Organ Donation for Compensation, For Serious

Organ Donation for Compensation

Last week, we posed a question you probably don’t hear every day: would you “donate” a kidney to the tune of $1 million? Your responses were really fun to read. Some were appalled that anyone would even consider taking cash for organ donation. Others were appalled that more people weren’t jumping onto the operating table to collect the handsome reward. And while the post was meant as a completely hypothetical situation that none of us will likely find ourselves confronted with, the topic of organ/tissue/etc. donation is clearly a serious topic that hits home to many.

A few weeks ago, we were indulging our nerd-selves by catching up on a few 60 Minutes and Rock Center episodes saved on our DVR. One particular story on Rock Center really captured our attention and we found ourselves discussing it throughout the week. We thought it’d be interesting to let the discussion to spill over onto the blog to hear your thoughts.

The Story

Here’s a brief synopsis of the story. A single mother’s three daughters all have a rare blood condition that requires a bone marrow transplant for their survival. Only 30% of those needing a transplant will find a match within their own family, leaving the remaining 70% to find a match from a stranger on donor lists. The problem is that even if a match is found on the donor list, only 50% of those people ever fulfill their commitment to donate when a match is found. Some don’t want to give up their time, others think it’s too big of a hassle, and others simply don’t respond. To help find willing donors for her children, this desperate mother challenged the federal government’s ban on compensating donors. The woman’s lawyer argues, “Bone marrow is just like anything else in the world… it’s valuable. And if you compensate people for it, you’re going to get more of it, it’s just that simple.” In March, she won her legal battle, making compensation to donors legal so long it’s in the form of coupons or goods (not money).

If you’re interested, you can read/watch the story here, but that’s the gist of it. There’s two sides to every story and those opposed to compensating say that it’s unnecessary and that altruism — not money — should be the motive for donating. And while this particular story only touched on bone marrow, this debate can also extend to other organ donations.

Our Take

This won’t be a future He Says/She Says topic, because Joanna and I pretty much see eye-to-eye on the issue. In the case of the story we shared, we absolutely think those searching should be able to compensate donors to incentivize and expedite match transplants. There’s definitely a role for regulation and setting maximum compensation amounts to avoid bidding wars and ensure fair access to all income classes. And while we’d love for altruism to be the motive in all donation scenarios, bone marrow is bone marrow is bone marrow, and if you need it, you should be able to do more than just rely on altruism.

Bone marrow regenerates so it’s in a different league than, say, kidney donation. This would likely require even more stringent regulation, but we still think the point remains: if allowing donors to be compensated means more people receive the organs they need, it’s something worth considering. But scientists will probably be growing organs out of test tubes soon, so in all likelihood (and hopefully) this whole post will be moot in a few years.

What’s your take? Yay or nay on compensation for organ, blood, marrow donation? And if you’d like to find out more information on registering as an organ or bone marrow donor, visit

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  • Reply Tara May 23, 2013 at 8:32 am

    I strongly disagree with compensation for organs because of the possibility for folks being taken advantage of. A low income person who is in one of their worst lows could be swindled into selling their kidney if they think that’s their only option for getting some money. And for folks where say, type 2 diabetes runs in their family, that $2,500 or whatever they got to help them out of a rut 10 years ago may end up hurting them in the long run when they have to go on dialysis early with one less kidney. And when it comes to a low-income recipient, I could see many of the higher income folks, not just in the US, but across the world taking advantage of a for-sale organ situation, only further hurting low-income folks from getting access to needed organs. I live in a city where corruption is in the cities history and I know this would easily be abused by all the rich people who can get access to US passports even if they put citizenship requirements for organ sale recipients.

    With regenerative tissue, like bone marrow, I’m with you on that. But there are some super-shady people out there who prey on people when it comes to money and it just scares me thinking of the people who can be taken advantaged of when it comes to their organs.

    • Reply Joanna May 24, 2013 at 10:14 pm

      You bring up some really good points, Tara. The only way compensation could work in any sense would be with lots of safeguards so no one was swindled. I don’t see any harm with bone marrow, but I’m with you with organs… I don’t know that there’s a way it could ever work.

