Paying for Kidneys: Reflections on Welfare Economics, Political Economy, and Market Design

British philosopher Janet Radcliffe Richards at the University of Oxford has written: “If you die through mistakes in moral reasoning, you are just as dead as if you die through mistakes in medicine.” 1 Richards J. The Ethics of Transplants: Why Careless Thought Costs Lives. Oxford University Press, Oxford, England2012 Google Scholar The aim of the authors of this thought-provoking cost-benefit analysis is to estimate and inform us about the cost to American society of the limits—perhaps owing to mistakes in both moral and economic reasoning—on the ability of healthy individuals to donate or supply their second or “extra” kidney to those who have kidney failure. 2 McCormick F. Held P.J. Chertow G.M. Peters T.G. Roberts J.P. Projecting the economic impact of compensating living kidney donors in the United States: cost-benefit analysis demonstrates substantial patient and societal gains. Value Health. 2022; https://doi.org/10.1016/j.jval.2022.04.1732 Abstract Full Text Full Text PDF Scopus (1) Google Scholar The 1984 National Organ Transplant Act makes it unlawful to share anything of value between organ donor and recipient, prohibiting exchange for “valuable consideration” (meaning, specifically, payments beyond “reasonable” expenses for removal, implantation, etc).