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The scar from a kidney donation. In this case, the organ was donated freely by a family member, but some economists argue that a freely competitive market for organs would stabilize prices and mitigate trafficking. The idea is highly controversial. (Deborah Baic/The Globe and Mail)
The scar from a kidney donation. In this case, the organ was donated freely by a family member, but some economists argue that a freely competitive market for organs would stabilize prices and mitigate trafficking. The idea is highly controversial. (Deborah Baic/The Globe and Mail)

Can paying for a new kidney save organ donation? Add to ...

The Internet advertisement reads like a used-car classified: "33 yr old American male. Non smoker or drinker with a clean bill of health. $75,000 U.S. Will travel anywhere. Facility and Physician must meet the highest standard."

Meet those conditions, and his kidney can be yours.

"This is a rough economy," says the California man who placed the ad, speaking on the condition his name won't be used: What he's doing is illegal. But a good price for a spare organ (plus paid travel and medical expenses) would knock a chunk off the $100,000 he owes on his student loans. A day after placing his latest ad online, he says he has already received 16 e-mails. Eventually, he figures, someone will pay his price for a sturdy, American-bred kidney. Most other sellers on the website say they're from places such as India or Indonesia - organ-trafficking hot spots.

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The right contact in those countries will find a citizen willing to sell a kidney dirt cheap, by Canadian prices. So if you're rich enough, why wait in line? A quick trip, and you can fly home with your new body part installed (properly, you hope). Good for you, not so good for your donor, who has just received a relative pittance from a broker and now faces questionable follow-up care. And certainly pointless to your fellow Canadians - now numbering about 3,800 - who linger on an ever-growing wait list because too few people are willing to give up what they don't need for those who will die without it.

Organ donation is a tragic case of supply not meeting demand, even though transplants have become much safer for recipients and donors. Living Canadians are relatively generous on international rankings, on par with Britain, but our posthumous donations lag far behind leading Spain. Either way, there aren't nearly enough to go around, especially as the population ages. In British Columbia, those who can't afford the international black market can expect to wait an average of nearly six years for a kidney - longer than many patients survive on dialysis.

The best way to bring supply in line, as any economist knows, is to sweeten the deal for the suppliers. So why don't we?

In June, when Canadian Blood Services is due to deliver recommendations on the situation to the provinces, what won't be on the list will be allowing people to profit from the sale of what they clearly own - the parts of their own bodies. It won't even be up for discussion.

However many lives and however much money a market for organs may save, the thought of trading coin for kidney makes too many of us squeamish - that is, until we're watching the slow death of someone we love.

"When something is repugnant to you," Arthur Matas says, "you just keep finding reasons to justify your gut reaction rather than thinking about it."

Dr. Matas is the Canadian-born director of the renal-transplant program at the University of Minnesota and a former president of the American Society of Transplant Surgeons. He has long been a vocal advocate for a broader incentive system for donors that would go beyond covering travel and missed-work expenses, as some provinces do now. (Saskatchewan announced this week that it would provide up to $5,000 to reimburse donors.)

Profiting from organ donations is illegal in most countries, including Canada and the U.S., despite the occasional ad on Craigslist. Iran allows people to sell their organs - receiving cash from both the government and the recipient - and claims to have eliminated its waiting list. And despite prohibitions, an underground market thrives in nations such as China, Egypt and Brazil.

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