Should the Sale of Kidneys Be Legalized?
About eleven Americans died yesterday waiting for a kidney. Eleven more will die today. Roughly four thousand a year. One proposed fix is to let people sell a kidney — and almost everyone's first reaction to that is immediate and strong. This week is designed to test whether your reaction survives contact with the details. Fair warning: it's one of the few topics where the class might genuinely not agree by Friday, and that's allowed.
Reading List
Two argue for legal organ sales and two argue against. Read all four — and read the Afghanistan piece even if you already agree with legalising sales, because it shows what an unregulated market actually looks like.
Required
- Why Selling Kidneys Should Be Legal — New York Times
- Paid Organ Donation: The Case Against — National Library of Medicine
- In Afghanistan, a Booming Kidney Trade Preys on the Poor — New York Times
- Why Legalizing Organ Sales Would Help to Save Lives, End Violence — The Atlantic
If You Want More
- For Sale, By Owner: The Psychology of Repugnant Transactions — NPR. On why certain trades feel wrong even when they help people.
- The Sale of Human Organs — Stanford Encyclopedia of Philosophy
- Books, if this topic grabs you: Never Let Me Go by Kazuo Ishiguro, and What Money Can't Buy by Michael Sandel.
One-Week Plan
Here's the shape of the week. Your guide will set the exact timing for your section.
Eleven a Day
Write first, before you see anything: should a person be allowed to sell one of their kidneys?
Then the numbers, which are worse than most people realise. About 90,000 Americans are waiting for a kidney, and only around 27% will get one this year. The rest stay on dialysis — hours hooked to a machine, painful, expensive, and hard to build a life around.
You'll learn how donations actually work: a match with a compatible relative; a swap, where two families trade so both patients get a compatible kidney; or a chain, where one stranger's gift sets off a whole sequence of donations. Only 2% of donations come from strangers.
And then the number that ends the obvious solution. If every single American signed up as an organ donor, and every usable organ from every death was donated, it would still take 80 years to clear the waiting list — because most people who die have kidneys that can't be used.
One more thing to sit with: about 20% of kidney donations worldwide already come from an illegal black market. So the choice isn't really between having a market and not having one.
Four Lenses, Not Two Teams
Instead of a for-and-against split, you get four ways of looking at it. You don't have to adopt any of them, and none of them is the right answer — they're tools for thinking:
- Freedom. It's your body, and you should get to decide what happens to it. Markets are also good at moving scarce things to where they're needed.
- Sanctity. Selling parts of a person treats a human being as property. Something is lost — something about being a person rather than a thing — when a body becomes something you can shop for.
- Life Value. Someone dies every couple of hours waiting. Whatever discomfort a market causes, it doesn't outweigh that.
- Class. In practice, kidneys would move from poor people's bodies into rich people's bodies. Somebody selling an organ because they're desperate isn't obviously making a free choice.
Some data to bring in: kidney disease causes 2.7% of American deaths — much more than it gets discussed. The waiting list has grown faster than donations for years. And two interesting splits: people your age are much more likely than older generations to support legal organ sales, and economists support it far more than the general public does. Both are worth explaining rather than just noting.
The Questions Designed to Break Your Position
Whatever you decided on Monday, one of these is aimed at you:
- Swaps are legal and common — and a swap is trading a kidney for a kidney. If trading is fine, what exactly does money add that makes it wrong?
- Women can legally be paid for donating eggs, which are also finite and also involve medical risk. What's the difference?
- Poor people already take the most dangerous jobs — mining, construction, the military. If we accept that, does the "it's coercive" argument still hold?
- Should some kidneys cost more than others? What if the government bought every kidney at one fixed price — does that fix the fairness problem or dodge it?
- Doctors swear to do no harm. Does allowing payment cause harm — or does banning it cause harm to the 4,000 people who die each year?
Before you leave, find a resource to bring on Thursday.
Push to the Edges
Share what you found, then take the three hardest questions of the week:
- One person, one kidney. The patient will definitely die tomorrow without it. The donor will only do it for money. Does that change anything? If your answer is yes — what was your objection actually about?
- Pigs. Scientists are working on transplanting organs from animals. If the choice is between paying an adult who agrees to it and using a pig that can't agree to anything, does the moral maths change?
- Where's your line? If you can sell a kidney, can you sell an arm? A heart? Nearly everyone says no somewhere. The real work is explaining why there.
Score Your Own Week
What went well, what to improve, what you learned, and whether anything you believed changed. Then the participation matrix. Be honest with yourself.