The 4 principles of ethics are beneficence (The duty to do good and help others achieve their best health.), nonmaleficence (“do no harm”), autonomy (The right of a patient to make their own decisions about their care), and justice (The duty to treat all people equally and fairly, without discrimination). The End Kidney Deaths Act upholds all four principles.

Many bioethicists have voiced their support for compensating kidney donation through tax credits.

  • Luke Semrau, Professor of Philosophy at Bloomsburg University, kidney donor

There are literally more than 300,000,000 kidneys in the United States alone. For decades, we’ve tried asking people to donate them freely. Those efforts have decisively failed. Every year thousands of people die perfectly avoidable deaths, and countless more endure needless suffering. This is what the present policy delivers. But there’s an alternative.  

A carefully designed system for compensating kidney donors would benefit virtually everyone involved. Those who receive a kidney would clearly benefit, enjoying longer, healthier lives. Those who provide a kidney, because fairly compensated, would also benefit. And those who would have provided a kidney under the present policy, would benefit when their intended recipient receives a transplant from a compensated donor instead. Indeed, even the taxpayer would benefit. This proposal comes at a fraction of the cost we pay for the present system. 

Rarely do we contemplate such an easy choice. The use of compensation for kidney donors is a moral imperative. 

  • Peter Jaworski, Professor of Strategy, Ethics, Economics, and Public Policy at Georgetown University

It should be uncontroversial that if we can save lives with relatively low risks to others, we should. Kidney donations save lives and typically involve relatively minor risks to healthy donors. That is a reason to encourage donation however we can, including by compensating donors. 

The status quo of treating all compensation as morally impermissible is as grievous a moral error as anything else that prevents us from saving lives when we can.

  • Justin Tourigny, Bioethics Student at Harvard University, kidney donor

For over forty years, committed and concerned doctors, ethicists, activists and citizens have stressed the moral imperative we have to save tens of thousands of lives every year (and tens of millions of taxpayer dollars spent on poor health outcomes). Over that time, the stakes and cost to patients and to society have increased, while the risks to donors have continually decreased.

We owe it to our family, friends and neighbors to act; compensation of donors through a highly regulated system is the best way forward.

  • Janet Radcliffe Richards, Professor of Practical Philosophy at the University of Oxford

It is easy to understand the disgust that followed the discovery that kidneys were being bought and sold, and horror at the current flourishing black market. But it was a serious mistake to conclude that all reward for donation must be wrong in principle. Total prohibition is not only preventing our investigating policies that might save many thousands of lives every year.  It is also in direct conflict with our basic rights of freedom and respect for autonomy.

  • James Stacey Taylor, Professor of Philosophy at The College of New Jersey

    In an ethically complex world it is rare for there to be a clear solution to a pressing social issue. A policy of compensating people who give up a kidney to save the life of someone who needs one is such a clear and moral solution to the problem of the current shortage of transplant kidneys. Not only would this policy save the lives of people who would otherwise die, it would also improve the lives of those who gave up part of themselves so that another might live. We should have no moral qualms about instituting such a policy--indeed, morality demands this.

  • Dr. Frederike Ambagtsheer, Principal investigator of organ trafficking research projects at Erasmus University Rotterdam; MSc in Criminology from Erasmus University Rotterdam; LL.M in Public International Law from Leiden University; PhD on Organ Trade, Editorial board member of Transplant International since 2021

    After 2 decades of studying black market abuses amidst an ever-increasing organ scarcity, I can only conclude that the trade is proliferating globally, despite its prohibition. This prohibition does little to protect donors and patients. Instead, in many parts of the world, it has increased the risk of concealment, exploitation and medical malpractice amongst the world’s most vulnerable populations. We owe it to them, to at least TRY and TEST whether a government-controlled incentivized system for organ donation leads to better outcomes, especially when the public supports it. For this reason, I support the US End Kidney Deaths Act.

    *************************************************************************