¹Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts, USA

Correspondence: F L Delmonico, Massachusetts General Hospital, White 505, Boston, MA 02114, USA. E-mail: francis_delmonico@neob.org

Abstract

As a result of the increasing use of live organ donors, international conferences have been held in Amsterdam and Vancouver to address the transplant community's concern for the well-being of such donors. Congress has considered arguments to permit a regulated market of organ sales but has rejected such a proposal, in part because of a fundamental ethical principle: selling one's kidney or any other part of one's body violates the dignity of the human person. The "system failure" is not only at the doorstep of organ donation. The expansion of the waiting list for kidney transplants is heavily composed of the elderly who could have benefited by preventive medical care.