    • Reply Ahiloh February 8, 2016 at 2:42 pm

      I would be a bone marrow or kidney transplant candidate for the right amount of money.. shilohdoak@gmail

  • Reply Emory May 23, 2013 at 9:54 am

    I had some pretty strong feelings about organ and tissue donation before now. But after reading some on the website linked above and listening to the story of that woman and her daughters I have mixed feelings.

    I think that in an ideal world people would donate because they can and share with others what they don’t possess – health. But since we don’t live in a world where this always happens compensation sounds great, right? But I like the points made by Tara about low income families. In a free market type system those who can afford to pay will, and those who can’t won’t get the transplants. Or will get left overs. But in a highly regulated system like what we are working with now donors are backing out and not following through. I don’t know that there is a simple answer to the questions you posed. It’s almost like picking the lesser of two evils when it comes down to it. I don’t support socioeconomic inequality that would come with a system of compensation, but I also hate to hear stories of people losing their health, family members, or children to horrible diseases that were beyond their control. Maybe one day a system can be created that makes the donation process more accessible to donors across the board (i.e. takes less time, possible compensation for missed work, etc.).

    That was a lot of words to say, “not really sure where I stand on that, but it’s a wonderful question.” And I am sure I would have a completely different perspective if I had a family member who was desperately needing a transplant of some kind.

    • Reply Joanna May 24, 2013 at 10:25 pm

      I think I know just what you mean, Emory. There are so many factors to consider that it’s not a simple “yes” or “no” answer. The way things work now is obviously flawed, but it’s hard to know what could make it better. I do like your idea of compensation for missed work and other incentives. I think there are plenty of people willing to donate and help, but it’s just about being too busy or needing an extra little nudge to actually make it happen!

  • Reply Brian May 23, 2013 at 10:43 am

    If you can donated eggs/sperm/blood for money I don’t see why marrow is a problem. Besides even before it was “legal” to compensate them for it, it isn’t like there weren’t people getting some cash under the table for this anyways.

    • Reply Joanna May 24, 2013 at 10:38 pm

      When it comes to marrow, I really don’t get what the problem is, especially when people’s lives are at stake. But I do think there should be some guidelines as to how the compensation can happen.

  • Reply Jake Erickson May 23, 2013 at 11:24 am

    This is an interesting debate. I think that donors should be allowed to be compensated for a donation just because they are normally taking a decent risk donating in the first place. I agree that it shouldn’t turn in to a bidding war, but a little compensation would be nice.

    • Reply Joanna May 24, 2013 at 10:39 pm

      Yeah, I’m not sure there’s a simple solution, but I agree that some changes to the current system could definitely help.

  • Reply Well Heeled Blog May 23, 2013 at 11:45 am

    This is a hard question… I can see both sides, but I also see the ripe areas of abuse. Maybe all the dystopian books/movies about the dangers of organ donation for compensation have colored my views. It’s undeniable that the current system fails many people who need organs, but I don’t know if cash compensation is necessarily the answer.

    • Reply Joanna May 24, 2013 at 10:43 pm

      As far as organs go, I’m not sure what the answer is either. I mean, it’s a pretty big deal to give up an organ, and adding compensation to the mix seems like it would be playing with fire! But when it comes to bone marrow, I think some incentive would help the current situation.

  • Reply Chris May 23, 2013 at 12:02 pm

    Like with anything, if people want it they will get it regardless if the government tells them no. The black market for human organs isn’t just in the movies, it’s real.

    I am completely for an open organ market. Since I’m a cold-hearted conservative I also think that if someone makes the choice to sell their kidney because they are poor, it’s their choice. We all make choices be it to sell a kidney or get into credit card debt. Dealing with those consequences are part of life.

    • Reply Joanna May 24, 2013 at 11:02 pm

      Johnny and I also tend to be of the mindset that adults can make up their own minds. That said, I can’t imagine there being some form of regulation with donating organs (although, this one of few areas where we would ever advocate for stricter regulations :)).

