The arguments for and against

YES

Arthur Matas, professor of surgery, University of Minnesota

"Today’s biggest problem in kidney transplantation is the shortage of organs. Each year more patients are placed on the waiting list for a deceased donor transplant than there are available organs. Each year the waiting list gets longer.

A regulated system would provide strict control and limit harm. It would include payment made by the government, allocation of kidneys [by predefined criteria] so that every candidate has an opportunity for a transplant, full donor evaluation, long-term follow-up and treatment of the donor with dignity and appreciation for providing a life-saving gift. Compensation for living donors will increase the number of transplants and decrease death and suffering on dialysis. No other alternative to compensation will provide a sufficient numbers of kidneys.

I believe we should advocate a change in the law to allow a trial of regulated compensation for living donors to increase the supply of organs and protect the health and dignity of waiting patients."

NO

Jeremy Chapman, professor of transplant research, University of Sydney

"Transplantation is threatened by the daily global carnage brought about by paying for organs. Sale of organs is advocated by the rich as a human freedom, but this right is exclusively exercised by the poor.

Selling organs does not help people lift themselves from destitution. In the bazaars of India and Pakistan, people sell kidneys to pay off debts, but then average family incomes decline by more than a third, more live below the poverty line and 86 per cent report deterioration in their health.

Organ sales distort the vendor country. Sales of kidneys and livers boomed in China. Executions also boomed and were measured with precision since each execution meant one liver transplant.

Organ sales also destroy donation. In countries where paid organ transplants occur, there is little or no donation. In countries where many transplant recipients go overseas, domestic programmes are underfunded and failing.

Source: British Medical Journal