And in addition, people should be able to donate WHO they want to, if they wish. They shouldnt be forced to donate to people they don't want to -- if thats the only way that organs can be donated.

If the Halacha says it is permitted, then it is moral. If the Halacha says it is forbidden, then it is immoral. In Judaism's eyes, morality is not in the eyes of the beholder but what G-d and His Torah have defined as moral and immoral. It makes no sense to listen to someone's personal opinion as to what he thinks is or isn't moral since morality is not defined by Man, even by many Men, but by G-d.

First, i would like to thank the author for this important article. The answer to the question "is it ethical to buy/sell organs" depends on which branch of ethics do you follow. Personally, i am against the sale of human organs for the following reasons: 1- Society should not allow any practices that would result in injustices or would violate the rights of individuals. Allowing organs to be bought and sold will do both. 2- Justice demands an equal right to life. However, if we allow trading organs, ability to pay would determine who could buy organ, and financial need would determine who could sell which makes the whole practice unjust. 3- Money and economic need affect the seller's free will. In addition, ethical actions should not be driven (even partially) by any sort of material interest. 4- Although we all have a moral duty to save lives and reduce human suffering when we have the ability to do so, but we will all die one day. Socrates got it right when he said "not life, but good life, is to be chiefly valued". My father passed away seven years ago because he had kidney failure, and he had the chance and financial ability to buy a kidney, but he chose to accept his fate.

The author answers your points. The author says rule of law should be in place to prevent discrimination against the poor when recieving a kidney. I am sorry for your father's passing. ... Your father had a choice to buy or not to buy. He made his choice. Would you deny others the same ability to choose because of your father's choice not to have a kidney?

suffering of one whose organs are failing ,

To #4: Thank you for your comment. Ethics is about what is "right" and "wrong" which makes it very subjective. Personally i believe that morality should be valued in itself, and should be related to our understanding of the world and of our place within it. As such, buying a kidney does not reflect my personal values and i was just pointing out my reasons for that. I was not denying any one the right to choose their own values. To #5: thank you for your nice words, and i hope none of us will ever experience such pain. What i like about this kind of articles that it reminds us that we (human beings) are so vulnerable and so weak and we will all face the inevitablity of death. This fact (death) makes life objectively absurd, so its up to us to find a meaning for our lives (as existialists suggested). We are here for a very short period of time, so let us love and forgive each other. Let us value human lives more than valuing a peice of land. Let us not allow the extermists to spoil our relationships, at the end of the day we are all humans.

It would make people, their very BODIES a commodity, they would become SLAVES, their fates doomed to the market system, poverty and financial exigencies would force poor people to sell their organs and family pressure those of their spouses and children, it would make people into organ prostitutes and to intermesh religion making parts of a healthy person's living soulful body a commercial transaction is sickening. In addition please don't think Rabbis are driven only by pure motives, they are human being like everyone else and are prone to the pathologies as we all are.

No mater how one put it, our lives must never depend on organ donations no mater what. Regardless of one's perception, organ transplant = organ theft = organ trafficking = money = crime. Pain is part of life so is love, so is enjoyment of one's company, so is losing of a loved one. What an irony, how many, today living man and women' thanks to organ transplant are at this moment engaged in destroying other lives. Those life could have been saved otherwise...

It is an interpetation of God's word. Maybe we should not condone selling organs, but we should certainly allow donation of organs from those who have signed a declaration to do so in dire situations with no hope of recovery. I think God would want us to face reality and do the kindest thing we could do for one another. I think when God gave us free Will, it was in order for us to judge, to weigh alternatives and to make intelligent decisions.