  • Reply Nicole May 23, 2013 at 12:39 pm

    No easy answers for this one. I think the current altruism system doesn’t work, because while people may want to help, there’s a risk and a financial cost to them. For many, there’s no paid time off and of course, no compensation for the risk they’re taking. Any surgery has risks. While I donate blood and am a registered organ donor, there’s a very short list of people I would do a living donor transplant for, because of the risk to my health. It’s self-preservation. I’ve also seen people in my community wait for years for a transplant – and die waiting.

    I think that it’s a slippery slope and the potential for abuse is there. At the same time, I think organ donation for money already happens – a lot more than we think it does. I wonder if there isn’t a middle ground. Allow compensation for donation from the wealthy recipients who can afford it, which reduces the number of people waiting for donation/organs. However, part of that compensation, say 10%-20% or so is placed in a fund that provides compensation for donors who don’t want to be paid, but can’t afford to donate otherwise. This would be similar to paid time off. Obviously, this would require a lot of regulation and oversight, but I think it has the potential to save more lives and reduce health-care costs over the long term.

    Just a thought…

    • Reply Joanna May 24, 2013 at 11:08 pm

      You have some great thoughts, Nicole! With organ donors, there’s a huge risk, so some sort of incentive is definitely worth considering. And I really like the method your propose. Obviously it’s not something that could be made foolproof overnight. But your idea makes me much more inclined to think there are ways to make it work!

  • Reply Mrs PoP @ Planting Our Pennies May 23, 2013 at 1:33 pm

    I think I mentioned this on your previous post, but I’m registered in the donor pool at It’s my understanding that if I’m a match, I’ll be contacted and given the opportunity to donate. While there will be discomfort, there aren’t huge risks to donate, and all the costs for my health care would be paid for by the recipient (or their insurance ). It doesn’t take a whole lot more than that for me to see wht good can come of registering for a minimal downside.

    I donate hair for locks of love, and do a lot these things because I’m physically unable to donate blood. I guess I’m trying to pay it forward in case I ever need a donation.

    Should pay be involved? I’d probably be okay with lost wages for time or something, but beyond that the risks for predation seem pretty high.

    • Reply Johnny May 24, 2013 at 11:06 pm

      Thanks to a comment below, I should be receiving a kit in the mail in a few weeks so that I can be thrown into the pool. It was an easy enough process and researching all of this gave me no excuse to not sign up.

      And while I didn’t need to be compensated to start the process of registering, I don’t think it’d hurt to throw a little incentive out there for those who aren’t motivated to register.

  • Reply Grayson @ Debt RoundUp May 23, 2013 at 3:06 pm

    This one is hard to debate because both sides can justify themselves. I think that donors should be compensated and you will increase the amount of donations. On the other hand, there will be many that take advantage of those and it will create problems. six in one hand, half a dozen in another.

    • Reply Johnny May 24, 2013 at 11:02 pm

      So long as there are more organs donated and lower-income folks aren’t at a disadvantage, I think everyone wins.

  • Reply Meghan May 23, 2013 at 4:48 pm

    I hear ads all the time that offer $5000 for a woman’s eggs. Of course that kind of money is appealing to lower-income people AND they have a kid running around. My guess is that knowing you have children running around would be unnerving. You’d wonder if every little one who looks slightly like you is from your egg.

    At least with bone marrow donation, there’s aren’t kiddos! My step-dad is about to have a bone marrow transplant. As a white male, his chances of finding a match were good, and there were 4 matches. The donor is a 39 year old and he has already agreed to donate. How generous! Unfortunately, if my sd was African American or Asian, he’d wouldn’t have had four matches. He would be extremely blessed with one, and that one may not have been the best match. There is a serious shortage of minorities on the list, around the world.

