Doing a good deed for a price; Sally Satel's mailbox on kidney sales

" “For the right price, yes, I would give up one of my organs to save someone’s life,” read the e-mail message, one of three dozen I received last month," writes Sally Satel in her latest NY Times op-ed A ‘Gift of Life’ With Money Attached.

She goes on to say "...if compensated donation were allowed, it would come to resemble surrogate motherhood. In some states, mothers who agree to carry a baby for an infertile couple are legally compensated for their time and for the risk they assume.
And while surrogate mothers surely welcome such payments, they are hardly the only factor in the decision; many say they are motivated by a strong desire to help another woman fulfill her maternal dream. At first, organ compensation, like surrogacy, would seem odd, but then it would become more generally accepted. "

The combination of altruistic motives and financial gain reminds me of the complicated way these issues are viewed. In Repugnance as a Constraint on Markets, I explored the very wide variety of religious opinion on this subject. In this connection I mentioned the view of Pope John Paul II that virtuous organ donations are transformed into immoral commercial transactions by the introduction of monetary payments. (Pope Benedict has reaffirmed this view.*) Other religious traditions view the matter differently. I noted the "... opinion of the eminent Rabbi Shlomo Zalman Auerbach that someone who sells a kidney with the intention of saving a life does a good deed “even if he would not have donated his kidney only to save life.” "

*The Catholic thinker Michael Novak argues that the Popes' views are consistent with some kinds of government compensation for donors, as proposed in draft legislation by Senator Arlen Specter: For Those Who Desperately Need Organ Donations. Novak writes
"Senator Specter's legislative action does two necessary things: (a) it blocks potential abuses by commercialization and international (or even intra-national) trafficking; and (b) it allows individual states to make concrete judgments about non-transferable, non-cash benefits to potential donors, providing these incentives fall within moral guidelines. Senator Specter's legislation establishes that the 1984 federal law prohibiting the commercialization of organs (that is, a sale between individuals or through a broker) does not apply to state governments, when they encourage organ donation through non-transferable incentives. These incentives are not "compensation," and they are not tradable."..."What Specter’s bill does is frame government benefits for donors as what they really are: gifts from the government in appreciation for the generosity of the donor. They are not intended inducements to donate. For John Paul II and Benedict XVI, the invention of appropriate incentives for more frequent donations of organs is a noble endeavor. The U.S. Congress and the several states should take thought about this important task."

(Novak remarks in the article that his views on this subject have evolved since he took part as a discussant in an American Enterprise Institute symposium on my paper on Repugnance, in January 2008. The symposium site has audio and video recordings of the proceedings.)

Uncompensated deceased donation is supported by most religions; here's a summary from the Louisiana Organ Procurement Agency..