I am a senior organ donor coordinator, in the US, and I wish to remark on this article as a professional person in the field. For years I have worked around the ethics of organ donation as it exists as a non profit agency system inside the US, controlled by the FDA. Although it is my intention to compose an opinion piece on this subject as it relates to the recent disgusting article by the Swedish newspaper, I will pause here to respond to the idea that individuals should be paid to donate their kidneys. Let me begin by suggesting that the vain idea that anybody's life is the responsibility of this writer is repulsive. It is highly inappropriate to suggest yourself as the bearer of life and death in a medical setting. It is strangely vain, and if I had someone on my team suggesting such things, I would immediately place him on leave and re-evaluate his competency to work with the terminally ill. To begin with although most Americans do support organ donation as an ethical idea, I seriously doubt that a poll taken among people with a cursory understanding of the FDA and MA oversight controls would agree to loosen the criteria in place that controls a process which has many layers of rule outs. Those layers are there to manage the procurement of tissues so that no mistakes can happen and as a donation match is evaluated, many, many pages are turned over. This includes extensive investigative interviews with family members, physicians and others as a means to rule out medical histry criteria, as well as negative personal behaviors that can affect the tissue. For example, recently I ruled out someone for a donation because a friend I interviewed told me he had done his own tattoo. This is but one example of the rule outs, but there are dozens more. It is far from a matter of simply finding someone who says yes I will give you my kidney. We are so tightly controlled that my office is under 24 hour lock down. The topic at hand is whether or not people should be able to gain monetarily for donating a kidney. The writer suggests it is a mitzvah that could somehow become more of a mitzvah if a payment was involved. I suggest the opposition. In fact, I suggest it is a greater mitzvah to donate for free than to be paid. But let's set that aside for now and look at the ramification of coordinating a kidney that has been bought from a stranger. From a system management viewpoint, this highly complicates a system set up to procure other major organs from expected deaths in hospitals. For kidneys, the most common donation already happens between matched clienteles, so the process is already established to a degree. It is not as simple as finding a tissue match, by any means, and this is where it gets tricky to think about bringing in masses of potential volunteer donors who may need the money and not understand the process. The hurdles are: 1.) Enormous liability costs for hospitals and physicians, as any major surgery involves high risks. National health coverage does not eliminate litigation. 2.) That kidney donation is most often harder on the donor than the recipient, and it is far worse for the donor medically. In the US, there is a great debate going on about informed consent for donations. Care coordination is not illegal in the US. That two people have made, quote, “tons of money" suggests to me that the core issue should be whether or not all donations and matches be made within a NON profit system database. This eliminates the profit motive by coordinators, which IS the core issue here-NOT WHETHER OR NOT A DONOR SHOULD BE PAID. It is the SELLERS of the matches who are profiteering! In a true NGO, administrative costs amount to no more than 20% of overall intake of donations. So why not set up a national NON PROFIT coordination registry and create a medical baseline system, THEREBY ELIMINATING THE OPPORTUNITY for sellers of tissue matches?? This is to issue as it really stands.

Once you START CHARGING FOR ORGANS, what do those without millions or even tens of thousands do? The donors are obviously going to queue up for a check, rather than just a pat on the back. Congratulations, you've rationed life via the free-market. Ayn Rand would be proud. After the latest round of scandals involving organ scams, Israel and Israelis should be staying 100 miles away from any sort of organs-for-sale nonsense, but some people never learn.

Illegal trafficking in organs is like illegal trafficking in drugs and illegal trafficking in sex in that just because you make it illegal doesn't mean it goes away. In other words, just because a government makes something illegal, doesn't mean that demand for that newest form of contraband has been eliminated. Where there are people who are willing and able to pay for healthy kidneys, there will always be people willing to provide those kidneys. The question, therefore, should not be one of removing "profit" from the system (profit = financial stability = jobs = food on people's tables and the government teat only has a limited amount of milk, that amount itself determined by the level of "profit" its citizens achieve), but one in which those who provide the organs are assured the largest piece of the reimbursement pie. Do you know how difficult it is to smuggle a kidney into the United States or Israel? Do you understand the risks a person takes engaging in an illegal service in order to save people's lives and provide income to people who otherwise wouldn't have any? Scarcity + High Risk = High Profit If you remove the draconian restrictions on letting people donate organs for money, organ brokers will get much less profit because there will be much less risk involved in selling organs, plus, their role as middlemen will be eliminated entirely if donors get to meet recipients face to face. The problem, therefore, is not a lack of regulation, but that the regulation that currently exists impedes the natural interfacing of supply with demand, to the detriment of everyone involved...