    While I understand that we wouldn’t want to make organ donation a big business, we pay for eggs, sperm, plasma, hair, etc, and I don’t think that compensating for replenish-able life-giving items should be prohibited. I do think that there should be a limit, or we could have a situation where lower-income Americans would be excluded.

    PS – I am registered with Be the Match and would not personally want to be compensated, but maybe that’s because someone I love’s life depends on a successful donation.

    • Reply Johnny May 24, 2013 at 11:00 pm

      I’m with you on egg/sperm donation. Sorta creeps me out to think of little me’s running around without me knowing about it. I’d consider it if it was someone close to me.

      Congrats on your step-dad’s finding a match! That’s great to hear! And thanks for passing along the group your registered with. I actually just took 10 minutes to register and they’ll be shipping me a kit in a few weeks. Thanks for the heads up.

      And thanks for sharing your story!

      • Reply Meghan May 24, 2013 at 11:04 pm

        Yay, thanks for registering, Johnny! 😀

        Also, excuse the typos above. I don’t pay attention sometimes.

  • Reply Brittney May 23, 2013 at 7:05 pm

    Honestly, I wouldn’t think twice about people being compensated for bone marrow. It seems like a close relative of blood products. People are paid for giving plasma and no one bats an eye. There are plenty of incentives to donate blood too, in our office, if you gave blood every 12 weeks you were given additional vacation days. You can bet people were lined up for donation!

    I would definitely draw the line at paying for organs though. I think that could get out of hand quickly and a lot of people could be taken advantage of.

    • Reply Miranda May 24, 2013 at 4:20 pm

      I would totally have to agree. I think anything that would replenish should be eligible for compensation, but to draw the line at organ donation.

    • Reply Johnny May 24, 2013 at 10:34 pm

      Good answer, and I think the sensible side of me agrees with you 100%. My work also gaves us vacation days for donating blood, so I always made it a point to give up that red stuff. Part of me still thinks that regulation could make organ selling work, but I realize that’s a longshot.

  • Reply Maya Symone May 23, 2013 at 7:32 pm

    I can see both sides of this debate and how they might justify it. People are going to sell organs under the table for cash and if making it legal means that people sell theirs when they’re in a tight spot, well that’s all their own doing. Actions have consequences.
    I personally would be compensated for bone marrow but never for organs, because I’m not giving them away. It may sound harsh, but I have two kidneys for a reason, and I’m not giving them away that easy.

    • Reply Johnny May 24, 2013 at 10:25 pm

      I agree. Bone marrow is free for all. Organs? I’m saving those for myself or my children. Maybe other family members, too. And if it ever did become legal, I’m sure the max. price allowed for the transaction wouldn’t get close to wetting my greed ($1 million+).

  • Reply Diane May 23, 2013 at 7:37 pm

    As a parent, I would move heaven & earth to get whatever my child needed for his/her health… including bone marrow. I would pay for it, if necessary.

    That said, I think the ethical problem is that if you start allowing payment for bone marrow or a kidney, for example, then people will expect to be paid. This creates a situation where only wealthy people get what they need. Why would I donate bone marrow, if I could get paid for it… especially if I need the money?

    There could potentially be bidding wars, where wealthy people offer higher payments to get what they need! I think this is one of the reasons why organ donations are so tightly controlled… How would you feel if your extremely ill child could not get what they need, because you can’t come up with as much money as the family next door?

    • Reply Johnny May 24, 2013 at 10:21 pm

      I totally see eye-to-eye with you on the bidding wars issue. I think maximum amounts would have to be set. But I also think that many organs would still be donated without compensation.

      And in the current system, wealthy folks do actually have an advantage. Many states run their own waiting lists. When Steven Jobs was seeking a liver transplant, he enrolled in each respective state’s waiting list by flying all over the country since it was required to do it in person. Obviously it required a lot of effort and money to make that happen. Money that middle-class folks simply don’t have. And in Steve Jobs’ case, he was able to get a liver much faster than the normal waiting list-er.

      It’s all to say that there will always be ways for wealth to play an advantage. But if compensation opens up more donated organs, I like that outcome.

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