When capitalism meets medicine, questionable yet lucrative markets creep around the corner, sparking the ethically challenging “that would be crazy, but what if” thought. The economy has the drive of an unyielding animal, enticed by profit and uninhibited by ethics or law; in other words, where demand goes, supply follows. With 100,000 people in need of a kidney transplant, America must employ its beloved capitalistic instinct to buy and sell, or else opportunists around the world will continue to exploit this demand with the fruits of the black market.

The development of a black market often begins with the development of a governmental prohibition—in this case, the National Organ Transplant Act. Despite the unlawfulness of selling organs in the United States, the donation sector still provides some access to physiologically derived goods such as blood, plasma, bone marrow, hair, skin, eggs, sperm, and even parts of livers, lungs, and pancreases. However, in resuming to the premise of the demand for kidneys alone, the American donation market only provided 11,570 kidneys in 2014, leaving roughly 89,000 humans without a transplant. This drastic shortage only worsens when considering that the waiting list receives an additional patient every 14 minutes, while, simultaneously, 13 people die each day awaiting a life-saving kidney transplant.

In the time it takes grandma to go up the stairs, approximately one kidney transplant takes place every hour in the black market—or about 10,000 illegal transplants annually. Additionally, those purchasing the kidney and looking for a few more years of quality life undergo unregulated and dangerous transplants and pay an average of $150,000 per kidney.  

However, the underground surgeries and the inflated prices in the black market do not even begin to summarize the victimization and exploitation that results from illegal kidney transplants. Studies found that patients may travel to China, India, or Pakistan for surgery and pay $200,000 for a kidney—a kidney sold on the black market for approximately $5,000—consequently under-buying those desperate enough to sell their kidney and over-charging those looking to preserve their life with a transplant. Without the legalization and regulation of an organ market, imperative parameters such as price ceilings, price floors, insurance guidelines, and Food and Drug Administration (FDA) principles will not protect these patients.

The ethics at hand do not offer enough severity to debunk the need for a legal organ industry. Marketing physiologically derived products, such as those previously mentioned, does not necessarily introduce a new concept, but rather a more scientifically advanced opportunity to capitalize on the human body. The U.S. currently allows people to sell certain bodily derivatives for profit, such as blood, plasma, hair, bone marrow, surrogacy, skin, sperm, eggs, and the body itself as a research subject. Of course, the body does not reproduce kidneys like it does plasma, sperm, eggs, and hair, however, a healthy human can live an equally fulfilling life with only one kidney and a hefty compensation for the sold one. Since this editorial looks to hypothetically explore a fascinatingly controversial concept rather than to push for a feasible implementation of selling organs, one must have an open mind when reading, not one swayed by ethics and fear.

In opening a legal organ market, a lucrative branch fusing the economy and medicine will grow, while simultaneously catering to thousands of those on the transplant waiting list. However, with the good comes the bad. A new insurance sector would have to develop when considering that a legal transplant costs a total of $260,000—with a donated kidney, not a purchased one. Consequently, this will result in the painfully overplayed “this only works for the rich” argument. The extreme prices of legally purchasing a kidney will inevitably alienate those who cannot afford the transaction, but this should not inhibit the possibility of this new market. To prohibit the sale of a life-saving product simply because of its cost not only flirts with immoral socialist ideals, but also tears away the possibility of survival to those who can afford it.

Obviously, one of the most sensitive, circumstantial, and complicated dilemmas will arise with the market of kidneys: donations. Will donors drop philanthropy and rush to the price tag? Will a deceased organ donor’s family receive compensation? To concisely address this conflict will do it little justice, considering its gravity and complexity, so for now, it will remain among the infinite “what if” questions left unanswered.

Innovative ideas never stay in an era’s comfort zone, and they always challenge the principles of the common person. To merely discuss and dissect controversial concepts may spark the commencement of a revolutionary industry waiting for progressive minds and effective thinkers to act.