Addressing the Shortage of Kidneys for Transplantation: Purchase and Allocation Through Chain Auctions

57 Pages Posted: 1 Aug 2011 Last revised: 8 Aug 2011

See all articles by Lara Rosen

Lara Rosen

University of Wisconsin-Madison

Aidan Vining

Simon Fraser University

David L. Weimer

University of Wisconsin - Madison - Department of Political Science; University of Wisconsin - Madison - La Follette School of Public Affairs

Date Written: 2011

Abstract

Transplantation is generally the treatment of choice for those suffering from kidney failure. Not only does transplantation offer improved quality of life and increased longevity relative to dialysis, it also reduces End-Stage Renal Disease Program expenditures, providing savings to Medicare. Unfortunately, the waiting list for kidney transplants is long, growing, and unlikely to be substantially reduced by increases in the recovery of cadaveric kidneys. Another approach is to obtain more kidneys through payment to living “donors,” or vendors. Such direct commodification, in which a price is placed on kidneys, has generally been opposed by medical ethicists. Much of the ethical debate, however, has been in terms of commodification through market exchange. Recognizing that there are different ethical concerns associated with the purchase of kidneys and their allocation, it is possible to design a variety of institutional arrangements for the commodification of kidneys that offer different sets of ethical concerns. We specify three such alternatives in detail sufficient to allow an assessment of their likely consequences and we compare these alternatives to current policy in terms of the desirable goals of promoting human dignity, equity, efficiency, and fiscal advantage. This policy analysis leads us to recommend that kidneys be purchased at administered prices by a non-profit organization and allocated to the transplant centers that can organize the longest chains of transplants involving willing-but-incompatible donor-patient dyads.

Keywords: transplantation, commodification, organ donation, policy analysis, End-Stage Renal Disease Program

JEL Classification: I10,I18

Suggested Citation

Rosen, Lara and Vining, Aidan and Weimer, David L., Addressing the Shortage of Kidneys for Transplantation: Purchase and Allocation Through Chain Auctions (2011). APSA 2011 Annual Meeting Paper. Available at SSRN: https://ssrn.com/abstract=1901059

Lara Rosen

University of Wisconsin-Madison ( email )

Aidan Vining

Simon Fraser University ( email )

8888 University Drive
Burnaby, British Columbia V5A 1S6
Canada

David L. Weimer (Contact Author)

University of Wisconsin - Madison - Department of Political Science ( email )

1050 Bascom Mall
Madison, WI 53706
United States
608-265-3233 (Phone)

University of Wisconsin - Madison - La Follette School of Public Affairs ( email )

1225 Observatory Drive
Madison, WI 53705
United States

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