Intended for healthcare professionals

Analysis And Comment Controversy

Payment for living organ donation should be legalised

BMJ 2006; 333 doi: (Published 05 October 2006) Cite this as: BMJ 2006;333:746

Payment for living organ donation; time for government action.

Dear Editor,

We welcome Friedman’s sound argument for a regulated market in
payment for donor kidneys [1]. It is widely agreed that this market would
have a significant effect on the enormous shortfall in organ requirements.

The idea of selling human organs may sit uncomfortably with many but
to deny people life saving treatment requires better reasons than our own
squeamishness [2]. Although there remains some opposition, the frequency
with which this topic is discussed seems to suggest that the argument is
being won in favour of paid donation.

Her point regarding the public acceptability of drug trials for
monetary reward is a novel one and particularly pertinent given recent
events at Northwick Park [3]. Drug trials are continuing in this country
despite these well publicised events. Companies that organise trials do so
on the assumption that they will minimize any risk to their participants,
who in turn accept this minimal risk in return for financial remuneration.

Western society has deemed its population competent to make an
assessment of risk in these instances and for them to bear these
consequences should things go wrong.
It seems odd that we do not consider foreign donors, who are likely to
provide the bulk of donor kidneys, capable of making the same valued

Here in the UK, the NHS is in the privileged position of being able
operate as a sole purchaser, a monopsony that would ensure properly
regulated sales, screening, payment, insurance and financial advice.

The clamour for paid living organ donation is increasing, yet very
little forward progress seems to have been made. We would call for the
government to consider legislation that would allow the NHS to use its
unique position to become a pioneer in the payment for living organ

1. Friedman, AL. Payment for living organ donation should be
legalised. BMJ. 2006;333:746-8.

2. Hiley, CT., Jones, RP., Johnson, RWG. Cash for kidneys: right or
wrong. sBMJ. 2005;13:369.

3. Wadman, M. London's disastrous drug trial has serious side effects
for research. Nature. 2006;440:388-9.

Competing interests:
None declared

Competing interests: No competing interests

09 October 2006
Robert P Jones
F2 Cardiothoracic Surgery
Crispin T Hiley.
Manchester Royal Infirmary. Oxford Road, Manchester. M13 9QL