplant — that's 17 people every day.
When it comes to kidneys, you're born with two, but you only need one to survive. So, why, with literally billions of spare kidneys kicking around inside us, do so many people die each year waiting for a transplant?
Three years ago, after previous transplants failed, Steve was back on the waiting list.
At that time, Steve said, the list was up to 30,000 people.
His doctors said he might never get a kidney.
And so Steve decided to look for a living donor.
This is the dirty little secret in the organ transplant world. Buying and selling an organ may be illegal, but a look at some Web sites suggests something like that is happening anyway — all the time.
"I knew that if I carefully worded an ad and just let people know that I needed a kidney transplant," Steve said, "then there wouldn't be a discussion about money."
He posted an ad, and responses came in from all over the world. Steve said some people did want to sell him their kidneys.
Steve and his wife, Elaine, decided that even though it was illegal, they were willing to pay.
"It's a fair exchange. You know, you're talking about two desperate people," Steve said.
Some desperate for a kidney, others desperate for money.
"There were some sad stories out there," Steve said, "one couple had gotten bankrupt. He just was looking for a way to pay everything off, start over fresh, and move on."
These exchanges are made in other countries. Some men from the Philippines gave up one of their kidneys for $1,000. It's not a choice you might make, but no one forced them. They're poor, and they wanted $1,000 more than they wanted two kidneys.
"I don't think that there's anything wrong with paying money for a kidney transplant. … I think it's a wonderful thing, and I think more people should try to do it," Steve said.
Altruism Isn’t Working
Dr. Brian Pereira, president of the National Kidney Foundation, disagrees with Steve. He says, "This is not a wonderful thing. This is a dangerous precedent."
He says there must be no trade, or barter, or sale of organs. He says the government and the professional societies who help the government make policy decisions should be in charge of the system.
But Steve just wants a kidney that works.
Pereira said, "I empathize with this patient's need for a kidney that works. The good news is that this person can continue on dialysis under the current system, which functions extremely well."
Do 17 deaths a day add up to a system that's functioning extremely well?
Pereira said, "17 deaths a day is a statistic that we need to understand in the light of what could happen on the downside."
Poor people will be exploited, he says, and it's just immoral to sell body parts.
Pereira said, "The fact that the current situation is desperate, doesn't justify an unwise policy decision."
"Organ donation is purely an issue of altruism," he said.
But altruism isn't working.
Motor vehicle departments offer license applicants a chance to volunteer their organs after they die. Some people agree to it, but most people don't.
It's a reason some medical organizations that used to object to buying or selling organs, now say we ought to at least consider paying small amounts to increase organ donation after people die. The money could help families pay funeral costs.
But would a few hundred dollars change people's mind?
Lots of people we spoke with said it might.
But some were opposed to any payment.
"If you don't want to do it for free I don't think you should do it. I don't know. I don't think it's appropriate," one woman said.
And that's a reason it's against the law. Dr. Pereira says bringing in money would exploit everyone.
"They miss the pleasure, or the gratification of having made this decision purely out of altruism," Pereira said.
But, shouldn't that be their choice?
"There are some issues in life that we cannot completely leave to the choice of the family who has to make a decision," Pereira said.
Steve finally did get another kidney and he didn't pay for it.
Rebecca, an acquaintance of Steve and his wife volunteered her kidney. "She said she wanted to do it because it was the right thing to do," Steve said. So no money changed hands.
Rebecca said, "I know Steve and Elaine are very generous people and I know that I will benefit greatly from this."
Rebecca went to live with the Rivkins, and they've talked about taking her to Paris.
The operation was a success. Steve left the hospital with Rebecca's kidney functioning well inside his body, and Rebecca's doing well, too.
Good for Steve, but why can't other people buy and sell what he got? After all, he says, everyone else makes money from transplants.
"The doctors make money, the hospitals make money, the organ procurement organizations make money. Everybody gets something except for the donor," Steve said.
Good point. If you find selling an organ immoral, fine — you don't have to do it. But should all sick people be denied transplants because some people believe selling organs is bad?
Give me a break.