October 2, 2002

Ethical and Social Consequences of Selling a Kidney

Author Affiliations

Author Affiliation: Center for the Study of Society and Medicine, College of Physicians and Surgeons of Columbia University, New York, NY.

JAMA. 2002;288(13):1640-1641. doi:10.1001/jama.288.13.1640

The controversies surrounding the ethical and social consequences of permitting the sale of organs (essentially kidneys) for transplantation are at once intense and perplexing. The intensity is easily understood because both sides of the debate believe that the stakes are very high. Proponents look to the sale of organs to resolve a life-or-death situation. Since the number of patients who have end-stage renal disease and are awaiting a transplant far exceeds the supply of organs, individuals who cannot survive despite dialysis treatment or lack access to it will die unless a kidney is available. As a dialysis patient who was also a member of the British Parliament declared in resisting a ban on commerce in organs: "Those who want organs want them now because life is finite."1 Opponents, on the other hand, perceive sale as an egregious exploitation of the poor, a literal pound of flesh, whereby those without resources must sacrifice bodily integrity for those with resources.2

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