I'm glad that a donor professional (12) responded. We already know that third world children are being used as 'unwitting' organ donors, and are often abandoned after. We already know that there is human trafficking across all borders, and as many victims end up in the US as elsewhere. We also know that it would be extremely easy to combine sexual trafficking with organ donation, at the expense of anyone, anywhere, who lives in dire circumstance. Why, then, would we expect that any 'for profit' system would be 'moral'? Many years ago I was a 'matchmaker' : patients to good therapists. I was excellent at this. I never took a penny--it was a social service, and would have been seen as unethical if I did take money from either party. I suppose today I could make money at this--isn't that our problem? Isn't that at the moral core of the organ donation issue? Should money be able to buy anything--should the person with $200-300K be able to get the kidney while the person with only $2-300. total dies...and how much of this generous sum does the donor get(besides medical bills)? Never enough. I do believe willing persons should be able to donate organs, and should have their medical bills paid...but never for a fee. There are still those of us who worry about egg/sperm donation and 'womb rental'...when there are already too many of us for the world to support.

when doctors and nurses start donating their 'spare' kidneys in large numbers. To the Donor Coordinator -- has she/he donated kidney? How does one determine the diminution of the health and shortening of a life span of a live donor, when the consequences can appear years down the road? And what has happen to the major Western medical rule--first rule, physician do no wrong? The emoval of a healthy organ from a healthy individual cannot really be morally justified, under this rule. I believe that in the zeal of saving one life, the life and health of another may well be endangered. The donor, who likely will be a healthy young person with the entire life ahead of him/her and who cannot begin to imagine all the health problems awaiting him as years go by and there are no studies showing long term effects of a kidney removal. As I said -- if it is that safe let the physicians lead the way. Otherwise, a human being should not be used as a spare parts receptacle.

>Do you understand the risks a person takes engaging in an illegal service in order to save people's lives and provide income to people who otherwise wouldn't have any? It is nothing less than absurd to attempt to size this up as some heroic deed that saves lives and provides income. That is preposterous beyond the pale. It has proven that the middlemen--the illegal coordinators of bad foreign tissue make the money in the very few cases of successful matching. What about the money pilfered from sick patients—that doesn’t count with you? Most matching is extremely dangerous and questionable and most of the tracked cases resulted in death after tissue rejection. To suggest this is an industry affecting the employment stats is ridiculous for a variety of reasons, especially when one considers that a healthy person who donates a kidney usually cannot work or perform their normal tasking for months afterwards. >Scarcity + High Risk = High Profit When poor people are used for body parts with the excuse that it will help them pay their bills, our society is lessened. No person should have to ever consider donation except for reasons that are associated with a sense of doing what feels right to them. I challenge you to believe that there is almost no possibility that you will hear about the deaths that result from failed sub standard donation matches. There is overwhelming evidence that rich people or even people less than rich will purchase organs and allow risky donations without consideration of what that may have meant for someone in a desperate situation The answer is not to prey upon the poor, but to increase awareness of the need for more donors and broaden the system of donation matches and to regulate it and oversee it using a non profit model.

"Once you START CHARGING FOR ORGANS, what do those without millions or even tens of thousands do?" If there are no governmental or monopolist obstructions to trade, the price of the organs will fall to a level where they can be affordable to almost everybody who needs one. This is the way supply and demand work. If people can't afford something, they don't buy that thing. If enough people can't afford something, somebody comes along and offers it at a better price so they can tap into the underserved demand that exists. This is how business works. If there still are people who can't afford organs, they can ask for charity. "Congratulations, you've rationed life via the free-market." As opposed to 'rationing' life based upon some arbitrary centralized scheme? The 'free-market' consists of individuals using reason and logic to act out their individual free will. How exactly is this rationing when it seems to be its absolute antithesis?

