Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Viewpoint
  • Published:

Losing the kingdom: the case against commercial organ donation

Nature Clinical Practice Urology volume 4, pages 290–291 (2007)Cite this article

“A horse! A horse! My kingdom for a horse!” Richard III, Act V scene iv, William Shakespeare

After years of vying for control of England, King Richard III would have traded his crown in an instant for a horse to spirit him away from certain death in the Battle of Bosworth Field. Uttered by the monarch after his own horse had been wounded, these words have long fascinated us, because they serve as a reminder that context is an important market force: it determines the value of all things one may buy or sell. The king's words could apply to a living-donor organ exchange based on a financial, rather than an altruistic, arrangement. Just as a wealthy, but unhealthy, individual might surrender all material goods for a life-saving organ, so might a person in dire financial straits trade an organ for temporary financial security. Shakespeare's reminder that context governs value is relevant not only to the mindset of parties to an organ sale, but also to the whole transplantation community. Were it not for the context—a continuing dearth of transplantable organs—we would hardly doubt that the sale of organs is unethical and the practical implications dire. Context, therefore, determines not only the market value of things, but also the values that govern the market.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Ojo AO et al. (2002) Trends in cadaveric organ donation in the United States: 1990–1999. Clin Transpl 16: 105–109

    Google Scholar 

  2. Fehrman-Ekholm I et al. (2000) Kidney donors don't regret: follow-up of 370 donors in Stockholm since 1964. Transplantation 69: 2067–2071

    Article  CAS  Google Scholar 

  3. Medical Professionalism Project (2000) Medical professionalism in the new millennium: a physician's charter. Lancet 359: 520–522

  4. Richardson R (2000) Death, dissection and the destitute, edn 2. Chicago: University of Chicago Press

    Google Scholar 

  5. Friedman EA and Friedman AL (2006) Payment for donor kidneys: pros and cons. Kidney Int 69: 960–962

    Article  CAS  Google Scholar 

  6. Langer C et al. (2004) Selectin inhibitor bimosiamose prolongs survival of kidney allografts by reduction in intragraft production of cytokines and chemokines. J Am Soc Nephrol 15: 2893–2901

    Article  CAS  Google Scholar 

  7. Keller F et al. (2006) Discourse ethics in practical medicine. Med Humanit 32: 99–103

    Article  CAS  Google Scholar 

Download references

Author information

Author notes

  1. Division of Immunology and Organ Transplantation, Department of Surgery, The University of Texas, Medical School, Suite 6.240, 6431 Fannin Street, Houston, TX 77030, USA bkahan@uth.tmc.edu

Authors and Affiliations

  1. BD Kahan is Director of the Division of Immunology and Organ Transplantation at The University of Texas Medical School, Houston, TX, USA.,

    Barry D Kahan

Authors
  1. Barry D Kahan
    View author publications

    You can also search for this author in PubMed Google Scholar

Ethics declarations

Competing interests

The author declares no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kahan, B. Losing the kingdom: the case against commercial organ donation. Nat Rev Urol 4, 290–291 (2007). https://doi.org/10.1038/ncpuro0810

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ncpuro0810

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing