GILL AND SADE • PAYING FOR KIDNEYS: THE CASE AGAINST PROHIBITION

ABSTRACT. We argue that healthy people should be allowed to sell one of their kidneys while they are alive—that the current prohibition on payment for kid-neys ought to be overturned. Our argument has three parts. First, we argue that the moral basis for the current policy on live kidney donations and on the sale of other kinds of tissue implies that we ought to legalize the sale of kidneys. Second, we address the objection that the sale of kidneys is intrinsically wrong because it violates the Kantian duty of respect for humanity. Third, we address a range of consequentialist objections based on the idea that kidney sales will be exploitative. Throughout the paper, we argue only that it ought to be legal for an individual to receive payment for a kidney. We do not argue that it ought to be legal for an individual to buy a kidney. OUR SOCIETY PLACES A HIGH PRIORITY on value plural-ism and individual autonomy. With few constraints, people makepersonal decisions regarding what they wish to buy and sell based on their own values. There are laws prohibiting certain kinds of trade; these laws are generally aimed at preventing commercial interac-tions that are associated with serious harms. Payment to living organ donors has been perceived to be just such a harmful transaction.1 The Uniform Anatomical Gift Act (UAGA), originally approved by the National Conference of Commissioners on Uniform State Laws in 1968, was intended to permit individuals to specify their desire to donate or-gans at the time of their deaths (Uniform Anatomical Gift Act, Uniform Laws Annotated 8, 1972). Although the framers of the proposed act con-sidered the possibility that a market for organs could develop, they did not conclude that buying and selling organs was intrinsically wrong. The UAGA was, in fact, silent on the question of payment for organs. Yet, today, every major organization that has an official position on the mat