Thursday, August 4, 2011

Debate over kidney sales in Scotland

Here's a 4 minute interview on Radio Scotland from August 2011, on kidney sales, in which Sarah Toom talks to me about the debate there about whether payments to living kidney donors should be allowed, and other ways of increasing transplants (including kidney exchange).

The proximate cause was a proposal by Sue Rabbitt Roff, a senior research fellow at the University of Dundee, in the BMJ: "We should consider paying kidney donors."
Her proposal calls for a tightly regulated system with a standard payment to donors of around the current average Scottish salary (at which price transplantation is still a bargain compared to dialysis).

She concludes "So it’s time to begin to explore how to pilot paid provision of live kidneys in the UK under strict rules of access and equity. We need to extend our thinking beyond opt-in and opt-out to looking at how we can make it possible for those who wish to do so to express their autonomy in the same way as current donors are encouraged to do by making available a healthy kidney for a fee that is not exploitative.

The proposal has sparked a lot of British press coverage, e.g. here, and here, and here, and here. In each of the articles, the other reported comments are all negative. (I can't tell if British reporters work differently than American reporters and only solicited negative views to balance the proposal being reported as the main story, or if it is harder to find pro as well as con views in the UK.)
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Here are links to my previous blog posts on compensation for donors, and to my two papers that lead to unexpected calls on this subject from radio journalists in far places.

  • Roth, Alvin E. "Repugnance as a Constraint on Markets", Journal of Economic Perspectives, 21:3, Summer, 2007, pp. 37-58. 


  • Leider, Stephen and Alvin E. Roth, ''Kidneys for sale: Who disapproves, and why?'' American Journal of Transplantation , 10 (May), 2010, 1221-1227.
  • 2 comments:

    Paola Manzini said...

    As for negative coverage, I fear much has to do to with the fact that the BMJ article links the compensation to student loans:

    But if the standard payment were equivalent to the average annual income in the UK, currently about £28000, it would be an incentive across most income levels for those who wanted to do a kind deed and make enough money to, for instance, pay off university loans.

    As you noted in another post, university fees are going to be introduced in England from 2012/13, there is at least some discussion to do so in Scotland too, and the issue of student debt is hotly debated.

    I guess many newspapers couldn't miss the opportunity for a strong headline, and it is interesting to see how some have turned a statement of fact into more and more of an incitation, from the mild "Students could pay off debts by donating kidneys, says academic" in The Telegraph to "Hard-up students 'should sell a kidney for £28k to pay off debts'" on STV (Scottish TV), to the Scotsman's "Debt-hit students urged to sell their kidneys". Sad.

    Paola Manzini said...

    one point on the negative press - I think the fatal rethorical mistake in the BMJ article was to link kidney sales and student debt:

    But if the standard payment were equivalent to the average annual income in the UK, currently about £28000, it would be an incentive across most income levels for those who wanted to do a kind deed and make enough money to, for instance, pay off university loans.

    As noted in one other of your posts, university tuition fees are coming to England, and there are discussions regarding introducing them in Scotland too - the debate on student fees and the consequent debt is still hot over here in the UK, and my guess is that most newspapers couldn't let the connection go by unused.

    Depending on which newsource you look at, the original statement is portraied as the still mild "Students could pay off debts by donating kidneys, says academic" in The Telegraph to "Hard-up students 'should sell a kidney for £28k to pay off debts'" on STV (Scottish TV) to "Debt-hit students urged to sell their kidneys" in The Scotsman. Sad.