Felix Salmon, at Bloomberg, reviews Moral Economics

  Felix Salmon, at Bloomberg, reviews Moral Economics, which starting today is now sold in stores (at least in the U.S.):

An Economist’s Case for Selling a Kidney.  In a new book, Nobel laureate Alvin Roth argues that decriminalizing taboo markets can save lives.  

He tells this story from the book:

"Roth gave a talk in 2017 at the Organ Donation Congress in Geneva about one such chain that started in 2015. A woman from the Philippines, known in the literature as FW, was willing to give up one of her kidneys to save the life of her husband, FM. The two flew to the US, where FM received a kidney from an altruistic donor in Georgia, and FW’s kidney was transplanted into a man in Minnesota. A friend of the Minnesota man, who had been willing to give up one of her kidneys to save his life, instead gave one to a man in Washington, whose father-in-law gave a kidney to a woman in Georgia, and so on. By the end of the year there had been 11 successful transplants, and the chain was still continuing.

" After his talk, Roth was confronted by a Spanish doctor who was deeply concerned about the potentially problematic implications of the economic inequality between the Philippines and the US. Roth pointed out that without the transplant, the patient would surely have died. Replied the Spanish nephrologist: “He should be dead!” Spain’s National Transplant Organization later denounced Roth as an organ trafficker.

"Roth tells this story in his most recent book, Moral Economics (Basic Venture, May 12), which, at least in part, is an attempt to apply the empiricism of economics to domains that are often resistant to such analysis. The opposition to the 2015 kidney chain, for instance, comes from nephrologists who have no problem with chains but who draw the line at international chains, or at least chains linking poor and rich countries."

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Much of the objection to cross-border kidney exchange appears to be fading, some of it was based on the idea that countries should be self-sufficient in transplants.

See earlier posts:

Friday, January 9, 2026  WHO Says Countries Should Be Self-Sufficient In (Unremunerated) Organs And Blood by Krawiec and Roth (now open source)

 

Friday, September 11, 2020  Global Kidney Exchange supported by the European Society of Transplantation's committee on Ethical, Legal, and Psychosocial Aspects of Transplantation .

Abundant, the movie about nondirected kidney donors, is now available for streaming.

 Abundant, the movie about (mostly) non-directed (mostly) kidney donors (but also some livers), is now available for streaming.

You can get it at https://abundantmovie.com/ 

You can see all my posts about the movie Abundant here. 

Kidney donation, in today's NYT

 Here's an article and an argument from a nondirected kidney donor, in today's NYT

 Want to Make a Difference? Donate Your Kidney.  by German Lopez, Feb. 2, 2026, 

"Nearly 50,000 people in the United States die each year because there are not enough kidneys for transplant, which adds up to more than double the number of annual murder victims. Hundreds of thousands more are on dialysis, a lifesaving but time-sucking and physically draining treatment. Humans need only one kidney to live, but we have two. Giving away my kidney, to a 23-year-old woman I didn’t know, has been the most fulfilling experience of my life.

...

"The chain is a wonderful, and fairly recent, innovation that has allowed many more people to get lifesaving transplants. Imagine three people — Patients A, B and C — need kidneys. B’s and C’s spouses are willing to donate, but Spouse B is a match for Patient A and Spouse C is a match for Patient B. They all agree to pull the trigger if a donor can be found for the remaining patient, C. An undirected donor can come in at that point to complete the chain of donations. The largest chain on record led to 126 transplants.

...

"I also learned about some of the health care system’s absurdities. As a gay man, I could donate my kidney but not my blood. The government prohibited blood donations from sexually active gay men until 2023, thanks to outdated fears about H.I.V. My kidney was fine, although the doctors had to inform the receiver that it was “higher risk.” Thankfully, the threat assessment did not deter the recipient from accepting my gay kidney.

...

My donation felt like a rejection of the day’s politics — and not just because it required overcoming some light homophobia. It felt like an act of defiance; I was plugging a small hole in a porous health care system while our leaders’ proposed cuts to Obamacare and Medicaid attempted to open a chasm."   

Heroines of organ donation

Last week I had the opportunity to see a screening of the movie Abundant, about non-directed organ donors, who have donated organs to strangers.  Here is a snapshot of me and two of the donors who tell their story in the film, Laurie Lee and Laura Diaz Moore.  They are both pretty inspiring.

 

 See also this story.

The End Kidney Deaths Act is reintroduced to the 119th Congress

 Resolved: lets be generous to nondirected kidney donors

H.R.2687 - To amend the Internal Revenue Code of 1986 to provide a refundable tax credit for non-directed living kidney donations.
119th Congress (2025-2026) |
Sponsor:    Rep. Malliotakis, Nicole [R-NY-11] (Introduced 04/07/2025)
Committees:    House - Ways and Means; Energy and Commerce 

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Earlier

Tuesday, January 21, 2025 The debate over compensating organ donors is heating up

Tuesday, August 13, 2024 End Kidney Deaths Act intoduced in Congress

 

 

Kidney exchange chain at Ohio State--a gift transforms 20 lives

 Here's a recent big kidney exchange chain, begun by a nondirected donor, involving patient-donor pairs all at OSU's medical center

The Columbus Dispatch has the story. (If I had written the headline, it would have said "transforming 20 lives," since many of the donors I've met have also been transformed.)

Ohio State Wexner sets record-breaking kidney 'donation chain,' transforming 10 lives   by Samantha Hendrickson

"On Dec. 13, Samantha Fledderjohann donated one of her kidneys to a stranger in need, and in the process, transformed 10 lives.

The 46-year-old was the first of a record-breaking "chain" of 20 surgeries over a two-day period at the Ohio State University Wexner Medical Center Comprehensive Transplant Center, both to remove and transplant kidneys from 10 living donors to 10 recipients. That means 10 people now have another chance to live more of their lives better and longer with a healthy kidney.

...

"The transplant swap begins with an "altruistic non-directed" donor like Fledderjohann, who saw a need for more kidney donors, and felt an internal pull to donate even without someone in mind

...

"The "chain reaction" continued, thanks to individuals like Carnahan staying on OSU's donor list despite not being a match for a loved one, instead extending that offer to a stranger in need.

...

"According to the Organ Procurement and Transplantation Network, there are 104,840 people on the transplant waitlist and 90,506 need a kidney in the United States, and 2,079 of them live in Ohio. Ohio State’s transplant center has performed more than 8,500 kidney transplants since 1967."