In our religion, every life we can save is a sanctification. We are commanded to do everything possible to save a human life, even if it's something that is normally against the Torah. I think that is why a lot of us(Jews) believe it would be ok to buy a kidney. Until recently, I also believed it was immoral, but a friend explained to me why he thought it should be legal. After thinking about it, and after several scandals, including the rabbis in New Jersey, I'm starting to change my mind. There are so many people whose lives could be saved and so few kidneys available. My grandfather died of a kidney problem when my mom was little(before any treatment was invented) and it was so tragic for their family at the time. How different my mom's childhood would have been if her father had lived.

who thinks medical society is somehow rationing organs and overcharging for them. Tell us, oh great one, how your business plan to grind out the organs of the poor and causes Walmart prices to fall, fall, fall ...will flood the market and make so many kidneys available people on dyalysis will jump out of their beds and run to your kidney five and dime! Blue light specials provded for by the poor people of the world who can't afford to shop for supper so they schlep into your organ grinder mobile where "certified" scienticians will remove their kidneys and have them back at the soup kitchen line in a matter of moments! Worried about incarceration, forget about it--the Ramat Gan Organ Grinder will arrange an early release so you ca donate and go! Can't stand all that pesky waiting around when you have cancer? Call the Ramat Gan supersavor for this week's special--two kidnyes for the price of one--bring a friend! You're a total idiot.

#18, Go read what #12 had to say. The number of organs available wouldn't change in your pollyanna'ish "free market" system. Assuming otherwise ignores the experience of the only organ-donation specialist commenting on this story. While nobody likes to wait, decisions to place scarce organs should be based on medical opinion and need, not the size of a recipient's check. If someone with 100k and 2 years to live buys the only matching kidney before the person with 10k and 1 month to live, you have just killed that person with your infallible "free market" system. The current system could save both by matching organs with need, rather than by bank account.

it caused something of a minor rowell here at the Pentagon. Bout the only thing I ever heard the christophile officers and the 1 Muslim officer agree on. The perfidy of the organ stealing Jews HAHAHAHA! makes me laugh these shlubs

If selling organs were legal, the prices would fall. It's expensive now because of the great risk in trafficking in organs. The prices might come down to a reasonable level so that even if a patient doesn't have the money he'll be able to get it. People will donate money or lend it to him. Friends and family will help. Perhaps eventually it will become so accepted that insurance will pay for it.

The system we have now isn't working. it's very nice to say organs should be matched by need, but a lot of needy people aren't getting organs. Most organs are rotting in graves. A lot of Jews here in Israel have the misconception that organ donation is against the religion. . Some come from executed Chinese prisioners. Some organs come from poor people in India who are hacked and terribly scarred from badly done operations to remove the kidney. Nope, the present system isn't working. Anyway, I saw an Oprah show where Dr. Oz talked about growing organs in a lab with the patient's own cells. This technology should ba available soon and would make the need for organs donations obsolete.

Susan, you are completely incorrect in your anatysis. The present system does work and it is vitally important that it be contolled. Your premise that people are taking their organs to the grave with them and that the present system of bad operations on Indian poor people and Chinese prisons would be improved if the trafficking is made legal is dead wrong. Please read the details in my previous posts. To begin with, you count on the traffickers to somehow create a clean donation system where the criterias for matches is followed and tissues preserved and transported in a manner where westewrnized physician would use them with trust. How will that be overseen if not by a system like the one already in place? YOU and others never hear about the many deaths of the donors who die of sepsis or the recepients of bad matches procured in third world countries. The survival rate is extremely low. Why is that, Susan? it is because the system is fraudulent, uncontrolled and managed by people with profit in mind, not good health care. Your premise is naive and misguided. The cost of organs will likely not fall at all if your so called "trafficking" is legalized. Mainstream hospitals would demand strict criteria be met --just as it is now within the system in place. This is to insure the tissue is a clear match and the rule outs I mentioned previously are certified by someone with the same background I possess. Next the removal of the organ and the transport of that organ would need to be arranged --it takes intensive coordination for me to accomplish this inside a regional area inside the US---so I am puzzled how you beleive that getting a kidney from a Indian or Chinese person will be less so. The flight of organs is astronaumical in cost. So the choice is to find matches and transport the ill person there. You suggest family and friends can donate. What will the family and friends of poor people do? I will leave you with two remarks. First of all, there is a debate on whether or not organ donation is approriate for Jewish people. I am involved in this debate as an ethicist. My response is this: major organs donations is in accordance with Judaism. This is because the organs are removed in an operating room setting by surgeons. From that room, the body is directly buried. Donation of other tissues such as skin, bones, legiments is not in accordance of Jewish law and I believe it is actually a horrible practice. The cadeavors of donors are butchered and handled in a disrespectful manner by technicions. The donation of eyes is questionable, since the entire eye is removed and discarded once the tissue is removed. As far as Dr. Oz's remarks about growing organs, the science is not there yet. It will not be available "soon" unless soon to you means possibly within your life span. In the meantime, pervaying upon the world's poor in order to buy their body parts is morally abhorent. A better method would be to go to all those frriends and relatives you believe would lend you money and ask them to instead go see about becoming a match themselves for someone on the database in existence for kidneys, for bone marrow. When poor people must sell their organs in order to feed their families, our world is lessened. The present system works. You just need to help make it stronger instead of helping theives hurt the world's disadvantaged.

... whether we want it to or not. Wherever there is demand for a good or a service and red tape exists that hinders that demand being met, a black market will surface to meet that demand. Remember the USSR banning Beatles albums? That worked out just swimmingly, didn't it? There's nothing 'pollyanna-ish' about this. It's a time-tested fact of our universe just like the laws of gravity. In light of this, it's 'pollyanna-ish' to advocate otherwise. Not only does banning organ sales turn rational people into criminals, it furthers criminal activity among black marketeers. Case in point, if a criminal knows he or she is going to serve what will amount to a life sentence for trafficking in organs, the only thing that will stop that person from kidnapping people and stealing their organs is a greater risk of being caught. Think about it- if you're a criminal who's going to go to jail for the legal maximum and your morals are already compromised, why not make the most of the time you have left before you get locked up? Also, if a patient spends $30k on a kidney that was promised by the organ trafficker to be a match, but it turns out the trafficker screwed them, it's not like that person is going to go the police to report the crime. Under this system, the organ trafficker is free to defraud anybody and everybody because those whom he defrauds have also become criminals. All this stuff is happening RIGHT NOW. This is the reality in which we find ourselves. For the sake of both donors and recipients, it is much wiser to let the government permit and then regulate activity that will occur regardless of whether it outlaws it or not. At least this puts some measure of quality control on the whole enterprise.

Letting supply and demand take its natural course isn't "grinding organs out of the poor". It's letting people make rational decisions to live their lives the way they best see fit. If you're starving on the streets and have a healthy body, what good does it serve to be dead with both kidneys intact? You act as if there aren't already plenty of venues for the poor to sell their organs for money. Why not grant them the human decency of allowing it to happen in a safe, controlled and regulated environment where they get their fair share of the reimbursement pie? It's draconian medieval moralists like you so eager to shove your morality down everybody's throat that you willfully blind yourself to the havoc your policies create. Who's the idiot here?

