Sally Satel thinks politicians are drawing the wrong lessons from the connection between clandestine kidney brokering and the New Jersey public corruption busts.
According to a federal criminal complaint filed in district court in New Jersey, Levy Izhak Rosenbaum of Brooklyn conspired to broker the sale of a human kidney for a transplant. The cost was $160,000 to the recipient of the transplant, of which the donor got $10,000. According to the complaint, Mr. Rosenbaum said he had brokered such sales many times over the past 10 years.
“That it could happen in this country is so shocking,” said Dr. Bernadine Healy, former head of the Red Cross.
No, it isn’t. When I needed a kidney several years ago and had no donor in sight, I would have considered doing business with someone like Mr. Rosenbaum. The current law—the National Organ Transplant Act of 1984—gave me little choice. I would be a felon if I compensated a donor who was willing to spare me years of life-draining dialysis and premature death.
The early responses to the New Jersey scandal leave me dismayed, though not surprised. “We really have to crack down,” the co-director of the Joint Council of Europe/United Nations Study on Trafficking in Organs and Body Parts told MSNBC. That strategy is doomed, of course. It ignores the time-tested fact that efforts to stamp out underground markets either drive corruption further underground or causes it to flourish elsewhere.
The illicit organ trade is booming across the globe. It will only recede when the critical shortage of organs for transplants disappears. The best way to make that happen is to give legitimate incentives to people who might be willing to donate. Instead, I fear that Congress will merely raise the penalties for underground organ sales without simultaneously establishing a legal mechanism to incentivize donors.
Dr. Satel was lucky to have a generous friend in Virginia Postrel who was willing to donate a kidney, many others are not so lucky. As Postrel wrote in The Atlantic:
Living donation is a low-risk procedure for the donor that offers life-changing rewards for the recipient. Yet the donor is the only person involved in the process who receives no compensation. “There’s no reason that someone who does this should not get something substantial that will make a difference in their lives,” says David. To people who like to celebrate living donors as heroes, payment seems terribly crass. But the vicarious thrill of someone else’s altruism comes at a terrible cost.
Our current system is perverse. We encourage the needy with means to travel abroad (so-called “transplant tourism”) and the desperate to enter the criminal underworld. Overall, fewer people are saved. Allowing payments to donors may be crass, but it is also more compassionate to those in need.