Freedom, Markets, and Well-being Fall 2019

Kidney Markets


Satz considers three arguments against kidney sales. Then she compares different ways of structuring markets for kidneys. Her conclusion is that some markets do more to address the concerns about kidney sals than others.

The three arguments are:

  1. Kidney markets undesirably restrict the options available to people: when it is possible to sell a kidney, lenders will demand kidneys as collateral for loans. She thinks that “people should not have to pay a cost for refusing to sell their body parts” on the grounds that “a person’s relationship to their body is so important that it should enjoy a special protection against the effects of market forces” (Satz 2008, 278).

  2. Inequality: kidneys are sold by poor people to rich people; the exchanges looks exploitative.

  3. Weak agency: the people selling the kidneys do not appreciate the consequences of doing so. Sometimes, they are forced to sell their kidneys by their husbands.

The markets are:

  1. Markets in supply and demand

  2. Markets in supply only (e.g. government is the buyer, distributes by need)

  3. Futures markets (payment and harvesting comes only after death)

  4. Matching markets (people who want to donate to specific patients but aren’t biological matches swap donations with similar people who are matches)

Here’s how it breaks down (+ = high concern, - = low concern)

Satz’s chart (Satz 2008, 285)
Weak agency Inequality Restricts Choice Sets
Markets in supply and demand + + +
Markets in supply only + - +
Futures markets + - -
Matching markets + - -

Our Discussion

Professor Brown said that futures markets raise agency problems too: you’re worth more dead than alive. This led to a discussion of what, exactly, an agency problem is.

Niyati wasn’t crazy about the reduced choice set argument. Why are body parts sacrosanct? That is, why is is to important to block people from having to make a choice between selling their body parts and going without a loan (say)? We let people do all sorts of other onerous things in exchange for money.

Gerald Dworkin’s article “Is More Choice Better than Less?” came up (Dworkin 1982). I put it on Sakai.


Dworkin, Gerald. 1982. “Is More Choice Better Than Less?” Midwest Studies In Philosophy 7 (1): 47–61.
Satz, Debra. 2008. “The Moral Limits of Markets: The Case of Human Kidneys.” Proceedings of the Aristotelian Society 108: 269–88.