We all know you find the idea of people willfully selling their organs distasteful, you don't need to shove it down our throats. "It has proven that the middlemen--the illegal coordinators of bad foreign tissue make the money in the very few cases of successful matching. What about the money pilfered from sick patients—that doesn’t count with you? Most matching is extremely dangerous and questionable and most of the tracked cases resulted in death after tissue rejection." I agree with you 100% and that is why it needs to be regulated and not banned unconditionally. People will ALWAYS sell their organs for profit because people will ALWAYS pay high prices for healthy organs. If people get defrauded, they need to have legal recourse- which they are denied when organ sales are banned. "When poor people are used for body parts with the excuse that it will help them pay their bills, our society is lessened." Society is also lessened when people engaging in natural, human behavior that can be regulated, efficient and safe are turned into criminals and penalized by those sworn to protect them. What happens when marginalized groups are unable to access legal recourse? It's as if the law doesn't exist in the first place. In sum, my argument consists of this: Organs will always be sold as long as there are people willing to buy them. It's an unavoidable fact of life. The only question we really have to answer from a practical perspective is if we want these sales to be done in the context of an unregulated black market or if we want them to be disclosed, regulated and as safe as possible for all parties involved. I think you know what the only rational answer is...

Not a student of medical science are you my friend? Try to grasp something. Your point is moot, since by default even if your trafficking laws were eliminated, no healthcare entity on earth would implant a kidney taken from an uncertifiable resource outside the conventional system that has no strict protocal in place that will disallow donations that are even slightly questionable. Your insistence that somehow there is a whole bunch of people with clients lined up waiting to give away healthy kidneys, but are somehow straddled by regs and by people with enough medical knowledge to understand the ramifications of implanting mystry meat inside their patients is pretty far out there. That you want to separate my vast knowledge base in the field from the commonly held ethics that are the mantle of medical practices across the board is almost childish. But I will allow your argument to stand for the sake of debate and let's say your organ donation traffickers are allow to "flood the market". What medical facility or practice will allow unregulated and uncontrolled donations to be used inside their practice? None. This is because of the science of pathogens and disease processes which as I said, rule out 99% of potential donors. Can you fathom that by default of science, your idea is a failure, since no medical professional in their right monds would use potentially inappropriate tissue? Think about it. Squint if you have to. With a profit making element involved, the chances are greatly increased that without the INPLACE system for determining appropriate MEDICAL SCIENCE protocals have been gone through to be certain the tissue is not diseased, contaminated, clocked out etc. So the question comes down to will surgeons be willing to implant a kidney that may be rejected or contaminated? I am shoulder deep in the medical field and with 30 years of practice behind me I can asure you the answer is NONE. Your argument that seems solely based upon supply and demand fails to consider that the demand is for clean and appropriate tissue o-n-l-y. You want to believe you somehow represent more than a tiny few people who, as a last measure go abroad for highly risky donations in under controlled situations, but you do not. I work in this field on a national and international level and I can most certainly say with authority that it is an extremely tiny amount of people, and that overwhlemingly they die afterwards in spite of their efforts and for a variety of reasons, most of which have to do with bad matches. Would they be saved if donations were allowed to be brought into the system by entities outside the current system? Not unless those entities regulated and came up to par with the current system--which brings us full circle back to the suggest that the current system should be expanded through the efforts of people like yourself who are frustrated with the lives lost. No medical entity would touch less than stellar tissue. It is a simple concept. As for your suggestion that I am moralizing, may I remind you that the care of terminally ill patients for 30 years may afford me some insight into the broad ramifications of this subject as it is presented by the author. It is my profession to look out after the whole experience of patients as well as the system that helps. Your argument that throws out ethics in exchange for a business plan is all I need to know about your morals.

Unless you can state unequivically that you have an income and also have donated one of your kidneys inside the current system, I would have to say you are the idiot, since your argument does not hold water. The current system is available to you to donate, so are you? did you? Will you refute this because you have money in the bank and don't need to sell anything yet? If you lose it all, will you be down the next day to let them open you up, remove a kidney and sew you up again? How much cash will you expect? When you walk around do you look at people on the beach without scars across their backs from kidney donation surgery and resent them for being selfish if they look poor? Do you also hate people on welfare for taking money to feed their children when they should be going to your illegal organ grinders and giving up a kidney? Most people could also afford to lose one eye for cornea transplants, how about that? Do you hate people with two good eyes? Afterall, there are blind people who could use one. You are the moralist here, shoving your opinions and your sophmoric reasoning down our throats. So to answer your question about who the idiot is, it is you, clearly.