response to this discussion. At a first

response to this discussion. At a first glance, I would say that the elasticity of demand for a patient in need of a kidney transplant is inelastic. Upon further observation, I think we find that this is not the case based on their being alternative treatment options (not curable treatments, but treatments nonetheless). Nearly 786,000 people in the United States are living with end-stage renal disease (ESRD). Of these, 96,315 were on the waitlist for a kidney transplant in 2022 according to Organ Procurement & Transplantation Network (OTPN). Of the total patient population with ESRD, 71% are on dialysis and 3.24% received a kidney transplant last year. There is of course an obvious supply and demand issue when it comes to organ transplantation, but I argue that the demand is not inelastic. If it were, we would see more than 12.25% of ESRD patients listed for a transplant. There are many criteria that must be met to be listed for an organ transplant, but there are many people that choose not to be listed because they are not willing to pay the price. Albeit at a lower quality of life, they choose to remain on dialysis rather than seek to be listed for a transplant. There are many factors as to why patients make this choice but from an economic perspective. I think the fact that they are not willing to pay any price (financial or otherwise) for a transplant makes the elasticity of demand somewhat elastic. I believe there is absolutely a moral hazard problem to paying individuals to donate kidneys. I’m a strong supporter of organ donation but also strongly believe that people should be afforded the opportunity to make informed decisions for themselves or their loved ones. I personally, do not believe that decision should be swayed by potential financial gain. I have personally spoken with many families about organ donation on the worst day of their lives. They have already lost so much and are in a position with so many things out of their control; introducing a potential financial reward adds complexity to an already chaotic time. While the financial incentive would certainly put many at ease who are trying to figure out medical bills and funeral expenses; I worry it may be trading one burden for another in the long run. Tainting such a deeply personal choice with money has the potential to have long-lasting mental, emotional, and/or spiritual consequences on that of the decision-maker. I must add that in the circumstances of deceased donation the certainty of organs being transplanted is not 100%. Organ procurement organizations do everything in their power to optimize the offer and get the organ to the right patient at the right place at the right time, but the transplant center still has to accept that offer. There are numerous variables in these situations, some based on medical decision-making but some out of everyone’s control. For example, based on all medical testing pre-OR a kidney may assume suitable for transplant but cancer somewhere else not previously detected may be found during the recovery. In this case, those kidneys would likely not be transplantable. Would the family lose out on the financial reward in that scenario? A (tragically) more common scenario is despite all best efforts the kidney can’t get to the accepting transplant center fast enough and an otherwise transplantable kidney is wasted. Would the family lose out on the financial reward in this scenario? For my reasoning in number 2, I think that selling your own kidney in a living donation scenario may be acceptable. Understanding the risks and benefits, and being able to make that decision for yourself is ethically acceptable in my opinion. I am honestly a bit undecided when it comes to a financial reward in a deceased donation scenario. Prior to reading the article, I was unaware of the potential economic reward and life-saving reward of paying for kidney donations. I am fascinated by the proposition and have no doubt it will be floating around in my mind for quite some time. I have considered living donation in the past and would do so again if I knew the person and was a match. To give up my kidney to a total stranger I would struggle more. The financial impact would certainly make me consider it more readily but I don’t know that $45,000 would be enough. You can only donate 1 kidney 1 time while living, for that I think I would be more motivated at a price closer to $100,000.

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