ABSTRACT Nondirected living kidney donation is safe and life‐saving, yet vanishingly rare. The standard account says this is because altruism is rare and warns against the use of money. I argue this gets things backwards. Donation is rare because, being so extraordinary, it is socially unintelligible: absent a suitable social narrative, we read donors as either pathological or saintly. Neither identity inspires. As a result, the practice fails to live up to the ideals it is supposed to embody. Its social meaning should be revised. I propose a civic model that frames donation as a contribution to the public good. The practice would be governed by the same nonmarket norms that are already in place, with donors receiving a service award that signals recognition, not price. Under these conditions, the award would function not primarily to induce but to restore intelligibility. Money, far from suppressing altruism, can enable it.
Luke Semrau (Thu,) studied this question.