Buying Kidneys to Benefit Sellers

The persistent shortage of transplantable kidneys is a problem. Decades have shown that donation is not the solution. Perhaps payment is. Since donation is permitted, many objections to kidney sales rely on assumptions about the conditions of sales—especially the assumption that prices would be set to efficiently induce within the bounds of fairness. This article considers an alternative where payment—set at $250,000—is designed to confer substantial benefit, and exchange is governed by the same nonmarket norms as donation. Under such conditions, many of the leading objections—concerning exploitation, fairness, complicity in injustice, dignity, commodification, and diminished status—lose much of their force, if they are not refuted outright.