Organs: Opting In or Opting Out

The solution favored by many economists — a market in which organs can be bought and sold — is “spectacularly unpopular.” But why?

Why, for example, is it O.K. for a parent to donate a kidney to save a child’s life but not for her to sell her kidney, thereby also saving a life? And why is it acceptable to risk your life for money, say, by becoming a coal miner, but not by selling a kidney?

Maybe there is another way. The current default rule on harvesting organs from deceased donors is “opt in.” You are presumed to withhold consent unless you explicitly give it. But in some countries you are presumed to give your consent unless you explicitly “opt out.” The default rule makes a difference.

In Germany, which uses an opt-in system, only 12 percent give their consent; in Austria, which uses opt-out, nearly everyone (99 percent) does.


Bach’s Organ


Comments (4)

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  1. Bart Ingles says:

    And then there’s the organization– I think it’s called Life Donors or something similar– in which members consent to donation in such a way that other members get preferential treatment (i.e. “first pick”). My only reservation is that non-members who have signed consent forms don’t seem to qualify for the preferential treatment. But I could be wrong about that.

  2. Bart Ingles says:

    Sorry, it’s called Life Sharers:

  3. Vicki says:

    Nice musical pairing.

  4. Devon Herrick says:

    The prohibition against compensation for organ donation at time of death is ludicrous. Currently, families bury organs worth tens of thousands of dollars during the typical funeral service. I believe more people would be willing to donate organs if the compensation was sufficient to pay funeral expenses. Each donated organ generates thousands of dollars in profit. But none of it accrues to the original owner’s family. You could almost argue that organ donation is controlled by a cartel – with an incentive to keep prices high and costs low. How could a cartel accomplish this? By backing laws prohibiting families from sharing in the monetary gain; and by removing the incentive for families to donate organs. This creates a scarcity that drives up the cost insurers and government must pay organ banks for donor organs.